Nevin Manimala

J Esthet Restor Dent. 2026 Jul 28. doi: 10.1111/jerd.70246. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this in vitro study was to evaluate the effects of different surface treatments on the shear bond strength of repaired milled and 3D-printed resin restorations.

MATERIALS AND METHODS: A total of 84 resin specimens (8 mm diameter, 5 mm height) fabricated using two different methods such as milling (Grandio Disc) and 3D-printing (Saremco Crowntec) were subjected to three surface treatments: silane (control), air abrasion + silane, and laser irradiation + silane. All specimens were subjected to thermocycling (5000 cycles each) before and after the repair protocol which was conducted with a flowable composite, and the shear bond strengths were measured. SEM images were obtained to evaluate the type of failures. Data were analyzed using IBM SPSS V23, and two-way ANOVA analysis was used for comparisons between surface treatments and samples (p < 0.05).

RESULTS: Laser irradiation yielded the highest bond strength (7.61 ± 1.94 MPa), showing a statistically significant difference (p = 0.001). The 3D-printed resin group exhibited significantly higher bond strengths after all surface treatments compared to the milled group (p = 0.028). Representative SEM observations revealed increased surface irregularity and fracture-surface complexity in laser-treated specimens.

CONCLUSION: Laser irradiation is an effective method for improving the bond strength in the repair of both milled and 3D-printed resin restorations. Particularly, 3D-printed resins showed superior repair bond strengths. Silane alone is insufficient; additional micromechanical surface treatments are required for reliable adhesion.

CLINICAL SIGNIFICANCE: Mechanical complications can occur with milled and 3D-printed resin restorations, which are increasingly used in indirect restorations, and intraoral repair protocols are becoming a crucial consideration. Determining the most appropriate repair protocol and surface treatment is crucial for the successful repair of these new-generation resin restorations.

PMID:42517210 | DOI:10.1111/jerd.70246

Knee Surg Sports Traumatol Arthrosc. 2026 Jul 28. doi: 10.1002/ksa.70548. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to compare implant survivorship and patient-relevant outcomes associated with the constraint level used at first-time aseptic revision total knee arthroplasty (rTKA).

METHODS: This retrospective cohort study used data from the National Joint Registry for England, Wales, Northern Ireland, the Isle of Man, Guernsey and Jersey, linked to Hospital Episode Statistics and national patient-reported outcome measures (PROMs). Patients undergoing first-time aseptic rTKA between 1 January 2009 and 30 September 2023 were included. Constraint was categorized as unconstrained, posterior-stabilized (PS), condylar-constrained (CCK) or hinge. The primary outcome was 10-year cumulative incidence of re-revision. Prespecified subgroups included patients at high risk of re-revision and those revised for aseptic loosening or instability. Secondary outcomes included 6-month PROMs; 90-day mortality and medical complications; and length of stay. Competing risk regression was used to estimate re-revision risk, treating death as a competing event.

RESULTS: After exclusions, 12,950 cases were analysed (median follow-up 7.4 years [95% confidence interval, CI 7.3-7.5]. CCK prostheses were associated with the lowest unadjusted 10-year cumulative incidence of re-revision overall (9.2% [95% CI 8.4-10.1]) and in all subgroups. In the primary adjusted analysis, unconstrained (subdistribution hazard ratio [sHR] 1.46 [1.23-1.74], p < 0.001), PS (sHR 1.23 [1.04-1.44], p = 0.013) and hinged prostheses (sHR 1.66 [1.38-2.01], p < 0.001) were associated with higher re-revision risk than CCK constructs. There was weak evidence that the association between PS implants and re-revision was greater among low-volume than high-volume surgeons (interaction sHR 1.30 [1.00-1.70], p = 0.053). After further adjustment for implant-related factors, re-revision risk was similar for unconstrained (sHR 0.97 [0.78-1.21], p = 0.792) and PS implants (sHR 1.00 [0.83-1.19], p = 0.972) versus CCK, whilst increased risk associated with hinges persisted (sHR 1.67 [1.36-2.05], p < 0.001).

CONCLUSION: CCK constructs were consistently associated with favourable implant survivorship across a range of clinical scenarios. These findings provide reassurance that clinically indicated use of CCK constraint is not associated with compromised implant survival.

LEVEL OF EVIDENCE: Level III.

PMID:42517199 | DOI:10.1002/ksa.70548

Eur J Phys Rehabil Med. 2026 Aug;62(4):432-440. doi: 10.23736/S1973-9087.26.09267-1.

ABSTRACT

BACKGROUND: A recent definition of clinical obesity emphasises the presence of age-adjusted limitations in activities of daily living (ADLs). Early identification of ADL limitations and factors negatively influencing the development of disability is needed to enhance the effectiveness of rehabilitation programs.

AIM: To investigate the relationship between functional limitations in ADLs, body composition parameters, and comorbid conditions in a large cohort of adults with different degrees of obesity.

DESIGN: Retrospective observational cross-sectional study.

SETTING: Hospital-based rehabilitation setting.

POPULATION: Adult inpatients with different degree of obesity, from mild to severe obesity.

METHODS: Patients were enrolled at hospital admission. Collected data included demographic/anthropometric measures, functional status (by modified Katz ADL Index), comorbidities, body composition, and muscle strength.

RESULTS: Out of 3229 enrolled patients, 193 (6.0%) resulted fully dependent, while 2115 (65.5%) were fully independent. The most frequently observed disabilities were in urine/fecal continence (24.7%) and toileting (15.5%). ADL impairments were significantly associated with older age, higher BMI, higher waist circumference, excess of fat mass, reduced fat-free mass and lower values of HGS. The logistic model identified 5 variables statistically associated with the probability to be a fully dependent patient: age, weight and waist circumference increased this probability, while Muscle Mass and Hand Grip strength lowered it. Osteoarthritis was present in 52% of patient with severe limitations.

CONCLUSIONS: The severity in ADLs is influenced by both body composition and comorbid conditions.

CLINICAL REHABILITATION IMPACT: Rehabilitation should focus on functional limitations and presence of comorbidities and risk factors in patients with obesity, and particularly on preventing muscle mass loss during weight management.

PMID:42517169 | DOI:10.23736/S1973-9087.26.09267-1

J Inflamm Res. 2026 Jul 23;19:608478. doi: 10.2147/JIR.S608478. eCollection 2026.

ABSTRACT

PURPOSE: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammation of the sinuses accompanied by the formation of obstructive nasal polyps, which may lead to symptoms of common mental disorders, including anxiety and depression, as a result of long-term discomfort. This study aimed to investigate the associations of severe CRSwNP, with anxiety and depression.

METHODS: Adult patients with severe primary diffuse CRSwNP scheduled to undergo sinus surgery and healthy control participants were prospectively enrolled. Clinical data were collected and the Sinonasal Outcome Test-22 (SNOT-22), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) were used to evaluate quality of life.

RESULTS: Ninety-six patients with CRSwNP and 40 controls were enrolled in this study. Patients with CRSwNP exhibited significantly higher BAI scores than controls. However, BDI-II scores were not significantly different. Among the patients with CRSwNP, 32.3% exhibited possible anxiety, defined as a BAI score >7. Comorbid asthma, SNOT-22 score, and blood eosinophil percentage were significant factors associated with anxiety in patients with CRSwNP in univariate logistic regression analysis and comorbid asthma and SNOT-22 remained statistically significant in multivariable analysis. An SNOT-22 score > 57 was the optimal cutoff value for identifying patients with possible anxiety.

CONCLUSION: A significant proportion of patients with CRSwNP exhibited anxiety symptoms. Comorbid asthma, SNOT-22 score, and blood eosinophil percentage were significant factors associated with the presence of anxiety. These findings emphasize the importance of screening for psychological symptoms and potentially integrating psychological assessments and interventions in the care of high-risk patients.

PMID:42517155 | PMC:PMC13404342 | DOI:10.2147/JIR.S608478

Front Psychiatry. 2026 Jul 13;17:1758127. doi: 10.3389/fpsyt.2026.1758127. eCollection 2026.

ABSTRACT

AIM: This study aimed to analyze the influencing factors of non-suicidal self-injury (NSSI) in adolescents with depression.

METHODS: This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. We systematically searched PubMed, Embase, Web of Science, the Cochrane Library, and the China National Knowledge Infrastructure (CNKI) for observational studies on factors influencing NSSI behavior in adolescents with depression published between 1 January 2010 and 7 May 2026. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale. Meta-analyses were performed in RevMan 5.4 using mean differences (MDs) with 95% confidence intervals. Between-study heterogeneity was evaluated using the χ² test and I² statistic, and fixed- or random-effects models were applied as appropriate.

RESULTS: In total, 11 studies were included, involving 529 patients in the study group and 1,716 patients in the control group. The meta-analysis showed that, compared with the control group, the study group had significantly higher scores for interpersonal problems, negative emotions, alexithymia, and negative self-esteem [MD = 5.88, 95% CI (3.19, 8.57), P < 0.001], somatic symptom scores [MD = 5.20, 95% CI (-0.03, 10.43), P = 0.05], emotional deficit [MD = 6.82, 95% CI (0.32, 13.31), P = 0.04], Hamilton Depression Rating Scale scores [MD = 2.97, 95% CI (1.76, 4.18), P < 0.001], emotional abuse [MD = 2.10, 95% CI (1.06, 3.13), P < 0.001], physical abuse [MD = 0.64, 95% CI (0.08, 1.20), P = 0.025], sexual abuse [MD = 0.27, 95% CI (0.12, 0.42), P < 0.001], emotional neglect [MD = 1.67, 95% CI (0.37, 2.97), P = 0.009], physical neglect [MD = 0.81, 95% CI (0.43, 1.19), P < 0.001], and Childhood Trauma Questionnaire total scores [MD = 8.93, 95% CI (3.63, 14.24), P < 0.001].

CONCLUSION: Adolescents with depressive disorders and NSSI tend to exhibit more severe depressive symptoms, maladaptive emotional regulation patterns, negative coping styles, and higher levels of childhood trauma exposure than those without NSSI. These psychosocial and emotional factors may play important roles in the occurrence and maintenance of NSSI behaviors. Early psychological assessment and targeted intervention may help reduce the risk of NSSI in adolescents with depressive disorders.

PMID:42517137 | PMC:PMC13403629 | DOI:10.3389/fpsyt.2026.1758127

Front Public Health. 2026 Jul 13;14:1845439. doi: 10.3389/fpubh.2026.1845439. eCollection 2026.

ABSTRACT

BACKGROUND: The rapid digitalization of healthcare has positioned Artificial Intelligence (AI) as a key driver of transformation in medical imaging. While its technical capabilities are well established, evidence on its real-world impact on departmental performance and workforce dynamics remains limited.

OBJECTIVE: This study evaluated the impact of AI integration on diagnostic accuracy, operational efficiency, and staff performance in medical imaging departments.

METHODS: A quantitative cross-sectional design was employed using a structured, validated Likert-scale questionnaire administered to healthcare professionals (N = 400), including radiologists, technologists, and department managers. Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression to assess the contribution of AI-related factors to departmental performance.

RESULTS: AI integration explained 57.8% of the variance in departmental performance (R ² = 0.578, p < 0.001). Diagnostic accuracy (β = 0.236, p < 0.001) and operational efficiency (β = 0.306, p < 0.001) emerged as statistically significant positive predictors of departmental performance, with operational efficiency demonstrating the strongest effect. Although Staff Performance demonstrated a positive association with departmental performance, it did not remain a statistically significant independent predictor after multivariate adjustment.

CONCLUSION: AI integration improves both clinical effectiveness and operational performance in medical imaging departments. Effective implementation requires workflow integration, workforce training, and alignment with broader health system priorities. Future research should explore longitudinal and multi-center impacts on patient and population health outcomes.

PMID:42517126 | PMC:PMC13402428 | DOI:10.3389/fpubh.2026.1845439

Front Public Health. 2026 Jul 13;14:1808521. doi: 10.3389/fpubh.2026.1808521. eCollection 2026.

ABSTRACT

BACKGROUND: Research on home-based eldercare has increasingly moved beyond physical safety and accessibility to consider psychological wellbeing and everyday activity. However, older adults are still often treated as a homogeneous group. Less is known about how different psychological profiles are associated with residential preferences, activity patterns, and perceived environmental support among early-stage aging adults.

METHODS: This study focused on early-stage older adults and applied a human-environment systems framework to examine the relationships among psychological characteristics, residential conditions, and home-based activities. A total of 509 valid household questionnaires were collected in northern China between July and September 2025. Psychological profiles were identified using K-means clustering, and differences in residential preferences, activity patterns, and facility provision across psychological types were analyzed using descriptive statistics and inferential tests.

RESULTS: Three psychological types were identified. Overall, 45.2% of respondents preferred living adjacent to their children, while lower-income participants showed a stronger tendency toward co-residence. Shared family meals and household chores were the most frequent activities, whereas participation in fitness, hobbies, and shared entertainment was limited. The psychologically vulnerable group exhibited poorer physical functioning, higher long-term medication use (49.5%), stronger preferences for low-brightness interior color schemes (χ² = 12.52), smaller and more constrained activity spaces, and lower engagement in internet use, fitness, and reading. Despite expressing the strongest willingness to modify their dwellings, this group showed low ownership of supportive facilities, indicating a demand-supply mismatch. High synchronization with family routines was observed alongside low autonomous activity participation, suggesting potential risks for autonomy and psychological wellbeing.

CONCLUSION: This study provides cross-sectional and context-specific evidence that psychological profiles are associated with differences in residential preferences, activity participation, perceived environmental support, and facility demand among early-stage aging adults in northern China. The inclusive spatial design model should be understood as an evidence-informed design translation tool, rather than as a validated theory, causal model, or intervention protocol. Its implications are limited to preliminary guidance for aging-friendly housing assessment and housing-related public health intervention planning. Further validation through covariate-adjusted analysis, cluster-stability testing, independent samples, and longitudinal or intervention studies is required before broader theoretical, policy, or practice-level generalization.

PMID:42517118 | PMC:PMC13402117 | DOI:10.3389/fpubh.2026.1808521

Front Public Health. 2026 Jul 13;14:1884531. doi: 10.3389/fpubh.2026.1884531. eCollection 2026.

ABSTRACT

OBJECTIVE: This study examined the relationship between adolescent sports participation and school adjustment and analyzed the serial mediating effects of peer relationships and depressive symptoms.

METHODS: The study sample comprised 8,096 adolescent participants. Assessments were conducted using the Physical Activity Questionnaire for Children (PAQ-C), the School Social Behavior Scale (SSBS), the Quality of Life Scale for Children and Adolescents (QLSCA), and the Symptom Checklist-90 (SCL-90). The hypothesized mediation effects were tested using the SPSS 26.0 macro PROCESS 4.5 with bias-corrected bootstrapping (5,000 resamples) to assess the significance of the indirect effects.

RESULTS: Group comparisons showed that boys scored higher than girls on sports participation, school adjustment and reported lower depressive symptoms scores (p < 0.001), while no significant gender difference emerged for peer relationships. No significant age differences were observed for sports participation, school adjustment, or peer relationships (all p > 0.05), but depressive symptoms increased significantly with age (p < 0.01), with the highest levels at age 19. Only children scored higher on sports participation and school adjustment and lower on depressive symptoms, but lower on peer relationships, than non-only children (p < 0.001). Students in remote areas showed lower school adjustment and higher depressive symptoms scores than those in several non-remote groups (p < 0.001). Sports participation was positively correlated with school adjustment (r = 0.260, p < 0.001) and peer relationships (r = 0.201, p < 0.001) and negatively correlated with depressive symptoms (r = -0.166, p < 0.001). Peer relationships were positively correlated with school adjustment (r = 0.344, p < 0.001) and negatively correlated with depressive symptoms (r = -0.362, p < 0.001). Depressive symptoms were negatively correlated with school adjustment (r = -0.226, p < 0.001). Peer relationships (effect = 1.76, 95% CI [1.50, 2.03]) and depressive symptoms (effect = 0.23, 95% CI [0.14, 0.33]) each mediated the association between sports participation and school adjustment. They also formed a small but statistically significant serial mediation effect pathway (effect = 0.20, 95% CI [0.14, 0.28]).

CONCLUSION: This study further clarifies the relationship between adolescent sports participation and school adjustment, and emphasizes the chain mediating role of peer relationships and depressive symptoms. These findings provide empirical evidence for the educational value of adolescent sports participation and offer practical implications for optimizing school physical education to enhance school adjustment and promote mental health.

PMID:42517114 | PMC:PMC13402566 | DOI:10.3389/fpubh.2026.1884531

Front Public Health. 2026 Jul 13;14:1789969. doi: 10.3389/fpubh.2026.1789969. eCollection 2026.

ABSTRACT

OBJECTIVE: Despite growing evidence on the association between peer relationships and academic burnout among left-behind children, the underlying psychological mechanisms remain insufficiently understood. This study targeted rural left-behind children experiencing moderate to high academic burnout, and aimed to explore the serial mediating roles of social support and cognitive reappraisal in the relationship between peer relationships and academic burnout among this high-risk vulnerable group.

METHODS: This study employed a cross-sectional design, recruiting a total of 888 eligible rural left-behind children after excluding participants with low academic burnout as participants. All participants completed the Peer Relationship Scale, the Academic Burnout Scale, the Social Support Scale, and the Cognitive Reappraisal subscale of the Emotion Regulation Questionnaire. Data analysis was conducted using SPSS 27.0, Amos 29.0, and the PROCESS macro.

RESULTS: Regression analysis confirmed a significant negative correlational association between peer relationships and academic burnout (β = -0.325, p < 0.001). Further mediation analyses identified significant statistical correlational pathways linking these variables: this cross-sectional association was transmitted not only through the significant independent correlational pathway roles of social support [β = -0.132, 95% CI (-0.188, -0.078)] and cognitive reappraisal [β = -0.075, 95% CI (-0.116, -0.041)], but also, critically, through the correlational linkage of cognitive reappraisal specifically between social support and academic burnout. These pathways converged into a significant chain mediation correlational effect from social support to cognitive reappraisal [β = -0.022, 95% CI (-0.037, -0.009)].

CONCLUSION: Among rural left-behind children with moderate-to-high academic burnout, peer relationships negatively affect academic burnout via the independent and serial mediating roles of social support and cognitive reappraisal, with social support exerting a stronger mediating effect.

PMID:42517112 | PMC:PMC13402382 | DOI:10.3389/fpubh.2026.1789969

Front Public Health. 2026 Jul 13;14:1847173. doi: 10.3389/fpubh.2026.1847173. eCollection 2026.

ABSTRACT

PURPOSE: Occupational health examinations have long relied on conventional health classes to assess worker health status. However, individuals within the same examination class may differ substantially in risk sources, pathophysiological background, and potential progression patterns. This study aimed to determine whether stable hidden health subtypes exist beyond conventional occupational health classifications in a large real-world cohort and to evaluate the utility of graph-enhanced deep representation learning for subtype discovery and biomedical interpretation.

METHODS: We included 63,988 occupational health examination records collected from five organizational units between 2022 and 2025. A standardized master dataset was constructed by harmonizing anthropometric measures, blood pressure, glucose metabolism, lipid metabolism, liver function, kidney function, inflammatory markers, and vascular-related indicators. We first established a benchmark panel including conventional statistical models, tree-based models, and neural network models. We then developed a domain-aware prototype tabular network (DAPTN) and its graph-enhanced variant (Graph-DAPTN) to learn individual-level latent health representations, prototype distances, and hidden subtype structure. The identified subtypes were further interpreted in terms of clinical abnormality burden, risk gradients, temporal drift, and cross-domain stability.

RESULTS: The cohort exhibited substantial heterogeneity across units and years, as well as strong coupling among biomedical indicators. Linear models showed limited performance in capturing complex occupational health phenotypes, whereas nonlinear models performed better overall. In subtype-discovery validation, Graph-DAPTN showed stronger cluster separation and class-subtype concordance than several conventional baselines. Based on this representation, six clinically interpretable hidden subtypes were identified beyond conventional health classes: resilient-healthy, hepato-inflammatory, uric-metabolic, gluco-lipotoxic, hypertensive-homocysteine, and ageing-vascular. These subtypes showed distinct abnormality spectra in glucose and lipid metabolism, blood pressure, liver enzymes, uric acid, homocysteine, and inflammatory burden, and their distributions varied across years and organizational units.

CONCLUSION: Conventional health classes in occupational health examinations do not fully capture the underlying heterogeneity of worker health status. Graph-enhanced deep representation learning can improve health-state modeling while identifying clinically meaningful hidden subtypes beneath routine classification. These findings may support more refined risk stratification, key-population screening, and unit-level health intervention planning in occupational health practice.

PMID:42517104 | PMC:PMC13402512 | DOI:10.3389/fpubh.2026.1847173