Nevin Manimala

J Med Econ. 2026 Dec;29(1):1230-1245. doi: 10.1080/13696998.2026.2652780. Epub 2026 Apr 28.

ABSTRACT

BACKGROUND: The costs associated with advanced Parkinson’s disease (aPD) extend beyond direct medical expenditure. As symptoms become more severe, professional and informal personal care costs are likely to exceed those incurred for medical and pharmacological treatment. The objective of this analysis is to explore the impact of treatment with subcutaneous foslevodopa/foscarbidopa (LDp/CDp) on the societal cost impact in the UK, France, Germany, Spain, and Canada.

METHODS: A model was developed to aggregate expected costs incurred by a cohort with aPD over a 5-year time frame. Resource use for direct medical, non-medical, and informal care are estimated from a real world data source (Adelphi), mapped to the severity of disease as estimated by the extent of OFF-time experienced by patients. Indirect societal costs are estimated from published literature. Unit costs for each of the included countries are then applied to these resource use estimates. Symptom progression of individuals within the cohort are derived from a previously developed Markov model, which captures the differential effect on OFF-time of LDp/CDp versus best medical treatment (BMT).

RESULTS: Overall costs for aDP patients were shown to rise over the 5-year time horizon, as symptom progression occurred. The use of LDp/CDp incurred greater drug costs than BMT, but, by delaying exacerbation of OFF-time, this additional cost was more than offset by other savings – principally attributable to professional and informal care. Aggregated results showed a net cumulative saving of €96,273 per patient over the 5 year time horizon. Results for the five individual countries evaluated ranged from €50,297 to €135,208 per patient saving.

CONCLUSION: LDp/CDp has been shown to significantly improve OFF-time burden in patients with aPD, compared with BMT. Once the costs of professional and informal care are taken into account, the additional acquisition costs of LDp/CDp are more than offset, yielding a net societal saving.

PMID:42047110 | DOI:10.1080/13696998.2026.2652780

Mol Biol Evol. 2026 Apr 28:msag107. doi: 10.1093/molbev/msag107. Online ahead of print.

ABSTRACT

Genomic prediction leverages all available markers, irrespective of their statistical significance in genome-wide association studies (GWAS). Recent advancements in marker density, sample sizes, and sophisticated statistical GWAS methods have demonstrated that integrating GWAS results can potentially boost the accuracy of genomic predictions. The Genomic Association and Prediction Tool (GAPIT) has recently begun incorporating GWAS findings into its prediction framework, streamlining this approach, referred to as GWAS-Assisted Genomic Best Linear Unbiased Prediction (GAGBLUP). A sufficient simulation study revealed that the benefits of GAGBLUP depend on the GWAS model used. Multiple-locus models, such as Bayesian-information and Linkage-disequilibrium Iteratively Nested Keyway (BLINK), outperformed single-locus models, like the mixed linear model. Specifically, when BLINK GWAS results in a real trait were incorporated into genomic Best Linear Unbiased Prediction (GBLUP), prediction accuracy improved by over 20% compared to GBLUP alone. This approach integrates the trait-specific insights from GWAS with the polygenic modeling capacity of GBLUP, resulting in more stable prediction across varying genetic backgrounds. This broader applicability enhances the utility of genomic selection in breeding programs, enabling its deployment across a wider range of crops and trait architectures.

PMID:42047095 | DOI:10.1093/molbev/msag107

J Prosthodont. 2026 Apr 28. doi: 10.1111/jopr.70152. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this in vitro study was to investigate the effect of print orientation and printing technology on the accuracy of static computer-aided implant surgery (s-CAIS).

MATERIALS AND METHODS: A cone beam computed tomography (CBCT) scan and a partially edentulous mandibular intraoral scan (IOS) of an unidentified patient missing the mandibular right first molar were used for this study. Fifty-two resin models were printed from the obtained IOS. Digital implant planning software CoDiagnostiX was used to virtually plan the implant based on a prosthetically driven approach. A tooth-supported surgical guide was designed, and the resultant STL files were then used to manufacture 52 different guides. Two different printing technologies were employed: stereolithography (SLA) and digital light processing (DLP). The groups were further subdivided according to print orientation into 0° and 45° orientations, with 13 guides per group (n = 13). Fifty-two fully guided implants were placed in their respective models. Scan bodies were placed on each implant, and an intraoral implant scan was obtained. Post-placement STL files were then imported into the CoDiagnostiX treatment evaluation tool to assess the accuracy of the placed implants compared to the planned ones. Three different parameters were assessed: implant angular deviation, deviation at the entry point, and deviation at the apex. Two-way analysis of variance (ANOVA) and post hoc Tukey pairwise comparison tests were used to compare the means, with a significance level set at p < 0.05 (α = 0.05) using the R programming language.

RESULTS: No statistically significant difference was observed in mean angular deviation among the groups (p > 0.05). At the entry point, the 45° SLA group demonstrated the lowest mean deviation (0.86 ± 0.13 mm), which was significantly lower than 0° SLA (1.35 ± 0.22 mm), 0° DLP (1.23 ± 0.20 mm), and 45° DLP (1.11 ± 0.29 mm) (p < 0.05). No significant differences were observed between 0° DLP and 0° SLA or between 0° DLP and 45° DLP. At the apical level, the 45° SLA group exhibited the lowest mean deviation (1.16 ± 0.23 mm) and differed significantly from both 0° SLA (1.45 ± 0.25 mm) and 0° DLP (1.49 ± 0.32 mm) (p < 0.05), whereas no significant differences were found between 45° SLA and 45° DLP.

CONCLUSION: Overall, print orientation (0° vs. 45°) and printing technology (SLA vs. DLP) did not significantly affect angular deviation. For the SLA group, printing at a 45° orientation significantly reduced the offset at both the entry point and the apex compared to the 0° orientation, with results favoring the 45° orientation. In contrast, print orientation did not significantly influence accuracy in the DLP group.

PMID:42047093 | DOI:10.1111/jopr.70152

Afr J Reprod Health. 2026 Apr 28;30(8):44-52. doi: 10.29063/ajrh2026/v30i8.5.

ABSTRACT

This study investigates the effects of elevit supplementation on liver function and maternal-neonatal outcomes in HBsAg-positive pregnant women. A total of 160 participants were divided into a control group (routine care) and an observation group (routine care plus elevit). Liver function markers (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase) were measured in early, mid, and late pregnancy. Maternal complications and neonatal outcomes were recorded, along with adverse reactions. No significant differences in liver enzymes were noted in early pregnancy. However, the observation group showed elevated alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase in mid and late pregnancy, indicating possible liver damage from prolonged elevit use. Despite this, the observation group experienced lower rates of hypertensive disorders, gestational diabetes, intrahepatic cholestasis, postpartum hemorrhage, low birth weight, and preterm birth, as well as higher Apgar scores. Adverse effects were slightly more frequent but not statistically significant. These findings suggest that while elevit may mildly affect liver function, it potentially improves pregnancy outcomes in HBsAg-positive women.

PMID:42047092 | DOI:10.29063/ajrh2026/v30i8.5

Med Glas (Zenica). 2026 Feb 27;23(1):233-237. doi: 10.17392/2052-23-01.

ABSTRACT

AIM: To assess the level of knowledge about risk factors and prevention of lung cancer among medical students, and to identify differences in knowledge based on the year of study and previous secondary education background.

METHODS: The study was conducted among 223 students of the School of Medicine, University of Zenica, and the School of Medicine, University Clinical Center Tuzla using an anonymous online survey via the Google Forms platform. The collected data were analyzed using descriptive statistics and the &chi;2 test to assess statistical significance.

RESULTS: The majority of students identified smoking as the main risk factor for lung cancer, while air pollution was rated as the most overlooked risk factor. There were significant differences in the perception of neglected risk factors between years of study (p&lt;0.05). Most students from Zenica acquire their knowledge through formal education, while students from Tuzla more often rely on the internet and media (p&lt;0.05). Additionally, 82.5% of students believe that passive smoking is equally harmful as active smoking, with no significant differences between groups.

CONCLUSION: Medical students demonstrate a good level of awareness regarding risk factors and prevention of lung cancer; however, there is a need for greater emphasis on environmental risks and passive smoking in their education. The results highlight the importance of continuous education to ensure that future healthcare professionals are equipped to effectively promote health and prevent this disease.

PMID:42047091 | DOI:10.17392/2052-23-01

Med Glas (Zenica). 2026 Feb 27;23(1):227-232. doi: 10.17392/2026-23-01.

ABSTRACT

INTRODUCTION: Environmental factors may influence postoperative outcomes and quality of life following total hip replacement (THR). This study investigated the impact of the geographical location of the surgical site, as well as the patient&rsquo;s place of birth and residence, on treatment outcomes in individuals with artificial hips.

METHODS: A prospective study was conducted involving 280 patients (both genderes; mean age 62 &plusmn; 8.8 years) who underwent THR due to primary or secondary hip osteoarthritis. Patients were divided into two groups: Group A (n = 64) included individuals who were not operated on in their place of birth and residence, while Group B (n = 216) consisted of those who were born, resided, and underwent surgery in the same geographical location. Outcomes were assessed using the EQ-5D questionnaire (covering mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), the Visual Analogue Scale (VAS) for pain, and a VAS-based treatment satisfaction scale, administered preoperatively and one year postoperatively. Statistical analysis was performed using Fisher&rsquo;s exact test (p &lt; 0.05).

RESULTS: Only 22.9% of all patients underwent surgery in their place of birth and residence, mostly for primary hip osteoarthritis. Preoperatively, Group A reported significantly greater limitations in self-care (p &lt; 0.05). One year postoperatively, Group B showed significantly higher VAS scores for treatment satisfaction (p &lt; 0.05).

CONCLUSION: Patients who underwent total hip replacement in their place of birth and residence demonstrated better postoperative outcomes compared to those who had relocated.

PMID:42047090 | DOI:10.17392/2026-23-01

Med Glas (Zenica). 2026 Feb 27;23(1):216-220. doi: 10.17392/2037-23-01.

ABSTRACT

AIM: Orthopedic implants must meet specific criteria, including mechanical strength, durability, and biocompatibility. This study compares the immune response of zirconia, polyether ether ketone (PEEK), and stainless-steel implants in vivo, focusing on lymphocyte and fibroblast infiltration as indicators of immune activation.

METHODS: A total of 27 New Zealand white rabbits were used, with nine animals in each group. Implants of zirconia, PEEK, or stainless steel were surgically placed in the thigh and observed for 4 weeks. Histological analysis measured lymphocyte and fibroblast infiltration at the implant site using a microscope at 400x magnification. Statistical analysis included the Kruskal-Wallis test for group comparisons, followed by Mann-Whitney and Bonferroni correction for pairwise comparisons.

RESULTS: The Kruskal-Wallis test showed significant differences in lymphocyte (p=0.002) and fibroblast (p=0.003) counts among the groups. Zirconia exhibited significantly lower lymphocyte (median=0.5) and fibroblast (median=1.0) infiltration compared to stainless steel (lymphocytes: median=3.0, fibroblasts: median=2.0), and PEEK (lymphocytes: median=2.0, fibroblasts: median=3.0). Bonferroni correction confirmed zirconia showed the least immune activation (p&lt;0.0167).

CONCLUSION: Zirconia offers superior biocompatibility with minimal immune response, making it an ideal material for orthopedic implants, particularly for patients with metal sensitivities. PEEK showed moderate immune activation but is helpful for non-load-bearing applications. Stainless Steel induced the highest immune response due to the release of metal ions and corrosion. Zirconia is the most biocompatible material tested, making it a promising choice for orthopedic implants.

PMID:42047088 | DOI:10.17392/2037-23-01

Med Glas (Zenica). 2026 Feb 27;23(1):206-210. doi: 10.17392/2058-23-01.

ABSTRACT

AIM: Tendon healing involves a crucial proliferative phase, during which fibroblasts and fibrocytes orchestrate collagen deposition. The use of liquid nitrogen (LN) in orthopedic oncology may inadvertently affect adjacent tendon tissues. This study aimed to evaluate the impact of LN exposure on the histological features of tendon healing.

METHODS: This experimental study employed a randomized post-test-only control group design involving 24 males Rattus norvegicus, randomly divided into four groups: control (no LN exposure) and three treatment groups exposed to LN for 1, 5, and 10 minutes, respectively, following Achilles tendon transection and repair. After a 21-day healing period, histological analysis was performed to assess the counts of fibroblasts, fibrocytes, and collagen content. Statistical analyses included one-way ANOVA, Post-hoc Tukey, and Pearson correlation (p&lt;0.05 was considered significant).

RESULTS: LN exposure significantly reduced fibroblast, fibrocyte, and collagen levels compared to controls (p&lt;0.05). The 10-minute group showed the lowest counts. A significant negative correlation was found between LN immersion duration and the number of fibroblasts (r= -0.87), fibrocytes (r= -0.829), and collagen content (r= -0.83) (p&lt;0.05).

CONCLUSION: Liquid nitrogen (LN) impairs tendon healing in a dose-dependent manner, likely due to cryo-induced cell death and disruption of blood flow. This results in an acellular and avascular tendon matrix, hindering the repair process. LN exposure negatively impacts the proliferative phase of tendon healing in rats, suggesting the need for caution in clinical use to prevent damage to surrounding tendinous tissues.

PMID:42047087 | DOI:10.17392/2058-23-01

Med Glas (Zenica). 2026 Feb 27;23(1):186-190. doi: 10.17392/2047-23-01.

ABSTRACT

BACKGROUND: Distal radius fractures are among the most common orthopedic injuries, posing significant challenges due to their high prevalence and potential for long-term functional impairment. Volar locking plates have emerged as the gold standard for managing unstable and extra-articular fractures, offering superior outcomes compared to traditional methods. This study evaluates the clinical, radiographic, and functional outcomes of volar locking plate fixation in 34 patients with intra and extra-articular distal radius fractures.

METHODS: This retrospective study analyzed 34 patients treated for intra and extra-articular distal radius fractures with volar locking plates at a single orthopedic center. Patients were followed for a mean duration of 24 months (range: 12&ndash;36 months). Outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score, Visual Analog Scale (VAS) for pain, range of motion (ROM), and radiographic parameters. Complications, including hardware-related issues and soft tissue irritation, were recorded. Statistical analysis compared preoperative and postoperative outcomes, with significance set at p &lt; 0.05.

RESULTS: The mean DASH score at the final follow-up was 4.2 &plusmn; 1.8, reflecting excellent functional recovery. Pain relief was complete, with all patients reporting a VAS score of 0. ROM restoration was highly satisfactory, achieving 93&ndash;98% of contralateral wrist motion. Radiographic evaluations confirmed 100% fracture consolidation with no cases of malunion or nonunion. Complications were minimal, with only two patients experiencing transient soft tissue discomfort, managed conservatively. No tendon irritation or hardware-related complications were observed.

CONCLUSIONS: Volar locking plate fixation for intra and extra-articular distal radius fractures demonstrated excellent clinical, functional, and radiographic outcomes in this cohort of 34 patients. The low-profile design and anatomical contouring of modern plates minimized complications while promoting effective pain relief and rapid functional recovery.

PMID:42047083 | DOI:10.17392/2047-23-01

Med Glas (Zenica). 2026 Feb 27;23(1):162-166. doi: 10.17392/2045-23-01.

ABSTRACT

AIM: Mild traumatic brain injury (mTBI) presents diagnostic challenges, with head computed tomography (head CT) often overutilized in emergency settings. Blood biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have shown promise in early injury detection. Aim of this study was to evaluate the diagnostic utility of GFAP and UCH-L1 in identifying&nbsp; &nbsp;intracranial injuries early and potential reduction in unnecessary head CT scans in mTBI patients.

METHODS: A prospective study was conducted on 102 adult patients with mTBI. Serum levels of GFAP and UCH-L1 were measured within 12 hours post-injury and compared with head CT findings using appropriate statistical analyses.

RESULTS: Both biomarkers demonstrated 100% sensitivity and moderate specificity, with high negative predictive value (NPV), supporting their utility in ruling out injuries detectable on CT.

CONCLUSION: GFAP and UCH-L1 are effective early biomarkers for excluding significant intracranial injuries and may help optimize head CT scan utilization in the acute management of mTBI.

PMID:42047078 | DOI:10.17392/2045-23-01