Tag: pubmed

BMC Oral Health. 2025 Apr 13;25(1):563. doi: 10.1186/s12903-025-05955-x.

ABSTRACT

PURPOSE: To evaluate the influence of guide support on the accuracy of sCAIS using a keyless guiding system in different cases of partial edentulism.

METHODS: Sixty polyamide models of partially edentulous maxillae, simulating anterior and posterior single-tooth gaps as well as anterior and distal extended edentulous areas, were fabricated. Full-arch, 2-teeth, and 4-teeth supported surgical guides were used to place implants at FDI 15, 17, 21, 26 sites in Model A and at FDI 12, 22, 15 sites in Model B. In total, 210 replica implants were placed using 120 surgical guides in seven implantation sites. Three-dimensional crestal and apical, angular and vertical deviations from the planned implant positions were compared using the Kruskal-Wallis H test with Dunn’s procedure for multiple pairwise comparisons.

RESULTS: Overall median 3D crestal and apical deviations of implants placed with 2-teeth guide support (0.62 mm [0.45-0.84], 0.92 mm [0.69-1.25]) and 4-teeth guide support (0.65 mm [0.52-0.81], 1.01 mm [0.8-1.26]) were significalty lower compared to the full-arch support group (0.86 mm [0.63-0.98], 1.26 mm [0.98-1.52]) with values of p < 0.017. Overall angular and vertical deviations of implants placed with 2-teeth guide support (2.61° [1.71-3.75], 0.32 mm [0.15-0.44]) were significantly lower compare to the full-arch support group (3.22° [2.25-4.41], 0.46 mm [0.24-0.62]). In the subgroup analysis, implants placed at the FDI 12, 22, and 15 positions exhibited significantly higher 3D and angular deviations with full-arch guide support, whereas the 3D apical and angular deviations of were significantly lower with 2-teeth guide support at the FDI 21 site.

CONCLUSIONS: The deviations in all guide support groups did not exceed the recommended safety margins. Statistically significant differences were found between guide support groups, with influence of guide support on the accuracy of sCAIS varying across different implantation sites.

TRIAL REGISTRATION: Not applicable.

PMID:40223057 | DOI:10.1186/s12903-025-05955-x

BMC Med. 2025 Apr 14;23(1):214. doi: 10.1186/s12916-025-04028-8.

ABSTRACT

BACKGROUND: Public adherence to cancer screening remains low and is influenced by both rational and non-rational factors, including decision biases that underestimate screening benefits. Digital nudge interventions have shown promise in promoting screening behaviors among at-risk populations, but systematic evidence is still lacking. This study aims to synthesize the effects of digital nudge interventions on promoting cancer screening behaviors in high-risk individuals.

METHODS: A systematic search of 10 electronic databases was conducted, and studies published before April 1, 2024, were included. Eligible studies were randomized controlled trials (RCTs) that compared the effects of digital nudge interventions on cancer screening behavior with those of a control group and reported at least one outcome. The risk of bias was evaluated using the Cochrane Risk of Bias tool. Data on cancer screening uptake rates were pooled using a random-effects model. Subgroup analyses were performed for cancer types, intervention media, delivery conditions, and sensitivity. The study identified digital nudge strategies via the MINDSPACE framework and explored their influence on screening behavior through the HSM.

RESULTS: Of the 14 randomized controlled trials included, 10 reported statistically significant results. The types of interventions in these studies were heterogeneous and available across multiple delivery channels based on the web, computer programmes, DVDs, telephones, patient navigation, or apps that tailored or served interactive information to participants to better understand screening risks and options. A random-effects model showed that digital nudge intervention strategies significantly improved adherence to cancer screening behavior (OR = 1.81, 95% CI = 1.35-2.44, p < 0.001). Differences between cancer types, intervention media, and delivery conditions were noted. Based on the MINDSPACE framework and HSM, eight nudge strategies were designed to promote screening behaviors, with the most common being the default strategy (n = 9). Most nudge tools were designed to leverage unconscious System 1 thinking, aiming to influence behavior in a more spontaneous and subtle way.

CONCLUSIONS: While digital nudge interventions have demonstrated significant positive effects in promoting early cancer screening participation among high-risk individuals, their impact varies. More robust research is needed to address methodological limitations and facilitate broader adoption and application of these interventions.

PMID:40223053 | DOI:10.1186/s12916-025-04028-8

BMC Ophthalmol. 2025 Apr 14;25(1):203. doi: 10.1186/s12886-025-04041-8.

ABSTRACT

PURPOSE: To evaluate the pupillary dynamics in patients with serum vitamin D (25(OH)-D) levels below normal and compared with healthy controls.

METHODS: This study included 132 patients and 76 healthy controls. Serum 25(OH)-D concentrations within the range of 10 to 30 ng/mL were classified as vitamin D insufficiency (VDI, Group 1), while those at or below 10 ng/mL were categorized as vitamin D deficiency (VDD, Group 2). The static phase of pupillometry, including scotopic, mesopic, and photopic pupil diameters, was evaluated. Additionally, in the dynamic phase of pupillometric evaluation, pupil dilation velocity (mm/sec) was calculated. These values were compared between patient and control groups.

RESULTS: In static pupil diameters, only photopic pupil diameters were significantly different between Groups 1 and 2 compared to the control group (p = 0.012 and p = 0.008, respectively). In dynamic measurements, the pupil diameter values showed a statistically significant difference between the patient and control groups (p = 0.003). In intragroup comparison, the mean pupil diameter was 3.42 ± 0.81 mm in group 1 and 3.94 ± 0.96 mm in group 2 (p = 0.029). Mean pupil dilation velocity was significantly slower in the patient group (p < 0.001). In intragroup comparison, the mean pupil dilation velocity was 0.162 ± 0.049 mm/sec in group 1 and 0.088 ± 0.032 mm/sec in group 2 (p < 0.001).

CONCLUSION: We demonstrated that VDD alters pupillary functions with objective measurements. Our study may shed light on the role of vitamin D in multisystemic diseases since it is expressed in many tissues and has multiple functions. Multicenter studies with a large number of participants are needed in the future.

PMID:40223050 | DOI:10.1186/s12886-025-04041-8

BMC Oral Health. 2025 Apr 13;25(1):557. doi: 10.1186/s12903-025-05964-w.

ABSTRACT

BACKGROUND: Titanium is commonly used for dental implants due to its high biocompatibility and durability. However, concerns about metal ion release and aesthetic limitations in certain tissue biotypes have driven the search for alternative materials. Polyetherketoneketone (PEKK), a high-performance polymer, has emerged as a promising option due to its biomimetic properties. Surface modifications, such as treatment with sulfuric acid (H2SO4), may further enhance its osteogenic potential.

AIM: The study aimed to evaluate the osteogenic efficacy of H2SO4-modified PEKK implants in comparison to titanium implants.

METHODOLOGY: Three groups were assessed: Titanium, unmodified PEKK and H2SO4-modified PEKK(SPEKK). Surface characteristics were analyzed using scanning electron microscopy (SEM). Wettability was checked through contact angle evaluation. Cell viability was evaluated through MTT assays. Implants were placed in rat mandibles, and bone formation was analyzed after 6 weeks using nano-CT and histological assessments. Toxicity was as Statistical comparisons were performed using one-way ANOVA and Tukey’s post-hoc test.

RESULTS: Acid-modified PEKK implants exhibited the highest bone formation (280.09 ± 12.03) significantly outperforming Titanium (265.12 ± 11.08) and unmodified PEKK (266.52 ± 7.28) (p < 0.05).

CONCLUSIONS: H2SO4-modified PEKK (SPEKK) implants demonstrated superior osteogenic properties compared to titanium, suggesting that these modified polymers could be viable alternatives for aesthetic implants.

PMID:40223045 | DOI:10.1186/s12903-025-05964-w

J Holist Nurs. 2025 Apr 13:8980101251330394. doi: 10.1177/08980101251330394. Online ahead of print.

ABSTRACT

Purpose: The purpose of this study is to evaluate if integrating a holistic mindfulness modality into group therapy can decrease violence with-injury on an inpatient psychiatric unit. Design: The research used a mixed experimental design. Method: Allied Therapy Services (ATS) staff was trained in the mindfulness modality Brief Intentional Grounding and implemented it within group therapy twice daily in two different acute psychiatric units. Six months of post-intervention data on workplace violence with-injury incidents was compared to 6-month pre-intervention statistics on workplace violence with-injury. Qualitative data included patient and staff surveys on benefits of the intervention. Findings: The study revealed the use of Brief Intentional Grounding correlated with a significant reduction in workplace violence with-injury in two adult acute inpatient psychiatric units over a 6-month period when compared to the previous six months. The qualitative survey-data showed significant improvement in patients’ emotional regulation, ability to manage stress, interpersonal connectivity, and gratitude after practicing Brief Intentional Grounding. Furthermore, staff reported practicing Brief Intentional Grounding was beneficial and improved their well-being. Conclusions: Integrating Brief Intentional Grounding into group therapy on an acute adult inpatient psychiatric unit improved patients’ ability to regulate their emotions and led to reductions in violence with-injury, providing a safer work environment for nursing staff.

PMID:40221990 | DOI:10.1177/08980101251330394

J Parkinsons Dis. 2025 Apr 13:1877718X251323914. doi: 10.1177/1877718X251323914. Online ahead of print.

ABSTRACT

BackgroundParkinson’s disease (PD) has marked phenotypic variability. Increased lipids have been suggested as being neuroprotective whilst hyperglycemia may increase α-synuclein aggregation.ObjectiveWe have tested whether high total cholesterol and high-density lipoprotein cholesterol (HDL-C) and low levels of fructosamine are associated with better PD phenotypes and predict less rapid progressionMethodsNon-fasting serum HDL-C, total cholesterol, and fructosamine were measured at baseline in 866 patients with early PD (median duration, 0.96; IQR, 0.43-1.98 years) from the Oxford Discovery cohort. These biomarkers were compared against our data-derived PD subtypes using multinomial logistic regression. We used multilevel models to predict longitudinal motor and non-motor outcomes (e.g., cognition, mood).ResultsHDL-C and total cholesterol differed across baseline PD phenotype clusters, with reduced levels associated with the most severe motor and non-motor phenotypes (psychological well-being, cognitive impairment, REM sleep behavior disorder, and daytime sleepiness). Higher HDL-C and total cholesterol, although the latter was attenuated after adjustment for statin use, were associated with better baseline activities of daily living (e.g., UPDRS-II score with 1 SD increase in HDL-C -0.74, 95%CI -1.22 to -0.26, p = 0.002) and non-motor features. Neither predicted the rate of motor or non-motor progression. Fructosamine levels were not associated with phenotypic variability or rate of disease progression.ConclusionsHypercholesterolemia was associated with a better motor/non-motor disease subtype and daily living impairment at presentation, but did not predict longitudinal change. Future research needs to determine if these associations are causally related or secondary to disease onset by examining prodromal subjects.

PMID:40221968 | DOI:10.1177/1877718X251323914

Stat Methods Med Res. 2025 Apr 13:9622802241313283. doi: 10.1177/09622802241313283. Online ahead of print.

ABSTRACT

Balancing influential covariates is crucial for valid treatment comparisons in clinical studies. While covariate-adaptive randomization is commonly used to achieve balance, its performance can be inadequate when the number of baseline covariates is large. It is, therefore, essential to identify the influential factors associated with the outcome and ensure balance among these critical covariates. In this article, we propose a novel adaptive randomization approach that integrates the patients’ responses and covariates information to select sequentially significant covariates and maintain their balance. We establish theoretically the consistency of our covariate selection method and demonstrate that the improved covariate balancing, as evidenced by a faster convergence rate of the imbalance measure, leads to higher efficiency in estimating treatment effects. Furthermore, we provide extensive numerical and empirical studies to illustrate the benefits of our proposed method across various settings.

PMID:40221962 | DOI:10.1177/09622802241313283

Eur Radiol. 2025 Apr 13. doi: 10.1007/s00330-025-11567-4. Online ahead of print.

ABSTRACT

PURPOSE: This multicenter trial was conducted to evaluate MRI for the longitudinal management of incidental pulmonary nodules in heavy smokers.

MATERIALS AND METHODS: 239 participants (63.9 ± 8.4 years, 43-82 years) at risk of or with COPD GOLDI-IV from 16 centers prospectively underwent two rounds of same-day low-dose computed tomography (LDCT1&2) and MRI1&2 at an interval of three years in the nationwide COSYCONET trial. All exams were independently assessed for incidental pulmonary nodules in a standardized fashion by two blinded readers, incl. axis measurements and Lung-RADS categorization, with consensual LDCT results serving as the standard of reference. A change in diameter ≥ 2 mm was rated as progress. 11 patients underwent surgery for suspicious nodules after the first round.

RESULTS: Two hundred twenty-four of two hundred forty nodules (93.3%) persisted from LDCT1 to LDCT2, with a sensitivity of MRI2 of 82.8% and 81.5% for readers 1 and 2, respectively. Agreement in Lung-RADS categories between LDCT2 and MRI2 was substantial in per-nodule (κ = 0.62-0.70) and excellent in a per-patient (κ = 0.86-0.88) approach for both readers, respectively. Concordance between LDCT2 and MRI2 for growth was excellent to almost perfect (κ = 0.88-1.0). The accuracy of LDCT1 and MRI1 for lung cancer was 87.5%. Lung-RADS ≥ 3 category on MRI1 had higher accuracy for predicting progress (23.1% and 21.4%, respectively) than LDCT1 (15.8%).

CONCLUSION: Compared to LDCT, MRI shows similar capabilities for the longitudinal evaluation of incidental nodules in heavy smokers. Decision-making for nodule management guided by Lung-RADS seems feasible based on longitudinal MRI.

KEY POINTS: Question Can MRI serve as an alternative to low-dose CT (LDCT) for the longitudinal management of pulmonary nodules in heavy smokers, addressing concerns over radiation exposure? Findings MRI demonstrated substantial agreement with LDCT in detecting nodule growth, accurately categorizing Lung-RADS, and comparable accuracy in identifying malignancy over a three-year follow-up. Clinical relevance Longitudinal MRI demonstrates high consistency with LDCT in assessing the growth of incidental pulmonary nodules and categorizing per-patient Lung-RADS, offering a reliable, radiation-free alternative for monitoring and early malignancy detection in high-risk populations.

PMID:40221941 | DOI:10.1007/s00330-025-11567-4

Eur Radiol. 2025 Apr 13. doi: 10.1007/s00330-025-11574-5. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to assess diagnostic performance of high-resolution dynamic contrast-enhanced (DCE) MRI with deep learning-based compressed sensing and super-resolution (DLCS-SR) reconstruction for identifying microadenomas.

MATERIALS AND METHODS: This prospective study included 126 participants with suspected pituitary microadenomas who underwent DCE MRI between June 2023 and January 2024. Four image groups were derived from single-scan DCE MRI, which included 1.5-mm slice thickness images using DLCS-SR (1.5-mm DLCS-SR images), 1.5-mm slice thickness images with deep learning-based compressed sensing reconstruction (1.5-mm DLCS images), 1.5-mm routine images, and 3-mm slice thickness images using DLCS-SR (3-mm DLCS-SR images). Diagnostic criteria were established by incorporating laboratory findings, clinical symptoms, medical histories, previous imaging, and certain pathologic reports. Two readers assessed the diagnostic performance in identifying pituitary abnormalities and microadenomas. Diagnostic agreements were assessed using κ statistics, and intergroup comparisons for microadenoma detection were performed using the DeLong and McNemar tests.

RESULTS: The 1.5-mm DLCS-SR images (κ = 0.746-0.848) exhibited superior diagnostic agreement, outperforming 1.5-mm DLCS (κ = 0.585-0.687), 1.5-mm routine (κ = 0.449-0.487), and 3-mm DLCS-SR images (κ = 0.347-0.369) (p < 0.001 for all). Additionally, the performance of 1.5-mm DLCS-SR images in identifying microadenomas [area under the receiver operating characteristic curve (AUC), 0.89-0.94] surpassed that of 1.5-mm DLCS (AUC, 0.83-0.87; p = 0.042 and 0.011, respectively), 1.5-mm routine (AUC, 0.76-0.78; p < 0.001), and 3-mm DLCS-SR images (AUC, 0.72-0.74; p < 0.001).

CONCLUSION: The findings revealed superior diagnostic performance of 1.5-mm DLCS-SR images in identifying pituitary abnormalities and microadenomas, indicating the clinical-potential of high-resolution DCE MRI.

KEY POINTS: Question What strategies can overcome the resolution limitations of conventional dynamic contrast-enhanced (DCE) MRI, and which contribute to a high false-negative rate in diagnosing pituitary microadenomas? Findings Deep learning-based compressed sensing and super-resolution reconstruction applied to DCE MRI achieved high resolution while improving image quality and diagnostic efficacy. Clinical relevance DCE MRI with a 1.5-mm slice thickness and high in-plane resolution, utilizing deep learning-based compressed sensing and super-resolution reconstruction, significantly enhances diagnostic accuracy for pituitary abnormalities and microadenomas, enabling timely and effective patient management.

PMID:40221940 | DOI:10.1007/s00330-025-11574-5

Eur Radiol. 2025 Apr 13. doi: 10.1007/s00330-025-11566-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Radiation safety concerns have spurred the development of real-time dosimetry systems. This study investigated the occupational dose exposure of interventional radiologists during lower extremity and abdominal procedures.

MATERIALS AND METHODS: Real-time dosimetry was performed during 102 consecutive interventions (51 lower extremity, 51 abdominal). Radiation protection measures included protective glasses (lead equivalent 0.5 mm), thyroid shielding (0.5 mm), vests (0.35 mm), aprons (0.25 mm), as well as movable acrylic and table shields (both 0.5 mm) during all procedures. Dosimeters were attached to the interventionalist’s glasses on the side of the x-ray tube, to the back of the supporting hand, and under the vest. Using standardized values over time to account for exposure time differences between interventions, dose-area products and the dose equivalent H_P(10) were recorded in all three positions.

RESULTS: Lower extremity angiographies were associated with a substantially lower median dose-area product (5.3 vs. 51.4 Gy × cm²) and exposure time (462 vs. 762 s) than abdominal interventions (both p < 0.001). For lower extremity procedures, H_P(10) per minute recorded by the hand, cranium/eye lens, and body trunk dosimeters was 2.45, 0.01, and < 0.01 µSv/min, respectively. Markedly higher dose equivalents were documented for the hand (7.54 µSv/min), cranium/eye lens (0.26 µSv/min), and body trunk (0.04 µSv/min) during abdominal interventions (all p < 0.001).

CONCLUSION: Real-time dosimetry confirmed sufficient radiation protection with the application of dedicated safety measures, even in dose-intensive abdominal procedures. Interventionalists’ supporting hands are subjected to the highest radiation exposure, followed by the cranium/eye lens and the body trunk.

KEY POINTS: Question Active dosimetry facilitates real-time assessment of radiation exposure in different measurement sites, but a multi-dosimeter setup has not been explored for interventional radiology so far. Findings Occupational radiation exposure is considerably higher in abdominal than in lower extremity procedures. Interventionalists’ supporting hands receive the highest dose equivalents regardless of procedure type. Clinical relevance Dose monitoring in real time is key to understanding the radiation burden of different anatomical features during image-guided interventions. Especially in dose-intensive abdominal procedures, protective measures are essential to minimize the occupational radiation exposure of the interventionalist.

PMID:40221939 | DOI:10.1007/s00330-025-11566-5