Tag: pubmed

J Conserv Dent Endod. 2025 Mar;28(3):231-236. doi: 10.4103/JCDE.JCDE_842_24. Epub 2025 Mar 3.

ABSTRACT

CONTEXT: The removal of intracanal medicament is essential for sealer penetration and the success of endodontic therapy.

AIMS: To evaluate and compare the dentinal tubule penetration of a silicone-based endodontic sealer following N-acetyl cysteine (NAC) intracanal medicament removal using ultrasonic agitation and laser-activated irrigation.

MATERIALS AND METHODS: Eighty-one extracted single-rooted mandibular premolars were decoronated and prepared with ProTaper Universal rotary files up to MAF F3. To prepare medicament, NAC powder was mixed with propylene glycol in the ratio of 1:1, placed using a size #30 Lentulospiral, and specimens stored in an incubator for 14 days. The specimens were then instrumented with #30 Hedström and divided into three groups according to final irrigant activation techniques: Group I: Diode laser activation, Group II: Passive Ultrasonic agitation, Group III: No agitation (positive control). Canals were obturated with GuttaFlow bioseal sealer mixed with 0.1% Rhodamine B dye and gutta-percha cones and incubated for 7 days. The specimens were sectioned horizontally to obtain 1 mm thick sections from 2, 5, and 8 mm from the apex. Sections were examined under Confocal Laser Scanning Microscope to measure the depth of sealer penetration (in µm).

STATISTICAL ANALYSIS: One-way analysis of variance and Tukeys multiple post hoc test.

RESULTS: The highest mean depth of penetration of 728.52 µm was seen with Group I, followed by Group II and least was seen in Group III.

CONCLUSIONS: Diode laser activation group was most effective in the removal of NAC intracanal medicament from all the three regions of the root canal.

PMID:40256695 | PMC:PMC12007743 | DOI:10.4103/JCDE.JCDE_842_24

J Conserv Dent Endod. 2025 Mar;28(3):258-263. doi: 10.4103/JCDE.JCDE_833_24. Epub 2025 Mar 3.

ABSTRACT

AIMS: The study aimed to assess and compare the cavity disinfection efficacy of 2% chlorhexidine, 940 nm diode laser, and photodynamic therapy (PDT) with Rose Bengal-functionalized chitosan nanoparticles (CS-NPs) in deep carious lesions.

SETTINGS AND DESIGN: This randomized controlled, parallel clinical trial was conducted in the Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Ahmedabad. A simple randomization technique was used for randomization of samples. A total of 90 patients participated in this study.

SUBJECTS AND METHODS: Ninety participants with reversible pulpitis were randomly assigned to three groups, each receiving a different cavity disinfectant: 2% chlorhexidine, 940 nm diode laser, and PDT with Rose Bengal-functionalized CS-NPs. Dentinal samples were collected before and after cavity disinfection, and microbiological analysis for total viable count (TVC), Streptococcus mutans, and Lactobacillus count was conducted. Clinical and radiographic evaluation was done at 1 and 6 months.

STATISTICAL ANALYSIS USED: Statistical analysis involved the Wilcoxon signed-rank, Kruskal-Wallis, and Tukey’s tests.

RESULTS: Intragroup comparison showed high significant reductions in TVC, S. mutans, and Lactobacillus count in all the groups. The Kruskal-Wallis test revealed that the chlorhexidine group had the greatest reduction in bacterial counts, followed by PDT and diode laser groups. No differences in clinical success rates were observed among the three groups up to 6-month follow-up.

CONCLUSIONS: All three cavity disinfectants significantly reduced total vital count, S. mutans, and Lactobacillus count. However, chlorhexidine showed the best results.

PMID:40256694 | PMC:PMC12007745 | DOI:10.4103/JCDE.JCDE_833_24

Int J Geriatr Psychiatry. 2025 Apr;40(4):e70079. doi: 10.1002/gps.70079.

ABSTRACT

OBJECTIVE: This study aims to describe the clinical and social determinants associated with delirium in elderly patients hospitalized in the geriatrics department of Hospital Universitario San Ignacio (HUSI), in Bogotá, Colombia, between June 2019 and June 2022.

METHODS: We conducted a retrospective analytical study. Data were extracted from the hospital’s electronic medical records. The primary outcome was delirium upon admission. Exposure variables included clinical (e.g., malnutrition, dementia, oropharyngeal dysphagia) and social factors (e.g., living alone, social networks). Associations between delirium and exposure variables were assessed using a multivariate logistic regression model.

RESULTS: The studied cohort comprised 4601 patients, mean age of 83.93 years and 56.26% were women. The prevalence of delirium upon admission was 22.39%. Key factors associated with delirium included older age (OR 1.04, 95% CI 1.01-1.06), malnutrition (OR 2.42, 95% CI 1.93-2.79), dementia (OR 2.57, 95% CI 2.02-3.38), functional impairment (OR 2.50, 95% CI 1.74-3.59), and oropharyngeal dysphagia (OR 1.49, 95% CI 1.08-1.99). Social determinants such as female sex, limited social networks, living alone, and enrollment in the subsidized health regime were not significantly associated with delirium.

CONCLUSION: Delirium upon admission is highly prevalent among elderly inpatients and is associated with clinical factors, particularly malnutrition, dementia, and oropharyngeal dysphagia. Although no significant associations were found between social determinants of health (SDH) and delirium in this cohort, further research in diverse healthcare settings is needed to better understand the broader impact of SDH on delirium risk.

PMID:40254716 | DOI:10.1002/gps.70079

Sci Rep. 2025 Apr 21;15(1):13652. doi: 10.1038/s41598-025-98632-6.

ABSTRACT

We evaluated the reliability and validity of the Korean translation of the quality of oncology nursing care scale (K-QONCS) and verified its suitability as a tool to assess the quality of cancer patient care in Korea. To validate the content validity of the K-QONCS, five oncology nurse experts assessed the suitability of the adapted tools. Exploratory factor analysis (EFA) was used to assess construct, convergent, discriminant, and criterion validity. A survey of 235 adults aged > 18 years who had been diagnosed with cancer and were receiving treatment was conducted to validate the K-QONCS. The QONCS was translated and appropriately modified to reflect expert opinion, and its content validity was confirmed to be high through indicators such as item-level content validity index, scale-level content validity index using an averaging calculation (S-CVI/Ave), and S-CVI/universal agreement. Eight factors were derived by EFA; each factor reflected different aspects of quality of care. The scale exhibited convergent and discriminant validity, demonstrated by multitrait-multimethod matrix analysis and correlation analysis with the Nursing Satisfaction Scale. The Cronbach’s alpha coefficient was 0.92, indicating high overall internal consistency. We demonstrated the reliability and feasibility of the K-QONCS. The K-QONCS may help oncology nurses to improve patient care experiences and outcomes as well as advance oncology nursing practices in South Korea.

PMID:40254715 | DOI:10.1038/s41598-025-98632-6

Int J Legal Med. 2025 Apr 21. doi: 10.1007/s00414-025-03496-0. Online ahead of print.

ABSTRACT

The Suchey-Brooks (S-B) standard is one of the most frequently applied approaches for age-at-death estimation in modern forensic practice. However, classification accuracy is known to vary across different populations. At present, there is a paucity of research related to the assessment of biological attributes in Indonesia, particularly the estimation of age-at-death. The use of computed tomography (CT) in S-B phase assignments has been validated in the literature. In considering further validating the use of CT, transition analysis (TA), and Bayesian statistics in age-at-death estimation, this study evaluated the accuracy of the S-B standard on a sample obtained from Indonesia. TA and Bayesian statistics are incorporated to address methodological issues such as age mimicry. A total of 378 multi-slice CT scans were analysed in OsiriX^®. TA and Bayesian statistics were used to derive age-at-death estimation models. Overall bias values were at – 6.0 years for females and – 13.1 years for males, while inaccuracy was at 9.6 years for females and 14.6 years for males. When applying the original S-B age ranges, 92.0% of females and 73.3% of males were correctly classified. Likewise, mean ages per S-B phase were higher in the Indonesian sample, except for females assigned to Phase VI. TA and Bayesian statistics derived age-at-death distribution models specific to the Indonesian population. The dissemination of an appropriate age-at-death estimation standard in the literature is of considerable benefit to casework conducted domestically in Indonesia, and also serves to further inform aspects of general forensic practice globally.

PMID:40254709 | DOI:10.1007/s00414-025-03496-0

Clin Transl Oncol. 2025 Apr 21. doi: 10.1007/s12094-025-03919-9. Online ahead of print.

ABSTRACT

BACKGROUND: The research activity is fundamental to improve knowledge in Medicine. In the setting of clinical oncology, radiotherapy (RT) represents a cornerstone for patients treated with curative intent.

PURPOSE: The aim of this snapshot was to investigate the number and the characteristics of clinical trials currently ongoing in the Lombardy (Italy) RT divisions highlighting involved resources and eventual needs to improve the process of study activation.

METHODS: In April 2024, a survey composed of two parts, a snapshot of clinical and research activity and a database to report data on ongoing clinical trials, was proposed to the 30 RT centers in Lombardy. The snapshot consisted of 19 short answer questions.

RESULTS: A total of 26 (87%) centers answered the survey. The total number of active studies was 161. The median age among principal investigators was 51 years. Most studies were multicentric (61%) national (76%). Among 72 studies with available phase, 43% resulted phase III studies. Fifty-three (33%) studies were sponsored. IRCCS (Istituti di Ricovero e Cura a carattere scientifico) RT have a median of 11 active studies vs versus 6 in non-IRCCS structures. More resources are available in IRCCS centers compared to non-IRCCS: data management service 50% vs 25%, dedicated scientific nurses 20% vs 0%, clinical statistics services 60% vs 25%. The main difficulties in conducting clinical trials were bureaucratic difficulties with ethics committees (5 centers), time constraints (5 centers), and a lack of resources and staff (15 centers). The most frequently (58% of the centers) proposed solution was an increase in resources and staff.

CONCLUSION: While the RT centers in Lombardy demonstrate a commendable commitment to clinical research, disparities in resources and infrastructure remain significantly challenging.

PMID:40254696 | DOI:10.1007/s12094-025-03919-9

Emerg Radiol. 2025 Apr 21. doi: 10.1007/s10140-025-02344-3. Online ahead of print.

ABSTRACT

PURPOSE: Artificial Intelligence (AI) algorithms in radiology are currently deployed as tools to augment radiologists rather than autonomous readers. An augmentative tool should improve performance above and beyond the baseline performance achieved by the user alone. We conducted a meta-analysis to elucidate the added value of augmentative AI to radiologists for detecting Pulmonary Embolism (PE) on CT scan.

METHODS: Using PRISMA guidelines, studies in which both AI and Human Interpreter (HI) assessed CT scans for pulmonary emboli were selected. Data extracted from these studies were used to compare diagnostic performance of AI and HI with an emphasis on the performance of AI above and beyond that of HI.

RESULTS: Both HI and AI performed similarly with no statistically significant difference in the pooled estimates of sensitivity, specificity, PPV, NPV and accuracy. Subsequent analysis focusing on the differences between performance of AI and HI within each study, followed by pooled estimate, also did not demonstrate any significant difference (p < 0.05).

CONCLUSIONS: In a meta-analysis of nearly sixteen thousand CTs, AI and HI had similar performance for detection of pulmonary emboli. On one hand, this buttresses AI’s use for triaging and for second reads. On the other hand, the outcomes may or may not be different when AI is added-on. The findings of this meta-analysis can be used to re-examine the use-scenarios of AI and to re-calibrate its value proposition.

PMID:40254693 | DOI:10.1007/s10140-025-02344-3

Emerg Radiol. 2025 Apr 21. doi: 10.1007/s10140-025-02340-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study explored POCUS knowledge, attitudes, confidence, barriers, enablers, and their associated factors among radiologists and emergency physicians in Jordan.

METHODS: A cross-sectional questionnaire-based study covered five sections: socio-demographics, knowledge, attitude, confidence, and barriers and enablers. Summary statistics, correlation, and regression analyses were performed.

RESULTS: A total of 164 physicians participated, with an average age of 33.8 (± 7.69) years; 52.4% were radiologists and 47.6% were emergency physicians. Participants exhibited good knowledge, attitudes, and confidence. Higher attitude scores (β = 0.28; p < 0.001) and having a POCUS machine (β = 1.70; p = 0.01) were associated with higher knowledge. Higher knowledge (β = 0.64; p < 0.001) predicted better attitudes, while attitude (β = 0.21; p = 0.01), specialty radiologist (β = 8.5; p < 0.001), age (β = 0.23; p < 0.001), and number of monthly scans (β = 0.01; p = 0.01) predicted confidence.

CONCLUSION: Radiologists and emergency physicians in Jordan demonstrated good POCUS knowledge, attitudes, and confidence. Specialty and usage frequency influenced these factors. Future studies should explore training effects on skill acquisition. The study found different factors that are associated with knowledge, attitude, and confidence levels such as specialty, frequency of using POCUS, and the levels of knowledge, attitude and confidence. Future studies, including large prospective studies and/or experimental studies that examine the effect of training on skill acquisition among various healthcare professionals are warranted.

PMID:40254692 | DOI:10.1007/s10140-025-02340-7

Neurol Sci. 2025 Apr 21. doi: 10.1007/s10072-025-08183-x. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic unilateral vestibulopathy (CUVP) is one of the most common causes of chronic dizziness/vertigo. The brain functional mechanisms of CUVP are currently unclear. The study aimed to clarify changes in brain topological properties and subnetwork functional connectivity in CUVP patients, elucidating the neural mechanisms behind their poor dynamic compensation.

METHODS: A total of 44 participants were included (22 CUVP patients and 22 age- and sex-matched healthy controls). Resting-state functional MRI was performed on all subjects. Network-Based Statistics (NBS) analysis was conducted to identify abnormal neural circuits in CUVP. Graph-theoretical analysis (GTA) was performed to elucidate changes in brain network topological properties. Correlation analysis was conducted to examine the relationship between brain network changes and clinical symptom severity.

RESULTS: NBS analysis revealed an abnormal neural network in CUVP patients, with key nodes including the parieto-insular vestibular cortex, sensory-motor cortex, occipital visual cortex, brainstem, and cerebellum. The most significant functional connectivity abnormalities were observed between the brainstem and visual/sensorimotor networks. Graph-theoretical analysis indicated increased characteristic path length, decreased global and local efficiency in CUVP patients. Node properties showed reduced node efficiency and clustering coefficients in multiple nodes within the visual and sensorimotor networks. Correlation analysis indicated that brain network topology and changes in brainstem-sensorimotor network connectivity were negatively correlated with DHI scores.

CONCLUSION: CUVP patients exhibit multisensory integration abnormalities and changes in brain network topology at both the brainstem/cerebellar and cortical levels, which may underlie the potential neural basis for poor vestibular compensation in CUVP patients.

PMID:40254685 | DOI:10.1007/s10072-025-08183-x

Clin Exp Med. 2025 Apr 21;25(1):121. doi: 10.1007/s10238-025-01650-x.

ABSTRACT

This study aims to evaluate the utility of gastric ultrasound in assessing gastric emptying dysfunction in patients with hepatitis B cirrhosis and its correlation with alterations in portal venous flow and liver stiffness. Gastric motility and emptying parameters, portal venous flow parameters, and liver stiffness were measured by ultrasound in 42 patients with hepatitis B cirrhosis and 48 healthy controls. Statistical analysis was performed to compare the differences in these parameters between the two groups and to analyze the correlation between gastric ultrasound parameters and alternations in portal venous blood flow and liver stiffness. Firstly, the Gastric Motility Index was significantly lower in the experimental group than in the control group, while other gastric ultrasound parameters were significantly higher (p < 0.01). Secondly, measurements obtained from two-dimensional ultrasound, Color Doppler Flow Imaging, and two-dimensional Shear Wave Elastography revealed that Portal Vein Diameter (PVD) and Liver Stiffness (LS) were significantly higher in the experimental group compared to the control group, while the maximum portal vein velocity (PVmax) was significantly lower (p < 0.01). Finally, correlation analysis demonstrated that gastric ultrasound parameters correlated with PVD, PVmax, and LS. Gastric function is significantly impaired in patients with hepatitis B cirrhosis compared to controls, and gastric ultrasound parameters demonstrate a notable correlation with PVD, PVmax, and LS. Gastric ultrasound effectively evaluates gastric motility and emptying function in these patients, offering a reliable foundation for clinical diagnosis and management.

PMID:40254679 | DOI:10.1007/s10238-025-01650-x