Category: Nevin Manimala

Int Dent J. 2026 Jun 11;76(4):109677. doi: 10.1016/j.identj.2026.109677. Online ahead of print.

ABSTRACT

OBJECTIVES: Sal is one of the ten islands of Cape Verde, a lower-middle-income country in Africa. Local reports suggest poor oral health among residents, but no scientific data exists. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) of Sal’s dentulous inhabitants, identify risk factors associated with oral health, and explore correlations between oral health and OHRQoL in adults.

MATERIALS AND METHODS: A population-based cross-sectional study was conducted among dentulous Sal residents. Final-year dental students from the Academic Centre for Dentistry Amsterdam (ACTA), Faculty of Dentistry in Amsterdam, performed duplicate oral health examinations. Outcomes included caries experience (dmft/DMFT), consequences of untreated caries (pufa/PUFA), and periodontal health (DPSI; in adults only). Data on brushing frequency, toothbrush ownership, toothpaste availability, dental visits, dental insurance, and tobacco use (adults only) were collected. Adults completed the OHIP-14 questionnaire (OHRQoL). Descriptive statistics summarized characteristics; multivariable regressions assessed associations.

RESULTS: A total of 1,371 dentulous residents participated (609 children aged 1-17 years; 762 adults aged 18-89 years). Caries prevalence was 87.5% and pufa/PUFA 52.2%. Mean dmft/DMFT was 3.7 ± 3.2 (children) and 7.5 ± 6.2 (adults). 63.1% had DPSI maximum-scores ≥3+ (periodontal disease). Toothbrush ownership was high (>96%), access to toothpaste (<90%) and dental insurance was limited (children 63%; adults 46%). Dental insurance was associated with lower dmft/DMFT (p = .019) and lower pufa/PUFA (p = .005). Higher DMFT, PUFA, and severe periodontal disease was associated with poorer OHRQoL.

CONCLUSIONS AND CLINICAL RELEVANCE: Oral health among Sal’s residents is poor, with a high disease burden and limited access to care. Improving preventive strategies and access to dental services is important to reduce disease prevalence and enhance quality of life.

PMID:42275744 | DOI:10.1016/j.identj.2026.109677

Blood Cells Mol Dis. 2026 Jun 6;120:103022. doi: 10.1016/j.bcmd.2026.103022. Online ahead of print.

ABSTRACT

BACKGROUND: Polycythemia vera (PV) is a chronic myeloproliferative neoplasm characterized by the clonal proliferation of hematopoietic stem cells, primarily driven by JAK2 mutations. Even though there are established diagnostic and therapeutic standards, there is not a lot of information about the clinical and molecular features of PV in Latin America. Our aim was to characterize the demographic, clinical, hematological, and treatment characteristics of patients with polycythemia vera at a specialized hematology/oncology center in southern Colombia.

METHODS: We conducted a retrospective cohort analysis involving patients aged 18 years and older diagnosed with polycythemia vera at Hemato Oncólogos S.A. and Clínica Imbanaco in Cali, Colombia, from July 2015 to July 2023. We looked at 59 consecutive medical records to get demographic information, JAK2 mutational status, hematologic parameters, initial treatment, relapse reasons, and outcomes. We used descriptive statistics and compared groups using the Chi-square/Fisher’s exact test for categorical variables and the Student’s t-test, ANOVA, or non-parametric alternatives for continuous variables. A p-value under 0.05 was considered statistically significant.

RESULTS: There were 59 patients in all, with a slight male majority (50.8%) and an average age of 70.1 ± 12.3 years; the average age at diagnosis was 60.1 ± 11.3 years. In 61.0% of patients, JAK2 mutations were found, and in 81.4% of patients, the risk was high. The average hemoglobin level upon diagnosis was 17.2 ± 2.9 g/dL, but by the last follow-up, it had dropped to 14.4 ± 2.6 g/dL. The main treatments were acetylsalicylic acid plus hydroxyurea (32.2%) or phlebotomy (28.8%). During the follow-up period (mean 0.9 ± 3.6 years), 37.3% of individuals experienced recurrence, sometimes requiring an increase in treatment to hydroxyurea or ruxolitinib. The overall death rate was 15.3%. No statistically significant differences were seen between patients who survived and those who died concerning baseline hemoglobin, age, JAK2 status, or therapeutic mode.

CONCLUSION: This study provides one of the first extensive characterizations of PV in southern Colombia, confirming internationally recognized clinical features, including advanced age at diagnosis, increased prevalence of cardiovascular comorbidities, and a predominance of high-risk classification. The low rate of finding JAK2 mutations suggests that molecular testing may not be as easy to get as it could be. Even if the treatment followed the guidelines, the risk of recurrence and thrombosis remained, showing that PV is a long-term and worsening condition. These findings highlight the urgent need to expand access to molecular diagnostics, develop tailored risk-adapted medicines, and initiate prospective multicenter studies in Latin America to optimize outcomes and quality of life in PV.

PMID:42275722 | DOI:10.1016/j.bcmd.2026.103022

Food Chem. 2026 Jun 8;522:149991. doi: 10.1016/j.foodchem.2026.149991. Online ahead of print.

ABSTRACT

Brandy flavor is shaped by complex production processes, yet comprehensive multivariate analyses of these stages remain limited. This study employed flavoromics and chemometrics to characterize the influence of grape variety, micro-region, distillation method, and aging protocol on brandy. HS-SPME-GC-MS and sensory data were analyzed using multivariate models (PCA, PLS-DA) and FDR-corrected univariate analyses. Results showed that representative compounds such as geraniol, ethyl heptanoate, and isoamyl lactate discriminated samples of micro-regions, while grape variety, distillation system, and aging regime generated distinct volatile and sensory patterns. Rather than being treated solely as statistical markers, these compounds were interpreted in relation to precursor differences, process-dependent transfer, and time-dependent chemical evolution. In particular, isoamyl lactate showed persistence from base wine to newmake brandy, whereas aging-related changes in esters and lactones reflected reaction equilibria associated with wood contact and toasting intensity. These findings provide a process-oriented framework for understanding how production variables shape brandy aroma.

PMID:42275714 | DOI:10.1016/j.foodchem.2026.149991

Clin Radiol. 2026 Apr 28;99:107371. doi: 10.1016/j.crad.2026.107371. Online ahead of print.

ABSTRACT

AIM: When radiologists encounter an unfamiliar musculoskeletal neoplasm on conventional and advanced MR images, they now have an option to search the internet for MRI image examples. The purpose of this project was to systematically evaluate the quality of images returned by a widely used general search engine.

MATERIALS AND METHODS: Systematic internet searches were conducted for 16 benign and malignant musculoskeletal neoplasms, focusing on T1-weighted (T1W), T2-weighted (T2W), contrast-enhanced, diffusion-weighted (DWI), and out-of-phase MR images. The top five images from each search were evaluated for image quality and clinical relevance using a 5-point scoring key.

RESULTS: General internet engine returned correct sequence among the top five results for 88% of lesions when searched for T1W images, 100% for T2W images, 100% for contrast-enhanced images, 63% for DWI, and 25% for out-of-phase images. Fleiss Kappa statistic demonstrated substantial agreement (Kappa = 0.72) for binary “useful” vs “not useful” image designation, and moderate agreement (Kappa = 0.48) for all five categories.

CONCLUSION: The general internet search engine returned useful results when searching for conventional MRI sequences but performed sub-optimally when searching for advanced MR image examples.

PMID:42275688 | DOI:10.1016/j.crad.2026.107371

JACC Adv. 2026 Jun 11;5(7):102869. doi: 10.1016/j.jacadv.2026.102869. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about end-of-life trajectories in survivors of cardiogenic shock complicating acute myocardial infarction (AMI-CS) who die beyond their index admission, or utilization of palliative care services in AMI-CS survivors.

OBJECTIVES: This study aimed to examine long-term palliative and end-of-life care among AMI-CS survivors.

METHODS: This was a population-based, retrospective cohort of AMI-CS survivors in Ontario, Canada, from 2009 to 2020 who died during longitudinal follow-up.

RESULTS: We identified 3,881 AMI-CS survivors (2009-2020) who died after discharge and before March 2024. The median survival time was 1,096 days (IQR: 312-2,139 days). Overall, 2,100 patients (54.1%) died in acute care, with no difference between those who did and did not receive palliative care. Patients who did not receive palliative care were more likely to die in intensive care units (ICU) than those who did (23% vs 17%, absolute standard difference 0.15). Most patients received palliative care in the final year of life (n = 2,485, 64%); 1,057 patients (42.5%) had outpatient visits, 505 patients (20.3%) had inpatient palliative care consultations, and 327 patients (13.2%) had palliative care hospitalizations. Palliative care, however, was most commonly initiated in the last 14 days of life (1,185 patients, 47.7%). Earlier palliative care referrals were associated with reduced rates of dying in hospital (adjusted OR: 0.50; 95% CI: 0.42-0.65) and ICU (adjusted OR: 0.34; 95% CI: 0.26-0.45).

CONCLUSIONS: Early and intermediate term palliative care involvement was associated with reduced risk of death in hospital and ICU. Such consultation may improve end-of-life outcomes in AMI-CS survivors.

PMID:42275681 | DOI:10.1016/j.jacadv.2026.102869

Am J Surg. 2026 May 6;260:117028. doi: 10.1016/j.amjsurg.2026.117028. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) carries a high recurrence risk. Aspirin has been proposed for secondary prevention, but its benefit remains uncertain. This systematic review and meta-analysis evaluated aspirin’s impact on disease-free survival (DFS) and overall survival (OS).

METHODS: A systematic search of four databases (PubMed, Embase, Scopus, the Cochrane Library) was conducted from inception to January 2025 using predefined inclusion and exclusion criteria. Screening and data extraction were performed independently. Study quality was assessed using RoB 2 and the Newcastle-Ottawa Scale. Ten studies were included, comprising retrospective cohorts, population-based cohorts, prospective observational analyses, and Phase III randomized controlled trials (RCTs). A random-effects meta-analysis was conducted to pool effect sizes as odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was quantified using I² and τ², and sensitivity analyses included leave-one-out testing. All analyses followed PRISMA guidelines.

RESULTS: Ten studies were included. Pooled analyses of observational studies showed no statistically significant improvement in OS (OR 0.92, 95% CI 0.78-1.08) or DFS (OR 0.90, 95% CI 0.74-1.08) among aspirin users. Considerable heterogeneity and inconsistency were observed across studies. RCTs likewise demonstrated no clear survival benefit, with effect estimates close to unity. Safety data were limited and variably reported, precluding firm conclusions regarding adverse outcomes.

CONCLUSION: Current evidence does not support aspirin as adjuvant therapy for secondary prevention in CRC. Future research should target biomarker-defined subgroups for potential benefits.

PMID:42275677 | DOI:10.1016/j.amjsurg.2026.117028

Comput Inform Nurs. 2026 Jun 8. doi: 10.1097/CIN.0000000000001582. Online ahead of print.

ABSTRACT

Measuring noninvasive blood pressure (NIBP) is a fundamental skill that nursing students are trained to master, and they are expected to possess comprehensive knowledge and proficiency in this procedure to ensure accurate measurements. The aim of this study was to evaluate the effect of interactive video-based training on noninvasive blood pressure measurement provided to first-year nursing students, focusing on its impact on their knowledge and skills in performing noninvasive blood pressure measurements. Conducted from October 2022 to June 2023, the randomized controlled trial involved 66 students, split into an experimental group (n = 32) and a control group (n = 34). Following theoretical instruction, the experimental group received the video intervention, while the control group did not. No statistically significant difference was found between the mean scores of noninvasive blood pressure measurement knowledge across the participant groups (P = .482; P > .05). A statistically significant difference was found in the noninvasive blood pressure measurement skill scores between the participant groups, with the students in the experimental group scoring higher than those in the control group (P = .000; P < .05). The interactive video application positively influenced noninvasive blood pressure measurement knowledge and skills. It is recommended that technology-supported applications be incorporated into basic skills training.

PMID:42275671 | DOI:10.1097/CIN.0000000000001582

Obstet Gynecol. 2026 Jun 11. doi: 10.1097/AOG.0000000000006336. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess whether the previously found neonatal survival advantage for Black (vs White) periviable births (20 0/7-25 6/7 weeks of gestation) persists over a 25-year period (1995-2019) in the United States, and to quantify changes in survivability over time. Assessments conceptualize race as a marker of exposure to racialized stressors and barriers to care.

METHODS: This population-based observational study used 1995-2019 U.S. restricted-use, cohort-linked birth and infant death data from the National Center for Health Statistics. The study included all non-Hispanic Black (n=149,601) and non-Hispanic White (n=158,500) periviable births. We used modified Poisson regressions to estimate risks of neonatal death (before age 28 days) based on the birthing person’s race and ethnicity and year of birth (measured in 5-year periods) and their interaction. We also controlled for a set of sociodemographic variables (maternal age, socioeconomic status) and pregnancy characteristics (plurality, neonatal sex) that predict neonatal mortality.

RESULTS: In 1995-1999, Black periviable neonates exhibited a survival advantage compared with their White counterparts (adjusted risk ratio [aRR] 0.86; 95% CI, 0.84-0.87). Over 20 years, White periviable neonates experienced a precipitous decrease in neonatal death risks (2015-2019 aRR 0.82; 95% CI, 0.80-0.83), whereas Black periviable neonates experienced slower improvements (2015-2019 Black×period aRR 1.07; 95% CI, 1.04-1.09). Estimates suggest that risks of neonatal death declined by 18% for White periviable neonates (from predicted probabilities of 53.0 in 1995-1999 to 43.3 in 2015-2019) but by only 13% for their Black counterparts (45.5-39.5). Black-White periviable risk ratios ranged from 4.0 to 3.6 over the study periods.

CONCLUSION: Both Black and White periviable births exhibited declines in neonatal death risks between 1995 and 2019, with White births showing faster declines. Clinically, these findings reveal overall improvements in periviable risks. However, because Black births are disproportionately represented among periviable deliveries, slower improvements in survival sustain a disproportionate burden of periviable deaths among Black neonates.

PMID:42275664 | DOI:10.1097/AOG.0000000000006336

N Z Med J. 2026 Jun 12;139(1636):102-109. doi: 10.26635/6965.7318.

ABSTRACT

Primary healthcare data can be used to conduct cost-effective research that improves understanding of population health and disease, leading to more effective prevention, earlier diagnosis, better-informed health models and improved health equity. However, Aotearoa New Zealand lacks a national primary healthcare data collection and has no national infrastructure to integrate and interrogate routinely collected primary healthcare data. This paper describes new technical approaches used internationally to improve researcher access to healthcare data and considers how this may be applied in the New Zealand context using Māori data governance and ethical data stewardship principles. Data access may be improved through platform-level, algorithm-level and data-level approaches. Māori data governance and ethical data stewardship principles can be applied to these new technical approaches. A governance model requires strict management, administration and oversight. An open-access model could provide easier access for researchers to develop and test models on synthetic data within a trusted research environment. Improving primary healthcare data access for research in New Zealand requires partnership that upholds Māori data governance principles and ethical research standards. Debate of the advantages and disadvantages of these technical approaches and stewardship models including patients and the public is welcomed.

PMID:42275661 | DOI:10.26635/6965.7318

N Z Med J. 2026 Jun 12;139(1636):87-101. doi: 10.26635/6965.7486.

ABSTRACT

AIMS: Life expectancy in Aotearoa New Zealand has increased over recent decades, but these increases have not been distributed equally across population groups. Examining how changes in cause-specific mortality have contributed to changes in life expectancy can improve understanding of evolving mortality patterns and persistent inequities. This study quantified the contribution of major causes of death to changes in life expectancy over approximately two decades.

METHODS: Mortality data from the New Zealand Mortality Collection and population estimates from Statistics New Zealand were used to calculate life expectancy at birth for Māori, Pacific, Asian, and European and Other populations for the periods 2001-2003 and 2020-2022. Changes in life expectancy were decomposed by age and cause of death using the Arriaga method. Deaths were grouped into major disease categories and selected individual causes to estimate their contribution to the change in life expectancy.

RESULTS: Life expectancy increased for all ethnic groups, with the largest absolute increases observed among Māori. Improvements were driven primarily by reductions in mortality at adult and older ages. Across all ethnic and sex groups, declines in cardiovascular disease and cancer mortality accounted for more than half of the total change in life expectancy. Reductions in mortality from diabetes and smoking-related conditions also contributed to increases among Māori and Pacific peoples. Despite these improvements, substantial ethnic inequities in life expectancy remain.

CONCLUSION: Increases in life expectancy in Aotearoa New Zealand between 2001-2003 and 2020-2022 were driven largely by reductions in mortality from major non-communicable diseases, primarily cardiovascular disease and cancer. Māori experienced some narrowing of the life expectancy gap relative to European and Other populations, whereas the gap for Pacific peoples remained largely unchanged. Despite overall improvement, substantial inequities persist. Further increases are likely to depend on strengthening primary prevention, particularly reductions in smoking and cardiovascular risk factors, alongside improved participation in screening and early detection programmes, including the potential role of lung cancer screening, and ensuring equitable access across care pathways.

PMID:42275660 | DOI:10.26635/6965.7486