Tag: pubmed

Clin Oral Investig. 2025 Dec 20;30(1):19. doi: 10.1007/s00784-025-06695-6.

ABSTRACT

OBJECTIVE: The current study aimed to evaluate the speech outcome of primary Furlow palatoplasty with buccal myomucosal flap (FPBF) versus two flap palatoplasty (TFP) in patients with cleft palate.

MATERIALS AND METHODS: Thirty patients with cleft palate were included in the current study. Fifteen patients received the primary FPBF as the surgical palatal repair technique, while the other 15 patients received the primary TFP as their cleft palate repair. All surgeries were done by a single surgeon at the age of 9-12 months. Speech assessment was done at the age of 4-8 years, including the amount of hypernasality, speech intelligibility, compensatory misarticulation, and nasopharyngoscopy VP valve competence.

RESULTS: Statistically significant improvements were detected in the 4 assessment methods while comparing primary FPBF versus the TFP groups’ scores.

CONCLUSION: Primary FPBF might be able to improve the speech outcome in comparison to TFP in patients with cleft palate. CLINICAL SIGNIFICANCE: Primary FPBF improves the amount of hypernasality, speech intelligibility, compensatory misarticulation, and nasopharyngoscopy VP valve competence. Accordingly, it limits the need for further VP repair surgeries.

TRIAL REGISTRATION: Clinicaltrials.gov (NCT06856330).

PMID:41420755 | DOI:10.1007/s00784-025-06695-6

J Cancer Res Clin Oncol. 2025 Dec 20;152(1):17. doi: 10.1007/s00432-025-06400-w.

ABSTRACT

PURPOSE: With increasing reliance on large language models (LLMs) for health information, this study evaluated reliability and quality, understandability, actionability, readability and misinformation risk of responses from LLMs to oral health concerns and oral side effects in head and neck cancer (HNC) patients.

METHODS: Frequently asked questions on oral health and HNC therapy side effects were identified via ChatGPT-GPT-4-turbo and Gemini-2.5 Flash, then submitted to eight LLMs (ChatGPT-GPT-4-turbo, Gemini-2.5 Flash, Microsoft Copilot, Perplexity, Chatsonic, Mistral, Meta AI-Llama 4, DeepSeek-R1). Responses were assessed using DISCERN and modified DISCERN instruments (reliability and quality), Patient Education Materials Assessment Tool (PEMAT [understandability and actionability]), Flesch-Reading-Ease-Score (FRES [readability]), misinformation score, citations, and wordcounts. Statistical analysis was done by Scheirer-Ray-Hare-test followed by Dunn’s post-hoc-tests and Bonferroni-Holm correction (p < 0.05).

RESULTS: A total of 40 questions belonging to 12 oral health-related categories were identified. Statistically significant differences between LLMs were found for DISCERN, modified DISCERN, PEMAT-understandability, PEMAT-actionability, FRES, and word counts (p < 0.001). Median DISCERN and modified DISCERN scores amounted from 47.0 (ChatGPT-GPT-4-turbo) to 59.0 (Perplexity, Chatsonic) and from 2.0 (Gemini-2.5 Flash, Mistral) to 5.0 (Perplexity) indicating good to fair reliability. LLMs were understandable (median PEMAT-understandability scores ≥ 75.0), but provided limited specific guidance (median PEMAT-actionability scores ≤ 40) and used complex language (median FRES ≤ 40.2). Misinformation risk was generally low and not statistically significant among LLMs (p = 0.768).

CONCLUSION: Despite a low overall misinformation risk, deficits in actionability highlight the need for cautious integration of LLMs into HNC patient education.

PMID:41420748 | DOI:10.1007/s00432-025-06400-w

Naunyn Schmiedebergs Arch Pharmacol. 2025 Dec 20. doi: 10.1007/s00210-025-04644-4. Online ahead of print.

ABSTRACT

BACKGROUND: Vitamin D regulates cell growth and differentiation, encourages pro-apoptotic effect, stimulates antiangiogenic effect, and affects both innate and adaptive immunity. However, serum vitamin D level could differ between countries according to geographic, genetic, and dietary factors.

AIM OF THE WORK: Cosidering that most studies of relations between vitamin D level and breast cancer were conducted outside Africa and considering the fact that populations differ in sun exposure, dietary habits, and genetic construction, this study aimed to investigate the relationship between serum levels of vitamin D3 and vitamin D- binding protein (VDBP) with pathological response, clinicopathological characteristics, and various biological markers in Egyptian breast cancer patients undergoing neoadjuvant chemotherapy (NACT).

METHODS: A total of 71 female breast cancer patients (mean age: 57 years) were enrolled in this prospective observational study. Fasting blood samples were collected 1 day before and 3 months after initiation of NACT. Serum levels of vitamin D3 and V DBP were quantified using high-performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA), respectively. Tumor expression of Ki-67, HER2, progesterone receptor (PR), and estrogen receptor (ER) was assessed via immunohistochemistry. Serum levels of CA 15-3 and Bcl-2 were also measured.

RESULTS: Complete pathological response (pCR) was achieved in 44 patients (68.7%). A statistically significant increase in both vitamin D3 and VDBP levels was observed following NACT (p < 0.001). Lower pre- and post-treatment levels of vitamin D3 and VDBP were significantly associated with postmenopausal status, higher tumor grade and stage, triple-negative breast cancer subtype, and high Ki-67 expression (p < 0.001). Conversely, higher levels were significantly associated with achieving pCR (p < 0.001). Both vitamin D3 and VDBP levels demonstrated a significant negative correlation with tumor stage and grade (p < 0.001). Among different clinical and laboratory parameters, only triple-negative subtype and baseline vitamin D were significantly predictive for pCR by multivariable analysis (OR 1.488 and 0.506, respectively) and (95% CI 1.109-1.825 and 0.331-0.75, respectively).

CONCLUSION: Serum levels of vitamin D3 and VDBP significantly increased after NACT and were associated with favorable clinicopathological features and pCR. Only triple-negative subtype and baseline vitamin D were significantly predictive for pCR by multivariable analysis. These findings suggest that vitamin D3 and VDBP may serve as potential prognostic indicators in breast cancer management.

PMID:41420735 | DOI:10.1007/s00210-025-04644-4

Stem Cell Rev Rep. 2025 Dec 20. doi: 10.1007/s12015-025-11035-y. Online ahead of print.

ABSTRACT

BACKGROUND: Steroid-induced osteonecrosis of the femoral head (SONFH) is a progressive and refractory orthopedic disorder characterized by deterioration of the subchondral bone microstructure and eventual femoral head collapse, leading to hip joint dysfunction. Current therapeutic strategies offer limited efficacy and fail to reverse the necrotic process, with approximately 70% of patients eventually requiring total hip arthroplasty. Therefore, developing novel treatments capable of halting disease progression and promoting bone repair is crucial for addressing this clinical challenge. Exosomes, bioactive nanovesicles that regulate apoptosis, angiogenesis, and inflammation, represent a promising regenerative modality. In particular, stem cell-derived exosomes are considered to play a key role in the treatment of SONFH by promoting osteogenesis and angiogenesis and modulating inflammatory responses. However, the efficacy and mechanisms underlying exosome-based therapy for SONFH have not been systematically evaluated. A comprehensive synthesis of current evidence is urgently needed to inform future clinical translation.

PURPOSE: By synthesizing preclinical evidence, this study explored the mechanism and therapeutic potential of stem cell-derived exosomes in SONFH and identified key methodological limitations to provide a roadmap for future research.

STUDY DESIGN: Systematic review and meta-analysis.

METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, the Cochrane Library, and Embase for preclinical studies published from database inception until August 2025, with a focus on exosome-based therapy for osteonecrosis of the femoral head. Studies meeting the predefined inclusion criteria were rigorously selected and assessed for methodological quality, and relevant data were extracted. All the statistical analyses were performed via Review Manager (RevMan) version 5.4 software.

RESULTS: A total of 12 studies were included, all of which involved rat models of SONFH. The results of the meta-analysis revealed that exosome intervention significantly increased bone mineral density (BMD), thickness of trabecula, percentage of bone mass, the number of trabecula, vascular length, vascular volume and vascular area and reduced trabecular bone dissociation.

CONCLUSION: Exosomes rescue SONFH through multiple pathways. By promoting angiogenesis and osteogenesis, they effectively reverse the core pathological process of femoral head necrosis.

PMID:41420719 | DOI:10.1007/s12015-025-11035-y

Eur J Pediatr. 2025 Dec 20;185(1):29. doi: 10.1007/s00431-025-06663-y.

ABSTRACT

The MOBAK-KG battery is a widely used tool for assessing motor skills in kindergartens. However, no normative data exists for Spanish-speaking children in Spain. The purpose of this study was two-fold: to develop normative reference values for the MOBAK-KG battery stratified by sex and age in children aged 4-6 years and to evaluate the factorial structure of the MOBAK-KG battery. This cross-sectional study enrolled 375 Spanish children (51.5% female). Smoothed percentile for object-movement, self-movement, and total MOBAK-KG scores were calculated using the LMS method, incorporating the γ-lambda, μ-mu, and δ-sigma parameters according to age and sex, and confirmatory factor analysis was performed to determine the construct validity. Fit indices and parameter estimates were reported. The MOBAK-KG battery (observable items) that cover the object movement and self-movement motor competencies (latent factors) were consistently higher in boys than in girls and increased across age groups for both sexes. The results confirm the structure of the one-factor model provided the best representation of the data (χ²/df ratio = 1.09, CFI = 0.997; RMSEA = 0.016), and the structure of the two-factor model in all sections of the MOBAK battery also demonstrated acceptable fit (χ²/df = 1.33, CFI = 0.972; RMSEA = 0.036).

CONCLUSION: This is the first study to provide normative MOBAK-KG data for preschool children in Spain, based on a representative sample from Northern Spain. Our results suggest that the MOBAK-KG is a valid tool to assess fundamental motor competence in children in Spain. These normative data provide pediatricians and educators with objective benchmarks to identify children at risk of motor deficits.

WHAT IS KNOWN: • Fundamental motor skills (FMS) are essential for children’s development and for sustaining lifelong physical activity. • MOBAK-KG is a validated tool for preschool motor competence, but normative data and structure have mainly come from German/Swiss cohorts, limiting use in Spain.

WHAT IS NEW: • We provide the first Spanish norms for MOBAK-KG (ages 4-6) and confirm its psychometric structure: the one-factor model fits best, while the two-factor (OM/SM) solution remains useful for domain profiling. • We quantified age-related gains and modest sex differences and provided percentile cut-offs to support screening and early pediatric assessment and intervention.

PMID:41420717 | DOI:10.1007/s00431-025-06663-y

Biodegradation. 2025 Dec 20;37(1):16. doi: 10.1007/s10532-025-10235-0.

ABSTRACT

Used engine oil is considered a major environmental concern due to difficulty in disposal or reuse. Using enrichment method, nine bacterial strains were isolated from the oil contaminated sites in Abbottabad. The NMD strain was considered the best biosurfactant producing strain, having the highest emulsification index and cell hydrophobicity up to 72% and 67% respectively. Based on morphology and 16S rRNA sequence analysis, the isolate was identified as Enterobacter hormaechei strain NMD. The effect of various factors which may influence the biodegradation rate including pH, incubation temperature and oil concentration were evaluated by response surface methodology with Box-Behnken design. The analysis of variance (ANOVA) indicated that regression coefficient (R²) is 0.99 with P-value 0.0325 with best fitted second-order quadratic regression model for used engine oil degradation. The F value of model is 338.13 with P-value < 0.0001 showed that the applied model is statistically significant and the optimal parameters i.e., temperature, pH and inoculum size, were observed to have significant effect on engine oil degradation efficiency. The optimum parameters temperature, pH and engine oil concentration were found to be 32.5℃, 6.5, and 4% (v/v) respectively. Under the optimized conditions, the degradation efficiency of used engine oil is observed 80%, which closely matched with the predicted values. The Monod kinetic equation is used to determine the growth rate of isolated strain utilizing used engine oil as sole carbon source with the highest rate of μmax (h-1) = 0.112, with Ks 9.5, and μmax/ Ks is 0.011 mg/L/h. The engine oil degradation was confirmed by GC/MS analysis, and its metabolites were also identified providing comprehensive insights into the breakdown products and degradation efficiency. This is the first report on the growth kinetics of these biosurfactants NMD on used engine oil, with these parameters helping to assess the isolated bacterial strain’s capability to degrade the pollutant effectively and guiding the development of more efficient bioremediation strategies. The future study should elucidate detail metabolomic study, optimization study at larger scale bioremediation process and enhancement of bacterial degradation efficiency through immobilization and use of consortium approaches.

PMID:41420715 | DOI:10.1007/s10532-025-10235-0

Eur Radiol. 2025 Dec 20. doi: 10.1007/s00330-025-12184-x. Online ahead of print.

ABSTRACT

OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is crucial for treating calcified aortic stenosis (CAS), yet post-procedural outcomes remain variable. The CAPRI score previously showed promising results in predicting 1-year all-cause mortality, by combining manually measured thoracic aortic calcium (TAC) volume with clinical risk factors. This study introduces an enhanced CAPRI score (eCAPRI), which automates TAC volume measurement and incorporates additional automatically extracted biomarkers from pre-operative CT scans.

MATERIALS AND METHODS: TAC volume extraction was automated using a deep learning model trained on 66 patients and evaluated on 1111 CT scans. Additional automatically extracted imaging biomarkers were incorporated into the eCAPRI score, following the original methodology for biomarker selection. The eCAPRI score was trained on 765 pre-TAVI CT scans for one-year mortality prediction and then compared to CAPRI and EuroSCORE Logistic using AUC, bootstrap tests, and calibration curves on 192 CT scans.

RESULTS: Automated TAC segmentation achieved a mean Dice score of 0.777 ± 0.108. The eCAPRI score included body surface area (BSA)-indexed right ventricle volume, BSA-indexed pulmonary arteries max diameter, and abdominal muscles surface at L3 level in addition to automatically computed TAC volume and clinical biomarkers previously identified in the CAPRI score. On the evaluation dataset, eCAPRI showed an AUC of 0.731, outperforming CAPRI (AUC = 0.669) and EuroSCORE Logistic (AUC = 0.588) significantly (p = 0.034), with better calibration.

CONCLUSION: The eCAPRI score, combining fully automated TAC volume extraction and additional imaging biomarkers, improved one-year mortality prediction over CAPRI and EuroSCORE Logistic. It may support standardized risk stratification in TAVI patients.

KEY POINTS: Question Can an eCAPRI using imaging biomarkers from pre-operative CT scans improve the prediction of one-year mortality in patients undergoing transcatheter aortic valve replacement? Findings The eCAPRI score, integrating automated TAC volume and additional biomarkers, outperformed CAPRI and EuroSCORE Logistic in predicting one-year mortality (AUC = 0.731, p = 0.034). Clinical relevance The eCAPRI score provides a standardized approach to mortality risk assessment in transcatheter valve procedures. By improving prediction accuracy, it supports more informed clinical decisions and personalized care planning, ultimately contributing to better outcomes for patients undergoing TAVI.

PMID:41420708 | DOI:10.1007/s00330-025-12184-x

Eur Radiol. 2025 Dec 20. doi: 10.1007/s00330-025-12225-5. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the diagnostic utility of T1ρ mapping for assessing hepatic fibrosis in patients with chronic liver disease (CLD), including steatotic liver disease (SLD).

MATERIALS AND METHODS: In this prospective study (September 2024 to May 2025), consecutive patients with CLD underwent liver MRI, including MR-elastography, PDFF, T1, extracellular volume fraction (ECV), and T1ρ mapping. MRE-based liver stiffness was used as the reference to assess the diagnostic performance of the MRI-derived mapping parameters. MR-elastography-based liver stiffness thresholds for significant fibrosis (≥ F2) were set at > 3.66 kPa for participants without hepatic steatosis (PDFF ≤ 5%), and > 3.14 kPa for participants with hepatic steatosis (PDFF > 5%). The t-test, Spearman’s correlation, and the ROC analysis were applied.

RESULTS: One hundred twelve CLD participants were included (mean age, 48 ± 16 years; 53 participants with hepatic steatosis). All assessed quantitative mapping parameters were significantly increased in participants with significant fibrosis than in those without (e.g., T1ρ: 110 ± 15 vs 92 ± 6 ms, p < 0.001). T1ρ revealed a moderate to strong correlation with MR-elastography-based stiffness, superior to T1 and ECV (entire cohort: r = 0.75 [T1ρ] vs 0.49 [native T1] vs 0.68 [ECV]; participants with hepatic steatosis: r = 0.67 [T1ρ] vs 0.32 [native T1] vs 0.62 [ECV]; p < 0.05 in each case, respectively). T1ρ provided the highest diagnostic performance for diagnosing significant fibrosis (in the entire cohort: AUC 0.90 [T1ρ] vs 0.73, p < 0.001 [native T1], vs 0.81, p = 0.05 [ECV]; in participants with hepatic steatosis: AUC 0.87 [T1ρ] vs 0.67, p = 0.03 [native T1], vs 0.79, p = 0.047 [ECV], p values are given vs T1ρ).

CONCLUSION: Hepatic T1ρ might be a more accurate marker of hepatic fibrosis in CLD, including SLD, compared to hepatic native T1 and ECV mapping.

KEY POINTS: Question Accurate non-invasive assessment of hepatic fibrosis remains challenging, particularly in the presence of steatosis, where MRI biomarkers such as native T1 and ECV fraction are limited. Findings T1ρ mapping outperformed native T1 and ECV for identifying significant fibrosis and maintained robust accuracy in the presence of hepatic steatosis. Clinical relevance T1ρ mapping offers a robust, non-invasive MRI biomarker for assessing hepatic fibrosis across the full spectrum of CLD, including SLD, with superior accuracy to native T1 and ECV and reduced influence from hepatic fat infiltration.

PMID:41420707 | DOI:10.1007/s00330-025-12225-5

Eur Radiol. 2025 Dec 20. doi: 10.1007/s00330-025-12179-8. Online ahead of print.

ABSTRACT

OBJECTIVES: Accurate localization of deep brain stimulation (DBS) electrodes is critical for effective therapy. Conventional CT is widely used postoperatively but fails to delineate individual electrode contacts due to metallic artifacts. This study aimed to evaluate extended Hounsfield unit (EHU) CT – using an expanded scale up to 40,000 HU- for accurate localization of individual DBS electrode contacts.

MATERIALS AND METHODS: This retrospective study included 29 patients (58 DBS electrodes) who underwent DBS implantation. Postoperative imaging comprised both conventional CT and EHU-CT reconstructions. Two independent raters localized electrode contacts using a standardized protocol. Inter-method and inter-rater agreement were quantified using intraclass correlation coefficients (ICCs) and Euclidean distances. Qualitative assessments of contact visibility were also performed.

RESULTS: Quantitative analysis showed near-perfect agreement between EHU-CT and conventional CT (ICC ≈ 1), with high inter-rater consistency. However, qualitative evaluation revealed superior contact visualization with EHU-CT: all contacts were clearly identifiable in 100% of cases, while conventional CT consistently failed to distinguish individual contacts due to blooming artifacts. Conventional CT localizations were also sensitive to window-level adjustments, particularly along the z-axis.

CONCLUSION: EHU-CT enables consistent and direct visualization of individual DBS contacts and provides a robust alternative to conventional CT. Its reduced sensitivity to display settings and improved interpretability may enhance intra-operative decision-making and postoperative programming, supporting more reliable DBS workflows.

KEY POINTS: Question Accurate deep brain stimulation (DBS) electrode localization is crucial for optimal intra-operative adjustments and outcomes, yet conventional CT is hindered by metallic artifacts limiting individual contact visualization. Findings Extended Hounsfield unit (EHU)-CT and conventional CT showed near-perfect agreement in electrode localization, but EHU-CT provided clearly superior visualization of individual electrode contacts. Clinical relevance By enabling direct visualization of individual contacts through an extended Hounsfield scale, EHU-CT can improve intra-operative decision-making and postoperative programming, potentially enhancing DBS localization accuracy and patient outcomes.

PMID:41420706 | DOI:10.1007/s00330-025-12179-8

Eur Radiol. 2025 Dec 20. doi: 10.1007/s00330-025-12231-7. Online ahead of print.

ABSTRACT

Radiomics is increasingly explored as a tool for improving diagnosis, prognosis, and treatment planning. However, concerns exist about the reproducibility and methodological rigor of its studies. The integration of high-dimensional radiomic features and machine learning makes the field prone to unintentional errors that may warrant retraction. Despite a rising number of retractions in science overall, no dedicated study has examined retractions specifically within radiomics. Therefore, this study aimed to review retracted radiomics publications and identify the characteristics and reasons for their retraction. We systematically searched six databases (Crossref, Retraction Watch Database, OpenAlex, PubMed, Scopus, Web of Science) and identified 93 retracted radiomics publications, of which 20 were included. These articles were analyzed with respect to publisher, country of origin, dates, citation counts, and reasons for retraction. Retraction rates were then estimated and compared with those in general radiology. Our findings indicate that a disproportionate number of retractions are linked to specific publishers and countries (particularly China and India), with overall low citation counts (median 4.0 citations). Retractions peaked sharply in 2023, followed by a strong decline. Many retraction notes lack a clear explanation for the retraction. Estimated retraction rates in radiomics were lower than in general radiology (6.7 vs 7.4 per 10,000 publications). Notably, no major radiological or oncological journal appears to have retracted a radiomics publication. Given that radiomics demands higher, interdisciplinary expertise, this suggests a gap, implying that flawed research may yet have to be retracted. KEY POINTS: Question Considering the technical complexity of radiomics studies and their susceptibility to unintentional errors, how do their retraction rates compare to those in general radiology? Findings Retractions in radiomics were disproportionately linked to specific publishers and countries; however, no retractions appeared in major journals. Estimated retraction rates were lower than those for general radiology publications. Clinical relevance A potential gap in the number of retracted radiomics studies was identified, implying that flawed research in the field may not yet have been addressed.

PMID:41420705 | DOI:10.1007/s00330-025-12231-7