Nevin Manimala

BMC Oral Health. 2026 Jul 13. doi: 10.1186/s12903-026-09010-1. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate age-related differences in transverse intermolar width and crown torque of maxillary and mandibular first permanent molars in adolescents, and to explore whether molar torque changes are associated with differential transverse growth.

METHODS: A total of 410 dental casts and corresponding posteroanterior cephalograms from 108 Chinese subjects (38 males and 70 females) aged 8-18 years were analyzed using a retrospective observational design with partially repeated measures. For subjects with records available at multiple ages, all eligible records were included to improve age-group representation. Maxillary and mandibular basal bone widths were measured on posteroanterior radiographs. Dental casts were digitized and analyzed to obtain intermolar width and molar crown torque. Statistical analyses included linear mixed-effects models for sex comparisons, one-way ANOVA with Bonferroni correction for age-group comparisons, Pearson correlation analysis, and sensitivity analysis.

RESULTS: Both maxillary and mandibular basal bone widths were greater in older age groups, with mandibular basal width exceeding that of the maxilla. Despite this skeletal pattern, maxillary intermolar width increased more than mandibular intermolar width (3.16 mm vs. 1.44 mm). Maxillary first molars exhibited a progressive shift toward palatal angulation of 7.43°, whereas mandibular first molars showed a buccal angulation change of 14.04°, both tending toward a more neutral buccolingual angulation.

CONCLUSIONS: In this Chinese population aged 8-18 years, transverse skeletal growth of the mandible exceeded that of the maxilla, whereas maxillary intermolar width increased more than mandibular intermolar width. Coordinated molar torque adjustments were observed alongside this skeletal-dental discrepancy and may reflect a dentoalveolar compensatory adaptation contributing to transverse occlusal coordination.

PMID:42443844 | DOI:10.1186/s12903-026-09010-1

BMC Surg. 2026 Jul 13. doi: 10.1186/s12893-026-03809-z. Online ahead of print.

ABSTRACT

BACKGROUND: The prognostic value of circumferential resection margin (CRM) width after neoadjuvant-treated esophagectomy remains uncertain.

OBJECTIVE: To assess whether CRM distance predicts early (12-month) locoregional recurrence (LRR) following hybrid Ivor-Lewis esophagectomy.

DESIGN/SETTING: Retrospective observational cohort at a tertiary cancer center, April 2023-October 2024.

PARTICIPANTS: Consecutive adults who underwent two-stage (hybrid) esophagectomy for malignancy; emergencies and abandoned resections excluded.

EXPOSURE: Pathologic CRM measured in millimeters, analyzed continuously and by RCPath thresholds (≤ 1 mm vs. > 1 mm).

MAIN OUTCOMES: Primary-12-month locoregional recurrence (LRR). Secondary-any recurrence and recurrence-free survival (RFS).

RESULTS: Sixty-three resections were analyzed. CRM was measurable in 45 (71.4%). Median CRM was 2.0 mm (IQR 1.0-3.0). Six patients (9.5%) developed recurrence within 12 months-five locoregional and one distant. One of twenty-nine pathological complete responders (pCR, 3.4%) recurred. Univariable analysis did not demonstrate a significant association between CRM distance and early recurrence. Kaplan-Meier analysis showed no statistically significant difference in recurrence-free survival between CRM categories.

CONCLUSIONS: Early recurrence occurred in 9.5% of patients, predominantly locoregional. CRM distance, whether analyzed continuously or using RCPath thresholds, was not associated with early recurrence. These findings suggest that, within this single-center cohort, early relapse may reflect underlying tumor biology rather than marginal radial clearance, although results should be interpreted with caution given limited event numbers.

PMID:42443838 | DOI:10.1186/s12893-026-03809-z

BMC Public Health. 2026 Jul 14. doi: 10.1186/s12889-026-28463-1. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Early initiation of substance use and concurrent use of multiple drugs are critical factors linked to adverse health outcomes. Thus, this study aimed to investigate the demographic, behavioral, and psychiatric associates of early-onset and poly-drug use among individuals with substance use disorders in Western Iran.

METHODS: In this cross-sectional study, data were collected from the Addiction Disorders Registry of inpatients admitted to Farabi Hospital in Kermanshah, Iran. A total of 1,030 individuals diagnosed with substance use disorders were included in the analysis. Data were gathered through structured clinical interviews and reviews of medical records. Statistical analyses included descriptive statistics, chi-square tests, t-tests, Mann-Whitney U tests, and logistic regression models.

RESULTS: Participants who began using substances before the age of 18 had a significantly lower mean age. Poly-drug users also tended to be younger. Logistic regression analysis indicated that male gender, being single, curiosity-driven initiation of use, and the presence of bipolar or personality disorders were significantly associated with early-onset substance use. Additionally, poly-drug use was associated with younger age, male gender, divorced marital status, and the presence of depressive disorders.

CONCLUSION: Demographic and psychiatric characteristics linked to early initiation and poly-drug use. These findings underscore the need for targeted prevention and intervention strategies that focus on vulnerable subgroups.

PMID:42443837 | DOI:10.1186/s12889-026-28463-1

BMC Pediatr. 2026 Jul 13. doi: 10.1186/s12887-026-07229-z. Online ahead of print.

ABSTRACT

BACKGROUND: Bone mineral density (BMD) is crucial for evaluating bone health, particularly in the pediatric population. Physical parameters such as lower body strength (assessed by jump tests) and handgrip strength (a marker of musculoskeletal health) have been linked to BMD. This study aims to investigate the association between upper and lower limb strength and BMD of the forearm and femur in children and adolescents stratified by sex.

METHODS: This cross-sectional study involved 57 participants (aged 9 ± 2 years) from a philanthropic institution in Brazil. Participants were assessed for anthropometric measurements, somatic maturation, and BMD and lean soft tissue using Dual X-ray Absorptiometry (DXA). Handgrip strength was measured using a dynamometer, and horizontal and vertical jump performances were also assessed. Statistical analyses included Quantile Regression to examine the relationships between strength measures and BMD, adjusted for somatic maturation and lean soft tissue.

RESULTS: Significant positive associations were found between handgrip strength and femoral BMD, especially in boys (Femoral neck: β = 12.65; 95%CI = 2.39; 22.92,; Trochanter: β = 17.37; 95%CI = 5.04; 29.70; Total femur: β = 11.13 95%CI = 0.98; 21.27).

CONCLUSION: Upper and lower limb muscle strength, particularly handgrip and vertical jump performance, were positively associated with BMD of the forearm and femur in children and adolescents with low socioeconomic status, with associations observed in boys.

PMID:42443834 | DOI:10.1186/s12887-026-07229-z

BMC Public Health. 2026 Jul 14. doi: 10.1186/s12889-026-28450-6. Online ahead of print.

ABSTRACT

BACKGROUND: China’s rapid urbanization has coincided with a substantial rise in poor vision (PV) and myopia prevalence among youth. Understanding this association is crucial for formulating evidence-based ocular health strategies.

METHODS: We analyzed nationally representative data from 640,266 children and adolescents (7-18 years) across three waves (2010, 2014, 2019) of the Chinese National Surveys on Students’ Constitution and Health. Urbanization-related characteristics were derived from official statistical data and satellite remote sensing data. Six urbanization factors were extracted by exploratory factor analysis, and a composite score of urbanization was constructed. Bivariate spatial autocorrelation analysis and β mixed-effects models are utilized to evaluate the associations of urbanization with PV and myopia prevalence.

RESULTS: The prevalence of PV and myopia increased from 2010 to 2019, and both show a similar spatial correlation with urbanization scores. Urbanization scores were positively associated with PV prevalence (β: 0.03; 95% CI: 0.00-0.05), whereas the association with myopia prevalence was non-significant (β: 0.03; 95% CI: -0.00-0.05). After adjusting for all factors, economic factors (PV: β: 0.12; 95%CI: 0.07 ~ 0.18. Myopia: 0.14; 0.08 ~ 0.20) and innovative capacity (PV: β: 0.08; 95%CI: 0.02 ~ 0.14. Myopia: β: 0.07; 95%CI: 0.01 ~ 0.13) were positively associated with PV and myopia prevalence.

CONCLUSIONS: The positive association between urbanization and both PV and myopia prevalence underscores the imperative to integrate health into all policies. This calls for aligning urban development with preventive eye health strategies through enhanced eye care services and optimized urban environments, with a particular focus on economically dynamic regions.

PMID:42443833 | DOI:10.1186/s12889-026-28450-6

JMIR Form Res. 2026 Jul 10;10:e89416. doi: 10.2196/89416.

ABSTRACT

BACKGROUND: Heart failure is a chronic condition that significantly impacts patients’ quality of life and increases health care burden. Effective self-monitoring and lifestyle modification are essential components of heart failure management and can support improved health outcomes. Mobile health technologies, such as smartphone apps, are increasingly used to assist patients with heart failure in self-management. However, evidence regarding patient engagement, user experience, and the effectiveness of these mobile health tools remains limited and continues to evolve.

OBJECTIVE: This study aimed to explore the feasibility of a mobile health platform, MoTER-HF, which incorporates a smartphone app and a web-based clinical portal to support self-management in patients with heart failure.

METHODS: The feasibility study used a single-group pretest-posttest mixed methods design. A total of 23 participants diagnosed with heart failure were recruited to use the app and 2 Bluetooth-enabled measurement devices (a blood pressure monitor and a digital weight scale) over a 12-week period. Participants’ engagement and acceptance were assessed using a satisfaction questionnaire, semistructured interviews, and platform usage logs. Potential health and behavioral outcomes were explored using validated instruments administered at baseline and week 12.

RESULTS: Most participants found the MoTER-HF app easy to use and aligned with their routine self-monitoring practices. Daily monitoring features such as blood pressure and weight tracking were used frequently. However, features such as symptom tracking and exercise logging were used less often, reflecting individual preferences and perceived relevance. Participants reported improved self-monitoring practices and valued the ability to visualize and track their data, and the reassurance provided through nurses’ oversight in the satisfaction questionnaire and interviews. Changes in health and behavioral outcome measures were not statistically significant, although exploratory changes were observed in the scores of self-care, quality of life, and psychological well-being.

CONCLUSIONS: The MoTER-HF platform has demonstrated potential in supporting self-management among individuals with heart failure, particularly when it incorporates features that participants find engaging. Further research is needed to better understand the platform’s impact on health outcomes and the implementation challenges, and to involve clinicians in developing a scalable digital model of care.

PMID:42440360 | DOI:10.2196/89416

Bioinformatics. 2026 Jul 13:btag512. doi: 10.1093/bioinformatics/btag512. Online ahead of print.

ABSTRACT

SUMMARY: DamID, and its cell-type specific adaptations, including Targeted DamID (TaDa) and Chromatin Accessibility TaDa (CATaDa), are now widely-adopted as techniques for the genome-wide profiling of DNA binding proteins. Despite this popularity, no dedicated software solution exists for identifying differentially bound or accessible loci, or differentially transcribed genes, between cell types using DamID. The R/Bioconductor package damidBind provides these functions, allowing an end-user to move from processed binding profiles to identifying differentially-bound loci in a reproducible, statistically appropriate and straightforward workflow.

AVAILABILITY AND IMPLEMENTATION: damidBind is an open-source R/Bioconductor package and freely available from Bioconductor at https://bioconductor.org/packages/damidBind/, and from GitHub at https://github.com/marshall-lab/damidBind. It is released under the GPLv3 licence.

PMID:42440342 | DOI:10.1093/bioinformatics/btag512

Cochrane Database Syst Rev. 2026 Jul 13;7:CD015988. doi: 10.1002/14651858.CD015988.

ABSTRACT

RATIONALE: Childhood obesity is a major global public health concern. Although physical activity is recognised as an effective non-pharmacological intervention, most existing evidence synthesis has primarily focused on the role of physical activity in preventing obesity, with limited attention given to its effects on managing children with obesity.

OBJECTIVES: To synthesise evidence on the benefits and harms of physical activity for the management of obesity in children up to 9 years of age.

SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and two trial registries from 2012 to 2 June 2023, with an update on 4 December 2025. We also used Google Scholar to identify additional studies. We did not impose language or publication status restrictions.

ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) that investigated the effects of physical activity interventions of any frequency, mode (e.g. aerobic, resistance), or intensity, with a minimum intervention duration of 12 weeks, in children up to 9 years of age with obesity (as defined by the trialists) at baseline. Eligible comparators were standard care, waiting-list, no physical activity, or any other active interventions, such as comparisons of different physical activity parameters (e.g. duration, frequency, intensity).

OUTCOMES: Critical outcomes: body mass index (BMI), BMI z-score, body weight, health-related quality of life, adiposity and fat distribution, glycaemia, and adverse events (minor and serious). Important outcomes: physical well-being, mental well-being, physical activity levels, blood pressure, hyperinsulinemia, resistance to insulin, alterations in lipid metabolism, presence of obesity-related comorbidities or any non-communicable diseases, obesity-associated disability, lipid hormones, alterations in hunger or satiety, disability, mortality, prevalence of obesity in adulthood, and access to health services.

RISK OF BIAS: Pairs of review authors independently assessed the risk of bias in included studies using the original version of the Cochrane tool (RoB 1).

SYNTHESIS METHODS: We synthesised results using meta-analysis when appropriate. Given the clinical and statistical heterogeneity, we predominantly used a random-effects model alongside sensitivity analyses. When meta-analysis was not feasible, we employed synthesis without meta-analysis (SWiM) methods. We assessed the certainty of the evidence using the GRADE approach.

INCLUDED STUDIES: We included four studies (five references, 517 children; female 46%; mean age ranged from 8.9 to 9.9) conducted in three countries (the USA, Brazil, and Iran). Three studies (75%) delivered the physical activity interventions in school settings. Three studies (75%) compared physical activity interventions with non-exercise controls, while one compared physical activity with a behaviour-changing intervention. The duration of physical activity interventions ranged from 12 to 32 weeks. We assessed three studies as having an overall high risk of bias.

SYNTHESIS OF RESULTS: Physical activity interventions compared to control The evidence is very uncertain about the effect of physical activity interventions on BMI (mean difference (MD) -1.52 kg/m², 95% confidence interval (CI) -2.74 to -0.29; I² = 0%; 2 studies, 118 children; very low-certainty evidence), BMI z-scores (MD -0.10 z-score units, 95% CI -0.22 to 0.02; I² = 29%; 1 study, 222 children; very low-certainty evidence), body weight (MD -0.86 kg, 95% CI -3.17 to 1.46; I² = 0%; 2 studies, 118 children; very low-certainty evidence), health-related quality of life (MD -0.60 points, 95% CI -4.22 to 3.02; 1 study, 175 children; very low-certainty evidence), adiposity and fat distribution, assessed as body fat percentage (MD -1.23%, 95% CI -2.50 to 0.03; I² = 0%; 3 studies, 456 children; very low-certainty evidence), minor adverse events (risk ratio (RR) 3.58, 95% CI 1.95 to 6.55; 1 study, 222 children; very low-certainty evidence), and serious adverse events (RR 1.08, 95% CI 0.10 to 11.76; 1 study, 222 children; very low-certainty evidence). No studies assessed glycaemia. Combined training (aquatic exercises) versus combined training (video game exercises) The evidence is very uncertain about the effect of combined training in an aquatic setting compared to video-game-based combined training on BMI (MD -0.90 kg/m², 95% CI -3.21 to 1.41; 1 study, 39 children; very low-certainty evidence), BMI at 4-week follow-up (MD 0.03 kg/m², 95% CI -2.54 to 2.60; 1 study, 39 children; very low-certainty evidence), body weight (MD -1.30 kg, 95% CI -5.66 to 3.06; 1 study, 39 children; very low-certainty evidence), and body weight at 4-week follow-up (MD -0.70 kg, 95% CI -5.70 to 4.30; 1 study, 39 children; very low-certainty evidence). This study did not assess the other critical outcomes. Low-dose versus high-dose combined training The evidence is very uncertain about the effect of low-dose versus high-dose combined training on BMI z-scores (MD 0.12 z-score units, 95% CI 0.10 to 0.14; 1 study, 144 children; very low-certainty evidence), adiposity and fat distribution, assessed as body fat percentage (MD 1.07%, 95% CI -0.74 to 2.88; 1 study, 144 children; very low-certainty evidence), glycaemia, assessed as fasting glucose level (MD -0.50 mg/dL, 95% CI -2.77 to 1.77; 1 study, 144 children; very low-certainty evidence), minor adverse events (RR 0.91, 95% CI 0.64 to 1.30; 1 study, 144 children; very low-certainty evidence), and serious adverse events (RR 3.08, 95% CI 0.13 to 74.45; 1 study, 144 children; very low-certainty evidence). This study did not assess the other critical outcomes.

AUTHORS’ CONCLUSIONS: The evidence from four randomised studies on the effects of physical activity interventions in children aged 0 to 9 with obesity is of very low certainty. Serious methodological limitations, clinical heterogeneity, small-study effects, and imprecise results constrained this evidence base. Important knowledge gaps remain because none of the included RCTs enroled children with disabilities. The RCTs provided little information on contextual factors. Future high-quality and better-reported RCTs will likely change our findings.

FUNDING: The Department of Nutrition and Food Safety at the World Health Organization (WHO) commissioned and provided financial support for this work. WHO acknowledges financial support from the Norwegian Agency for Development Cooperation, the Swedish International Development Cooperation Agency, the Government of the Grand Duchy of Luxembourg, and the Government of Germany to the Department of Nutrition and Food Safety.

REGISTRATION: Protocol available via https://doi.org/10.17605/OSF.IO/DSHUP.

PMID:42440326 | DOI:10.1002/14651858.CD015988

JAMA Netw Open. 2026 Jul 1;9(7):e2622743. doi: 10.1001/jamanetworkopen.2026.22743.

ABSTRACT

IMPORTANCE: Genomic screening for Centers for Disease Control and Prevention Tier 1 conditions, ie, hereditary breast and ovarian cancer syndrome (HBOC), Lynch syndrome, and familial hypercholesterolemia, enables early detection of these rare, but highly penetrant disorders and supports timely, evidence-based interventions. However, states with large rural and socially disadvantaged populations, such as South Carolina, face substantial structural and access-related barriers that limit the reach of population-wide genomic screening (PWGS).

OBJECTIVE: To examine whether combining implementation science and informatics infrastructure supports PWGS and to assess screening coverage and positivity by rurality and social disadvantage.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from In Our DNA SC, a statewide PWGS program launched on November 8, 2021, in South Carolina. Recruitment and sample collection occurred via the health system, community-based collection events, and at-home kits. Analyses included adults aged 18 or older who completed screening as of July 23, 2025.

EXPOSURE: Genomic screening for Centers for Disease Control and Prevention Tier 1 conditions.

MAIN OUTCOMES AND MEASURES: County-level screening coverage rates (per 100 000 population) and positivity prevalence (per 100 000 valid results) were stratified using rural-urban continuum (RUC) codes (1 = most urban to 9 = most rural) and Social Vulnerability Index (SVI) quartiles (from 1 = least disadvantaged to 4 = most disadvantaged).

RESULTS: Of a total of 82 420 adults enrolled in the PWGS program, 50 897 completed screening (71.6% aged <65 years and 28.4% aged ≥65 years, 72.6% female). The program enrolled and screened participants from all 46 South Carolina counties. Screening coverage rates varied by RUC code and SVI. Screening rates per 100 000 population exceeded 1000 in RUC codes 1 through 3 and were significantly higher than RUC code 6 (791.4; 95% CI, 757.1-827.2), RUC code 8 (861.4; 95% CI, 801.1-926.2), and RUC code 9 (839.6; 95% CI, 683.6-1030.8). Screening coverage by overall SVI score was significantly higher in quartile 1 (1422.1; 95% CI, 1406.3-1438.1) and quartile 2 (1188.4; 95% CI, 1167.3-1209.9) compared with quartile 3 (888.4; 95% CI, 866.5-910.9) and quartile 4 (839.6; 95% CI, 952.3-1025.4). Positivity prevalence was generally similar across RUC codes, except for HBOC, which was significantly higher per 100 000 in RUC code 2 (801.3; 95% CI, 715.3-897.4) compared with RUC code 1 (268.5; 95% CI, 123.1-584.5). When examined by overall SVI quartiles, positivity prevalence for HBOC, Lynch syndrome, and familial hypercholesterolemia remained consistent, with no statistically significant differences across levels of disadvantage.

CONCLUSIONS AND RELEVANCE: This cross-sectional study of a statewide PWGS program supported by an implementation framework and informatics platform suggests broad geographic and social reach. Evaluation of clinical and behavioral outcomes is the critical next step for determining program effectiveness and performance in community and clinical settings. Taken together, these findings suggest that pairing implementation science with robust informatics infrastructure may support PWGS delivery in diverse communities.

PMID:42440321 | DOI:10.1001/jamanetworkopen.2026.22743

JAMA Netw Open. 2026 Jul 1;9(7):e2622832. doi: 10.1001/jamanetworkopen.2026.22832.

ABSTRACT

IMPORTANCE: It is critical that women undertaking medically assisted reproductive (MAR) treatment and their clinicians know whether the treatments are associated with an increased risk of hormone-related cancers.

OBJECTIVE: To determine the risk of hormone-related cancers following MAR treatment.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used an emulated target trial design including Australian health registries and administrative datasets. Participants included women enrolled in Medicare, Australia’s universal health insurance scheme, aged 18 to 55 years between January 1, 1991, and December 31, 2018. Data were analyzed from April 2024 to July 2025.

EXPOSURES: Exposures were defined from Medicare records: assisted reproduction therapy, intrauterine insemination or ovarian stimulation, and ovulation induction with clomiphene citrate.

MAIN OUTCOMES AND MEASURES: Hormone-related invasive cancers (identified in the Australian Cancer Database) included breast, ovarian, uterine, thyroid, colorectal cancers and melanoma; in situ cancers included breast cancer and melanoma. Three cancers with no hormonal links-pancreatic, lung, and hematological-were included as negative controls. Flexible parametric survival models ascertained hazard ratios (HRs) and cumulative marginal survival differences in incident cancers per 100 000 population. E-values assessed the risk of bias due to unmeasured confounding.

RESULTS: A total of 1 748 927 women were identified, including 396 661 with history of MAR exposure. Although elevated risk of most hormone-related cancers was observed after MAR treatment (HRs, 1.09-1.64), E-value analysis suggested confounding due to underlying infertility conditions (ie, endometriosis, polycystic ovarian syndrome) could account for this observed elevation for uterine, ovarian, and thyroid cancers. For any specific invasive cancer, fewer than 20 extra cancers per 100 000 women each year were estimated for treated vs comparator groups. Emulated trials on the 6 hormone-related cancers and pancreatic and hematological cancers showed increased cancer risk in the first years after treatment, suggesting detection bias. Increased risk of hematological cancers was observed after MAR treatment (HRs, 1.18-1.27), indicating uncontrolled confounding by race and ethnicity may account for observed excess risk seen for several cancers. Some treatments were associated with decreased lung cancer risk (HRs, 0.72-0.82).

CONCLUSIONS AND RELEVANCE: In this cohort study of MAR and cancer using a target trial emulation design, although associations between MAR and some hormone-related cancers were observed, the estimated difference in the number of expected cancers was small and may be explained by unmeasured confounding and detection bias.

PMID:42440318 | DOI:10.1001/jamanetworkopen.2026.22832