Nevin Manimala

BMC Public Health. 2026 Feb 7. doi: 10.1186/s12889-026-26526-x. Online ahead of print.

ABSTRACT

BACKGROUND: Academic performance is often highly prioritized among college students, sometimes at the expense of their health. Despite growing interest in this relationship, limited research with college students has explored how diet quality (DQ) varies by gender, first-generation status, and grade-point average (GPA). The purpose of this paper was to: (1) examine the relationship between DQ and academic performance in college students and (2) identify potential differences based on gender, first-generation status, and varying GPAs.

METHODS: In this cross-sectional study, undergraduate students (n = 301), mean age 21.2 (SD ± 2.49), completed the validated Short Healthy Eating Index (sHEI) based on the USDA’s Healthy Eating Index (HEI) per 2015-2020 Dietary Guidelines for Americans, to examine DQ. Academic performance was assessed using self-reported GPA. Students were predominantly non-Hispanic White (63%), Female (61%), and 75% had at least one parent graduate college. Descriptive statistics, correlation, and one-way ANOVAs were used to analyze the data using SPSS V.29. GPA was categorized into 3 groups: high, mid, and low GPA groups. Results were significant when p < 0.05.

RESULTS: DQ scores ranged from 21% to 68%, with a mean of 44% (SD: ±2.494). There were no significant associations between GPA and total DQ. However, significant associations were found between gender and specific dietary components. Further, total protein scores were greater among students with a high GPA compared to low and mid-GPA groups (F = 5.214, p = 0.006). Plant-based protein was greater among students who had at least one parent graduate college compared to first-generation students (F = 3.435, p = 0.034). Students living independently had lower total protein scores compared to those living with family (F = 4.841, p = 0.029). Additionally, students without a current job had higher dairy scores than those employed (F = 4.280, p = 0.039).

CONCLUSION: Overall, college students reported poor DQ; however, personal (e.g., gender) and environmental factors (e.g., living arrangements) were associated with one’s DQ. Further investigation is needed to facilitate the development of effective interventions that encourage healthier dietary habits among college students to improve their overall health and wellness.

PMID:41654838 | DOI:10.1186/s12889-026-26526-x

J Orthop Surg Res. 2026 Feb 7. doi: 10.1186/s13018-026-06727-1. Online ahead of print.

ABSTRACT

PURPOSE: To explore the clinical significance of the artificial intelligence (AI)-assisted three-dimensional (3D) planning system AI-HIP in total hip arthroplasty (THA) and evaluate its accuracy and efficacy in clinical practice.

METHODS: Preoperative planning was done using the AI-HIP system in the AI group and two-dimensional (2D) template measurements in the conventional group. The two groups were compared for postoperative radiographic results, perioperative monitoring indicators, and the degree of consistency between preoperative planning and actual implant size. Postoperative Harris scores, hip joint range of motion (ROM), and Barthel index were used to evaluate clinical effectiveness.

RESULTS: None of the patients who ultimately completed the 6-months follow-up experienced adverse events such as hip dislocation and infection during follow-up. Compared to the conventional group, the AI group had significantly higher Harris scores (P = 0.026), hip ROM (P = 0.018), Barthel index (P = 0.042) at 6 months postoperatively, and conformity rates of the acetabular (P = 0.001) and femoral components (P < 0.001) between intraoperative application of prosthesis model and preoperative planning. Additionally, the AI group had significantly shorter operation time (P = 0.041), less intraoperative blood loss (P = 0.012), and smaller discrepancy between bilateral acetabular offset (P = 0.032) and vertical distance of hip center of rotation (P = 0.011). However, no statistically significant intergroup differences were observed for the acetabular abduction angle, anteversion angle, femoral offset and leg length discrepancy.

CONCLUSION: Preoperative planning for THA using the AI-HIP system has a high accuracy rate and allows for effective reconstruction of the rotation center and acetabular offset, reduction of surgical time, and early recovery of joint function. Further research is needed to confirm its potential clinical value.

CLINICAL REGISTRATION NUMBER: ChiCTR210004826, Date:28/03/2021, https://www.chictr.org.cn/showproj.html? proj=52846.

PMID:41654837 | DOI:10.1186/s13018-026-06727-1

BMC Oral Health. 2026 Feb 7. doi: 10.1186/s12903-026-07727-7. Online ahead of print.

ABSTRACT

OBJECTIVE: This study evaluated multiple deep learning approaches for automated classification of dental conditions in panoramic radiographs, comparing custom convolutional neural networks (CNNs), hybrid CNN-machine learning models, and fine-tuned pre-trained architectures, comparing the performance of custom convolutional neural networks (CNNs), hybrid CNN-machine learning models, and fine-tuned pre-trained architectures for detecting fillings, cavities, implants, and impacted teeth.

METHODS: A dataset of 1,512 panoramic X-ray images with 11,137 manually annotated bounding boxes for four dental conditions (fillings, cavities, implants, and impacted teeth) was analyzed, with regions of interest extracted using expert annotations for subsequent AI-based classification. Class imbalance was addressed through random downsampling, creating a balanced dataset of 894 samples per condition. Multiple approaches were evaluated via 5-fold cross-validation: a custom CNN, hybrid models combining CNN features with traditional classifiers (Support Vector Machine, Decision Tree, Random Forest), and fine-tuned pre-trained networks (VGG16, Xception, ResNet50). Performance was assessed using accuracy, precision, recall, and F1-score metrics.

RESULTS: The hybrid CNN-Random Forest model achieved the highest accuracy of 85.4 ± 2.3% with macro-F1 score of 0.843 ± 0.028, representing an 11% point improvement over the custom CNN (74.29% accuracy, 0.724 macro-F1). VGG16 demonstrated superior pre-trained architecture performance (82.3 ± 2.0% accuracy, 0.817 macro-F1), followed by Xception (80.9 ± 2.3%) and ResNet50 (79.5 ± 2.7%). CNN + Random Forest exhibited exceptional fillings detection (F1: 0.860 ± 0.033) with balanced multi-class performance. Systematic misclassifications between morphologically similar conditions revealed inherent diagnostic challenges.

CONCLUSION: Hybrid CNN-based approaches combining feature extraction with Random Forest classification provide superior discriminative capability for dental condition detection on manually annotated regions compared to standalone architectures. While computationally efficient hybrid models show promise as supportive diagnostic tools, observed misclassification patterns indicate these AI systems should serve as adjuncts to clinical expertise, requiring prospective validation studies.

PMID:41654817 | DOI:10.1186/s12903-026-07727-7

BMC Public Health. 2026 Feb 7. doi: 10.1186/s12889-026-26510-5. Online ahead of print.

ABSTRACT

BACKGROUND: Although many studies have investigated COVID-19 outbreaks in long-term care facilities (LTCFs), evidence that combines multiple clustered levels is scarce. We aimed to describe individual, LTCF, and regional-level factors associated with COVID-19 infections.

METHODS: We conducted a nationwide study using insurance claims data from Germany between 1st October 2020 and 31st March 2021. The sample comprised 284,186 residents over 60 years in 9,869 LTCFs across all of Germany’s 400 districts. We used multilevel logistic regression to model associations between individual, LTCF, and district-level factors, and the probability of a COVID-19 infection.

RESULTS: A total of 44,042 (15.5%) COVID-19 infections were recorded during the study period. On the individual level, male sex (OR 1.15; 95% CI 1.12-1.18), dementia (OR 1.09; CI 1.06-1.11), medium-severe care dependency level 3 and 4 (OR 1.17; CI 1.12-1.22 / OR 1.21; CI 1.16-1.26) were associated with greater risk of infection. At the LTCF level, infection risks increased with the mean age of residents (OR 1.09; CI 1.03-1.15) and higher resident numbers (OR 1.20; CI 1.14-1.27). On the district level, a higher proportion of public LTCFs was associated with lower infection risks (OR 0.90; CI 0.84-0.97), while a higher mean number of residents (OR 1.16; CI 1.05-1.28), and the district-level SARS-CoV-2 incidence rate among the general population (OR 1.54; CI 1.41-1.67) was associated with higher risks. A cross-level interaction between facility size and COVID-19 prevalence was not significant (p > 0.5).

CONCLUSION: We found evidence of individual, facility, and regional levels factors associated with COVID-19 infections among older adults in LTCFs. Future measures to combat infections, outbreaks, and pandemics should take an orchestrated multilevel approach.

PMID:41654798 | DOI:10.1186/s12889-026-26510-5

BMC Public Health. 2026 Feb 7. doi: 10.1186/s12889-026-26323-6. Online ahead of print.

NO ABSTRACT

PMID:41654778 | DOI:10.1186/s12889-026-26323-6

J Periodontol. 2026 Feb 7. doi: 10.1002/jper.70072. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to perform a prediction model validation for furcation involvement (FI) risk in molars receiving a new fixed prosthesis (FP) using a unique cohort assessed at three time points.

METHODS: Following the Oral Health Statistical (OHStat) reporting guidelines, this cohort study examined 181 patients (203 molars) from 2018-2023. Teeth without FI were followed longitudinally post-crown placement at 1- (T1), 3- (T2), and 5-years (T3). A logistic regression model was built in order to predict FI and the related performance was assessed through metrics like AUC, sensitivity, specificity, and calibration.

RESULTS: FI was observed in 4.43% of teeth at 1 year, increasing to 21.67% at 3 years and 28.57% at 5 years. Univariate analysis revealed significant predictors at 3-5 years: a history of periodontitis was associated with higher FI risk at 5 years (RR = 3.56, p = 0.024), with advanced stages also increasing risk-stage III: RR = 2.59 at 3 years and RR = 3.32 at 5 years; stage IV: RR = 3.76 at 3 years and RR = 3.75 at 5 years. Short root trunks significantly increased FI risk across all intervals (1 year: RR = 3.96; 3 years: RR = 6.08; 5 years: RR = 4.75). Medium trunks did not differ significantly from long trunks. The predictive model performed best at 3 years (AUC = 0.81, sensitivity = 0.79, specificity = 0.87) and remained robust at 5 years (AUC = 0.76, sensitivity = 0.69, specificity = 0.90).

CONCLUSION: The predictive model demonstrated high accuracy with a substantial ability to identify FI cases over time. Clinicians should consider such an assessment before crown or bridge restoration, with particular caution in patients with periodontitis.

PMID:41653409 | DOI:10.1002/jper.70072

Aging Clin Exp Res. 2026 Feb 7. doi: 10.1007/s40520-026-03336-0. Online ahead of print.

ABSTRACT

BACKGROUND: Low back pain (LBP) is a global health problem that contributes to disability, psychological distress, and reduced quality of life in older adults. Current treatment guidelines for LBP support the use of conservative therapies such as physical therapy alongside medication management. However, interventional pain management strategies for LBP such as lumbar epidural steroid injection (LESI) are rarely mentioned.

AIMS: We conducted this systematic review to characterize and evaluate the use and effectiveness of LESI amongst older adults with LBP.

METHODS: We conducted a systematic English-language literature search of Ovid MEDLINE, Ovid EMBASE, and Cochrane Library. We used an iterative approach to identify both keywords and controlled vocabulary related to treatment outcomes of epidural interventions for LBP among older adults. The results were reviewed by three members of the team.

RESULTS: Our search of 3 databases produced a total of 2657 studies and 12 met final inclusion criteria. In all studies, the use of LESI was associated with improvement in pain and/or quality of life.

DISCUSSION: As compared to medication management, LESI was associated with statistically significant improvements in pain and functional status. The addition of physical therapy was not superior to LESI alone.

CONCLUSIONS: This systematic review is the first that focuses on the effectiveness of LESI in managing LBP in older adults. This review suggests that LESI may reduce pain and improve functional status in older adults, particularly as compared to medication management.

PROSPERO REGISTRATION: The study was prospectively registered on Prospero (ID # 422087).

CLINICAL TRIAL NUMBER: Not Applicable.

PMID:41653389 | DOI:10.1007/s40520-026-03336-0

Clin Exp Med. 2026 Feb 7. doi: 10.1007/s10238-026-02065-y. Online ahead of print.

NO ABSTRACT

PMID:41653319 | DOI:10.1007/s10238-026-02065-y

Eur J Pediatr. 2026 Feb 7;185(2):125. doi: 10.1007/s00431-026-06775-z.

ABSTRACT

The aim of this study was to assess the impact of caffeine and other methylxanthines on bronchiolitis-related apnea (BRA) in infants under 12 months of age, through a systematic review and meta-analysis. The review was conducted in accordance with the PRISMA guidelines. Inclusion criteria were studies published from January 1990 to August 2023, in English or French, and involving children from 35 weeks’ gestational age to 1 year with BRA. Relevant articles were selected and data extracted by 2 members of the blinded investigative team. Four hundred sixty-nine articles were retrieved. Eleven studies conducted in Europe and North America were considered in the systematic review. Six studies were used in the meta-analysis. The meta-analysis showed no positive impact of caffeine on the length of non-invasive ventilation (mean difference = – 0.26 days, 95% CI [- 1.71; 1.20], p = 0.53), invasive ventilation requirement (mean difference = – 0.05 [- 0.24; 0.13], p = 0.44), or length of pediatric intensive care unit and hospital stay (mean difference = – 0.62 days, 95% CI [- 9.31; 8.07], p = 0.79; mean difference = 1.60 days, 95% CI [- 3.65; 6.85], p = 0.32, respectively). However, caffeine was associated with a trend towards a decrease in the total length of respiratory support (mean difference = – 2.63 days, 95% CI [- 5.61; 0.34], p = 0.06).

CONCLUSION: This study highlights the ongoing debate surrounding the role of caffeine and other methylxanthines in BRA. The general paucity of literature, its low level of quality, the heterogeneity of results, different caffeine regimens, and population definition greatly impaired the quality of the conclusions. However, by identifying gaps in the literature, this study helps build a framework for future trials.

WHAT IS KNOWN: • Apnea is a recognized complication of bronchiolitis in infants, particularly in those born preterm or at a young corrected age, and may necessitate intensive respiratory support. • While caffeine is a cornerstone therapy for apnea of prematurity, evidence supporting its use in bronchiolitis-related apnea (BRA) remains limited and inconclusive.

WHAT IS NEW: • This is the first systematic review with meta-analysis evaluating caffeine in BRA, showing no significant improvement in major clinical outcomes, but suggesting a possible reduction in overall respiratory support duration. • The study identifies critical methodological limitations in the existing literature, including heterogeneous apnea definitions and non-standardized caffeine dosing, and proposes a framework for future controlled studies.

PMID:41653310 | DOI:10.1007/s00431-026-06775-z

Naunyn Schmiedebergs Arch Pharmacol. 2026 Feb 7. doi: 10.1007/s00210-026-05077-3. Online ahead of print.

ABSTRACT

Despite the rising burden of hypertension (HTN) across Africa, the rate of blood pressure (BP) control among hypertensive patients remains unacceptably low. One of the key contributors to this treatment gap is therapeutic inertia (TI) the failure to initiate or intensify therapy when clinically indicated. However, evidence on the magnitude and determinants of TI in Ethiopia remains scarce. Objective: To assess the prevalence of therapeutic inertia and identify associated factors among hypertensive patients attending the outpatient department of Wolaita Sodo University Comprehensive Specialized Hospital. A hospital-based cross-sectional study was conducted among 189 hypertensive patients from August to November 2023. Participants were selected through consecutive sampling. Data were collected via interviews with patients and physicians, along with a review of medical charts. Descriptive statistics (frequencies, percentages, means ± SD, and medians with interquartile ranges) were used to summarize patient characteristics. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with TI. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Of the 189 patients, 50.8% were male, with a mean age of 53.8 years. The prevalence of therapeutic inertia was 58.7% (95% CI: 52.3%-65.4%). Factors significantly associated with lower odds of TI included treatment with amlodipine (AOR = 0.137; 95% CI: 0.019-0.975), use of NPH insulin (AOR = 0.174; 95% CI: 0.036-0.833), and higher diastolic BP readings (AOR = 0.910; 95% CI: 0.839-0.986). In contrast, physician-reported reasons for not intensifying treatment such as “BP being close to the target value” (AOR = 6.074; 95% CI: 1.315-28.060) and “concerns about patient adherence” (AOR = 5.487; 95% CI: 1.061-28.362) were positively associated with TI. Therapeutic inertia was observed in nearly 6 out of 10 cases of uncontrolled hypertension in this setting, highlighting a significant gap in clinical decision-making. Addressing therapeutic inertia through improved adherence to hypertension treatment guidelines and strengthened physician education may help improve blood pressure control in similar settings. Stakeholders should implement systems that support timely treatment intensification and encourage adherence to evidence-based management strategies.

PMID:41653282 | DOI:10.1007/s00210-026-05077-3