Nevin Manimala

Sci Rep. 2026 May 28. doi: 10.1038/s41598-026-50447-9. Online ahead of print.

ABSTRACT

The triglyceride-glucose (TyG) index has recently gained attention as a cost-effective and easily calculable surrogate marker reflecting insulin resistance-related metabolic risk. Given the close interplay between thyroid hormones, lipid metabolism, glucose regulation, and inflammation, evaluating the association between thyroid dysfunction and the TyG index remains clinically relevant. This study aimed to investigate variation in the TyG index across different thyroid function states-overt hypothyroidism (OH), subclinical hypothyroidism (SCH), euthyroidism (EH), and healthy controls-and to assess its associations with lipid parameters and inflammatory markers, including the CRP/albumin ratio. In this cross-sectional observational study, 222 adults were categorized according to thyroid status based on TSH and free T4 levels. The TyG index was calculated using fasting glucose and triglyceride values. Associations with lipid and inflammatory markers were evaluated, and receiver operating characteristic (ROC) analysis was performed to assess the ability of the TyG index to discriminate individuals with elevated TyG-defined metabolic risk. No statistically significant differences in TyG index levels were observed across thyroid function groups (p = 0.152). However, the TyG index showed significant positive correlations with triglyceride levels (r = 0.419, p < 0.001), CRP/albumin ratio (r = 0.342, p < 0.001), and LDL-C (r = 0.204, p = 0.009). ROC analysis demonstrated moderate discriminatory performance (AUC = 0.731; 95% CI: 0.652-0.809), identifying individuals with higher TyG levels associated with increased metabolic risk. Although TyG index levels did not differ significantly across thyroid function states, their associations with lipid and inflammatory markers suggest that the TyG index reflects metabolic and inflammatory risk profiles independent of thyroid status, rather than serving as a direct diagnostic measure of insulin resistance.

PMID:42204188 | DOI:10.1038/s41598-026-50447-9

Sci Rep. 2026 May 27. doi: 10.1038/s41598-026-53247-3. Online ahead of print.

ABSTRACT

Patients with schizophrenia are at high risk for insomnia, but the associated influencing factors in this population have not been fully elucidated. Therefore, this study aimed to investigate the associations between insomnia symptoms and psychopathological indicators and hematological parameters in patients with schizophrenia, as well as to analysis the gender differences. From October 2022 to December 2024, this study recruited 184 patients with schizophrenia. The Insomnia Severity Index Scale (ISI), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale (CDSS), and Modified Overt Aggression Scale (MOAS) were used to assess insomnia symptoms, psychotic symptoms, depressive symptoms, and aggressive behaviors, respectively. In addition, this study examined a range of blood parameters including leukocytes, neutrophils, lymphocytes, monocytes, platelets, total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH); and calculated the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and monocyte to lymphocyte ratio (MLR). Finally, independent factors of insomnia symptoms were identified using stepwise logistic regression, and the predictive value of each factor was evaluated via ROC curve analysis. The prevalence of insomnia symptoms in patients with schizophrenia was 34.8%, with 29.1% in males and 42.0% in females. Regression analysis showed that the independent influences of insomnia symptoms in the total sample were BPRS total score, CDSS total score, NLR (Ln) and T3. In male patients, BPRS total score, CDSS total score, and NLR (Ln) remained significant independent predictors. In contrast, only CDSS total score emerged as a statistically significant independent predictor in female patients. Furthermore, ROC curve analysis further demonstrated that the four-item combination of BPRS total score, CDSS total score, NLR (Ln), and T3 (AUC = 0.825, 95% CI = 0.766-0.885, P < 0.001) had a better ability to identify symptoms of insomnia in the total sample. Meanwhile, the three-item combination of BPRS total score, CDSS total score and NLR (Ln) (AUC = 0.850, 95% CI = 0.773-0.926, P < 0.001) had a better ability to identify insomnia symptoms in male patients. Patients with schizophrenia exhibited a relatively high risk of insomnia (29.1% in males vs. 42.0% in females); however, this difference was not statistically significant. Insomnia symptoms may be associated with psychotic symptoms, depressive symptoms, NLR, and T3. And there may be some gender differences in these correlations, with psychotic symptoms and NLR being independently linked to insomnia only in males.

PMID:42204187 | DOI:10.1038/s41598-026-53247-3

Sci Rep. 2026 May 27. doi: 10.1038/s41598-026-50775-w. Online ahead of print.

ABSTRACT

Despite national progress in water, sanitation and hygiene (WASH), substantial disparities persist among Scheduled Tribe (ST) populations, including the Vantangiya community in Gorakhpur, India. This study assessed household-level WASH conditions and their association with waterborne diseases using a complete survey of 621 households across five villages conducted in 2024. Composite WASH indices were developed based on WHO/UNICEF Joint Monitoring Programme (JMP) indicators, including sanitation access, water source and treatment, and handwashing facilities; associations were analysed using Firth’s bias-reduced penalized logistic regression alongside household-level spatial analysis. Only 16% of households demonstrated good WASH conditions; 23% lacked toilet access, 32% relied on unimproved water sources, and 52% lacked handwashing facilities. Poor WASH conditions were associated with significantly higher odds of diarrhoea (aOR: 6.41, 95% CI: 2.08-10.11), typhoid (aOR: 8.91, 95% CI: 5.62-14.00), and any waterborne disease (aOR: 5.10, 95% CI: 1.48-9.89), compared with households with good WASH conditions. Spatial analysis identified statistically significant but very weak spatial autocorrelation, indicating localized heterogeneity rather than strong clustering. Notably, many existing toilets were poorly maintained, reflecting measurable behavioural gaps alongside infrastructure deficits. This finding provides context-specific evidence that WASH inequities remain closely linked to household disease risk. Integrating behavioural-focused interventions with infrastructure improvements may enhance effectiveness. Micro-scale spatial assessment further highlights localized high-risk households, supporting targeted, micro-area WASH interventions integrated within frontline public health delivery systems and aligned with Sustainable Development Goal (SDG) 6 in underserved communities.

PMID:42204183 | DOI:10.1038/s41598-026-50775-w

Int Dent J. 2026 May 27;76(4):109643. doi: 10.1016/j.identj.2026.109643. Online ahead of print.

ABSTRACT

INTRODUCTION AND AIMS: The aims of this study were to evaluate the clinical and radiological characteristics of patients diagnosed with mandibular medication-related osteonecrosis of the jaw (MRONJ) and to examine its associations with neurosensory disturbances (NSD) related to the inferior alveolar nerve.

METHODS: A retrospective review was conducted of all patients diagnosed with MRONJ who had undergone cone-beam computed tomography (CBCT) or computed tomography (CT) imaging in the Department of Oral and Maxillofacial Surgery at the Prince Philip Dental Hospital between January 2013 and August 2024. Clinical characteristics and the radiological manifestations of the mandibular canal were extracted. Statistical analyses were carried out with the significance level set at 5%.

RESULTS: A total of 61 patients with 65 MRONJ lesions were included, of which 21 lesions (32.3%) exhibited neurosensory disturbances. The most common radiological manifestation of the MC was osteosclerotic (60%) and osteolytic changes (60%), followed by sequestration (46.2%). Multivariate logistic regression analysis identified active infection (adjusted OR 4.91, 95% CI: 1.14-21.2, p = .033) and sequestrum impingement (adjusted OR: 6.17, 95% CI: 1.76-21.7, p = .005) as significant associations of NSD. Four out of 15 patients with active infection and preintervention NSD presented with complete resolution of NSD following the elimination of the infection.

CONCLUSION: Approximately one-third of mandibular MRONJ lesions presented with NSD. Sequestration impinging on the MC and active infection are associated with the presence of NSD.

CLINICAL RELEVANCE: The removal of sequestrum and treatment of infection may lead to an improvement in pre-intervention NSD; therefore, the inferior alveolar nerve should not be sacrificed routinely during the operation.

PMID:42202388 | DOI:10.1016/j.identj.2026.109643

Int Dent J. 2026 May 27;76(4):109641. doi: 10.1016/j.identj.2026.109641. Online ahead of print.

ABSTRACT

BACKGROUND: Oral cancer constitutes a significant public health burden globally and has long been associated with substantial socioeconomic, racial, and regional disparities worldwide. Population-level mortality surveillance in high-income countries such as the United States can provide crucial epidemiological evidence and methodological references for global cancer control and prevention strategies. However, national-level updated evidence on long-term trends, subgroup heterogeneity, and pre- and post-COVID-19 pandemic trends in oral cancer mortality in the United States remains limited. This study assesses the temporal trends and differences in oral cancer mortality in the United States from 1999 to 2024.

METHODS: Mortality data were extracted from the CDC WONDER Underlying Cause of Death database. Overall oral cavity cancer was defined using ICD-10 codes C00-C06, while subsite analyses focused on C02-C06. Adults aged 25 years and older were included. Joinpoint regression was used to analyse temporal trends in age-adjusted mortality rates (AAMRs, per 100,000 population) and to estimate annual percent change (APC) and average annual percent change (AAPC), with stratification by sex, region, and subsite. In addition, custom time intervals of 1999-2019 and 2020-2024 were specified to assess trend changes before and during the pandemic period. A supplementary age-stratified analysis comparing adults aged 25 to 44 years and those aged ≥45 years was also performed.

RESULTS: Overall oral cavity cancer mortality exhibited one joinpoint in 2009. Mortality declined significantly from 1999 to 2009 (APC = -1.81%, 95% CI: -2.48% to -1.28%, P < .001), but increased significantly from 2009 to 2024 (APC=1.29%, 95% CI: 0.99% to 1.66%, P < .001), whereas the AAPC for the full study period was not statistically significant (0.04%, 95% CI:-0.11% to 0.19%, P = .624). Mortality rates were consistently higher in males than in females, and pairwise comparison showed that sex-specific trends were neither parallel nor coincident (parallelism P = .012; coincidence P = .001). All 4 U.S. Census regions demonstrated an initial decline followed by a later rebound, although only the Midwest showed a significant net increase over the full study period. Marked heterogeneity was observed across subsites: tongue cancer (C02) was the only subsite with a significantly increased AAPC over the full study period, whereas floor-of-mouth cancer (C04) and palate cancer (C05) showed sustained net declines. Custom interval analyses further demonstrated a declining trend before the pandemic (1999-2019; AAPC=-0.2709%, 95% CI:-0.4281 to -0.1087, P < .001) and an increasing trend during the pandemic period (2020-2024; AAPC=1.2879%, 95% CI: 0.9922 to 1.6558, P < .001). Significant sex-based differences were observed, with additional heterogeneity across regions and subsites. In supplementary age-stratified analyses, no significant joinpoint was identified among adults aged 25-44 years, whereas adults aged ≥45 years showed a significant reversal in mortality trend, suggesting that the overall mortality rebound was driven predominantly by the older age group.

CONCLUSIONS: In the United States, oral cavity cancer mortality shifted from a declining trend to a sustained increase around 2009 and accelerated further during 2020-2024, indicating a biphasic rather than a simple linear pattern. Substantial heterogeneity was observed across sex, region, and subsite. Tongue cancer may have been a major contributor to the recent rebound in mortality, while the post-2020 trend reversal underscores the need to further examine the potential effects of diagnostic delay, disparities in healthcare access, and post-pandemic health system recovery on oral cavity cancer outcomes. Supplementary analyses further suggest that this mortality reversal was concentrated mainly in adults aged ≥45 years rather than in younger adults.

PMID:42202385 | DOI:10.1016/j.identj.2026.109641

N Engl J Med. 2026 May 28;394(20):1991-2001. doi: 10.1056/NEJMoa2513525.

ABSTRACT

BACKGROUND: Biologic ventricular assist tissue (BioVAT) is formulated from engineered heart muscle composed of cardiomyocytes and stromal cells derived from allogeneic induced pluripotent stem cells for cardiac remuscularization in patients with heart failure and a reduced left ventricular ejection fraction.

METHODS: We conducted an open-label, phase 1-2 study of tissue-engineered heart repair by means of BioVAT transplantation. Patients with heart failure and a left ventricular ejection fraction of 35% or less and at least one hypokinetic or dyskinetic left ventricular segment were treated with BioVAT allografts, which consisted of 5, 10, or 20 engineered-heart-muscle units. All the patients received immunosuppression. Safety was assessed as adverse events related to the procedure. The primary efficacy end points were the change from baseline in the target heart-wall thickness, the left ventricular ejection fraction, and the Kansas City Cardiomyopathy Questionnaire-Overall Summary Score (KCCQ-OSS).

RESULTS: A total of 20 patients were treated in the study. Three patients died during the study (1 each from vasoplegia, coronavirus disease 2019, and aortic dissection). One patient underwent heart transplantation. Immunosuppression was discontinued in 4 patients because of implantation of a left ventricular assist device (in 2 patients), renal failure (in 1 patient), and urothelial carcinoma (in 1 patient). Of the 16 patients who were treated with the safe maximal dose (20 engineered-heart-muscle units), 12 patients completed the prespecified 3-month interim follow-up. The least-squares mean increase in the target-wall thickness was 4.5 mm (90% confidence interval [CI], 3.7 to 5.4; P<0.001), the increase in the left ventricular ejection fraction was 3.9 percentage points (90% CI, 0.9 to 6.8; P = 0.04), and the increase in the KCCQ-OSS was 6.7 points (90% CI, 1.0 to 12.5; P = 0.06). All the patients had at least one adverse event.

CONCLUSIONS: In this interim analysis, cardiac remuscularization with BioVAT was associated with an increase in the target heart-wall thickness, left ventricular ejection fraction, and KCCQ-OSS at 3 months; all the patients had at least one adverse event. Longer-term follow-up and further clinical investigation are warranted. (Funded by the German Center for Cardiovascular Research and Repairon; BioVAT-HF ClinicalTrials.gov number, NCT04396899.).

PMID:42202318 | DOI:10.1056/NEJMoa2513525

Afr J Reprod Health. 2026 May 27;30(10):49-59. doi: 10.29063/ajrh2026/v30i10.4.

ABSTRACT

This study explores dance education as an informal health pathway linked to movement, gender, and reproductive wellbeing among Chinese women. A quantitative cross-sectional design surveyed women of reproductive age using a structured questionnaire measuring dance education participation, psychosocial mediators, and reproductive wellbeing. Data were analyzed with descriptive statistics, reliability analysis, correlation, regression, and mediation models. Results showed that higher levels of dance education participation were associated with greater reproductive wellbeing. Dance education also positively correlated with emotional regulation, body awareness, and social connection, and negatively with perceived stress. Mediation analysis confirmed that these psychosocial mechanisms partially explain the relationship between dance education and reproductive wellbeing. These findings position dance education as a cultural, gender-responsive, non-clinical intervention for women’s health promotion. The study provides empirical support for the proposed conceptual framework and aligns with Sustainable Development Goals 3 and 5, demonstrating how informal, community-based practices can support women’s reproductive wellbeing in China.

PMID:42202313 | DOI:10.29063/ajrh2026/v30i10.4

Int J Occup Saf Ergon. 2026 May 27:1-10. doi: 10.1080/10803548.2026.2655008. Online ahead of print.

ABSTRACT

Objectives. Empirical data on how different workspace clearance dimensions affect manual task outcomes and worker posture remain scarce, despite the acknowledged importance of spatial design in ergonomics. This study investigates the effects of horizontal and vertical clearances on cycle time, error count and postural behaviors. Methods. A within-subject repeated-measures design was employed, where participants (n = 12, mean age 23 ± 3.4 years) performed a simulated assembly task under varying horizontal and vertical clearance conditions. Results. Horizontal clearance has a statistically significant effect on cycle time (F = 36.15, p < 0.001, η² = 0.475), with reduced horizontal clearance leading to longer cycle times. In contrast, vertical clearance did not significantly influence cycle time. Analysis of error counts using a Poisson generalized linear model showed no significant impact of either horizontal or vertical clearance on assembly errors (p = 0.628), suggesting that error rates were not strongly affected by experimental parameters. Postural observations revealed that reduced horizontal clearance resulted in adoption of compensatory postures such as increased shoulder elevation and arm adduction, especially under limited vertical clearance. Conclusion. These findings highlight the importance of optimizing horizontal clearance (minimum of 450 mm) to improve efficiency while managing vertical clearance to reduce ergonomic risk in constrained workspaces.

PMID:42202309 | DOI:10.1080/10803548.2026.2655008

JMIR Form Res. 2026 May 27;10:e80769. doi: 10.2196/80769.

ABSTRACT

BACKGROUND: A prevalent and serious complication of diabetes mellitus is the development of diabetic foot ulcer (DFU). There is a need for effective solutions that help prevent DFU to support our increasingly stressed health care systems. The use of mobile health (mHealth) tools has been shown to improve awareness and effective self-care management skills in people at risk of developing diabetic foot ulceration.

OBJECTIVE: In this study, we aimed to investigate the perceived usefulness, engagement, and overall user experience of the Feetchecker app, a self-monitoring mHealth app for people at risk of DFU.

METHODS: A total of 24 patients (mean age 71, SD 8.6 years) with type 2 diabetes mellitus at risk of developing diabetic foot ulceration completed a 3-month evaluation period (70 recruited, 36 included, 12 dropped out) of a self-monitoring mobile app called Feetchecker app. A mixed methods approach was used to combine insights from app data with qualitative data from a pre- and postsurvey as well as interviews with patients and involved podiatrists. Data were analyzed using descriptive statistics and thematic analysis. We evaluated overall use of the app, patient engagement, and user experiences.

RESULTS: Patients who fully completed the study conducted 393 feetchecks. In total, 7 patients sent in 9 pictures; all 7 were called for follow-up by a podiatrist. Overall, patients had a positive experience with the app and perceived the Feetchecker app as a valuable tool to monitor their feet for potential risk factors of DFU. Ease of use in performing a feetcheck and sending the podiatrist a picture was described as an important feature. Three main types of engagement with the Feetchecker app emerged: continuous, frequent, and no to little engagement. These patterns highlight enablers for self-monitoring such as ease-of-use, easy access to a podiatrist, and social support, as well as barriers such as digital skills and sustained engagement. Podiatrists highlighted the benefits of having patients report potential issues quicker and the ability to monitor their patients remotely. Challenges remain in integrating the promotion of the Feetchecker app into their consultations.

CONCLUSIONS: The Feetchecker app supported patients in self-monitoring risk factors associated with DFU through routine checks and quick contact with a health care professional in case of a potential issue. Overall, patients described a positive user experience and considered the app helpful. While mHealth tools are not for everyone, user engagement for many patients was high and shows that such apps can offer support for people able to use them. Future research should focus on improving usability and engagement with the app as well as extend the way patients can communicate with health care professionals beyond a picture.

PMID:42202301 | DOI:10.2196/80769

Int J Prosthodont. 2026 May 27;39(3):387-396. doi: 10.11607/ijp.9281.

ABSTRACT

PURPOSE: To investigate the effects of build angle and position in the build platform on the dimensional accuracy of 3D-printed molar crowns using digital light processing technology (DLP).

MATERIALS AND METHODS: A mandibular right first molar crown was designed digitally and printed using DLP at nine standardized positions in the build platform at 90-, 120-, 135-, 150-, 180-, 210-, 225-, 240-, and 270-degree build angles. The experiment was repeated three times per build angle. Specimens were scanned with a TRIOS 4 scanner (3Shape). STL files of each specimen were compared to the original file using Geomagic Control X. Accuracy was evaluated by root mean square (RMS), 2D Compare, and simulated coordinate measuring machine (CMM) measurements. Results were analyzed using two-way and one-way ANOVA. Statistical significance was set at P < .05.

RESULTS: Build angle influenced the dimensional accuracy of DLP, with the lowest RMS values recorded at 210 degrees and C2 position. Crowns oriented toward 90 degrees (152 ± 46.6 μm) and 270 degrees (209 ± 25.7 μm) exhibited the greatest amount of deviation at mesial and distal internal axial surfaces and the greatest amount of deviation at external finish lines, which ranged from -81.9 to 79.9 μm.

CONCLUSIONS: Molar crowns can be placed in any position of the build platform of a DLP printer. However, crowns should be oriented at build angles that reduce the effects of resin pooling and minimize the number of layers at the finish line to maximize accuracy. A build angle of 210 degrees is recommended for optimal results.

PMID:42202298 | DOI:10.11607/ijp.9281