Nevin Manimala

BMC Oral Health. 2026 Feb 4. doi: 10.1186/s12903-026-07720-0. Online ahead of print.

ABSTRACT

BACKGROUND: Recent advances in orthognathic surgery-particularly the adoption of virtual 3D planning and patient-specific 3D-printed splints-have improved surgical precision, reduced operative time, and enhanced predictability of outcomes. Despite these developments, accurate intraoperative positioning of the mandibular condyle, especially the condylar head, during bilateral sagittal split osteotomy (BSSO), remains a major challenge. Although multiple techniques for condylar positioning have been proposed, their impact on postoperative condylar head position and joint space morphology has not been comprehensively assessed. This study aimed to evaluate postoperative changes in condylar head position and temporomandibular joint (TMJ) space using a Procrustes algorithm, and to investigate potential effects of surgeon handedness.

METHODS: A retrospective cone beam computed tomography (CBCT) analysis was conducted on 40 patients (24 female, 16 male) who underwent orthognathic surgery. The cohort comprised 27 patients with Angle Class II and 13 with Angle Class III malocclusion. Eighteen patients underwent bimaxillary procedures, and 22 underwent monomaxillary osteotomies. Condylar position and joint space dimensions were measured, and Procrustes shape analysis was applied to quantify TMJ space deformation. Statistical tests assessed positional changes and correlations with skeletal class, displacement, and surgeon handedness.

RESULTS: Significant postoperative changes were observed, with a bilateral reduction in cranial distances, reflecting a more caudal condylar head position, and a significant widening of the cranial joint space on the right side. Procrustes analysis confirmed measurable deformation of anterior and posterior TMJ compartments. Condylar heads were frequently positioned dorsally during initial registration, and results suggest that surgeon handedness may systematically influence condylar positioning.

CONCLUSIONS: Postoperative condylar head position and TMJ space morphology are influenced by intraoperative handling, with surgeon handedness emerging as a potential contributor. Incorporating shape analysis methods such as Procrustes algorithms into future digital workflows may improve condylar positioning strategies and enhance surgical outcomes in BSSO.

PMID:41639816 | DOI:10.1186/s12903-026-07720-0

BMC Urol. 2026 Feb 5. doi: 10.1186/s12894-025-02018-9. Online ahead of print.

ABSTRACT

BACKGROUND: Robot-assisted laparoscopic radical prostatectomy (RALRP) and intensity-modulated radiotherapy (IMRT) are the main curative options for localized prostate cancer (PCA). However, both may significantly affect patients’ quality of life (QoL).

OBJECTIVE: To retrospectively compare post-treatment QoL after at least 24 months of follow-up between bladder-neck- and nerve-sparing RALRP and IMRT in patients with intermediate-risk localized PCA.

METHODS: A total of 164 patients treated between October 2016 and May 2023 were analyzed (104 RALRP; 60 IMRT). QoL was evaluated using the Expanded Prostate Cancer Index Composite (EPIC-2002). Urinary, bowel, sexual, and hormonal domains were compared using appropriate statistical tests .

RESULTS: Baseline demographics were similar between groups. The mean age was 68.82 ± 6.72 years in the RALRP group and 68.89 ± 7.81 years in the IMRT group. IMRT patients reported better sexual function (p < 0.05), but this advantage was counteracted by hormonal side effects due to androgen deprivation therapy (ADT). Urinary continence was comparable (p > 0.05), whereas irritative urinary symptoms were more common in IMRT (p < 0.001). Bowel function and overall satisfaction were significantly better in RALRP (both p < 0.001).

CONCLUSIONS: After ≥ 24 months of follow-up, RALRP provided superior bowel and hormonal outcomes, while IMRT yielded slightly better sexual function scores. Overall satisfaction favored RALRP.

PMID:41639812 | DOI:10.1186/s12894-025-02018-9

BMC Ophthalmol. 2026 Feb 4. doi: 10.1186/s12886-026-04637-8. Online ahead of print.

ABSTRACT

OBJECTIVE: The increasing prevalence of refractive errors in children has raised interest in exploring potential associations with physical development. This study aimed to explore a potential relationship between refractive status and growth parameters among children aged 7-10 years.

METHODS: A multistage stratified random sampling method was adopted to select 1260 primary school students in Pinggu District of Beijing in 2023, to measure their height and weight to calculate the body mass index (BMI). The height-for-age z-score (HAZ) and body mass index z-score(z-BMI) were calculated using the Least Mean Squares (LMS) method. Cycloplegic refraction was performed to determine spherical equivalent (SE). Ocular biometric data were collected, including axial length (AL) and anterior chamber depth (ACD). The ratio of AL to average corneal curvature (AL/CR) were calculated. Group comparisons used χ² test, t-test, analysis of variance (ANOVA) and Wilcoxon rank-sum test. Multiple linear regression models were used to analyze correlations between HAZ, z-BMI and ocular parameters.

RESULTS: The myopia rate was 21.19% and increased with age. Compared to girls, boys had significantly longer AL, deeper ACD, steeper CR, and higher AL/CR. As myopia severity increased, AL lengthened, ACD deepened, CR steepened and AL/CR increased. In the overall group, HAZ showed a positive correlation with AL (β = 0.208, Adjusted R²=0.084) and CR (β = 0.201, Adjusted R²=0.049), z-BMI showed a positive correlation with AL (β = 0.136, Adjusted R²=0.084) and AL/CR (β = 0.108, Adjusted R²=0.014), and a negative correlation with SE (β=-0.069, Adjusted R²=0.007). In the emmetropia group, pre-myopia group, and myopia group, HAZ showed a positive correlation with both AL and CR, while z-BMI demonstrated a positive correlation with AL.

CONCLUSIONS: This exploratory study suggests that accelerated physical growth shows statistically significant but clinically modest correlations with axial elongation and myopia development. The findings do not demonstrate causal relationships between growth and refractive changes. AL/CR appears to be a key biometric predictor of refractive error. These hypothesis-generating results underscore the potential value of growth monitoring in myopia prevention and for further investigation into distinct physiological pathways in ocular development.

PMID:41639800 | DOI:10.1186/s12886-026-04637-8

BMC Geriatr. 2026 Feb 5. doi: 10.1186/s12877-026-07126-1. Online ahead of print.

ABSTRACT

BACKGROUND: Due to advanced morphological tissue degradation and chemical alterations resulting from putrefaction, challenges arise in identification as well as in histopathological and toxicological examinations. Consequently, it has been debated that autopsies performed on decomposed bodies may have limited diagnostic and forensic value and may not always yield satisfactory results. With this study, we aimed to mitigate concerns and biases in the literature-particularly the view that autopsy has limited value in decomposed geriatric cases-and to delineate the diagnostic yield, contributory value, and limits of applicability of autopsy and histopathological evaluation.

METHODS: We examined 88 decomposed bodies cases arising from non-traumatic, in-home deaths among geriatric individuals. Detailed evaluations were conducted of autopsy, histopathological, toxicological, identification, medical history, and scene investigation findings. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS), version 25.0 (Chicago, IL, USA).

RESULTS: 83.0% of the cases were male, and the mean age was 70.9 years. 85.2% lived alone, and 70.5% had a history of chronic disease. On histopathological examination, the coronary arteries were the tissues most resistant to autolysis. Toxicological analysis detected therapeutic-range concentrations of pharmaceutical agents in 56.8% of cases and endogenous ethanol in 21.6%. Identification was achieved via DNA comparison analyses in 29.5% of cases. A cause of death was established in 69.3% of cases; the most common non-traumatic cause of death was cardiovascular diseases (48.9%).

CONCLUSION: Contrary to common presumptions, forensic autopsy and histopathological examinations of decomposed bodies in our study successfully determined the cause of death in a substantial proportion of cases (69.3%), a finding that is broadly consistent with the literature. In particular, the systematic histopathological evaluation of tissues resistant to autolysis-such as the coronary arteries and myocardium-combined with modern toxicological analyses and the integrated assessment of scene investigation findings and medical history data, enables a forensically satisfactory determination of the cause of death.

PMID:41639798 | DOI:10.1186/s12877-026-07126-1

BMC Microbiol. 2026 Feb 4. doi: 10.1186/s12866-026-04810-5. Online ahead of print.

NO ABSTRACT

PMID:41639761 | DOI:10.1186/s12866-026-04810-5

BMC Med Res Methodol. 2026 Feb 4. doi: 10.1186/s12874-026-02779-3. Online ahead of print.

NO ABSTRACT

PMID:41639760 | DOI:10.1186/s12874-026-02779-3

J Health Popul Nutr. 2026 Feb 4. doi: 10.1186/s41043-025-01219-0. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to clarify between serum calcium and mortality in osteoarthritis (OA) patients using NHANES data (2003-2018).

METHOD: A total of 1,249 adults with OA were included. Mortality outcomes were ascertained through linkage to the National Death Index (NDI). Cox proportional hazards models were used to assess the independent association of serum calcium concentration with the risk of death. We used a two-stage Cox proportional hazards model to elucidate the nonlinear relationship between serum calcium concentration and the risk of death in patients with OA. Stratified analyses were performed to identify patients at higher risk.

RESULTS: During follow-up (median: 9.7 years), 220 all-cause deaths occurred (56 CVD-related, 64 cancer-related). After adjusting for relevant variables, serum calcium concentration showed an inverse linear association with all-cause and CVD mortality. Although smoothed curve fitting visually suggested U-shaped and L-shaped patterns for all-cause and CVD mortality, respectively, formal tests for nonlinearity did not reach statistical significance (P for log-likelihood ratio > 0.05). Specifically, the risk was elevated at lower calcium levels and stabilized or showed a non-significant increase at higher levels. In the piecewise linear model, serum calcium below 9.50 mg/dL was inversely associated with all-cause mortality, where each 1 mg/dL increase was associated with a 48% lower risk (HR 0.52, 95% CI: 0.30-0.91). Above 9.50 mg/dL, the association was non-significant (HR 1.09, 95% CI: 0.51-2.35). A similar L-shaped pattern was observed for CVD mortality below the inflection point (HR 0.26, 95% CI: 0.09-0.74). However, formal likelihood ratio tests comparing the threshold model with a linear model did not reach statistical significance (P > 0.05), indicating that the data do not provide strong evidence against a linear association.

CONCLUSION: Our primary analysis supports an inverse linear association between serum calcium and mortality in OA patients. Although exploratory analyses revealed potential non-linear patterns visually, these were not statistically confirmed. Therefore, the overall relationship is best characterized as linear within the observed range, with lower serum calcium associated with higher mortality risk. Therefore, these findings highlight a potential optimal range for serum calcium but require verification in future studies designed to confirm nonlinearity and assess the clinical utility of calcium management.

PMID:41639742 | DOI:10.1186/s41043-025-01219-0

Implement Sci Commun. 2026 Feb 5. doi: 10.1186/s43058-026-00871-9. Online ahead of print.

ABSTRACT

BACKGROUND: Adaptations are expected when complex public health interventions are implemented in dynamically and rapidly changing real-world settings. Systematic documentation of adaptations to intervention components and strategies are critical when assessing their impact on implementation. The purpose of this paper is to describe our approach to systematically tracking, documenting, and evaluating adaptations made during the CO-CREATE-Ex project, which aimed to address COVID-19 testing disparities in the San Ysidro US/Mexico border community.

METHODS: The study utilized a longitudinal, prospective, multi- method approach to systematically document and assess adaptations across the pre-implementation, early and mid/late-implementation, and maintenance phases of the project. Adaptations were aggregated from a combination of sources (i.e., meeting notes, Advisory Board transcripts, and periodic reflections). Adaptations were entered weekly into an electronic database that captured information on 16 characteristics and were validated by study staff. Descriptive statistics were used to describe adaptation characteristics. Adaptation impact was evaluated using a combination of objective and subjective measures aligned with the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) outcomes.

RESULTS: Eighty-four unique adaptations were included in this analysis. Adaptations were organized by study phase with most occurring during pre-implementation. Most adaptations (n = 79, 94.04%) were planned (i.e., proactive) and expected (n = 63, 75%), and (n = 21, 25.0%) adaptations were considered unexpected (e.g., reactive). Across all adaptations, 71.2% were perceived as positive (i.e., had a positive impact on RE-AIM implementation outcomes) and 19.1% were perceived to be negative (i.e., worsened implementation outcome or decreased implementation). Unexpected adaptations, though reactive in nature, generally had a positive impact on implementation outcomes. For instance, 14.3% of unexpected adaptations were perceived to increase reach and effectiveness. Within maintenance, 19% of unexpected adaptations were perceived to increase this outcome. Lastly, adaptations were generally small in scope with less than a tenth of adaptations affecting 50% or more of core elements.

CONCLUSION: Our systematic approach to documenting and analyzing adaptations has highlighted the importance of understanding the impact of adaptations on implementation outcomes. These insights underscore the need for continued research to refine methods for adaptation documentation and impact evaluation, ensuring interventions remain effective, equitable, and responsive to real-world challenges.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT05894655, Registered 8 June 2023.

PMID:41639712 | DOI:10.1186/s43058-026-00871-9

AIDS Res Ther. 2026 Feb 4. doi: 10.1186/s12981-026-00852-x. Online ahead of print.

ABSTRACT

BACKGROUND: As Uganda scales up integrated chronic care, understanding viral load suppression (VLS) among people living with HIV (PLHIV) with non-communicable diseases (NCDs) is critical for optimizing service delivery. This study thus determined VLS among the PLHIV with NCDs and associated factors.

METHODS: We conducted a cross-sectional analysis using routine program data from 10 districts in Eastern Uganda and 18 health facilities-three general hospitals, seven health centre (HC) IVs, seven HC IIIs and one Special HIV Clinic. We included PLHIV aged 20 + who were active in care during the April-June 2025 quarter and screened for NCDs (hypertension, diabetes mellitus, anxiety/depression and alcohol abuse). VLS was defined as < 1000 copies/ml. Robust Poisson regression estimated crude and adjusted prevalence ratios (aPRs) for VLS using 95% confidence interval (CI) and p < 0.05 for statistical significance. A forest plot visualized effect sizes and confidence intervals. STATA Corp version 15 was used for the analysis.

RESULTS: Among 8,306 PLHIV, 62.4% were female, with a mean (Standard Deviation) age of 46.7 years (13.8). Overall VLS was 94.7% (96.72% for PLHIV with NCDs and 94.53% for those without). NCD comorbidity was 8.45%, predominantly hypertension (7%). Crude analysis showed higher VLS among PLHIV with NCDs (PR = 1.023; p = 0.002), but adjusted estimates attenuated (aPR = 1.015; 95% CI 0.999-1.031; p = 0.065). Older age groups (30-39, 40-49, 50+) had significantly higher VLS than those under 30 ( aPR = 1.063; 95% CI 1.034-1.091; p < 0.001), (aPR = 1.073; 95% CI 1.044-1.102; p < 0.001), (aPR = 1.071; 95% CI 1.043-1.100; p < 0.001) respectively. Males had lower VLS than females (aPR = 0.978, 95% CI [0.968, 0.989] p < 0.001). Clients at Health Centre III had reduced VLS (aPR = 0.979 95%CI [0.961, 0.997]; p = 0.023), while Health Centre IV and hospitals showed no significant difference when compared with those in the special clinic.

CONCLUSION: VLS among PLHIV with NCDs was comparable to those without, suggesting integrated care may mitigate disparities. However, age, sex, and facility level remain key determinants. Targeted interventions are needed for younger clients, men, and health centre IIIs to sustain viral suppression in the era of integrated health services.

PMID:41639705 | DOI:10.1186/s12981-026-00852-x

BMC Oral Health. 2026 Feb 4. doi: 10.1186/s12903-026-07820-x. Online ahead of print.

ABSTRACT

BACKGROUND: Smoking and alcohol consumption are major risk factors for oral potentially malignant disorders (OPMDs), yet the extent to which an OPMD diagnosis prompts behavioral change remains unclear. This study aimed to describe the changes in smoking and alcohol consumption in patients after an OPMD diagnosis and explore the role of demographic and clinical factors in these behavioral changes.

METHODS: A retrospective cohort study was conducted in the Department of Oral and Maxillofacial Surgery at the McGill University Health Centre, including OPMD patients from 2018 to 2023. Eligible patients had a confirmed OPMD diagnosis, no prior history of head and neck cancer, and at least six months of follow-up. Those without smoking or alcohol data were excluded. Descriptive statistics, McNemar’s and Wilcoxon signed-rank tests to assess behavioral changes, and logistic regression to identify factors associated with continued smoking and alcohol use were used.

RESULTS: The sample composed of 82 patients, 30 (36.6%) were female, with a mean age at diagnosis of 64 years. Leukoplakia (82.9%) was the most common OPMD, and the tongue was the most affected site (42.7%). Median follow-up was 29 months. Most patients (76.8%) had a histologic diagnosis of either mild or moderate dysplasia. At the time of diagnosis, about one-third were active smokers or moderate-to-heavy drinkers. Smoking prevalence decreased from 30.5% at diagnosis to 22.5% post-diagnosis, although this reduction did not reach statistical significance (p = 0.06), while moderate-to-heavy alcohol use remained largely unchanged (31.7% vs. 30.5%, p = 1.00). Younger patients were less likely to change smoking habits (OR = 0.96, 95% CI 0.91-1.00; p = 0.042). Patients from lower socioeconomic backgrounds had lower odds of alcohol use post-diagnosis (OR = 0.26, 95% CI 0.08-0.82; p = 0.021).

CONCLUSION: The findings suggest that smoking cessation is achievable post-diagnosis, whereas reducing alcohol intake may require more targeted interventions. Resistance to behavior change among younger patients may explain rising oral cancer rates in this population.

PMID:41639699 | DOI:10.1186/s12903-026-07820-x