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Verification of the relationship between awareness of clenching or the teeth contacting habit and the integral value of masseteric electromyogram during diurnal wakefulness

Clin Oral Investig. 2025 Oct 11;29(11):502. doi: 10.1007/s00784-025-06566-0.

ABSTRACT

PURPOSE: This study aimed to clarify the relationship between diurnal awake bruxism (AB) awareness, tooth-contacting habit (TCH) awareness, and the electromyographic (EMG) waveform integral value.

MATERIALS AND METHODS: Unilateral masseteric EMG recordings during the daytime were performed on the habitual masticatory side using an ultraminiature wearable EMG device. One hundred and seven participants (50 and 57 with and without diurnal tooth clenching (d-TC) awareness, respectively) were included. d-TC awareness and TCH awareness were assessed using questionnaires. The standardized burst integral (S-integral) value was calculated for each participant.

RESULTS: There was a statistically significant association between d-TC awareness and TCH awareness. The S-integral values were not significantly associated with the awareness d-TC or TCH. The frequency distribution of EMG waveforms of the awareness and non-awareness groups exhibited wide-range overlaps both for d-TC and TCH.

CONCLUSION: d-TC or TCH awareness showed no clear correlation with the S-integral value, suggesting that it is important to evaluate AB and TCH based on objective and quantitative test results, such as the masseter muscle’s EMG data.

CLINICAL RELEVANCE: Diagnosis, treatment, and management of AB and TCH are important issues in dental medicine. The obtained results regarding the actual state of awareness of AB and TCH, and the EMG integral value that was one of the important EMG indices, were considered useful information for establishing diagnostic and assessment methods for AB and TCH in future clinical dentistry.

PMID:41074973 | DOI:10.1007/s00784-025-06566-0

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Clinical and Socioeconomic Burden of RSV Infections Among Older Adults in Primary Care: An International Prospective Cohort Study

Influenza Other Respir Viruses. 2025 Oct;19(10):e70174. doi: 10.1111/irv.70174.

ABSTRACT

INTRODUCTION: Respiratory syncytial virus (RSV) is increasingly recognized as an important cause of acute respiratory infections (ARI) in older adults. However, primary care data on RSV infections are scarce.

METHODS: We conducted a prospective cohort study over two winter seasons (2022-2023 and 2023-2024) in Italy and the Netherlands (NCT06318936). Older adults (≥ 60 years) presenting to primary care with ARI were tested for RSV and influenza. Clinical and socioeconomic burden was assessed through questionnaires on Days 1, 14, and 30. In secondary analyses, we compared between RSV- and influenza-positive patients and estimated RSV-ARI incidence in Dutch primary care.

RESULTS: Of 703 older adults tested, 93 (13.2%) were RSV-positive and 100 (14.2%) influenza-positive. In RSV patients (mean age: 76 years [SD: 8], 63% ≥ 1 comorbidity), mean illness duration was 17 days (SD: 10). Repeat primary care visits occurred in 38% (33/87), emergency department referral in 5% (4/88), and hospitalization in 2% (2/88) of RSV patients. The mean costs per RSV episode were €78.1 (95%CI: 74.4-81.8) and €279.7 (95%CI: 245.5-318.2) from a healthcare system and societal perspective, respectively. The annual RSV-ARI incidence rate was 10.3 episodes per 1000 person-years. RSV patients were significantly older, and had less often fever, muscle pain, and fatigue than influenza patients, but clinical and socioeconomic burdens were comparable.

CONCLUSIONS: This prospective study is the first sufficiently large to demonstrate that the primary care burden of RSV infections among older adults is substantial and comparable with influenza. These findings are highly relevant for informing public health decisions on novel RSV vaccines.

PMID:41074665 | DOI:10.1111/irv.70174

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Assessing the Impact of Drawing in Biology Lecture Classes on Student Learning

Biochem Mol Biol Educ. 2025 Oct 11. doi: 10.1002/bmb.70018. Online ahead of print.

ABSTRACT

One type of active learning technique that instructors can incorporate is the use of various drawing activities. This study investigates the impact of drawing during biology lecture classes on student learning. Undergraduate students in two lecture sections of an introductory cellular and molecular biology course completed worksheets that either required them to draw (learner-generated) or required them to interpret a drawing (instructor-generated). The four topics that were assessed were amino acid polymerization, nucleotide polymerization, cellular respiration, and photosynthesis. Student learning was assessed using multiple-choice and short-answer exam questions. Students who completed the learner-generated worksheet related to amino acid polymerization performed significantly better than students who completed the instructor-generated worksheet. Differences in student learning were not statistically significant for the other three topics; however, trends indicated that for some topics, the learner-generated worksheet increased student understanding while for other topics the students who completed the instructor-generated worksheet performed better. These findings indicate that it is important to carefully align the type of drawing activity with the complexity of the topic. When the drawings were too complex, students did not gain as much from creating their own images. Instructors are encouraged to thoughtfully integrate various types of drawing activities into their courses to increase student learning.

PMID:41074661 | DOI:10.1002/bmb.70018

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Symptoms and quality of life assessment after coil and foam embolization in patients with venous-origin chronic pelvic pain (VO-CPP) – a subgroup of pelvic venous disorders (PeVD)

Ann Med. 2025 Dec;57(1):2570798. doi: 10.1080/07853890.2025.2570798. Epub 2025 Oct 11.

ABSTRACT

BACKGROUND: Venous-Origin Chronic Pelvic Pain (VO-CPP), a subgroup of Pelvic Venous Disorders (PeVD) can significantly affect Quality of Life (QoL). Previous papers have highlighted the lack of evaluations measuring QoL of patients before and after embolization. The aim of this study was to evaluate the effectiveness of embolization in reducing a variety of symptoms and improving QoL in patients with VO-CPP.

METHODS: A prospective analysis of 40 female patients (mean 36.9 years) diagnosed with VO-CPP, undergoing venous embolization between June 2020 and May 2023 was conducted. Patients with extrinsic compressions, other pelvic conditions, and S3V3 without S2 in SVP Classification were excluded. Patients were evaluated before and after treatment at mid-term (MT) (9.4 ± 5.1 months) and long-term (LT) (29.6 ± 6.94 months). The severity of 12 different symptoms were assessed using VAS scale (pelvic, postcoital, standing, back, hip, leg and abdominal pain; nausea frequency, urinary discomfort, sleep disturbance and dysmenorrhoea), while QoL was measured using the SF-36 questionnaire. Patient satisfaction was assessed using the Likert scale.

RESULTS: Significant reductions in all measured symptoms were observed between pre-treatment and MT and LT follow-ups (p < 0.0001). No statistically significant differences were found between MT and LT scores, indicating a sustained relief. The greatest benefits were observed in reducing daytime pelvic pain (6.25 ± 1.93 to 2.49 ± 2.47), standing (7.43 ± 1.65 to 3.41 ± 2.43) and postcoital pain (6.40 ± 2.63 to 2.54 ± 2.22). QoL scores in both physical and mental health showed statistically significant and sustained improvement after the procedure. Most patients were satisfied with the procedure (81%), with 86% willing to undergo it again and 89% to recommend it.

CONCLUSION: Embolization provides significant, sustained improvements in symptom relief while enhancing QoL in VO-CPP patients. Randomized controlled trials are needed to confirm these effects and exclude a placebo response.

PMID:41074660 | DOI:10.1080/07853890.2025.2570798

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Accessibility and acceptability of perinatal mental health services for women from ethnic minority groups: a synopsis of the PAAM study

Health Soc Care Deliv Res. 2025 Oct;13(36):1-22. doi: 10.3310/TDAS1298.

ABSTRACT

BACKGROUND: Ethnic minority women face worse maternity outcomes and increased risk of perinatal mental health issues, yet research on the accessibility and acceptability of perinatal mental health services for these groups is limited.

OBJECTIVES: (1) To explore access to and utilisation of mental health services during the perinatal period among ethnic minority women; (2) to explore care pathways to community and inpatient perinatal mental health services; (3) to explore the attitudes, experiences and service improvement suggestions of ethnic minority women with perinatal mental health problems, as well as those of their partners, family members and healthcare professionals and (4) to produce recommendations for improving clinical practice.

METHODS: Mixed-methods study was conducted during 2018-23, encompassing four studies aligned with specific aims: (1) a population-based study of 615,092 women who gave birth in National Health Services hospitals in England, using data from the National Commissioning Data Repository; (2) a retrospective evaluation of patients accessing community perinatal mental health services in Birmingham and London (n = 228) and inpatient services in Birmingham, London and Nottingham (n = 198) using an adapted World Health Organization care pathways questionnaire; (3) a qualitative study with four cohorts across England: service users (n = 37), non-users or those who disengaged (n = 23), partners/family (n = 15) and healthcare professionals (n = 24); (4) findings informed recommendations for practice improvements, coproduced with individuals with lived experience of perinatal mental illness and of being in a minoritised ethnic group. Data were analysed using quantitative and qualitative approaches.

RESULTS: Access issues to mental health services were evident for Black African, Asian and White other women compared to White British women. Variability in patient journeys to community perinatal mental health services seem to stem from service-level factors rather than patient needs. Asian patients had more emergency admissions to Mother and Baby Units, while Black patients were less likely to experience multiple services before Mother and Baby Unit admission. Barriers to access included limited service awareness, fear of child removal, stigma, remote clinical appointments and unresponsive services. Despite these challenges, many women found services helpful. Family members noted gaps in family-focused care. Recommendations for improvement include raising awareness, monitoring access for different ethnic groups and addressing concerns about child removal, with a focus on consistent care, family involvement and cultural sensitivity.

CONCLUSION: These findings shed light on health inequalities in perinatal mental health care for ethnic minority women. The results can be utilised to address existing barriers and improve outcomes for mothers, infants and families.

LIMITATIONS: Diversity within merged ethnic groups; limited sample of non-English-speaking women; reliance on self-reported measures; use of pre-COVID-19 data; under-representation of Black women who did not engage with services, and over-representation of Black and Asian patients in Birmingham and London samples in the study exploring patient pathways to Mother and Baby Units (compared to maternity population).

FUTURE WORK: Implementation of good practices in perinatal mental health care, targeted interventions to address the fear of child removal, innovative strategies to recruit Black and non-English-speaking women and exploring the experiences of ‘White other’ women.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number 17/105/14.

PMID:41074656 | DOI:10.3310/TDAS1298

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Prevalence and Risk Factors of Pediatric Neurosurgical Congenital Anomalies at Mbeya Zonal Referral Hospital, Tanzania

Birth Defects Res. 2025 Oct;117(10):e2536. doi: 10.1002/bdr2.2536.

ABSTRACT

BACKGROUND: Congenital neurosurgical anomalies, such as neural tube defects (NTDs) and hydrocephalus, are prevalent central nervous system disorders. This study investigates their prevalence and factors statistically associated with their occurrence.

METHODS: A retrospective cross-sectional study at Mbeya Zonal Referral Hospital (MZRH) from May 2023 to April 2024 included 978 patients. Data from 145 children with CNS anomalies were analyzed using Microsoft Excel and STATA-15, with binary logistic regression to identify potential risk factors associated with these conditions.

RESULTS: The prevalence of congenital neurosurgical conditions was 14.3% (145/978). Hydrocephalus occurred in 8.3% (81/978), NTDs in 5.01% (49/978), Chiari malformations in 0.92% (9/978), and encephalocele in 0.61% (6/978). Logistic regression found that folate deficiency associated with delayed antenatal care was linked to a higher likelihood of NTDs and hydrocephalus (OR 2.56, p ≤ 0.005). Other factors showing statistical associations included prematurity, low birth weight, pregnancy infections, unprescribed drug use, malnutrition, gestational diabetes, and hypertension.

CONCLUSION: Key factors statistically associated with congenital CNS anomalies in this cohort include low birth weight, prematurity, inadequate folic acid intake, gestational diabetes, maternal hypertension, and unprescribed drug use. These findings highlight the importance of early prenatal care and maternal health optimization to potentially reduce the occurrence of these anomalies.

PMID:41074652 | DOI:10.1002/bdr2.2536

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Automated MRI Segmentation of Brainstem Nuclei Critical to Consciousness

Hum Brain Mapp. 2025 Oct 1;46(14):e70357. doi: 10.1002/hbm.70357.

ABSTRACT

Although substantial progress has been made in mapping the connectivity of cortical networks responsible for conscious awareness, neuroimaging analysis of subcortical networks that modulate arousal (i.e., wakefulness) has been limited by a lack of robust segmentation procedures for ascending arousal network (AAN) nuclei in the brainstem. Automated segmentation of brainstem AAN nuclei is an essential step toward elucidating the physiology of human consciousness and the pathophysiology of disorders of consciousness. We created a probabilistic atlas of 10 AAN nuclei built on diffusion MRI scans of 5 ex vivo human brain specimens imaged at 750 μm isotropic resolution. The neuroanatomic boundaries of AAN nuclei were manually annotated with reference to 200 μm 7 Tesla MRI scans in all five specimens and nucleus-specific immunostains in two of the scanned specimens. We then developed a Bayesian segmentation algorithm that utilizes the probabilistic atlas as a generative model and automatically identifies AAN nuclei in a resolution- and contrast-adaptive manner. The segmentation method displayed high accuracy when applied to in vivo T1 MRI scans of healthy individuals and patients with traumatic brain injury, as well as high test-retest reliability across T1 and T2 MRI contrasts. Finally, we show through classification and correlation assessments that the algorithm can detect volumetric changes and differences in magnetic susceptibility within AAN nuclei in patients with Alzheimer’s disease and traumatic coma, respectively. We release the probabilistic atlas and Bayesian segmentation tool to advance the study of human consciousness and its disorders. Trial Registration: ClinicalTrials.gov: NCT03504709.

PMID:41074651 | DOI:10.1002/hbm.70357

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Robot-Assisted, Conventional Fluoroscopy (C-Arm), O-Arm Navigation, and Freehand Pedicle Screw Fixation in Thoracolumbar Spine Fracture Surgery: A Network Meta-Analysis

Orthop Surg. 2025 Oct 11. doi: 10.1111/os.70189. Online ahead of print.

ABSTRACT

Thoracolumbar fractures are a prevalent clinical disease, with several surgical techniques, including traditional freehand pedicle screw fixation (TFPSF), conventional fluoroscopy (C-arm) percutaneous pedicle screw fixation (CPPSF), O-arm-assisted percutaneous pedicle screw fixation (OPPSF), and robot-assisted percutaneous pedicle screw fixation (RPPSF), being currently applied. However, a comprehensive comparison of their relative efficacy across multiple perioperative and functional outcomes is lacking, leading to uncertainty in optimal technique selection. This network meta-analysis (NMA) evaluates and compares the clinical efficacy of these four surgical techniques to identify the most effective intervention and guide clinical decision-making. Researchers independently searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published before September 20, 2024. Studies were selected based on stringent eligibility criteria. Randomized controlled trials (RCTs) were assessed using RoB 2.0, while cohort studies were evaluated with the Newcastle-Ottawa Scale (NOS). After data extraction, Bayesian network analysis was executed using R 4.2.2 and Stata 16.0. Nineteen studies were included, encompassing 1344 patients with thoracolumbar fractures. For screw accuracy, OPPSF ranked highest (SUCRA = 92.7%), significantly outperforming TFPSF (RR 1.12; 95% credible intervals [CrI] [1.04, 1.23]) and CPPSF (RR 1.12; 95% CrI [1.04, 1.22]), with RPPSF also surpassing both. OPPSF showed superior intraoperative blood loss reduction (SUCRA = 79.8%) while TFPSF had significantly more bleeding than others. For hospitalization, RPPSF ranked highest (SUCRA = 65.0%) but CPPSF significantly shortened stays versus TFPSF (MD -2.24; 95% CrI [-4.48, -0.03]). CPPSF also showed better pain control (SUCRA = 77.9%) with significantly lower VAS scores versus TFPSF (MD -1.02; 95% CrI [-1.71, -0.37]). RPPSF demonstrated the lowest complication risk (SUCRA = 94.9%), with both CPPSF and RPPSF showing significant reductions versus TFPSF. Additionally, although CPPSF ranked first in SUCRA for both operative time (SUCRA = 81.6%) and Cobb angle (SUCRA = 72.4%), the pairwise comparisons did not demonstrate statistical significance, necessitating cautious interpretation. In summary, OPPSF tends to demonstrate superior precision and blood loss control, CPPSF may optimize rehabilitation efficiency, while RPPSF appears to be the safest technique. Technique selection should balance clinical outcomes, economic feasibility, and patient-specific priorities.

PMID:41074646 | DOI:10.1111/os.70189

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Impact of a Standardised Nurse-Driven Bowel Regimen on Bowel Frequency in Critically Ill Patients

Nurs Crit Care. 2025 Nov;30(6):e70207. doi: 10.1111/nicc.70207.

ABSTRACT

BACKGROUND: Critically ill patients are at an increased risk of constipation due to inadequate nutrition, prolonged immobility and opioid use. Constipation may increase intensive care unit (ICU) and hospital length of stay (LOS) and intra-abdominal infections.

AIM: To determine the impact of a nurse-driven bowel protocol on constipation in ICU patients.

STUDY DESIGN: This is a retrospective before-after cohort study of ICU patients between July 2019 and February 2020 and July 2023 and February 2024. Patients were divided into a bowel protocol and a no bowel protocol group. The primary outcome was constipation for > 72 h at any point during ICU admission. Key secondary outcomes included constipation for > 6 days during ICU admission, ICU and hospital LOS and incidence of diarrhoea.

RESULTS: A total of 116 patients were included, with 58 patients in each group. Patients in the bowel protocol group had a higher Simplified Acute Physiology Score II (SAPS II) score (52 vs. 48, p = 0.05) and lower rates of acute hypoxic respiratory failure (60% vs. 79%, p = 0.03). The primary outcome of constipation for > 72 h during ICU stay did not differ significantly between groups (79% vs. 78%, p = 0.82). Patients in the bowel protocol group had lower rates of constipation for > 6 days, (18% vs. 44%, p = 0.043), which remained significant after adjusting for covariates including morphine milligram equivalents (MMEs), SAPS II score and age (OR 0.30, p = 0.047, 95% CI [0.09-0.98]). No differences were seen in other secondary outcomes.

CONCLUSIONS: Patients receiving the bowel protocol experienced no difference in constipation but were less likely to have prolonged constipation (> 6 days) in the ICU.

RELEVANCE TO CLINICAL PRACTICE: Nurse-driven bowel protocols may decrease constipation in ICU patients.

PMID:41074640 | DOI:10.1111/nicc.70207

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Assessing Influenza and SARS-CoV-2 Coinfection in Brazil: A Comprehensive Study of Patient Outcomes From 2020 to 2023

J Med Virol. 2025 Oct;97(10):e70639. doi: 10.1002/jmv.70639.

ABSTRACT

Influenza and SARS-CoV-2 are major respiratory pathogens that have impacted global health, sharing similar transmission routes and clinical symptoms. The COVID-19 pandemic brought attention to coinfection with these viruses, which has been associated with worse clinical outcomes, but the full extent of this impact remains underexplored. As both viruses circulate together during seasonal outbreaks, understanding their coinfection dynamics is crucial for public health response. This retrospective observational study analyzed data from over 30 000 hospitalized patients sourced from the Brazilian Epidemiological Surveillance System (SIVEP-Gripe). Patients were classified into two groups: influenza mono-infection and influenza-SARS-CoV-2 coinfection. Descriptive statistics and multivariate logistic regression were performed to evaluate associations with primary (mortality) and secondary (ICU admission) outcomes. Among approximately 3.7 million reported severe acute respiratory syndrome cases, 35 831 were influenza-infected, with 1763 (4.9%) coinfected with SARS-CoV-2. Coinfected patients exhibited nearly double the risk of death (aOR: 1.87, 95% CI: 1.52-2.30) and a significantly higher likelihood of ICU admission (aOR: 1.27, 95% CI: 1.07-1.52), compared to those with influenza alone. Coinfected patients also presented with more severe respiratory symptoms and longer hospital stays. Coinfection with influenza and SARS-CoV-2 is associated with significantly worse clinical outcomes, including higher mortality and increased need for intensive care. Early identification and tailored management strategies for coinfected patients are essential to improving patient outcomes, particularly for those with underlying comorbidities.

PMID:41074627 | DOI:10.1002/jmv.70639