Nevin Manimala

J Periodontol. 2026 Feb 7. doi: 10.1002/jper.70072. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to perform a prediction model validation for furcation involvement (FI) risk in molars receiving a new fixed prosthesis (FP) using a unique cohort assessed at three time points.

METHODS: Following the Oral Health Statistical (OHStat) reporting guidelines, this cohort study examined 181 patients (203 molars) from 2018-2023. Teeth without FI were followed longitudinally post-crown placement at 1- (T1), 3- (T2), and 5-years (T3). A logistic regression model was built in order to predict FI and the related performance was assessed through metrics like AUC, sensitivity, specificity, and calibration.

RESULTS: FI was observed in 4.43% of teeth at 1 year, increasing to 21.67% at 3 years and 28.57% at 5 years. Univariate analysis revealed significant predictors at 3-5 years: a history of periodontitis was associated with higher FI risk at 5 years (RR = 3.56, p = 0.024), with advanced stages also increasing risk-stage III: RR = 2.59 at 3 years and RR = 3.32 at 5 years; stage IV: RR = 3.76 at 3 years and RR = 3.75 at 5 years. Short root trunks significantly increased FI risk across all intervals (1 year: RR = 3.96; 3 years: RR = 6.08; 5 years: RR = 4.75). Medium trunks did not differ significantly from long trunks. The predictive model performed best at 3 years (AUC = 0.81, sensitivity = 0.79, specificity = 0.87) and remained robust at 5 years (AUC = 0.76, sensitivity = 0.69, specificity = 0.90).

CONCLUSION: The predictive model demonstrated high accuracy with a substantial ability to identify FI cases over time. Clinicians should consider such an assessment before crown or bridge restoration, with particular caution in patients with periodontitis.

PMID:41653409 | DOI:10.1002/jper.70072

Aging Clin Exp Res. 2026 Feb 7. doi: 10.1007/s40520-026-03336-0. Online ahead of print.

ABSTRACT

BACKGROUND: Low back pain (LBP) is a global health problem that contributes to disability, psychological distress, and reduced quality of life in older adults. Current treatment guidelines for LBP support the use of conservative therapies such as physical therapy alongside medication management. However, interventional pain management strategies for LBP such as lumbar epidural steroid injection (LESI) are rarely mentioned.

AIMS: We conducted this systematic review to characterize and evaluate the use and effectiveness of LESI amongst older adults with LBP.

METHODS: We conducted a systematic English-language literature search of Ovid MEDLINE, Ovid EMBASE, and Cochrane Library. We used an iterative approach to identify both keywords and controlled vocabulary related to treatment outcomes of epidural interventions for LBP among older adults. The results were reviewed by three members of the team.

RESULTS: Our search of 3 databases produced a total of 2657 studies and 12 met final inclusion criteria. In all studies, the use of LESI was associated with improvement in pain and/or quality of life.

DISCUSSION: As compared to medication management, LESI was associated with statistically significant improvements in pain and functional status. The addition of physical therapy was not superior to LESI alone.

CONCLUSIONS: This systematic review is the first that focuses on the effectiveness of LESI in managing LBP in older adults. This review suggests that LESI may reduce pain and improve functional status in older adults, particularly as compared to medication management.

PROSPERO REGISTRATION: The study was prospectively registered on Prospero (ID # 422087).

CLINICAL TRIAL NUMBER: Not Applicable.

PMID:41653389 | DOI:10.1007/s40520-026-03336-0

Clin Exp Med. 2026 Feb 7. doi: 10.1007/s10238-026-02065-y. Online ahead of print.

NO ABSTRACT

PMID:41653319 | DOI:10.1007/s10238-026-02065-y

Eur J Pediatr. 2026 Feb 7;185(2):125. doi: 10.1007/s00431-026-06775-z.

ABSTRACT

The aim of this study was to assess the impact of caffeine and other methylxanthines on bronchiolitis-related apnea (BRA) in infants under 12 months of age, through a systematic review and meta-analysis. The review was conducted in accordance with the PRISMA guidelines. Inclusion criteria were studies published from January 1990 to August 2023, in English or French, and involving children from 35 weeks’ gestational age to 1 year with BRA. Relevant articles were selected and data extracted by 2 members of the blinded investigative team. Four hundred sixty-nine articles were retrieved. Eleven studies conducted in Europe and North America were considered in the systematic review. Six studies were used in the meta-analysis. The meta-analysis showed no positive impact of caffeine on the length of non-invasive ventilation (mean difference = – 0.26 days, 95% CI [- 1.71; 1.20], p = 0.53), invasive ventilation requirement (mean difference = – 0.05 [- 0.24; 0.13], p = 0.44), or length of pediatric intensive care unit and hospital stay (mean difference = – 0.62 days, 95% CI [- 9.31; 8.07], p = 0.79; mean difference = 1.60 days, 95% CI [- 3.65; 6.85], p = 0.32, respectively). However, caffeine was associated with a trend towards a decrease in the total length of respiratory support (mean difference = – 2.63 days, 95% CI [- 5.61; 0.34], p = 0.06).

CONCLUSION: This study highlights the ongoing debate surrounding the role of caffeine and other methylxanthines in BRA. The general paucity of literature, its low level of quality, the heterogeneity of results, different caffeine regimens, and population definition greatly impaired the quality of the conclusions. However, by identifying gaps in the literature, this study helps build a framework for future trials.

WHAT IS KNOWN: • Apnea is a recognized complication of bronchiolitis in infants, particularly in those born preterm or at a young corrected age, and may necessitate intensive respiratory support. • While caffeine is a cornerstone therapy for apnea of prematurity, evidence supporting its use in bronchiolitis-related apnea (BRA) remains limited and inconclusive.

WHAT IS NEW: • This is the first systematic review with meta-analysis evaluating caffeine in BRA, showing no significant improvement in major clinical outcomes, but suggesting a possible reduction in overall respiratory support duration. • The study identifies critical methodological limitations in the existing literature, including heterogeneous apnea definitions and non-standardized caffeine dosing, and proposes a framework for future controlled studies.

PMID:41653310 | DOI:10.1007/s00431-026-06775-z

Naunyn Schmiedebergs Arch Pharmacol. 2026 Feb 7. doi: 10.1007/s00210-026-05077-3. Online ahead of print.

ABSTRACT

Despite the rising burden of hypertension (HTN) across Africa, the rate of blood pressure (BP) control among hypertensive patients remains unacceptably low. One of the key contributors to this treatment gap is therapeutic inertia (TI) the failure to initiate or intensify therapy when clinically indicated. However, evidence on the magnitude and determinants of TI in Ethiopia remains scarce. Objective: To assess the prevalence of therapeutic inertia and identify associated factors among hypertensive patients attending the outpatient department of Wolaita Sodo University Comprehensive Specialized Hospital. A hospital-based cross-sectional study was conducted among 189 hypertensive patients from August to November 2023. Participants were selected through consecutive sampling. Data were collected via interviews with patients and physicians, along with a review of medical charts. Descriptive statistics (frequencies, percentages, means ± SD, and medians with interquartile ranges) were used to summarize patient characteristics. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with TI. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Of the 189 patients, 50.8% were male, with a mean age of 53.8 years. The prevalence of therapeutic inertia was 58.7% (95% CI: 52.3%-65.4%). Factors significantly associated with lower odds of TI included treatment with amlodipine (AOR = 0.137; 95% CI: 0.019-0.975), use of NPH insulin (AOR = 0.174; 95% CI: 0.036-0.833), and higher diastolic BP readings (AOR = 0.910; 95% CI: 0.839-0.986). In contrast, physician-reported reasons for not intensifying treatment such as “BP being close to the target value” (AOR = 6.074; 95% CI: 1.315-28.060) and “concerns about patient adherence” (AOR = 5.487; 95% CI: 1.061-28.362) were positively associated with TI. Therapeutic inertia was observed in nearly 6 out of 10 cases of uncontrolled hypertension in this setting, highlighting a significant gap in clinical decision-making. Addressing therapeutic inertia through improved adherence to hypertension treatment guidelines and strengthened physician education may help improve blood pressure control in similar settings. Stakeholders should implement systems that support timely treatment intensification and encourage adherence to evidence-based management strategies.

PMID:41653282 | DOI:10.1007/s00210-026-05077-3

Environ Monit Assess. 2026 Feb 7;198(2):213. doi: 10.1007/s10661-026-15042-5.

ABSTRACT

Springs in the Sirmaur district of the North-Western Himalayas are vital freshwater sources; however, systematic, multi-seasonal data on their physicochemical quality, trace metal concentrations, and land use influences remain scarce. Thirty springs were assessed over 2 years (2021-2023) for physicochemical and heavy metal parameters, seasonal variations, and land use impacts using multivariate statistical methods. Water was neutral to mildly alkaline (pH 6.97-8.06) with moderate mineralization. Calcium and magnesium occasionally exceeded BIS standards, reflecting geogenic inputs from carbonate- and dolomite-rich formations. Lead exceeded permissible limits in both pre- and post-monsoon seasons (up to 0.0163 mg L⁻¹), and iron exceeded limits during pre-monsoon (up to 0.3004 mg L⁻¹), indicating localized anthropogenic and lithological influences. Water Quality Index (WQI) classified overall quality as “Good” (pre-monsoon 36.26; post-monsoon 37.63), with forested catchments consistently superior. A significant difference (p < 0.05) between agricultural and settlement springs during pre-monsoon indicates enhanced contaminant transport under low-flow conditions. Spearman correlation showed positive associations between pH and Ca, Zn, and Mn, reflecting mineral weathering. Principal component analysis (PCA) distinguished regional geogenic controls from site-specific anomalies shaped by land use and lithology. The study provides a comprehensive, data-driven understanding of spring water quality dynamics, offering insights for springshed management, pollution mitigation, and sustainable water resource planning in Himalayan headwaters.

PMID:41653254 | DOI:10.1007/s10661-026-15042-5

Hum Genet. 2026 Feb 7;145(1):19. doi: 10.1007/s00439-025-02799-x.

ABSTRACT

Most existing genotype-by-environment interaction (G×E) methods assume a known causal direction as an assumption that often does not hold and can lead to biased estimates and spurious findings. To address this, we introduce the Genetic Causality Inference Model (GCIM), a novel approach designed to infer causal directions in G×E studies. GCIM integrates polygenic risk scores (PRS) for both the exposure and the outcome to strengthen causal inference and reduce spurious interaction signals. We evaluated GCIM using simulated data across varying genetic and residual correlation settings and compared its performance to existing PRS-by-environment (PRS×E) models under both null and alternative G×E scenarios. GCIM was also applied to real-world UK Biobank data in both causal directions. GCIM consistently outperformed existing methods by accurately identifying the absence of G×E variance and avoiding false positives, even in the presence of strong phenotypic heteroscedasticity due to residual heterogeneity. Other methods often generated spurious associations, especially under reverse causality. Applying GCIM to UK Biobank data, we investigated 11 circulating biomarkers (including liver enzymes, lipids, and inflammatory markers) and three anthropometric traits (BMI, body fat, and waist-to-hip ratio [WHR]). GCIM identified that bilirubin modulates genetic effects on BMI and WHR, while body fat modulates genetic effects on C-reactive protein, with associations remaining significant after multiple testing corrections. Overall, GCIM provides a more reliable framework for GxE analysis, particularly under challenging conditions such as residual heterogeneity and uncertain causal direction. However, further development is needed to improve its statistical power.

PMID:41653245 | DOI:10.1007/s00439-025-02799-x

Child Psychiatry Hum Dev. 2026 Feb 7. doi: 10.1007/s10578-026-01973-0. Online ahead of print.

ABSTRACT

Children victimized by their peers and those with sleep disturbances are at risk for developing an array of difficulties and disorders. While there is some evidence suggesting that sleep impacts peer victimization and peer victimization results in sleep disturbance, the longitudinal bidirectional associations between peer victimization and sleep disturbance have been understudied, particularly in late childhood. Further, gender differences in these associations are largely unknown. To further understand these links, 175 children (ages 8-11, M = 9.30, 51.4% girls) in grades 3-5 completed measures of peer victimization and sleep disturbance. Physical victimization at Time 1 significantly predicted sleep disturbance 6 months later at Time 2, while sleep disturbance at Time 1 showed a marginally statistically significant association with later physical victimization 6 months later, suggesting a potential bidirectional relationship. Relational victimization was not longitudinally related to sleep or vice versa. Results also suggest similar effects for boys and girls. Implications of these findings are offered.

PMID:41653244 | DOI:10.1007/s10578-026-01973-0

Child Psychiatry Hum Dev. 2026 Feb 7. doi: 10.1007/s10578-026-01969-w. Online ahead of print.

ABSTRACT

The School Anxiety Scale – Teacher Report (SAS-TR) assesses children’s anxiety from the teacher’s perspective. Originally developed in English and subsequently validated in Spanish and Iranian populations, a validated Italian version is still lacking. The current study aimed to translate, adapt and validate the SAS-TR into Italian. The SAS-TR was translated from English into Italian following 5 stages of cross-cultural adaptation and was assessed for face and content validity by five primary school teachers. A sample of 66 teachers completed the SAS-TR in a community sample of 201 children aged 6-11 years. Exploratory and confirmatory factor analysis were performed. To investigate the concurrent validity, teachers also completed the Strengths and Difficulties Questionnaire-Teacher (SDQ-T). After four weeks, the teachers re-provided ratings on the SAS-TR to assess test-retest reliability. SAS-TR ratings for the same children provided by permanent teachers (who have ≥ 10 teaching hours in classroom) and specialist teachers (who have < 10 teaching hours in classroom) were compared. Exploratory and confirmatory factor analysis confirmed the two-factor structure and the goodness fit of the scale, excluding item 12. The Italian SAS-TR exhibited strong face and content validity (mean = 3.71 ± 0.57), excellent internal consistency (α = 0.902) and almost perfect test-retest reliability over 4-weeks (ICC = 0.829). Additionally, moderate and statistically significant correlations between SAS-TR and SDQ-T “Emotional symptoms” subscale (ρ_s = 0.62) supported concurrent validity. Finally, permanent teachers reported higher levels of anxiety symptoms compared to specialist teachers (p < 0.05). Overall, the Italian version of SAS-TR demonstrates adequate psychometric properties, suggesting its suitability for assessing anxiety symptoms in children aged 6-11 by teachers.

PMID:41653243 | DOI:10.1007/s10578-026-01969-w

Int Orthop. 2026 Feb 7. doi: 10.1007/s00264-026-06740-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Despite its clinical importance, nationwide data on long-term hospitalization and surgical management trends in Germany remain scarce.

METHODS: A retrospective analysis was conducted using the German Federal Statistical Office’s hospital discharge database covering all inpatient cases with the primary diagnosis of DCM (ICD-10-GM code M50.0) from 2005 to 2024. Annual case numbers, age and sex distributions, and surgical procedures were analyzed descriptively. Hospitalization rates per 100,000 inhabitants were calculated using mid-year population data.

RESULTS: Between 2005 and 2024, approximately 70,000 hospital discharges with a primary diagnosis of DCM were recorded in Germany. Annual hospitalizations increased from 2,477 cases in 2005 to a peak of 4,076 cases in 2015, followed by a decline to 3,037 cases in 2024. Corresponding hospitalization rates rose from 3.0 to 4.96 per 100,000 inhabitants before decreasing to 3.7 per 100,000 in 2024. Segmented Poisson regression demonstrated a significant increase until 2015 followed by a significant decline thereafter. Age-specific analyses demonstrated a stable predominance of middle-aged and older adults, with consistently highest hospitalization volumes in patients aged 50-70 years. After age standardization to the 2015 reference population, the temporal pattern remained largely unchanged, indicating that observed trends were not solely attributable to population ageing. Mean length of hospital stay decreased steadily over time. Anterior surgical approaches accounted for the majority of procedures throughout the study period, while the proportion of surgically treated cases per hospitalization increased over time.

CONCLUSIONS: This nationwide, discharge-based analysis demonstrates substantial temporal changes in hospitalizations and surgical treatment patterns for DCM in Germany over the past two decades. Hospitalization volumes increased until approximately 2015 and declined thereafter, a pattern that persisted after age standardization. DCM predominantly affected patients aged 50-70 years throughout the study period, without a pronounced shift toward progressively older age groups. The increasing ratio of surgical procedures to hospitalizations suggests more selective inpatient admissions focusing on operative management. These findings provide a descriptive reference for long-term hospitalization and surgical trends in DCM.

PMID:41653231 | DOI:10.1007/s00264-026-06740-3