Category: Nevin Manimala

BMC Oral Health. 2026 Jun 27. doi: 10.1186/s12903-026-09059-y. Online ahead of print.

ABSTRACT

BACKGROUND: Oral health findings in pediatric chronic kidney disease (CKD) are heterogeneous, and CKD-related metabolic alterations may contribute to plaque mineralization and oral hygiene outcomes. Yet, the relationship between routinely measured serum biochemical parameters and standardized caries/oral hygiene indices in children with CKD is not well defined. This study aimed to evaluate the associations between serum biochemical parameters and oral health indices in pediatric CKD.

METHODS: This cross-sectional study included 34 children aged 6-14 years with diagnosed CKD. Demographic and available clinical data were recorded, and routinely measured serum biochemical parameters reflecting renal function, mineral metabolism, acid-base status, hematologic status, and nutritional/metabolic profile were obtained from routine laboratory records. Oral examination included caries assessment using Decayed, Missing, and Filled Teeth (dmft/DMFT) index for primary/permanent dentition and International Caries Detection and Assessment System (ICDAS) II indices, as well as oral hygiene evaluation using the Simplified Oral Hygiene Index (OHI-S), Debris Index (DI), and Calculus Index (CI). Developmental enamel defects were evaluated, and soft tissue lesions were examined. Pearson correlation analysis and Mann-Whitney U tests were performed. Statistical significance was set at p < 0.05.

RESULTS: Most serum biochemical parameters were not significantly associated with caries experience or oral hygiene indices (p > 0.05). Serum magnesium showed weak-to-moderate negative correlations with CI (r = – 0.383, p = 0.026) and OHI-S (r = – 0.362, p = 0.035), indicating lower calculus accumulation and lower OHI-S scores with higher magnesium levels. In contrast, ALP demonstrated a weak-to-moderate positive correlation with CI (r = 0.386, p = 0.024).

CONCLUSIONS: In this pediatric CKD cohort, routine serum biochemical parameters showed limited cross-sectional associations with caries experience and oral hygiene indices. However, the observed associations of serum magnesium and alkaline phosphatase with calculus accumulation suggest that mineral metabolism-related markers may be linked to plaque mineralization. These findings should be interpreted cautiously in view of the cross-sectional design, small sample size, and clinical heterogeneity of the study group.

PMID:42374410 | DOI:10.1186/s12903-026-09059-y

BMC Med Inform Decis Mak. 2026 Jun 29. doi: 10.1186/s12911-026-03662-3. Online ahead of print.

ABSTRACT

BACKGROUND: Large language models (LLMs), a form of artificial intelligence, are increasingly being utilized in healthcare to support patient education and information delivery. The aim of this study was to perform a comparative analysis of five different LLMs (i.e., ChatGPT-4o, Claude 3.7 Sonnet, Gemini 2.5 Pro Preview, DeepSeek-V3, and Microsoft Copilot) in terms of accuracy, completeness, and readability, based on their responses to frequently asked questions in preoperative patient education for mitral valve surgery (MVS).

METHODS: A standardized questionnaire comprising seven frequently asked questions by patients prior to MVS was developed. Prompting procedures and model parameters were fully reported to support reproducibility. These questions were presented to each LLM in an identical manner. The responses were evaluated by two academic experts in cardiac surgery using structured assessment criteria across three main dimensions: accuracy, completeness, and readability. For the readability analysis, the Simplified Measure of Gobbledygook (SMOG) Index and the Flesch-Kincaid Grade Level (FKGL) scale were utilized.

RESULTS: The ChatGPT-4o and Gemini 2.5 Pro Preview models received statistically significantly higher scores than Claude 3.7 Sonnet and Microsoft Copilot for both accuracy (median 5 for ChatGPT-4o and Gemini 2.5 Pro Preview vs. 4 for Claude 3.7 Sonnet and Microsoft Copilot, p < 0.001) and completeness (median 5 for Gemini 2.5 Pro Preview vs. 3 for Claude 3.7 Sonnet, p < 0.001). Claude 3.7 Sonnet achieved the highest readability scores, with significantly lower SMOG (10.90 for Claude 3.7 Sonnet vs. 12.24 for ChatGPT-4o, p = 0.006) and FKGL (8.0 for Claude 3.7 Sonnet vs. 9.04 for ChatGPT-4o, p = 0.004) scores, indicating simpler and more comprehensible sentence structures. Significant differences were observed among the evaluated models across all three assessment dimensions (p < 0.001 for all comparisons).

CONCLUSIONS: The LLMs represent valuable supplementary tools in patient education processes. However, their implementation in clinical practice must be carefully evaluated, particularly with regard to accuracy and completeness. This study highlights the potential applicability of ChatGPT-4o and Claude 3.7 Sonnet models for preoperative patient education in MVS, while emphasizing that all LLMs should be used under the supervision and guidance of healthcare professionals. For LLMs to be reliably utilized in the medical field, improvement in medical accuracy and standardization are essential.

PMID:42374405 | DOI:10.1186/s12911-026-03662-3

BMC Vet Res. 2026 Jun 27. doi: 10.1186/s12917-026-05653-y. Online ahead of print.

ABSTRACT

The efficacy and safety of pharmaceutical products are critically dependent on maintaining appropriate storage temperatures throughout the supply chain, from manufacturer to end-user. In veterinary medicine, this includes storage within clinics and during ambulatory services. The Federal Capital Territory (FCT) of Nigeria experiences high ambient temperatures, posing a significant risk to drug stability. This study aimed to investigate drug storage temperatures in veterinary clinics that also dispense and retail veterinary pharmaceuticals within the FCT and to assess their compliance with manufacturers’ recommended storage conditions. A cross-sectional study was conducted across 23 veterinary clinics in four Area Councils of the FCT (AMAC, Bwari, Gwagwalada, Kuje). A structured questionnaire was used to gather data on storage infrastructure, including refrigerator use, alternative power supply, and temperature monitoring devices. The temperature of drug storage areas was recorded over two weeks (March 1st-15th, 2025) using an HTC-2 thermometer (Guangdong, China). Data were analyzed using descriptive statistics. While all 23 (100%) clinics possessed a refrigerator, only 60% had an alternative power supply. Critically, 60.9% (n = 14) of clinics lacked any form of temperature monitoring device in their storage areas. The mean ambient storage temperatures in all clinics exceeded the recommended maximum of 30 °C for pharmaceuticals stored in cabinets, with some clinics recording temperatures above 36 °C. During ambulatory services, 87% of Clinicians used drug storage boxes, but 30% parked their vehicles in areas without shade, potentially exposing drugs to high temperatures during transport. This study reveals a significant gap in compliance with manufacturer drug storage temperature recommendations among veterinary clinics in the FCT. The lack of temperature monitoring and exposure to excessive ambient temperatures may compromise drug quality and pose a risk to patient safety and treatment efficacy.

PMID:42374404 | DOI:10.1186/s12917-026-05653-y

BMC Med. 2026 Jun 29. doi: 10.1186/s12916-026-05022-4. Online ahead of print.

ABSTRACT

BACKGROUND: Non-randomized studies of interventions (NRSIs) provide important evidence on harms, especially for rare adverse events that randomized controlled trials (RCTs) are often underpowered to detect. Evidence synthesis is therefore needed to integrate findings across study designs and to inform a comprehensive assessment of harms. However, synthesizing evidence from RCTs and NRSIs remains methodologically challenging. We examined how evidence from RCTs and NRSIs is synthesized in practice and how conclusions were drawn when findings conflict.

METHODS: The meta-epidemiological study included systematic reviews indexed in PubMed between 1 January 2017 and 31 December 2024 that synthesized evidence from both RCTs and NRSIs for the same outcome. We evaluated methodological practices across four synthesis scenarios. For reviews that combined RCTs and NRSIs in a meta-analysis, we assessed key methodological components of the review process. For reviews that meta-analyzed RCTs and NRSIs separately, we assessed qualitative agreement between RCTs and NRSIs based on the magnitude, direction, and statistical significance of the estimates. When qualitative disagreement was observed, we further evaluated whether the review conclusions were reasonable, taking into account the certainty of evidence and the heterogeneity of the estimates.

RESULTS: Of 42,341 records screened, 195 systematic reviews were included. 49 (25.1%) conducted only qualitative syntheses of both RCTs and NRSIs. 11 (5.6%) meta-analyzed only RCTs, with NRSIs synthesized qualitatively; and 7 (3.6%) meta-analyzed only NRSIs, with RCTs synthesized qualitatively. Among the 91 reviews (46.7%) that combined RCTs and NRSIs in a single meta-analysis, important methodological gaps were identified: 72.5% included NRSIs at moderate or high risk of bias, 49.5% used unadjusted estimates, and 53.8% did not conduct subgroup analyses by study design. Separate meta-analyses for RCTs and NRSIs were conducted in 37 reviews (19.0%), of which 67.6% showed qualitative disagreement between the two study designs, and 20.0% were judged to have inappropriate conclusions according to our assessment criteria.

CONCLUSIONS: Systematic reviews synthesizing RCTs and NRSIs for harms frequently overlook essential methodological considerations and often draw conclusions without adequately addressing conflicting findings across study designs. These practices risk compromising the credibility of harm assessments used in clinical, regulatory, and policy decision-making.

PMID:42374394 | DOI:10.1186/s12916-026-05022-4

BMC Oral Health. 2026 Jun 29. doi: 10.1186/s12903-026-08789-3. Online ahead of print.

ABSTRACT

BACKGROUND: The cross-modal correlations between radiomics and pathomics, as well as their clinical translational applications in oral tumors and cysts, remain unclear. Here, we proposed a novel radiomic feature selection strategy guided by radio-pathomic correlations in Ameloblastoma (AM) and Odontogenic Keratocyst (OKC) to enhance their preoperative differentiation.

METHODS: We automatically extracted radiomic and pathomic features from CBCT scans and multi-resolution (25, 50, 100, 200 μm) whole slide image-derived cell density maps, respectively. Subsequently, radio-pathomic associations were evaluated by correlation analysis at two levels, directly between features, and between latent factors derived from features via factor analysis, separately in AM and OKC. Additionally, we compared the diagnostic performance of machine learning models using our proposed pathomics-guided feature selection strategy against traditional selection approaches.

RESULTS: At the feature level, correlation analysis identified one and seven significant feature pairs in AM and OKC, respectively (all |ρ| > 0.50, q < 0.05), suggesting that radiomic morphological feature weres strongly correlated with pathomic textural features reflecting tissue complexity. At the factor level, one significant factor pair was revealed in AM (ρ = 0.50, q = 0.007) and another in OKC (ρ = – 0.41, q = 0.04). Additionally, classification performance was enhanced by our proposed strategy across all six models, with an average area under the receiver operating characteristic curve (AUROC) improvement of 0.036 and individual gains ranging from 0.016 in Logistic Regression to 0.063 in Lasso.

CONCLUSION: Significant cross-modal correlations between radiomic and pathomic features were identified in AM and OKC. Leveraging these associations, our proposed pathomics-guided radiomics showed the potential to improve the accuracy of preoperative differentiation between the two lesions, although these improvements reached statistical significance only in some models and still require further validation before clinical translation.

PMID:42374392 | DOI:10.1186/s12903-026-08789-3

JACC Adv. 2026 Jun 29;5(8):102965. doi: 10.1016/j.jacadv.2026.102965. Online ahead of print.

ABSTRACT

BACKGROUND: Sudden cardiac arrest (SCA) during marathons is a rare but life-threatening event. Although underlying cardiovascular conditions have been implicated in race-related SCA, the contribution of environmental factors, including meteorological conditions and ambient air pollution, remains incompletely understood.

OBJECTIVES: The objective of the study was to examine the associations of meteorological conditions and ambient air pollutants with SCA during marathon races.

METHODS: We conducted a nationwide race-level study in Japan using data from 4.53 million runners participating in Japan Association of Athletics Federations-certified full marathons between April 2011 and March 2020. Race-level SCA counts were linked to meteorological variables at race start, including ambient temperature, humidity, solar radiation, wind speed, precipitation, and air pressure, and to ambient air pollutants including fine particulate matter, suspended particulate matter, photochemical oxidants, sulfur dioxide, nitrogen dioxide, and carbon monoxide. Associations were examined using Poisson regression models with adjustment for race characteristics and participant composition.

RESULTS: Among 4.53 million runners, 75 cases of SCA were identified. Ambient temperature at race start was inversely associated with SCA risk (adjusted incidence rate ratio per 1 °C increase: 0.94; 95% CI: 0.90-0.99), corresponding to a higher risk at lower temperatures. No statistically significant associations were observed between ambient air pollutants and SCA risk.

CONCLUSIONS: In Japanese marathon races held predominantly in autumn and winter, lower ambient temperature at race start was associated with a higher risk of SCA, whereas no significant association was observed for ambient air pollutants.

PMID:42372349 | DOI:10.1016/j.jacadv.2026.102965

Lang Speech Hear Serv Sch. 2026 Jun 29:1-10. doi: 10.1044/2026_LSHSS-25-00225. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to examine the relationship between temporal processing and literacy performance in children with hearing aids.

METHOD: The study included a total of 45 children, comprising 21 with typical hearing and 24 who used hearing aids, all of whom were attending the second, third, or fourth grades of primary school. Temporal processing skills were evaluated using the Frequency Pattern Test and the Duration Pattern Test (DPT), whereas reading and writing abilities were assessed through the Literacy Assessment Battery.

RESULTS: Children using hearing aids demonstrated statistically significantly lower performance in the DPT and in the test assessing writing skills compared to their typically hearing peers. A positive, significant correlation was found between temporal processing skills and literacy skills. Moreover, temporal processing and literacy performance were observed to be negatively correlated with the age at which the child’s first amplification was provided and positively correlated with the duration of auditory rehabilitation.

CONCLUSIONS: This study found that in children using hearing aids, performance on temporal pattern tests was significantly correlated with reading and writing skills. Furthermore, these findings suggest that early amplification and consistent auditory rehabilitation may be correlated with better temporal processing and literacy skills.

PMID:42372307 | DOI:10.1044/2026_LSHSS-25-00225

Dis Esophagus. 2026 May 12;39(3):doag062. doi: 10.1093/dote/doag062.

ABSTRACT

Water-soluble esophagram and endoscopy are commonly used to detect anastomotic leak after esophagectomy. However, the comparative performance of these two modalities in detecting leaks has not been well established. We retrospectively reviewed all patients who underwent esophagectomy for cancer between January 2021 and December 2022 from a prospectively maintained database. Occurrence, management and consequences of leaks were examined. The primary outcome was to compare the diagnostic performance of esophagram and endoscopy in detecting anastomotic leak. Therefore, a total of 846 patients were identified. The overall incidence of anastomotic leak was 10.4%. Patients with leaks had older age and more retrosternal routes for reconstruction. Of them, 466 patients underwent endoscopy and 217 underwent esophagram. After matching, 434 patients, 217 per group were analyzed. The sensitivity and negative predictive value of endoscopy were 79.2% and 97.5%, whereas those of esophagram were only 37.9% and 91.3%, respectively (P = 0.003; P = 0.007). In the subset of patients with cervical anastomosis, endoscopy also demonstrated superior sensitivity (78.3% vs 36.0%, P = 0.004) and negative predictive value (97.4% vs 90.8%, P = 0.007). Esophagram showed false-negative results in 18 patients, while only 5 leaks were missed by initial endoscopy. Regarding the management of false negatives, esophagram group showed non-significant trends toward longer hospital stay and more interventions, including stenting (11.1% vs 0%) and clipping (5.6% vs 0%) (both P > 0.05). In conclusion, endoscopy showed higher sensitivity and negative predictive value than esophagram in detecting anastomotic leak after esophagectomy in this study. However, a large-scale, randomized study is warranted to validate these results.

PMID:42372290 | DOI:10.1093/dote/doag062

Subst Use Misuse. 2026 Jun 29:1-7. doi: 10.1080/10826084.2026.2685620. Online ahead of print.

ABSTRACT

Naswar, a form of smokeless tobacco, has become an important public health concern in southern Iran due to its increasing use and associated health risks. Despite its growing social acceptance, limited evidence is available regarding the combined influence of individual, cognitive, and social factors on Naswar consumption. This study aimed to investigate the individual and social determinants of Naswar use among residents of Bandar Abbas, southern Iran. This cross-sectional study was conducted from June to September 2024 among 399 individuals aged 15 years and older recruited from urban healthcare centers in Bandar Abbas. Data were collected through face-to-face interviews using a validated questionnaire assessing demographic characteristics, knowledge, attitudes, social norms, behavioral intention, and Naswar use. Descriptive statistics, univariate analyses, and multivariable logistic regression were performed to identify factors associated with current Naswar consumption. The prevalence of Naswar use was 6% in the study population. Univariate analyses indicated that male gender, lower educational level, and lower socioeconomic status were associated with higher odds of use. Greater knowledge of Naswar harms, more negative attitudes toward use, and stronger anti-use social norms were associated with lower odds of consumption. In the multivariable model, higher knowledge and stronger anti-use social norms remained significant protective factors, whereas stronger behavioral intention toward Naswar use was identified as a significant risk factor. Naswar use in Bandar Abbas is influenced more by psychosocial factors than demographic characteristics alone. Prevention strategies should strengthen health knowledge, reinforce anti-use social norms, and target behavioral intentions through culturally appropriate interventions.

PMID:42372287 | DOI:10.1080/10826084.2026.2685620