Tag: pubmed

Lasers Med Sci. 2025 Oct 13;40(1):429. doi: 10.1007/s10103-025-04694-3.

ABSTRACT

The aim of this study was to evaluate the antibacterial efficacy of various irrigation activation methods and their effects on the push-out bond strength (PBS) of glass fiber posts (GFP) to radicular dentin in teeth with post spaces infected with E. faecalis. Sixty human mandibular premolar teeth were decoronized. All root canals were shaped using a similar protocol and sterilized in an autoclave. Sterilization was confirmed in 10 randomly selected samples. 50 root canals were obturated. Post spaces were prepared in all samples, and root canals were contaminated with E. faecalis and incubated for 4 weeks. Bacterial growth was confirmed in 10 randomly selected samples. Samples were randomly divided into four groups according to irrigation activation methods (n = 10): Standard needle irrigation (SNI), passive ultrasonic irrigation (PUI), photon-induced photoacoustic streaming (PIPS), and shock wave-enhanced emission photoacoustic streaming (SWEEPS). CFU levels were recorded before and after disinfection by taking samples from the root canals with paper points. GFPs were cemented with self-adhesive resin cement. 2 mm thick sections were taken from the apical, middle, and coronal parts of GFPs, and a push-out test was performed with a universal testing machine. Failure modes were examined under a stereomicroscope (40×). Data were analyzed statistically. None of the irrigation methods tested achieved complete bacterial elimination. However, PIPS and SWEEPS achieved significantly greater bacterial reduction than SNI (ΔCFU [S1-S2], mean: PIPS 0.097; SWEEPS 0.090; SNI 0.045; P < .05). No significant differences were observed in PBS among groups (P > .05); values were generally higher coronally than apically (e.g., SNI 79.1 ± 50.1 vs. 34.1 ± 26.7 MPa), regardless of irrigation method. Adhesive fractures were dominant in all sections in SWEEPS, cohesive fractures were dominant in SNI, and mixed fractures were dominant in PUI. PIPS and SWEEPS are more effective than SNI in reducing bacterial load in the post space; however, this superiority is not reflected in bond strength. Irrigation activation method may affect the dentin surface and fracture type but does not make a decisive difference on PBS.

PMID:41081972 | DOI:10.1007/s10103-025-04694-3

Clin Lab. 2025 Oct 1;71(10). doi: 10.7754/Clin.Lab.2025.250331.

ABSTRACT

BACKGROUND: Ethylenediaminetetraacetic acid-induced pseudothrombocytopenia (EDTA-PTCP) is a well-documented in vitro artifact characterized by platelet clumping, leading to spuriously low platelet counts despite normal platelet quantity and function. This phenomenon can result in inappropriate clinical management, including unnecessary platelet transfusions. To address this issue, we propose a post-analytical correction strategy that integrates kanamycin treatment with event-based analysis in the PLT-F channel of the Sysmex XN-20 automated hematology analyzer to improve platelet count accuracy.

METHODS: The platelet surface markers CD41a and CD61 were evaluated using flow cytometry to compare their expression on single platelets and platelet clumps. Forward and side scatter characteristics, along with dot plot distributions, were analyzed to determine the extent of overlap between large platelet clumps and the neutrophil gating region. Additionally, blood smears were examined before and after kanamycin treatment to evaluate the degree of platelet clump dissociation. A regression model utilizing Gating-4 event counts from the PLT-F scatter-gram was developed to estimate corrected platelet counts. The diagnostic performance of Gating-4 as a surrogate marker for platelet clumps was assessed using receiver operating characteristic (ROC) curve analysis.

RESULTS: Flow cytometry revealed moderate CD41a and CD61 expression on single platelets, while platelet clumps exhibited markedly increased expression of these markers. Larger platelet clumps demonstrated increased forward scatter intensities, overlapping with the neutrophil population in dot plots. Blood smear analysis confirmed complete platelet clump dissociation in 87 out of 96 samples following kanamycin treatment, whereas residual clumping persisted in 9 cases, leading to unreliable platelet counts. Regression analysis demonstrated that Gating-4 event counts were strong predictors of corrected platelet counts (R² = 0.705, p < 0.001), with high statistical significance (t = 12.377, p < 0.001). A Gating-4 event cutoff of 138.5 optimally distinguished clump presence, with an area under the ROC curve of 0.969 (p < 0.001).

CONCLUSIONS: This study introduces a regression model utilizing Gating-4 events from the PLT-F scattergram to improve platelet count estimation in clumped samples. The model demonstrated high accuracy in moderate clumping cases; however, additional correction was required for severe clumping. To enhance accuracy, we propose a stepwise approach that incorporates platelet clump size assessment and kanamycin intervention.

PMID:41078198 | DOI:10.7754/Clin.Lab.2025.250331

Clin Lab. 2025 Oct 1;71(10). doi: 10.7754/Clin.Lab.2025.250303.

ABSTRACT

BACKGROUND: Hypoalbuminemia is associated with poor outcomes in patients with infectious diseases. We aimed to determine the effect of hypoalbuminemia on treatment failure in adult patients with P. aeruginosa bloodstream infections.

METHODS: This retrospective cohort study included adults with microbiologically and clinically documented bloodstream infections caused by P. aeruginosa between January 2012 and December 2021. Hypoalbuminemia was de-fined as baseline serum albumin level < 35 g/L. The main clinical outcomes were treatment failure, 14-day and 30-day mortality, length of hospital stay, and intensive care unit admission.

RESULTS: Out of 207 patients included in the 10-year study period, 145 (70.0%) presented with hypoalbuminemia. Hypoalbuminemia patients were more likely to receive mechanical ventilation (20.0% vs. 4.8%, p = 0.006) and have a higher treatment failure rate (32.9% vs. 12.9%, p = 0.003) compared to normoalbuminemia patients. Multivariate analyses showed that hypoalbuminemia, glucocorticoid use, and Pitt score ≥ 2 are associated with treatment failure (p < 0.05).

CONCLUSIONS: Glucocorticoid use, hypoalbuminemia, and Pitt score ≥ 2 points were more frequent in patients with P. aeruginosa bloodstream infections and were associated with poor outcomes. Therefore, P. aeruginosa bloodstream infections patients may benefit from early replenish albumin molecules.

PMID:41078193 | DOI:10.7754/Clin.Lab.2025.250303

Clin Lab. 2025 Oct 1;71(10). doi: 10.7754/Clin.Lab.2025.250147.

ABSTRACT

BACKGROUND: Dysregulations of triglyceride and glucose metabolism contribute to cardiovascular diseases. This study investigated the relationship between the triglyceride and glucose (TyG) index and the mortality rate of acute myocardial infarction (AMI) patients.

METHODS: A retrospective cohort study was conducted using data from the MIMIC-IV database, covering AMI patients admitted to Laizhou People’s Hospital between 2008 and 2023. The TyG index was calculated from laboratory test results, multivariate analyses adjusted for age, gender, comorbidities, and importantly, BMI categories and diabetes status, and Cox proportional hazards regression analysis was used to evaluate its relationship with patient mortality.

RESULTS: The study included 1,123 patients, with a median TyG index of 9.3. Hospital, ICU, and all-cause mortality rates were 19.0%, 14.9%, and 52.0%, respectively. The survival group had a significantly lower TyG index than the non-survival group (9.2 vs. 9.4, p < 0.001). Kaplan-Meier survival analyses indicated lower all-cause and hospital mortalities in patients with a low TyG index compared to those with a high TyG index. The TyG index was associated with all-cause mortality (hazard ratio 1.884, 95% confidence interval 1.189 – 2.984, p = 0.007), even after adjusting for potential confounders.

CONCLUSIONS: The TyG index is a promising predictor of mortality and can aid in risk stratification for AMI patients in the ICU, highlighting its potential utility in clinical management.

PMID:41078181 | DOI:10.7754/Clin.Lab.2025.250147

J Magn Reson Imaging. 2025 Oct 13. doi: 10.1002/jmri.70147. Online ahead of print.

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is an autoimmune demyelinating disease that attacks myelin. MRI is an important imaging modality for diagnosis and monitoring in MS. However, the current standard MRI protocol for MS lacks sequences capable of detecting molecular changes.

PURPOSE: To present a saturation-transfer-based MRI protocol, including chemical exchange saturation transfer (CEST) and magnetization transfer indirect spin labeling (MISL) sequences, for quantifying molecular changes and water exchange in the brain of MS patients.

STUDY TYPE: Prospective.

POPULATION: Fifty-two participants including 31 healthy controls (HC) (18 females and 13 males) and 21 MS patients (18 females and 3 males).

FIELD STRENGTH/SEQUENCE: 3D inversion-prepared gradient echo T1w, 3D fast spin echo T2w, 3D CUBE CEST and MISL at 3.0 T.

ASSESSMENT: Multiple CEST contrasts between HC and MS groups were analyzed using double-step multi-pool Lorentzian fitting (DMPLF) and Lorentzian difference analysis (LDA) to evaluate and compare their diagnostic performance. MISL signals at -20 and -10 ppm were quantified by the normalized signal reduction in cerebrospinal fluid (CSF). T1w MRI was used to quantify brain volumes.

STATISTICAL TESTS: Unpaired Student’s t-test, receiver operating characteristic (ROC) curve, area under the curve (AUC), and binary logistic regression analysis. p < 0.05 was considered statistically significant.

RESULTS: CEST detected decreased signals in the brain of MS patients using both DMPLF and LDA, with DMPLF demonstrating superior performance in differentiating MS from HC (AUC, 0.93; 95% CI: 0.86, 1.00). MS patients showed significantly lower whole brain MISL signals than HCs at both -20 ppm (0.04 ± 0.01 vs. 0.06 ± 0.02) and -10 ppm (0.06 ± 0.02 vs. 0.08 ± 0.02). MS patients showed a significant decrease (-6.57%) in brain tissue and an increase (+20.73%) in CSF volume ratios compared to HCs.

DATA CONCLUSION: The saturation-transfer-based MRI framework can effectively evaluate molecular changes and CSF-tissue water exchange in the brains of MS patients.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 3.

PMID:41078166 | DOI:10.1002/jmri.70147

J Clin Pharmacol. 2025 Oct 13. doi: 10.1002/jcph.70120. Online ahead of print.

ABSTRACT

Malnutrition occurs at higher rates in children with complex medical conditions and can independently influence drug disposition and action. Yet FDA-approved product labels rarely address dosing in malnutrition. This study explores the extent to which malnourished children are expressly excluded from clinical trials. Industry-sponsored, pediatric, phase I-III studies deposited in ClinicalTrials.Gov through December 2024 with a full study protocol were reviewed. Protocols were evaluated for inclusion and exclusion (I/E) criteria related to anthropometric and clinical indicators of malnutrition. I/E criteria were fully characterized along with the study phase, intervention type, and treatment indication. 9882 studies were identified, 1759 with an uploaded protocol. 616 studies (35%) contained 777 distinct I/E criteria related to malnutrition (1-6 per study). Across all protocols, 71% exclusively restricted participation of children with evidence of undernutrition, 9% with overnutrition, and 20% with both. There were no statistical differences observed based on intervention type, though differences by study phase were observed. Restrictions were seen most frequently for respiratory, mental/behavioral, obstetric/perinatal, and emergency use indications and least frequently for dermatologic, oncologic, and eyes, ears, nose, and throat disorders. Non-specific I/E criteria suggest that these findings likely underestimate the extent of malnutrition-based exclusions. Despite growing attention paid to obesity, pediatric clinical trials are far more likely to restrict the participation of undernourished children. Though unrealistic to relax malnutrition related I/E criteria for all studies, consideration should be given for conditions where high rates of malnutrition are expected to avoid trial populations that do not reflect clinical practice.

PMID:41078146 | DOI:10.1002/jcph.70120

Int J Gynaecol Obstet. 2025 Oct 13. doi: 10.1002/ijgo.70585. Online ahead of print.

ABSTRACT

OBJECTIVE: This study compares the effectiveness and safety of three prophylactic uterotonic regimens-intravenous carbetocin, oxytocin infusion, and oxytocin-ergometrine combination-in preventing postpartum hemorrhage (PPH) in women with isolated polyhydramnios.

METHODS: This retrospective cohort study included 286 term pregnancies complicated by isolated polyhydramnios, managed at a tertiary obstetric center between January 2020 and April 2024. Participants received a single prophylactic uterotonic immediately after placental delivery: carbetocin (n = 124), oxytocin (n = 116), or oxytocin-ergometrine (n = 46). Patients with additional PPH risk factors were excluded. Primary outcomes included hemoglobin and hematocrit changes, estimated blood loss, and 6-h postpartum shock index. Secondary outcomes were rates of transfusion, surgical intervention, and uterine-sparing procedures.

RESULTS: Carbetocin was associated with significantly smaller drops in hemoglobin and hematocrit, lower estimated blood loss, and more favorable shock index values compared to the other groups. These advantages were consistent across cesarean, primiparous, and multiparous vaginal deliveries. Although not statistically significant, fewer secondary interventions (e.g., transfusion, balloon tamponade, and compression sutures) were recorded in the carbetocin group.

CONCLUSION: Among women with isolated polyhydramnios, carbetocin offers superior prophylactic control of PPH compared to oxytocin and oxytocin-ergometrine regimens. Its long-acting effect provides sustained uterine contraction, reducing the need for additional interventions. Carbetocin might be especially beneficial in high-risk cases of uterine overdistension, supporting its targeted use in individualized obstetric care.

PMID:41078143 | DOI:10.1002/ijgo.70585

Anal Methods. 2025 Oct 13. doi: 10.1039/d5ay01251a. Online ahead of print.

ABSTRACT

This study presents a low-cost, 3D-printed portable device that integrates computer vision and an artificial neural network (ANN) to quantify biodiesel content (1-30% v/v) in fossil diesel blends using a solvatochromic assay with Reichardt’s dye. A total of 105 samples (35 biodiesel blend levels in triplicate) were analyzed with both the proposed method and the official Brazilian standard ABNT NBR 15568/2008 (FT-IR). While the standard method requires laboratory infrastructure and specialized equipment, the proposed system provides comparable accuracy directly at the point of fuel distribution. It achieved a mean absolute error (MAE) of 1.5% (R² = 0.969) for training data and 0.5% (R² = 0.995) for independent test data. Robust cross-validation confirmed model stability and absence of overfitting, and a paired Student’s t-test showed no statistically significant difference between the two methods (p > 0.05), confirming statistical equivalence. Beyond analytical performance, the device offers practical advantages: controlled lighting and webcam-based image acquisition coupled with ANN processing enable rapid, on-site biodiesel determination without specialized training. This contrasts with the official method, which is restricted to laboratory settings. By combining portability, low operational complexity, and real-time analysis capability, this system represents a significant advancement for fuel quality monitoring, allowing reliable control of BX diesel blends directly at fueling stations and other non-laboratory environments. BX diesel, dye solution, and ethanol.

PMID:41078134 | DOI:10.1039/d5ay01251a

Disaster Med Public Health Prep. 2025 Oct 13;19:e291. doi: 10.1017/dmp.2025.10212.

ABSTRACT

OBJECTIVE: CBRN events can occur randomly or intentionally. Rapid and appropriate response to CBRN events can significantly mitigate the adverse effects on physical health and reduce mortality rates. The effectiveness of these responses largely depends on the preparedness of hospital emergency Clinical staff.

METHODS: This study was a mixed-methods research aiming to develop and validate a psychometric research instrument in 2025. Based on the review of the literature regarding CBRN events, the items were extracted, rewritten, and validated. In the quantitative phase, the validity of the questionnaire was evaluated in terms of face, content, and construct validity, and its reliability was evaluated based on internal consistency and stability (Cronbach’s alpha and Interclass Correlation Coefficient [ICC]).

RESULTS: The designed questionnaire included 6 dimensions and 65 items. The dimensions included (1) programs and guidelines, treatment of the injured; (2) exercise; (3) decontamination and waste management; (4) education and human resources; (5) prevention, coordination, and security; and (6) PPE. The content and face validity of the questionnaire were approved by the specialists and experts of hospital emergency and health in disasters and emergencies. The content validity ratio was >0.6 for all items. The content validity index was also approved for all items. The Cronbach’s alpha coefficient and ICC were respectively 0.977 and 0.972 for the total questionnaire.

CONCLUSION: Hospital Emergency Clinical Staff play a vital role in responding to CBRN events; therefore, policies, programs, coordination efforts, budgets, and other necessary measures are strongly recommended to increase ED clinical staff preparedness against CBRN events.

PMID:41078130 | DOI:10.1017/dmp.2025.10212

J Viral Hepat. 2025 Nov;32(11):e70094. doi: 10.1111/jvh.70094.

ABSTRACT

This study aimed to evaluate the status of hepatitis B virus (HBV) mother-to-child transmission (MTCT) among infants born to hepatitis B surface antigen (HBsAg)-positive mothers from 2021 to 2023 and identify key factors influencing HBV MTCT, providing critical insights to inform future HBV prevention strategies. Data were obtained from the case records of HBsAg-positive pregnant women and their newborns in Guangdong Province from January 1, 2021, to December 31, 2023. For HBsAg and anti-HBs positive rates, bivariate analysis was conducted to examine associations between maternal and infant characteristics. Additionally, Firth’s bias reduction logistic regression analysis was conducted to identify factors influencing MTCT. Our study analysed data from 131,781 HBsAg-positive pregnant women and their newborns in Guangdong Province from 2021 to 2023. Among 131,781 infants completing PVST, the overall HBV MTCT rate was 0.44%, with an anti-HBs positivity rate of 93.48%. Maternal age, administration of HepB-BD and HBIG and use of antiviral treatment during pregnancy were significantly associated with HBV MTCT. However, birth weight, maternal education level, mode of delivery and number of births were not significantly associated with HBV MTCT risk. This study provides a comprehensive analysis of HBV MTCT among HBsAg-positive pregnant women and their infants in Guangdong Province from 2021 to 2023. Despite significant advancements in HBV MTCT prevention, our findings underscore the need for enhanced strategies, particularly for pregnant women with high HBV viral loads. Strengthening maternal antiviral treatment, ensuring timely and comprehensive infant follow-up, and implementing targeted health education programs will be essential for further reducing MTCT rates and improving long-term outcomes.

PMID:41078127 | DOI:10.1111/jvh.70094