Nevin Manimala

Oral Health Prev Dent. 2026 Jun 17;24:405-415. doi: 10.3290/j.ohpd.c_2714.

ABSTRACT

PURPOSE: To explore the relationship between dental caries and non-alcoholic fatty liver disease (NAFLD) and its advanced stage of liver fibrosis, and to confirm causality by employing a bidirectional two-sample Mendelian Randomization (MR) analysis to confirm causality.

MATERIALS AND METHODS: 6650 participants of the National Health and Nutrition Examination Survey (NHANES), 2017-2020 were included. Two multivariable logistic regression models were used to evaluate the relationship between untreated dental caries (UDC) and liver conditions of NAFLD and fibrosis, with adjustments for demographics, lifestyle, and medical history. Furthermore, two-sample MR was performed with caries as exposure and NAFLD with NAFLD-related conditions as outcome, and vice versa for bidirectional causality validation.

RESULTS: In observational research, UDC was notably associated with NAFLD (OR [odds ratio]: 1.40, 95% CI [confidence interval]: 1.06-1.86) and significant fibrosis (SF) (OR: 1.29, 95% CI: 1.03-1.62). NAFLD and SF were statistically significantly associated with UDC (OR: 1.40, 95% CI: 1.08-1.83; OR: 1.62, 95% CI: 1.26-2.08). In the MR analysis, caries posed a statistically non-significant risk for liver conditions. In contrast, liver conditions non-significantly protected against caries (NAFLD: OR: 0.99, 95% CI: 0.98-1.01; fibrosis: OR: 0.99, 95% CI: 0.99-1.00; cirrhosis: OR: 0.99, 95% CI: 0.99-1.00; fibrosis/cirrhosis: OR: 1.00, 95% CI: 0.98-1.02).

CONCLUSION: Observational studies suggested a statistically significant association between UDC and liver conditions of NAFLD and fibrosis. However, MR suggested a statistically non-significant causal relationship between caries and liver conditions; in contrast, liver conditions had a non-significant protective effect on caries.

PMID:42306875 | DOI:10.3290/j.ohpd.c_2714

Food Funct. 2026 Jun 8. doi: 10.1039/d6fo00295a. Online ahead of print.

ABSTRACT

Synbiotic and functional food formulations modulate gut microbiota, SCFA production, immune signalling and metabolic pathways, yet current development pipelines remain largely empirical and constrained by nonlinear trade-offs among probiotic viability, prebiotic functionality and sensory acceptance. Artificial Intelligence (AI) and machine learning (ML) approaches offer data-driven strategies to support formulation, multi-objective optimization and functional assessment. This review systematically identified and critically synthesized literature published between 2020 and 2025 across five thematic domains: (i) formulation and ingredient selection; (ii) viability and shelf-life modelling; (iii) functional and antioxidant bioactivity assessment; (iv) sensory and consumer prediction; and (v) personalization and precision nutrition. Studies were identified through database searches and screened for relevance to synbiotics, functional foods, microbiome modulation and nutrition outcomes, following PRISMA 2020 guidelines. Current evidence indicates that AI can assist ingredient pairing, viability forecasting, sensory modelling and functional property prediction, often complementing conventional statistical tools such as Response Surface Methodology in multivariate design spaces. However, most implementations remain computational or pilot-scale, with minimal integration of microbiome-informed personalization, clinical endpoints or adherence outcomes. Major translational gaps include data heterogeneity, model interpretability, regulatory substantiation and scarcity of longitudinal evidence. AI should therefore be considered a complementary decision-support tool that can accelerate hypothesis generation and formulation refinement rather than substitute mechanistic validation or human trials. Bridging computational modelling with microbiome science and nutritional evidence may enable precision synbiotic strategies and next-generation functional food innovation.

PMID:42306833 | DOI:10.1039/d6fo00295a

Health Promot J Austr. 2026 Jul;37(3):e70207. doi: 10.1002/hpja.70207.

ABSTRACT

ISSUE ADDRESSED: For people in rural and remote areas, government-funded travel subsidy schemes provide vital financial assistance and equitable access to specialist healthcare in city centres. However, few studies have examined users’ experiences of these schemes.

METHODS: Adults travelling for healthcare in Queensland, Australia, completed an online survey capturing their most recent experience applying for the Patient Travel Subsidy Scheme (PTSS). Participants’ responses were analysed using descriptive statistics and thematic analysis.

RESULTS: From 69 respondents (aged 29-80 years, 60% female, 88% most recent application for cancer-related care), 57% agreed information about the scheme was easy to access, although only 39% found the initial registration process easy. Most indicated that local hospital staff and PTSS officers were knowledgeable and helpful (65%-70%). Less agreed that staff were available to assist (48%) or that processes were well-coordinated across hospitals (42%). Of those who sought reimbursement for travel costs (75%), almost two-thirds (63%) were out-of-pocket post-reimbursement (mean = AU$725; range = AU$20-10 000). Delayed reimbursement was relatively common (60%) and contributed to financial hardship (36%). For some (13%), challenges accessing the scheme impacted treatment decisions. User feedback included improved visibility of online application and reimbursement status, and fast-tracking of high-risk, urgent and ongoing cases.

CONCLUSIONS: While information about the scheme and interactions with frontline staff were viewed positively by most, several system-level challenges remain. SO WHAT?: Substantial out-of-pocket costs and reimbursement delays contribute to financial hardship and can affect treatment decisions. Increased subsidy reflecting actual travel costs, timely reimbursement, fast-tracking, and greater application assistance and coordination would improve user experiences.

PMID:42306832 | DOI:10.1002/hpja.70207

Biometrics. 2026 Jun 17:ujag113. doi: 10.1093/biomtc/ujag113. Online ahead of print.

ABSTRACT

This discussion provides commentary on the paper “INTACT: A method for integration of longitudinal physical activity data from multiple sources” by Jingru Zhang, Erjia Cui, Hongzhe Li, and Haochang Shou. The authors introduce an FPCA-based approach for integrating information from multiple sources with longitudinal measurements. We focus on the paper’s covariance-eigensystem assumptions and discuss how covariance alignment facilitates knowledge integration and transfer in functional and longitudinal settings.

PMID:42306831 | DOI:10.1093/biomtc/ujag113

Geohealth. 2026 Jun 15;10(6):e2026GH001854. doi: 10.1029/2026GH001854. eCollection 2026 Jun.

ABSTRACT

Due to legacy leaded products, soil Pb is generally higher in older urban centers triggering substantial implications for environmental equity. By integrating a gridded soil Pb analysis of about 150 samples each in two historically industrial cities (Hartford, CT and Springfield, MA) with block-level census data, we tested the hypotheses that (a) high soil Pb areas correlate spatially with older housing, (b) historical processes of discrimination have caused long-lasting environmental injustices with respect to Pb exposure, and (c) multiple social, demographic and geographic factors intersect in determining areas in need of targeted remediation efforts. Our data and geospatial analysis showed higher Pb concentrations in Hartford than Springfield and confirmed the prevalence of elevated (>200 ppm) Pb in soils closer to older homes in both cities. Using a decision tree statistical partition, we show that exposure to elevated soil Pb was most prevalent in communities with children population higher than the city median, who live in multi-family housing. In Springfield, ethnicity was a significant factor in exposure as census blocks populated by non-Hispanic Whites were least likely to contain lead in soils above 200 ppm. Our analysis highlights that historical discriminatory practices, including redlining, have anchored environmental injustices in the studied communities, creating an invisible legacy challenge recorded in the land and carried across decades. The use of decision trees in the context of soil lead contamination provides a new method to help identify vulnerabilities of marginalized populations, providing quantitative tools to advocate for targeted mitigation and remediation.

PMID:42306802 | PMC:PMC13267425 | DOI:10.1029/2026GH001854

Front Oncol. 2026 Jun 1;16:1858960. doi: 10.3389/fonc.2026.1858960. eCollection 2026.

ABSTRACT

PURPOSE: This simulation study aims to integrate four-dimensional computed tomography (4DCT) ventilation imaging into functional planning using different radiotherapy (RT) techniques and compare the dosimetric differences across these techniques.

METHODS: 4DCT ventilation images from eighteen lung cancer patients were created using Jacobian values obtained via deformable image registration and a ventilation imaging algorithm. For each patient, we designed both anatomical and functional plans using intensity-modulated radiotherapy (IMRT), hybrid IMRT (static plus IMRT beams treated concurrently), and volumetric modulated arc therapy (VMAT). Dosimetric parameters were systematically compared, with particular attention to the functional lung (FL) radiation dose.

RESULTS: The results showed that regardless of the RT technique (IMRT, hybrid IMRT, or VMAT), functional planning reduced fV₅ (fVx: percentage of functional lung volume receiving ≥ x Gy), fV₁₀, fV₂₀, fV₃₀, and functional mean lung dose (fMLD), while maintaining planning target volume (PTV) dosimetric coverage. Although functional planning increased the radiation dose to most organs at risk (OARs), these increases were not statistically significant. Among the different RT techniques, compared with f-hybrid IMRT, both f-IMRT and f-VMAT reduced radiation dose to the FL and OARs, while achieving superior PTV conformity. Further comparison between f-IMRT and f-VMAT showed that f-VMAT resulted in a lower mean dose (D_mean) to the esophagus.

CONCLUSION: Compared with anatomical planning, functional planning reduces the radiation dose to the FL while preserving target dose coverage and meeting dose constraints for OARs. Among the RT techniques for functional planning, f-VMAT may serve as the preferred technique.

PMID:42306800 | PMC:PMC13265367 | DOI:10.3389/fonc.2026.1858960

Front Oncol. 2026 Jun 1;16:1823812. doi: 10.3389/fonc.2026.1823812. eCollection 2026.

ABSTRACT

BACKGROUND: Cancer is a major threat to public health around the world. Diet is a key factor that we can change to help prevent it. This study explores the association between adherence to the EAT-Lancet diet and cancer incidence and mortality.

METHODS: A systematic search was conducted across PubMed, Web of Science, Embase, and the Cochrane Library for cohort studies published from January 2019 to September 2025. In the primary analyses, we pooled adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the association between EAT-Lancet diet adherence scores and cancer outcomes, prioritizing linear score-increment estimates and using categorical adherence contrasts only when linear estimates were unavailable. Subgroup analyses were performed by cancer type and adherence level; adherence-level subgroup analyses used categorical contrasts reported in the original studies. Sensitivity analysis and publication-bias assessment were conducted.

RESULTS: A total of 15 cohort studies were included. In the primary analyses, higher EAT-Lancet diet adherence scores were linearly associated with lower overall cancer incidence and overall cancer mortality (incidence: HR = 0.90, 95% CI: 0.84-0.95, P<0.001; mortality: HR = 0.92, 95% CI: 0.90-0.95, P<0.001). The clearest site-specific associations were observed for lung cancer incidence (HR = 0.93, 95% CI: 0.90-0.95, P<0.001) and lung cancer mortality (HR = 0.94, 95% CI: 0.90-0.97, P<0.001). No statistically significant associations were observed for breast, prostate, or colorectal cancer incidence (P>0.05).

CONCLUSION: Higher EAT-Lancet diet adherence scores may be associated with lower overall cancer incidence and mortality, with the clearest association observed for lung cancer. These findings should be interpreted cautiously because of heterogeneity, residual confounding, and differences in adherence assessment across cohorts.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251141170.

PMID:42306796 | PMC:PMC13265285 | DOI:10.3389/fonc.2026.1823812

Data Brief. 2026 May 29;67:112898. doi: 10.1016/j.dib.2026.112898. eCollection 2026 Aug.

ABSTRACT

The rapid growth of Vietnam’s transport sector presents challenges for sustainable energy and transport planning, particularly due to rising fuel consumption and associated carbon emissions. To help address these challenges, this paper presents a comprehensive dataset designed to support the modelling of future transport demand, energy use, and CO₂ emissions in Vietnam. The dataset covers population, GDP, passenger and freight activity, vehicle stock, energy intensity, load capacity, and CO₂ factors across nine transport modes: motorcycles, cars, buses, light-duty vehicles, heavy-duty vehicles, rail, inland waterways, maritime, and aviation. These are further disaggregated into nine fuel types: petrol, diesel, compressed natural gas, electricity, biofuel, fuel oil, hydrogen, ammonia, and jet fuel. Data were compiled from national statistics, government reports, online databases, academic journals, and media sources. Structured for use with open-source modelling tools, the dataset supports analyses of transport demand and carbon accounting, offering researchers, policymakers, and consultants a resource to evaluate long-term decarbonisation pathways and inform evidence-based policymaking.

PMID:42306784 | PMC:PMC13266183 | DOI:10.1016/j.dib.2026.112898

J Thorac Dis. 2026 May 31;18(5):502. doi: 10.21037/jtd-2026-1-0291. Epub 2026 Apr 30.

ABSTRACT

BACKGROUND: Severe respiratory failure (SRF) is a major cause of intensive care unit (ICU) admission, while multiple organ dysfunction syndrome (MODS) serves as a critical contributor to poor prognosis. This research examined the risk factors for in-hospital MODS in individuals with SRF based on ultrasound and laboratory parameters. A predictive model was constructed via the least absolute shrinkage and selection operator (LASSO)-Cox regression and subsequently validated.

METHODS: Data were collected from individuals with SRF admitted to the ICU of Wuhan Third Hospital between January 1, 2024, and May 31, 2025. LASSO regression was utilized to identify the risk factors for MODS. A Cox proportional hazards model was then established based on the selected variables by LASSO regression. The predictive performance of the models was appraised via the concordance index (C-index). Risk stratification was conducted via X-tile software, and the performance of the stratification system was assessed with the Kaplan-Meier method.

RESULTS: In total, 246 individuals with SRF were enrolled and randomly stratified into a training cohort (n=173) and a validation cohort (n=73) in a 7:3 ratio. Variables selected by LASSO regression, including pH, HCO₃ ^–, respiratory rate, activated partial thromboplastin time, procalcitonin, and inferior vena cava, were included in the Cox model. The model yielded a C-index of 0.793 in the training cohort and 0.748 in the validation cohort. In the training cohort, the area under the curve (AUC) of the predictive model was 0.824 [95% confidence interval (CI): 0.726-0.923] for the 15-day outcome and 0.809 (95% CI: 0.676-0.942) for the 28-day outcome. In the validation cohort, the corresponding AUCs were 0.721 (95% CI: 0.501-0.942) and 0.737 (95% CI: 0.503-0.971). Based on the constructed model, risk stratification was carried out via X-tile software. According to the optimal cutoff value of 118.4, individuals were categorized into high- and low-risk groups. Statistical analysis demonstrated that the risk of MODS was significantly elevated in the high-risk group in comparison to the low-risk group (P<0.05).

CONCLUSIONS: This research constructed and validated a nomogram based on LASSO-Cox regression to predict the MODS risk among individuals with SRF. This nomogram may assist clinicians in identifying individuals at high risk of MODS and tailoring individualized follow-up and treatment strategies based on risk prediction, thereby improving patients’ long-term outcomes.

PMID:42306759 | PMC:PMC13266719 | DOI:10.21037/jtd-2026-1-0291

J Thorac Dis. 2026 May 31;18(5):475. doi: 10.21037/jtd-2025-1-2790. Epub 2026 May 27.

ABSTRACT

BACKGROUND: Atrial functional mitral regurgitation (AFMR) is caused by atrial enlargement and mitral annular dilation due to atrial fibrillation (AF). Although the outcomes of mitral valve surgery in AFMR have been reported, concomitant Maze procedure outcomes in AFMR remain poorly understood. This study aimed to evaluate the clinical and rhythm outcomes of concomitant mitral valve plasty and the Maze procedure in patients with AFMR.

METHODS: We retrospectively analyzed 122 patients who underwent the mitral valve plasty (repair) concomitant with Maze procedure between August 2010 and June 2025. The cohort was divided into an AFMR group (n=50) and a non-AFMR group (n=72). The cumulative incidence of permanent pacemaker (PPM) implantation was analyzed using the Fine-Gray subdistribution hazard model with death as a competing risk. Postoperative rhythm dynamics were evaluated using a continuous-time multi-state Markov model.

RESULTS: The overall cumulative incidence of PPM implantation was significantly higher in the AFMR group than in the non-AFMR group (P<0.001). While early (≤30 days) PPM implantation rates did not differ (P=0.53), the AFMR group showed a higher risk of late (>30 days) PPM implantation (P<0.001). Multivariable analysis identified AFMR as an independent risk factor of late PPM implantation [subdistribution hazard ratios (sHR) 14.963, P=0.02]. Furthermore, the AFMR group demonstrated a higher rate of postoperative junctional rhythm compared to the non-AFMR group.

CONCLUSIONS: AFMR was not associated with a statistically significant difference in overall survival and the incidence of major adverse cardiovascular events following the Maze procedure compared to the non-AFMR group. However, AFMR was associated with a higher risk of transition to junctional rhythm following the Maze procedure, which was associated with an increased rate of PPM implantation. Notably, the risk of pacemaker implantation was predominantly late-onset, which may be due to a progressive decline in sinus node function. Therefore, close long-term rhythm monitoring and follow-up are warranted.

PMID:42306743 | PMC:PMC13266807 | DOI:10.21037/jtd-2025-1-2790