Tag: pubmed

J Mater Sci Mater Med. 2025 Oct 11;36(1):78. doi: 10.1007/s10856-025-06938-8.

ABSTRACT

OBJECTIVES: This study evaluated the mechanical and surface characteristics of the transition zone of multilayered translucent zirconia (TZ) after aging and analyzed the correlation between the 4-point bending flexural strength (4PBFS) and biaxial flexural strength (BFS) in each zone.

METHODS: Traditional (3Y-TZP of LT; L, 4Y-TZP of MT; M) and multilayered TZ (5Y-TZP of MT Multi; T, 3Y/5Y-TZP of Prime; P, 4Y/5Y-TZP of Prime esthetic; E) IPS E.max ZirCAD blocks were used to fabricate 525 disk-shaped and 300 bar-shaped specimens. Specimens were separated into three groups, aged in an autoclave at 134 °C under 0.2 MPa for 0 h, 5 h, and 10 h. The mechanical and surface characteristics of the transition zone in multilayered TZ were analyzed, following statistical analyses (α = 0.05).

RESULTS: L showed the highest 4PBFS and BFS, irrespective of aging. Consistent correlations between the 4PBFS and BFS were found in all groups. L showed the highest Weibull characteristic strength under all conditions. T showed the highest nanoindentation hardness and Young’s modulus, and the Vickers hardness of L and P were lower than other groups. Aging led to surface uplifts and microcracks caused by phase transformation, particularly in L and P.

CONCLUSIONS: The flexural strength of 3Y/5Y-TZP and 4Y/5Y-TZP was comparable to that of 3Y-TZP and 4Y, 5Y-TZP respectively, regardless of aging. Surface roughness showed a marked increase after aging in 3Y-TZP and 3Y/5Y-TZP. Furthermore, the interaction between yttria content and aging was evident across all mechanical and surface characteristics, except for flexural strength.

PMID:41075051 | DOI:10.1007/s10856-025-06938-8

Aging Clin Exp Res. 2025 Oct 11;37(1):291. doi: 10.1007/s40520-025-03183-5.

ABSTRACT

Global population aging is increasing the demand for Long-Term Care Facilities to support older adults with complex health needs. The Prescription Day LTCFs project is a national multicenter point-prevalence study, conducted by the Italian Society of Gerontology and Geriatrics in collaboration with the ANASTE Humanitas Foundation, investigated medication prescription patterns and administration practices in 3,400 residents across 82 facilities in Italy. Participants had a mean age of 84.7 years, with a high prevalence of frailty (49.7%) and polypharmacy (84.8% taking five or more medications). Common chronic conditions included hypertension, dementia, and dysphagia. The study highlighted the complexity of pharmacological regimens, emphasizing risks related to potentially inappropriate medications, drug-drug interactions, and frequent modifications of solid oral dosage forms to facilitate administration in residents with swallowing difficulties or cognitive impairment. These complexities contribute to increased nursing workload. Despite advances in deprescribing research, polypharmacy remains highly prevalent, underlining the need for tailored prescribing guidelines. Variability among Long Term Care Facilities reflects differences in organization and regional healthcare frameworks. The findings provide a valuable foundation for developing strategies to optimize medication management, enhance safety, and improve quality of care in Italian Long Term Care Facilities. This study also offers insights to inform healthcare policies and best practices in pharmacological care for older adults in Long Term Care settings. PRE BIO CE n. 0027032 (20/06/2024), National Ethics Committee, Istituto Superiore di Sanità, Rome, Italy.

PMID:41075050 | DOI:10.1007/s40520-025-03183-5

J Robot Surg. 2025 Oct 11;19(1):678. doi: 10.1007/s11701-025-02869-2.

ABSTRACT

The comparative effectiveness of da Vinci robot-assisted versus conventional laparoscopic Nissen fundoplication for gastroesophageal reflux disease remains controversial despite increasing adoption of robotic platforms. Previous meta-analyses have yielded conflicting results regarding patient-centered outcomes and long-term durability. We conducted a systematic review and meta-analysis of randomized controlled trials comparing da Vinci-assisted versus conventional laparoscopic Nissen fundoplication. This review was prospectively registered with PROSPERO (CRD420251139110). We searched MEDLINE, Embase, Cochrane CENTRAL, Web of Science, Scopus, ClinicalTrials.gov, WHO ICTRP, and grey literature sources through August 2025. Primary outcomes included postoperative dysphagia, proton pump inhibitor use, and intraoperative complications. Secondary outcomes encompassed reoperation rates, operative time, length of stay, and conversion to open surgery. Risk ratios and mean differences were calculated using random-effects models. Evidence certainty was assessed using the GRADE methodology. Four randomized controlled trials involving 160 patients (79 robotic, 81 conventional laparoscopic) met the inclusion criteria. No significant differences were observed in early dysphagia (RR 1.05, 95% CI 0.45-2.45), postoperative proton pump inhibitor use (RR 0.97, 95% CI 0.25-3.79), or intraoperative complications (RR 0.43, 95% CI 0.07-2.81). Secondary outcomes showed no differences in reoperation rates (RR 1.65, 95% CI 0.40-6.90), length of hospital stay (MD -0.03 days, 95% CI -0.41 to 0.36), or conversion rates (RR 1.23, 95% CI 0.19-7.99). Operative time demonstrated substantial heterogeneity; sensitivity analysis revealed significantly longer times with robotics when one outlier study was removed (MD 40.28 min, p < 0.00001). Da Vinci robot-assisted and conventional laparoscopic Nissen fundoplication achieve equivalent clinical outcomes with no significant differences in patient-reported outcomes, complications, or long-term effectiveness, while robotic procedures consistently require longer operative times and substantially higher costs without demonstrable clinical benefits. These findings question the routine application of robotic platforms in antireflux surgery until cost-effectiveness and operative efficiency are optimized.

PMID:41075046 | DOI:10.1007/s11701-025-02869-2

J Robot Surg. 2025 Oct 11;19(1):679. doi: 10.1007/s11701-025-02834-z.

ABSTRACT

The da Vinci robotic platform, as the earliest operative platform implemented in routine clinical use, has been employed for various complex surgical conditions owing to its precision in manipulation. However, its prohibitive costs have restricted widespread adoption in certain regions. Consequently, China’s domestically developed KangDuo robotic surgical platform was developed to address this need. Currently, comparative studies on perioperative outcomes between these two platforms for performing robot-assisted radical prostatectomy (RARP) remain scarce. This meta-analysis aims to systematically compare perioperative outcomes among these robotic platforms. A structured search of the literature was undertaken across several principal online databases-such as PubMed, Web of Science, the Cochrane Library, and SpringerLink-to locate prospective investigations comparing K-RARP with D-RARP published before August 1, 2025. The comparative outcomes across the two robotic systems consisted of total operating time, estimated intraoperative blood loss, length of hospitalization, urinary continence recovery, post-operative complications, and positive surgical margin rates. This quantitative synthesis included four comparative studies encompassing an aggregate of 188 participants. The results revealed no significant differences in PSM rates (OR 1.06, 95% CI 0.55-2.04; p = 0.86), estimated intraoperative blood loss (WMD – 1.04 ml, 95% CI – 21.72 to 19.63; p = 0.92), length of hospitalization (WMD – 0.32 days, 95% CI – 1.33 to 0.70; p = 0.54), urinary continence (OR 0.96, 95% CI 0.50-1.83; p = 0.90), when contrasting K-RARP with D-RARP. Moreover, no meaningful differences were detected in the incidence of Clavien-Dindo grade I complications (OR 1.14, 95% CI 0.33-3.89; p = 0.84), grade II complications (OR 1.11, 95% CI 0.39-3.18; p = 0.84), or overall complication incidence (OR 1.28, 95% CI 0.59-2.76; p = 0.53). However, for K-RARP, operative duration was significantly longer (WMD 41.34 min, 95% CI 22.42-60.26; p < 0.05). As the inaugural comparative assessment of perioperative outcomes between KangDuo and da Vinci robotic systems, this study demonstrated that while K-RARP required significantly longer operative times, it achieved comparable outcomes to D-RARP in EBL, positive surgical margin rate, hospital stay, continence, and complication rates. This evidence positions the KangDuo platform as a viable future option for localized prostate cancer management. However, this conclusion remains preliminary and exploratory, and will need to be confirmed through large-scale, multicenter, multi-regional randomized controlled trials combined with long-term follow-up.

PMID:41075042 | DOI:10.1007/s11701-025-02834-z

Aging Clin Exp Res. 2025 Oct 11;37(1):293. doi: 10.1007/s40520-025-03195-1.

ABSTRACT

BACKGROUND: Hand grip measures are promising candidate markers for recovery in geriatric patients.

AIMS: To advance interpretation of these measures, we examined: (1) the associations between grip measures at admission and measures of frailty, daily functioning and fatigue to understand the constructs they measure; (2) alternate operational definitions of grip measures.

METHODS: 181 geriatric inpatients completed twice daily grip measurements using the Eforto^® vigorimeter, including maximum grip strength (GSmax), fatigue resistance (FR), grip work (GW) and capacity to perceived vitality ratio (CPV). Associations with each of these measures and the outcomes frailty index (range 0-100), functional limitations (10-40), and total (4-20) and physical (20-100) fatigue were examined using linear regression. Analyses were repeated for the baseline value, average of first two measurements, within-person standard deviation of all values, and the coefficient of variation of all values for each of the grip measures.

RESULTS: Associations approached statistical significance for baseline GSmax and the outcomes frailty (B=-0.09, 99%CI=–0.21, 0.02), functional limitations (B=-0.10, 99%CI=-0.20, 0) and physical fatigue (B=-0.07, 99%CI=-0.14, 0). Baseline, average and standard deviation values for FR, GW and CPV showed trends towards associations with functional limitations, but not with frailty or fatigue.

CONCLUSIONS: GSmax and CPV constructs overlapped more strongly with the construct of frailty than FR and GW. FR, GW and CPV overlapped with functional limitations, supporting their potential as early markers of recovery. Average values are more reliable than single values and variance measures may add additional information.

PMID:41075041 | DOI:10.1007/s40520-025-03195-1

Clin Oral Investig. 2025 Oct 11;29(11):497. doi: 10.1007/s00784-025-06580-2.

ABSTRACT

OBJECTIVE: To evaluate the influence of different surface roughness levels of titanium disks, induced by alumina blasting, on bacterial adhesion.

MATERIALS AND METHODS: Twelve different surface roughnesses, ranging from 0.01 μm to 6 μm, were produced using a shot blasting technique with varying alumina particle sizes. Surface roughness was measured using confocal interferometry, wettability was assessed by contact angle measurements, and compressive residual stress was evaluated by X-ray diffraction. For each roughness level, 720 samples were used to culture Porphyromonas gingivalis (Gram-negative, anaerobic) and Streptococcus sanguinis (Gram-positive, anaerobic). The colonies formed per unit area, the ratio of dead bacteria to total bacteria, and the metabolic activity for each roughness ere determined.

RESULTS: The polished surface (Sa = 0.01 μm) showed the highest bacterial adhesion for both strains compared to the 0.13 μm roughness, which exhibited a antibacterial activity, likely due to nanostructured peaks causing bacterial membrane disruption. For surface roughness values between 0.5 and 3 μm, Gram-positive bacterial colonies increased approximately threefold. When the roughness exceeded 3.8 μm, colony formation rose fivefold. In contrast, Gram-negative bacteria did not exhibit statistically significant changes in adhesion between 0.5 and 2 μm. However, beginning at 2.6 μm, a marked increase was observed, with colony numbers reaching nearly four times the control at 6 μm. The ratio of dead bacteria and metabolic activity confirms bacterial colonization studies (CFU/mm²).

CONCLUSIONS: Surface roughness significantly influenced bacterial colonization on titanium implants. An antibacterial effect was observed at a roughness of 0.13 μm. Bacterial adhesion increased moderately up to 2.1 μm for Gram-negative and 3 μm for Gram-positive strains, followed by a sharp rise at higher roughness values. An optimal surface roughness range of 1 to 2 μm appears to promote favorable osteoblastic response while minimizing bacterial adhesion.

CLINICAL RELEVANCE: These results enhance our understanding of how implant surface roughness influences bacterial adhesion. This knowledge could contribute to the development of clinical approaches designed to lower the risk of peri-implantitis.

PMID:41075034 | DOI:10.1007/s00784-025-06580-2

Sleep Breath. 2025 Oct 11;29(6):313. doi: 10.1007/s11325-025-03478-x.

ABSTRACT

INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder characterized by recurrent pauses in breathing during sleep and is responsible for serious cardiovascular and metabolic complications. Although its prevalence has been rising in parallel with the increasing obesity rates among young people, OSAS remains markedly underdiagnosed. In Vietnam, OSAS was only formally recognized and diagnosed within the past ten years, and it was introduced into the undergraduate curriculum at Hanoi Medical University just two years ago; consequently, both clinical awareness and attitudes toward this condition are still limited.

OBJECTIVES: This study aims to determine the proportion of students at Hanoi Medical University (HMU) who are at risk of OSAS and to analyze the clinical characteristics of those identified as high-risk.

SUBJECTS AND METHODS: A cross-sectional study was conducted on 135 HMU students between June 15 and September 15, 2024. We assessed OSAS risk using three versions of the STOP-BANG questionnaire (original, Asian, and Vietnamese-adapted “VietSBQ”), with body mass index (BMI) thresholds modified for the local population.

RESULTS: According to the original STOP-BANG scale, 8.1% of students were classified as having an intermediate-to-high risk of OSAS, whereas the VietSBQ identified 17.0% as high-risk. The prevalence of obesity differed significantly between high-risk groups: 9.1% by the original scale versus 65.2% by VietSBQ (p < 0.005). Among students at high risk, the predominant factors were male sex (95.7%), excessive daytime sleepiness (73.9%), and BMI > 25 kg/m² (65.2%).

CONCLUSION: The Vietnamese-adapted STOP-BANG questionnaire enhances the detection of OSAS risk in Vietnamese young adults. Given the recent introduction of OSAS into both clinical practice and medical education in Vietnam, particular attention should be paid to male students, those reporting daytime somnolence alongside snoring or witnessed apneas, and individuals with elevated BMI to facilitate early identification and intervention.

PMID:41075033 | DOI:10.1007/s11325-025-03478-x

Appl Microbiol Biotechnol. 2025 Oct 11;109(1):221. doi: 10.1007/s00253-025-13555-6.

ABSTRACT

Nasal cavity and nasopharynx are habitats for both pathogenic and non-pathogenic bacteria. Adenoid hypertrophy (AH) is the main cause in children, with a high incidence, for the airflow reduction in the upper airways. However, limited research described the differences of nasal microbial compositions in AH patients and healthy children. To determine the association between nasal microbiota and AH, total DNAs were collected and extracted from the nasal cavity and the hypertrophic adenoid of the donors, and the 16S rRNA gene V3-V4 region was sequenced. Microbial diversity was compared between the healthy and AH groups, and the enriched functional pathways were predicted. Although the alpha-diversity of microbial communities did not show statistically significant differences between the groups, principal coordinate analysis (PCoA) revealed that the microbiota component in the nasal cavity as well as in the hypertrophic adenoid tissues of children with AH was significantly different from that of healthy children. Genera Alloiococcus, Moraxella, Streptococcus, and Bacteroides were specifically enriched in the AH group’s samples, among which Moraxella spp. was significantly enriched in both nasal cavity and adenoid tissues, indicating a potential association of it with AH. In addition, Tax4fun prediction revealed disordered microbial functions in AH children. Nutrient metabolism, signaling system, chemotactic reaction, genetic replication, and reproduction-related pathways significantly decreased in the AH group but increased after adenoidectomy treatment. This study revealed a high association between specific microorganisms and AH disease. Future work is needed to investigate the role of Moraxella spp. in AH development. KEY POINTS: • Microbiota in the nasal cavity has high specificity in distinguishing patients with adenoidal hypertrophy from healthy individuals, indicating that the homeostasis of microbiota in the nasal cavity is highly associated with the healthy status of adenoid. • Several bacterial taxa, including Alloiococcus, Moraxella, Streptococcus, and Bacteroides, are bio-markers for adenoidal hypertrophy, which enriches specifically in both nasal cavities and hypertrophied adenoid tissues of patients. • In the nasal cavity of patients with adenoidal hypertrophy, microbial functions related to pathogenicity were enriched, indicating an association between adenoidal hypertrophy and disorder of microbiota in the nasal cavity.

PMID:41075002 | DOI:10.1007/s00253-025-13555-6

Heart Vessels. 2025 Oct 11. doi: 10.1007/s00380-025-02613-8. Online ahead of print.

ABSTRACT

BACKGROUND: Drug-coated balloons (DCBs) are increasingly being used to treat superficial femoral artery (SFA) lesions during endovascular therapy (EVT). However, the evaluation of paclitaxel distribution following DCB treatment remains challenging. This study aimed to develop a novel criterion to systematically semi-quantitatively grade the degree of paclitaxel distribution using nonobstructive general angioscopy and analyze the clinical factors affecting this criterion.

METHOD AND RESULTS: This study included 18 patients (20 limbs) who underwent EVT for SFA lesions using DCBs. Angioscopic observation of the vessel surface was performed before and after DCB treatment. The amount of paclitaxel distribution was systematically graded using the novel surface observation by nonobstructive general angioscopy of wall drug-distribution (SNOW) grade. Clinical factors were statistically analyzed to determine their relationship with the SNOW grade. Paclitaxel particles were observed on vessel walls after DCB treatment in all patients. A significant relationship was found between the DCB diameter and reference vessel and lumen diameter, measured by intravascular ultrasound; specifically, a same DCB-to-vessel ratio was associated with greater drug distribution.

CONCLUSIONS: The SNOW grading system was successfully developed for systematic evaluation of paclitaxel distribution. Our findings suggest that appropriate DCB sizing is essential for adequate drug application, highlighting that an undersized DCB may provide insufficient coverage. Therefore, a careful DCB selection that balances optimal drug delivery with the imperative to avoid vessel injury is crucial.

PMID:41074993 | DOI:10.1007/s00380-025-02613-8

Ann Hematol. 2025 Oct 11. doi: 10.1007/s00277-025-06645-y. Online ahead of print.

ABSTRACT

Multiple myeloma (MM) is a malignancy characterized by the clonal proliferation of plasma cells. It accounts for approximately 1% of all cancers and is the second most common hematologic malignancy after lymphoma. Infections represent a major cause of morbidity and mortality in patients with newly diagnosed multiple myeloma (NDMM), contributing to approximately 45% of early deaths, particularly in elderly individuals and during the initial months of therapy. Current treatment options for MM, including anti-CD38 monoclonal antibodies (CD38 mAbs), proteasome inhibitors, immunomodulatory drugs (such as lenalidomide and thalidomide), and glucocorticoids, have significantly improved clinical outcomes in NDMM patients. However, these therapies are associated with an increased risk of infections. Daratumumab (Dara), an anti-CD38 monoclonal antibody, is a key component of modern MM treatment and is approved for both NDMM and relapsed/refractory MM (RRMM). While Dara has improved patient outcomes, it has also altered the frequency and epidemiology of infections in this population. We conducted a retrospective analysis of 472 NDMM patients treated with Dara-containing regimens at 10 centers of the European Myeloma Network Italy (EMN-I) between 2020 and 2023 to assess the incidence of infectious events (IEs). Among these patients, 148 (31.3%) experienced infectious complications during therapy. No significant differences in infection rates were observed across the three treatment subgroups analyzed. In our experience, the addition of Dara during the induction phase did not increase the frequency, severity, or duration of infections in any of the three cohorts. Although the difference was not statistically significant, we observed an earlier onset of infections in the D-VTD group compared to the others. Further studies are needed to better define the incidence of infections in this patient population and to identify risk factors for infection. This may also inform the role of prophylactic strategies in the clinical management of NDMM.

PMID:41074984 | DOI:10.1007/s00277-025-06645-y