Category: Nevin Manimala

BMC Public Health. 2026 Jan 2. doi: 10.1186/s12889-025-26126-1. Online ahead of print.

ABSTRACT

BACKGROUND: Emerging evidence suggests a bidirectional relationship between oral health and chronic kidney disease (CKD), yet population-based data from upper-middle-income countries remain limited. This study aimed to evaluate the association between oral health indicators and CKD in a nationally representative sample of Brazilian adults.

METHODS: We conducted a cross-sectional, nationally representative analysis using data from the 2019 Brazilian National Health Survey (PNS), which employed a three-stage stratified cluster sampling design. The outcome was CKD, and the main exposures were self-related oral health, tooth loss, toothbrushing frequency, and eating difficulty due to oral conditions. Multivariable survey-weighted logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs), controlling for age, sex, race/ethnicity, diabetes, and hypertension.

RESULTS: The study included 279,382 individuals, representing a weighted population of over 209 million Brazilians. Poor self-rated oral health was associated with higher odds of CKD (OR: 2.15; 95% CI: 1.56-2.97). Complete tooth loss showed a trend toward an association with CKD (adjusted OR: 1.30; 95% CI: 1.00-1.69; p = 0.050), and oral health-related eating difficulty was associated with higher odds of CKD (adjusted OR: 2.06; 95% CI: 1.45-2.93). In contrast, brushing teeth three times per day was associated with lower odds of CKD (adjusted OR: 0.43; 95% CI: 0.14-0.81). Fewer than half of participants reported visiting a dentist within the past year, and only 22.6% utilized public dental services.

CONCLUSION: Oral health conditions, including poor hygiene practices, tooth loss, and eating difficulties are significantly associated with CKD. These findings highlight the need to integrate oral health into chronic disease prevention strategies, particularly within public health systems in upper-middle-income countries.

PMID:41485009 | DOI:10.1186/s12889-025-26126-1

Eur J Med Res. 2026 Jan 3. doi: 10.1186/s40001-025-03711-z. Online ahead of print.

ABSTRACT

BACKGROUND: Diet may impact the risk of attention deficit hyperactivity disorder (ADHD) via altering inflammation. However, no investigations have been conducted to evaluate the relationship between ADHD and the diet’s inflammatory potential. The study sought to investigate the relationship between ADHD and the dietary inflammatory index (DII).

METHODS: We used data from the cross-sectional National Health and Nutrition Examination Survey 2001-2004 to investigate the relationship between DII and ADHD in 6481 children and adolescents aged 6-19 years. The relationship between ADHD and DII was investigated using weighted logistic regression and restricted cubic spline (RCS). We also explored the potential causal associations between ADHD and 187 types of food preferences using Mendelian randomization (MR).

RESULTS: Despite thorough multivariate correction, a significant association between lower DII scores and an elevated probability of ADHD persisted (OR = 0.91, 95% CI 0.82-0.99). Nevertheless, when stratifying the DII into quartiles (T1-T4) for analysis, no statistically significant correlation was seen between DII and ADHD (P > 0.05). RCS analysis indicated a U-shaped correlation between DII and ADHD, with an inflection point at approximately 2.9. Mediation analysis indicated that the Frailty Index partly mediated the association between DII and ADHD, representing about 5.49% of the overall impact. The findings from the univariate MR analysis revealed that fruit liking is significantly linked to a reduced risk of ADHD. Conversely, a liking for red meat, such as lamb, as well as a fondness for flavorings like onions, is significantly associated with an increased risk of ADHD. Reverse two-sample MR analyses revealed that genetic predisposition to ADHD significantly altered 37 food preferences (FDR < 0.05).

CONCLUSIONS: We observed a U-shaped association between the DII and ADHD risk. The Frailty Index may partially mediate (5.49%) the association between DII and ADHD. However, the cross-sectional design precludes causal inference. Fruit liking lowered ADHD risk, while red meat/onion liking increased risk. ADHD was associated with a generalized reduction in liking for a wide range of foods. Future studies should investigate the role of a moderate-inflammatory diet in ADHD prevention.

PMID:41485000 | DOI:10.1186/s40001-025-03711-z

BMC Geriatr. 2026 Jan 3;26(1):4. doi: 10.1186/s12877-025-06727-6.

ABSTRACT

BACKGROUND: Research on the association between atherosclerosis cardiovascular diseases (ASCVDs) and hearing loss (HL) in older people has yielded mixed findings in recent years. Understanding this relationship is crucial for developing early strategies that address both cardiovascular health and auditory function in older adults.

METHODS: To examine the potential association between common ASCVDs (heart attack, coronary heart disease, and stroke) and HL, assessing the mediating effect of the frailty index (FI) and Life’s essential 8 (LE8) metrics. The degree of HL was measured by pure tone average (PTA). This cross-sectional analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2003 to 2018, including 4,441 adults aged 60 or older with comprehensive cardiovascular and hearing measurement data. Statistical analysis was conducted from February 16, 2024, to July 7, 2024.

RESULTS: The study identified significant correlations between all three ASCVDs and HL in older participants aged 60 or older, particularly noting that heart attacks were notably associated with HL at higher frequencies (2 and 4 kHz). Older participants, especially those aged 75 and above, were more susceptible to stroke-related HL, with a delayed impact observed in females. FI and LE8 mediated the heart attack-HL association in adults aged 75 and above, with FI demonstrating a stronger role than LE8.

CONCLUSION: The findings elucidate a complex interplay between cardiovascular health and auditory function, emphasizing that heart attacks may exacerbate HL through the frailty pathway in certain older populations. These results highlight the need for tailored cardiovascular interventions and proactive measures to mitigate HL risks. Future research should focus on defining these pathophysiological associations more clearly to develop targeted interventions for vulnerable older people.

PMID:41484995 | DOI:10.1186/s12877-025-06727-6

J Orthop Surg Res. 2026 Jan 2. doi: 10.1186/s13018-025-06594-2. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate and compare clinical and radiological outcomes of surgical strategies for osteochondritis dissecans (OCD) lesions across ICRS grades, and to investigate the impact of recipient hole drilling (RHD) as a biological augmentation to osteochondral grafting.

METHODS: This retrospective study included 60 knees (ICRS grades 1-4) treated surgically from 2001 to 2022. Stable lesions (grade 1) were managed with either retrograde or antegrade drilling with bioabsorbable pin fixation. For unstable lesions (grades 2-3), in situ osteochondral autograft transfer (OATS) or detach-and-fix techniques were performed. Detached lesions (grade 4) underwent either mosaicplasty or fragment fixation. RHD was introduced in select OATS and mosaicplasty cases to stimulate subchondral bone remodeling. Outcomes were assessed using the Lysholm and Tegner scores and MOCART-based MRI evaluations. Statistical comparisons were performed across groups.

RESULTS: Antegrade drilling resulted in significantly higher Lysholm, Tegner, and MOCART scores than retrograde drilling for ICRS grade 1 lesions. In situ OATS for ICRS 2-3 lesions showed superior clinical and radiological outcomes compared to detach-and-fix, with no reoperations. For ICRS 4 lesions, both mosaicplasty and fragment fixation yielded favorable outcomes, though only Tegner scores showed a significant difference. RHD tended to improve cartilage repair quality in OATS and mosaicplasty but did not reach statistical significance.

CONCLUSIONS: Antegrade drilling and in situ OATS were superior to retrograde drilling and detach-and-fix, respectively. No statistically significant advantage was found between mosaicplasty and fragment fixation. RHD may enhance subchondral integration and healing, supporting its further evaluation.

CLINICAL RELEVANCE: Optimizing OCD treatment requires surgical strategies that achieve both mechanical stability and biological activation. Integrating these principles may enhance repair quality and long-term joint preservation.

LEVEL OF EVIDENCE: Level III, retrospective comparative study.

PMID:41484975 | DOI:10.1186/s13018-025-06594-2

BMC Public Health. 2026 Jan 3. doi: 10.1186/s12889-025-26089-3. Online ahead of print.

ABSTRACT

BACKGROUND: Mexico is undergoing rapid population ageing, but its pace and intensity vary markedly across regions. This process unfolds amid deep social and economic inequalities, particularly in rural and marginalized areas where limited access to healthcare and social protection increases the risk of chronic disease, disability, and dependence.

OBJECTIVE: To examine how demographic ageing, socioeconomic, and health conditions relate to disability prevalence among older adults at the municipal level, emphasizing the structural and territorial factors that constrain healthy ageing.

METHODS: Using data from the 2020 Population and Housing Census and 2015-2019 mortality records, a municipal composite ageing index was developed to capture both the magnitude and structure of ageing. Spatial analytical techniques-Moran’s I, Local Indicators of Spatial Association (LISA), and Geographically Weighted Regression (GWR)-were applied to identify spatial dependence and local variation.

RESULTS: Bivariate Moran’s I indicated limited global autocorrelation between ageing and disability, but LISA revealed pronounced local clusters. Ageing was more advanced in northern and central Mexico, whereas disability concentrated in the south and southeast. Lower educational attainment, reduced social protection coverage, and greater socioeconomic disadvantage were linked to highter disability prevalence.

CONCLUSIONS: The findings show that ageing and disability are spatially patterned outcomes shaped by long-standing territorial inequalities. Recognizing these spatial dynamics is key to designing regionally differentiated, place-based public health and social policy responses that promote equitable ageing in Mexico.

PMID:41484974 | DOI:10.1186/s12889-025-26089-3

BMC Musculoskelet Disord. 2026 Jan 2. doi: 10.1186/s12891-025-09462-6. Online ahead of print.

ABSTRACT

PURPOSE: Thoracic hyperkyphosis (THK) is a prevalent spinal deformity in adolescents, which can impair respiratory function by affecting diaphragm morphology and thoracic mechanics. This study investigates the relationship between THK and diaphragmatic thickness using ultrasonography (USG) to explore its diagnostic and therapeutic implications.

METHODS: This prospective study included 25 adolescents with THK and 29 healthy controls. Diaphragmatic thickness was measured using ultrasonography at the end of inspiration and expiration, and spirometry was conducted to assess respiratory function. Thoracic hyperkyphosis was diagnosed based on Cobb angle measurements. Statistical analysis included regression and ROC analyses to determine predictors of THK and evaluate diagnostic accuracy. The study was approved by the local Ethics Committee of the University of Healthy Science, Gaziosmanpasa Training and Research Hospital (IRB number: 109, date: 16 August 2023). The study protocol was registered to the clinicaltrial.gov.tr (NCT06418334 and initial release date: 01/11/2024).

RESULTS: Adolescents with THK exhibited significantly higher Cobb angles (59.3 ± 7.9°) compared to controls (34.6 ± 3.7°, p < 0.001). Diaphragmatic thickness during inspiration (2.5 mm vs. 3.1 mm, p = 0.125) and expiration (1.50 mm vs. 1.56 mm, p = 0.965) was lower in the THK group, with significant reductions in thickening ratio (1.76 ± 0.29 vs. 1.98 ± 0.30, p = 0.008) and thickening fraction (DTf) (75.4% vs. 97.6%, p = 0.008). A negative correlation was observed between Cobb angle and diaphragmatic thickening (r=-0.378, p = 0.005). ROC analysis indicated that USG parameters, particularly thickening fraction (AUC = 0.72, p = 0.002), are reliable predictors of THK.

CONCLUSION: Adolescents with THK demonstrate reduced diaphragmatic thickness and impaired respiratory function. Ultrasonography emerges as a valuable, non-invasive tool for early diagnosis and monitoring of THK, offering potential for timely intervention to mitigate respiratory complications.

PMID:41484972 | DOI:10.1186/s12891-025-09462-6

J Health Popul Nutr. 2026 Jan 3. doi: 10.1186/s41043-025-01211-8. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm birth (PTB) is a global epidemic, defined as delivery before 37 weeks of gestation, and is an important risk factor for neonatal death, morbidity and abnormal childhood development. Premature birth is currently regarded as a complex disease influenced by multiple factors. Common risk factors include nutritional deficiency during pregnancy, maternal obesity, environmental exposure, infection and inflammation, among which maternal nutrition during pregnancy is an important modifiable factor.

OBJECTIVE: To assess the relationship between maternal dietary calcium, phosphorus intake, and calcium supplement use before and during pregnancy was associated with the risk of PTB in offspring.

METHOD: This study was a nested case-control study conducted based on a large cohort study. And included pregnant women who were registered at the Perinatal Medicine Center of Gansu Provincial Maternal and Child Health Hospital from March 2018 to March 2019 and whose birth outcomes could be followed up. One-on-one dietary interviews were conducted during pregnancy, and a database was established based on the overall dietary intake levels for subsequent statistical analysis. PTB was defined as the outcome variable, while the intake levels of different substances during pregnancy were set as independent variables. Unconditional logistic regression models estimated the association between nutrient intake and the risk of PTB. Calculating the odds ratio (OR) and its 95% confidence interval (CI) to analyze the impact of different substance intake levels on PTB. Additionally, a restricted cubic spline (RCS) model with multivariable adjustment was applied to excess the non-linear association between dietary magnesium and calcium intake was associated with the risk of PTB.

RESULT: A total of 8897 pregnant women were included in the study, with 880 assigned to the case group and 8017 to the control group. Multivariate logistic regression analysis showed that low phosphorus intake in the second trimester was associated with an increased risk of PTB (OR = 1.297, CI: 1.020-1.649, P = 0.0341). Furthermore, similar results also exist for non-use of calcium supplements during the third trimester and low calcium intake preconception and during pregnancy. In addition, calcium, phosphorus and calcium supplements have a synergistic effect was associated with the risk of PTB.

CONCLUSION: During the second and third trimesters of pregnancy, the intake of phosphorus and the use of calcium supplements should be increased. Additionally, to prevent premature birth, the intake of calcium should be increased preconception and during pregnancy. Furthermore, this might lead to the optimization of public health policies or the formulation of guidelines for prenatal nutrition.

PMID:41484936 | DOI:10.1186/s41043-025-01211-8

Commun Chem. 2026 Jan 3. doi: 10.1038/s42004-025-01866-8. Online ahead of print.

ABSTRACT

Machine learning (ML) and artificial intelligence (AI) techniques are transforming the way chemical reactions are studied today. Datasets from high-throughput experimentation (HTE) are generated to better understand the reaction conditions crucial for outcomes such as yields and selectivities. However, it is often overlooked that datasets from such designed experiments possess a specific structure, which can be captured by a statistical model. Ignoring these data structures when applying ML/AI algorithms can result in misleading conclusions. In contrast, leveraging knowledge about the data-generating process yields reliable, interpretable, and comprehensive insights into reaction mechanisms. A particularly complex dataset is available for the Buchwald-Hartwig amination. Using this dataset, a statistical model for such HTE-generated chemical data is introduced, and a parameter estimation algorithm is developed. Based on the estimated model, new insights into the Buchwald-Hartwig amination are discussed. Our approach is applicable to a wide range of HTE-generated data for chemical reactions and beyond.

PMID:41484279 | DOI:10.1038/s42004-025-01866-8

Eye (Lond). 2026 Jan 4. doi: 10.1038/s41433-025-04229-8. Online ahead of print.

NO ABSTRACT

PMID:41484256 | DOI:10.1038/s41433-025-04229-8

Eur Radiol. 2026 Jan 4. doi: 10.1007/s00330-025-12272-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of prostate volume on the risk of clinically significant prostate cancer (csPCa) across a range of PSA-density (PSAd) values, and to explore the relationship between PI-RADS category and PSAd in predicting csPCa.

MATERIALS AND METHODS: We retrospectively analyzed 2190 patients undergoing mpMRI for suspected PCa. Patients were classified as csPCa and clinically insignificant (negative and insignificant PCa). Logistic regression was performed to assess the csPCa risk at different PSAd cut-offs across different prostate volume subgroups (< 40, 40-60, 60-80, > 80 mL) and PI-RADS categories. The effect of prostate volume on PSAd performance was evaluated using ROC analysis. To assess robustness, we performed an 80:20 split-sample internal validation.

RESULTS: 747/2190 (34.1%) patients had PCa, including 571 (26.1%) with csPCa. Regardless of PSAd, csPCa risk exceeded 30% for PI-RADS 4 and 50% for PI-RADS 5. At a 10% csPCa risk threshold, the optimal PSAd cut-offs were 0.20 ng/mL² for PI-RADS 1-2 and 0.12 ng/mL² for PI-RADS 3. Logistic regression showed a significant inverse correlation between prostate volume and csPCa probability. Notably, 79% of csPCa patients with prostate volume ≤ 40 mL had a PSAd ≥ 0.15 ng/mL², compared to only 22.4% with volumes ≥ 60 mL. PSAd performed significantly worse for larger glands (≥ 60 mL), with AUCs of 0.70 versus 0.84 (≤ 40 mL) and 0.82 (40-60 mL), both p < 0.001.

CONCLUSION: The optimal PSAd cut-offs for guiding biopsy decisions were 0.20 ng/mL² for PI-RADS 1-2 and 0.12 ng/mL² for PI-RADS 3. When using PSAd to guide biopsy decision for PI-RADS 1-3 patients with large prostates (> 60 mL), caution is warranted, as PSAd becomes significantly less accurate.

KEY POINTS: Question The optimal PSA-density thresholds for biopsy decisions in PI-RADS 1-3 patients remain uncertain, and data on the impact of prostate volume on its performance are limited. Findings Optimal PSA-density thresholds were 0.20 ng/mL² for PI-RADS 1-2 and 0.12 ng/mL² for PI-RADS 3. Diagnostic performance of PSA-density decreased significantly in men with larger glands (≥ 60 mL). Clinical relevance PSA-density cut-offs of 0.20 (PI-RADS 1-2) and 0.12 ng/mL² (PI-RADS 3) can guide biopsy decisions. In PI-RADS 1-3 patients with large prostate (≥ 60 mL), PSA-density becomes significantly less predictive, and low values may not reliably exclude csPCa.

PMID:41484253 | DOI:10.1007/s00330-025-12272-y