Tag: pubmed

Int Endod J. 2025 Nov 25. doi: 10.1111/iej.70072. Online ahead of print.

ABSTRACT

BACKGROUND: There is a strong association between root canal curvatures and iatrogenic complications during root canal treatment.

INTRODUCTION: This study compared the curvature of mesiobuccal (MB) and mesiolingual (ML) canals in mandibular first molars between sagittal and coronal planes using cone-beam computed tomography.

METHODS: Two hundred mesial roots (400) canals from a Brazilian subpopulation were analysed. Curvature angles were measured in sagittal and coronal planes using Schneider’s and Weine’s methods, while curvature radii were calculated geometrically. The prevalence of S-shaped canals was also recorded. Curvature severity was classified according to the American Association of Endodontists Case Difficulty Assessment form, EndoApp, and modified versions incorporating curvature and radius. The influence of the angle measurement method and radius on case complexity was evaluated. Statistical analyses were performed using t-tests and chi-squared tests, with significance set at p ≤ 0.05.

RESULTS: Sagittal planes showed significantly greater angles and smaller radii than coronal planes. Weine’s method yielded consistently higher angles and smaller radii than Schneider’s. Severe single curvatures (≥ 30°) were more frequent in sagittal planes, whereas S-shaped canals were more prevalent in coronal planes. MB was more often classified as higher difficulty than ML canals. Incorporating radius into the classification systems generally shifted cases towards greater severity.

CONCLUSIONS: Sagittal planes revealed more severe single curvatures, whereas coronal planes showed a higher prevalence of S-shaped canals. Weine’s method resulted in greater curvature severity than Schneider’s. Inclusion of radius increased case severity grading. These findings highlight the importance of considering both measurement method and projection plane in endodontic treatment planning and research.

PMID:41287941 | DOI:10.1111/iej.70072

Cardiol J. 2025 Nov 25. doi: 10.5603/cj.99990. Online ahead of print.

ABSTRACT

BACKGROUND: The global mortality rates due to cardiovascular diseases (CVD) are still alarmingly high, highlighting the need for accurate assessment of the risk of severe cardiovascular (CV) events. To address this, the Pol-SCORE and SCORE2 scales have been developed.

METHODS: We conducted an observational and retrospective analysis of 450 patients with LDL ≥ 100 mg/dL admitted to the Clinical Hospital of the Medical University of Warsaw between 2019 and 2020. The objective of our study was to assess the treatment in patients with high levels of LDL cholesterol, without pre-existing CVD, by estimating their CV risk using the Pol-SCORE and SCORE2 scales.

RESULT: We enrolled a total of 150 patients in the study: 86 women (57.3%) and 64 men (42.7%), with an average age of 55.1 years. The high-risk category in the SCORE2 scale included patients with low, moderate, high, and very high risk estimated in the Pol-SCORE scale. It was statistically significant (p < 0.0001) in the distribution of risk assessment results between groups of CV risk.

CONCLUSIONS: According to research, the Pol-SCORE scale has been found to potentially underestimate the likelihood of CV events occurring when compared to the SCORE2 scale, which has a more cautious and restrictive approach. Patients with high and very high risk of fatal and non-fatal CVD are not receiving appropriate treatment. To identify and implement proper recommendations and treatments for patients with elevated risk, the SCORE2 scale should be utilized to estimate CV risk events.

PMID:41287937 | DOI:10.5603/cj.99990

Dis Model Mech. 2025 Nov 25:dmm.052460. doi: 10.1242/dmm.052460. Online ahead of print.

ABSTRACT

Collagen VI Related Dystrophies (COL6-RD) are congenital muscle diseases, typically inherited as an autosomal dominant trait. A frequent type of mutation involves glycine substitutions in the triple helical domain of collagen VI alpha chains, exerting a dominant-negative effect on the unaltered protein. Despite this, no prior animal model captured this mutation type. Using CRISPR/Cas9, we generated transgenic mice with the equivalent of the human COL6A1 c.877 G>A; p. Gly293Arg mutation. We characterized their skeletal muscle phenotype over time, utilizing computer-aided tools applied to standardized parameters of muscle pathology and function. Knock-in mice exhibited early-onset reduced muscle weight, myopathic histology, increased fibrosis, reduced collagen VI expression, muscle weakness, and impaired respiratory function. These features provide adequate outcome measures to assess therapeutic interventions. The different automated image analysis methods deployed here analyze thousands of features simultaneously, enhancing accuracy in describing muscle disease models. Overall, the Col6a1 Ki Gly292Arg mouse model offers a robust platform to deepen our understanding of COL6-RD and advance its therapeutic landscape.

PMID:41287928 | DOI:10.1242/dmm.052460

J Esthet Restor Dent. 2025 Nov 25. doi: 10.1111/jerd.70064. Online ahead of print.

ABSTRACT

OBJECTIVE: Multimodal large language models (LLMs) have the potential to transform dental learning and decision-making by addressing multimodal dental inquiries that integrate text, images, and analytical data. The purpose of this study was to evaluate the performance of various multimodal LLMs in responding to multimodal dental queries and to identify factors influencing their performance.

MATERIALS AND METHODS: Four multimodal LLMs (ChatGPT-4V, Claude 3 Sonnet, Microsoft 365 Copilot 2024, and Google Gemini 1.5 Pro) were evaluated based on their correct answers and passing margin for the Integrated National Board Dental Examination (INBDE) and the Advanced Dental Admission Test (ADAT). Descriptive statistics, χ² tests, Cohen’s κ, Kruskal-Wallis tests, and Mann-Whitney U tests were used to analyze the performance across different question types, independent inputs, and picture types (α = 0.05).

RESULTS: Claude 3 Sonnet outperformed the other models in both INBDE and ADAT exams, achieving the highest accuracy, followed by ChatGPT-4V, Microsoft 365 Copilot 2024, and Google Gemini 1.5 Pro. χ² tests revealed significant differences between chatbots in the ADAT exam, but not in the INBDE. Cohen’s κ showed weak to moderate model agreement for INBDE and stronger agreement for ADAT, with the highest agreement between Claude 3 Sonnet and ChatGPT-4V (κ = 0.757) and the lowest between Google Gemini 1.5 Pro and Microsoft 365 Copilot 2024 (κ = 0.059). Model performance was influenced by question type (theoretical and clinical), with common errors including misinterpreting clinical scenarios, visual data difficulties, and dental terminology ambiguities.

CONCLUSION: Multimodal LLMs show potential in answering multimodal dental inquiries, though performance varies across models, with challenges in interpreting clinical scenarios, visual data, and terminology ambiguity.

CLINICAL SIGNIFICANCE: Large language models canbe applied not only to memorization-type but also interpretation andproblem-solving cognitive questions in dentistry. Tomaximize the utility of these artificial intelligence models, users need bothan understanding of their differences and the ability to manage complexclinical data.

PMID:41287924 | DOI:10.1111/jerd.70064

Psychol Med. 2025 Nov 25;55:e358. doi: 10.1017/S003329172510264X.

ABSTRACT

BACKGROUND: Ecological momentary assessment (EMA) is increasingly recognized as a vital tool for tracking the fluctuating nature of mental states and symptoms in psychiatric research. However, determining the optimal sampling rate – that is, deciding how often participants should be queried to report their symptoms – remains a significant challenge. To address this issue, our study utilizes the Nyquist-Shannon theorem from signal processing, which establishes that any sampling rate more than twice the highest frequency component of a signal is adequate.

METHODS: We applied the Nyquist-Shannon theorem to analyze two EMA datasets on depressive symptoms, encompassing a combined total of 35,452 data points collected over periods ranging from 30 to 90 days per individual.

RESULTS: Our analysis of both datasets suggests that the most effective sampling strategy involves measurements at least every other week. We find that measurements at higher frequencies provide valuable and consistent information across both datasets, with significant peaks at weekly and daily intervals.

CONCLUSIONS: Ideal frequency for measurements remains largely consistent, regardless of the specific symptoms used to estimate depression severity. For conditions in which abrupt or transient symptom dynamics are expected, such as during treatment, more frequent data collection is recommended. However, for regular monitoring, weekly assessments of depressive symptoms may be sufficient. We discuss the implications of our findings for EMA study optimization, address our study’s limitations, and outline directions for future research.

PMID:41287919 | DOI:10.1017/S003329172510264X

Int J Surg. 2025 Nov 24. doi: 10.1097/JS9.0000000000004104. Online ahead of print.

ABSTRACT

BACKGROUNDAIMS: Current binary definition of early allograft dysfunction (EAD) was not sufficiently accurate for discriminating clinical outcomes after liver transplantation (LT). We investigated the clinical heterogeneity among EAD sub-criteria and explored the necessity of dividing EAD into different stages to grade the severity of graft dysfunction.

METHODS: 1242 LT patients from 5 centers were included. EAD patients were divided as i) EAD-type-A: only AST/ALT criteria; ii) EAD-type-B: bilirubin or INR criteria; iii) EAD-type-C: meeting two or three EAD sub-criteria. Peri-operative clinical complications and survival outcomes were compared.

RESULTS: Three-month early graft failure (EAF) from non-EAD to EAD-type-C were 1.6%, 3.5%, 12.8% and 29.6%. EAD-type-B and EAD-type-C were significantly associated with higher rates of AKI, RRT, in-hospital death, longer hospital stay, ICU stay, ventilator support time, and inferior one-year survival outcomes(P<0.001); However, there were no statistical differences between EAD-type-A and non-EAD (P>0.05). New EAD classification with three stages was proposed to grade EAD severity: a)EAD-stage-I: only ALT/AST≥2000 U/L within POD7; b)EAD-stage-II: only bilirubin 10-30 mg/dL or INR≥1.6 on POD7; c)EAD-stage-III: bilirubin≥30 mg/dL; both bilirubin≥10 mg/dL and INR≥1.6 on POD7. Clinical outcomes and survival rates deteriorated following EAD stages. New EAD classification had an excellent discrimination (AUROC = 0.84, CI 0.81-0.86) in determining EAF, superior to binary EAD definition (AUROC = 0.73, CI 0.70-0.77) and MEAF (AUROC = 0.76, CI 0.73-0.79) (P<0.001), while similar to L-GrAFT-7(AUROC = 0.87, CI = 0.84-0.90 P>0.05). Consistent with findings in derivation cohort, external validation confirmed its excellent discrimination of graft dysfunction and 3-month EAF.

CONCLUSIONS: Different EAD sub-criteria had significantly different clinical outcomes. EAD definition should be further reclassified with different severities. New EAD classification with 3 stages could be serve as an effective tool to accurately grade the severity of EAD and identify patients in high risk of early graft failure.

PMID:41287877 | DOI:10.1097/JS9.0000000000004104

Int J Surg. 2025 Nov 25. doi: 10.1097/JS9.0000000000003891. Online ahead of print.

ABSTRACT

BACKGROUND: While the relationship between adult obesity and dysfunction-associated steatotic liver disease (MASLD) is well-established, the impact of childhood obesity remains unclear. We aimed to comprehensively characterize the causal effect and genetic relationships of child obesity-related exposures at different ages and MASLD.

METHODS: Using summary statistics from large-scale genome-wide association studies (GWAS) of child obesity-related traits and MASLD in European-ancestry populations, we performed LDSC and SUPERGNOVA to quantify overall and local genetic correlations, respectively. Univariable Mendelian randomization (UVMR) analysis infers causal relationships. Genomic structural equation modeling (GenomicSEM) and multivariable Mendelian randomization (MVMR) estimated independent genetic correlations and causal effects of each obesity-related trait on MASLD. A two-step MR analysis investigated the mediating pathway from childhood obesity to MASLD through adult obesity.

RESULT: We observed a positive genetic correlation between BMI at age 5 and MASLD ( = 0.45, P-value = 0.01), and a similar correlation for BMI at age 7 ( = 0.44, P-value = 0.044). A significant negative genetic correlation was identified between birth weight and MASLD ( = – 0.23, P-value = 4.4 × 10-8). UVMR indicated increased MASLD risk was associated with overall obesity (OR ivw = 1.40, 95% CI = 1.22, 1.62) and obesity at age 8 (OR ivw = 1.34, 95% CI = 1.01, 1.78). Birth weight had a protective effect (OR ivw = 0.69, 95% CI = 0.61, 0.78). The birth weight effect estimate attenuated to null after collectively adjusting for lifestyle factors in MVMR (OR = 1.05, 95%CI = 0.98-1.12). Mediation analysis showed that this masking effect was mediated by adult obesity.

CONCLUSION: These findings suggest that the association between childhood obesity at different ages and MASLD may differ, indicating a contribution of childhood obesity to MASLD risk and confirmed that sustained obesity into adulthood is the mediating pathway.

PMID:41287864 | DOI:10.1097/JS9.0000000000003891

Int J Nurs Educ Scholarsh. 2025 Nov 26;22(1). doi: 10.1515/ijnes-2025-0047. eCollection 2025 Jan 1.

ABSTRACT

OBJECTIVES: Nurse educators play a vital role in supporting disadvantaged nursing students, especially in rural areas. This project implemented innovative strategies including full scholarships, academic support, and mentorship panels featuring rural nurse leaders role models to improve student success at a rural public university in the Midwest U.S.

METHODS: Disadvantaged students-including those from low-income households, first-generation college backgrounds, and rural underserved communities-encounter substantial barriers to successfully completing nursing programs. To address these challenges, targeted interventions are essential to support their admission, retention, graduation, and transition into employment, particularly in rural and medically underserved communities (MUCs). This study analyzed admission, retention and graduation outcomes of 73 scholarship recipients. An online survey evaluated the effectiveness of various support strategies.

RESULTS: Admission and retention outcomes for disadvantaged nursing students improved substantially over the course of the project. Admission rates increased more than fourfold, rising from a baseline of 5 % in 2019 to 24.3 % by 2025. Among the 73 disadvantaged scholarship recipients, the retention rate reached 88 %, and all graduates achieved a 100 % pass rate on the RN licensure examination. Student feedback also reflected that 95.2 % of participants rating the mentorship panels as “very effective”.

CONCLUSION: Scholarships and structured academic and social support programs improved disadvantaged students’ success, contributing to a more diverse and competent nursing workforce. Holistic support, equity-focused access, and alignment with underserved community needs offer a practical framework for international nursing education to strengthen workforce diversity and reduce health disparities.

PMID:41287863 | DOI:10.1515/ijnes-2025-0047

Hum Vaccin Immunother. 2025 Dec;21(1):2591463. doi: 10.1080/21645515.2025.2591463. Epub 2025 Nov 25.

ABSTRACT

New treatment strategies are needed for patients who relapse during or following first-line immune checkpoint inhibitor-based treatment for esophageal squamous cell carcinoma (ESCC). Second-line immune checkpoint inhibitors (ICI) rechallenge aims to reactivate the immune system’s response to tumor cells and may improve the prognosis of patients who progressed during or after completing previous treatment. The purpose of this study is to explore the effectiveness and safety of second-line ICI rechallenge therapy in the treatment of advanced ESCC. We retrospectively reviewed the records of patients with advanced ESCC at the Department of Oncology of Jiangsu Cancer Hospital (January 2021 to June 2023) who had at least one measurable lesion at progression after first-line immunotherapy, received at least two cycles of second-line treatment, and who had subsequently undergone radiographic response assessment. The primary outcomes of interest were the progression-free survival (PFS)and overall survival (OS). Treatment-related adverse events were also recorded. In the ICI rechallenge and non-ICI rechallenge groups, the objective response rate (ORR) was 15.4% and 11.8%, the disease control rate (DCR) was 67.6% and 44.1% (P = .011). Compared with the non-ICI rechallenge group, median PFS2 in the ICI rechallenge group was significantly prolonged (5.63 vs. 3.03 months, hazard ratio [HR] = 0.45, 95% confidence interval [CI]: 0.28, 0.73; P = .001), while there was no statistically significant difference in median OS (12.33 vs. 7.10 months, HR: 0.80, 95% CI: 0.51, 1.27; P = .344). ICI rechallenge therapy and radiotherapy administered during second-line treatment were recognized as independent predictive factors influencing PFS2. These findings suggest that second-line ICI rechallenge is tolerable and could benefit a subset of patients with advanced ESCC.

PMID:41287859 | DOI:10.1080/21645515.2025.2591463

PeerJ. 2025 Nov 20;13:e20146. doi: 10.7717/peerj.20146. eCollection 2025.

ABSTRACT

OBJECTIVE: This meta-analysis aimed to explore the effects of multi-component exercise interventions on glycemic and lipid metabolism, physical fitness, and cognitive function in individuals with type 2 diabetes mellitus (T2DM).

METHODS: From inception to December 28, 2024, PubMed, Web of Science, Cochrane, and Elsevier databases were systematically searched for randomized controlled trials (RCTs) investigating multi-component exercise interventions for T2DM. A total of 37 articles, comprising 3,201 participants, were included. Primary and secondary outcome measures were categorized, summarized, and analyzed using RevMan 5.4 software.

RESULTS: Compared to control groups, multi-component exercise interventions produced statistically significant improvements across all measured outcomes in individuals with T2DM: (1) Glycemic control: HbA1c (standard mean difference (SMD) = -0.52, 95% confidence interval (CI) [-0.76 to -0.28]); fasting blood glucose (SMD = -0.53, 95% CI [-0.93 to -0.12]). (2) Lipid metabolism: high density lipoprotein (HDL) (SMD = 0.32, 95% CI [0.21-0.44]); low density lipoprotein (LDL) (SMD = -0.21, 95% CI [-0.33 to -0.09]); triglycerides (SMD = -0.18, 95% CI [-0.30 to -0.06]). (3) Physical fitness: upper limb strength (SMD = 0.67, 95% CI [0.51-0.83]); lower limb strength (SMD = 0.56, 95% CI [0.10-1.02]); peak oxygen consumption (SMD = 0.62, 95% CI [0.31-0.93]); body mass index (BMI) (SMD = -0.38, 95% CI [-0.67 to -0.09]). (4) Cognitive function: overall cognitive performance (SMD = 0.34, 95% CI [0.18-0.50]). (5) Quality of life: vitality (SMD = 0.37, 95% CI [0.09-0.64]); physical functioning (SMD = 0.48, 95% CI [0.20-0.75]); mental health (SMD = 0.35, 95% CI [0.07-0.63]); general health (SMD = 0.34, 95% CI [0.06-0.61]). Quality assessment indicated that the included studies were of high overall quality. Egger’s regression analysis did not reveal significant publication bias.

CONCLUSIONS: Multi-component exercise interventions significantly improved glycemic and lipid metabolism, physical fitness, and cognitive function in individuals with T2DM. These findings support the clinical value of incorporating multi-component exercise programs-particularly those performed at least three times per week and lasting 6 months or longer-into diabetes management strategies.

PMID:41287857 | PMC:PMC12640639 | DOI:10.7717/peerj.20146