Tag: nevin manimala

Biodemography Soc Biol. 2026 Aug 16:1-15. doi: 10.1080/19485565.2026.2716716. Online ahead of print.

ABSTRACT

In 2020, the total fertility rate in Puerto Rico was estimated at 0.93 children per woman, one of the lowest in the world. While fertility decline preceded the new millennium, little is known about whether the onset of the 2006 economic crisis influenced its pace. Using birth counts from the Puerto Rico Vital Statistics System and population estimates, we calculate fertility measures for 1990-2020. Regression models estimated by ordinary least squares, with Newey-West standard errors, were fit to estimate the overall annual percent change (APC), and to compare the periods before and after the onset of the economic crisis (1990-2005 and 2006-2020). The pace of decline changed for eight of the nine indicators: accelerating for seven, while the ASFR for women aged 40-44 years declined at a slower pace. Stratified models show that all fertility measures and the share of women aged 15-44 declined significantly in both periods, with a faster decline observed in the post-crisis period for six of the nine. A significant acceleration in fertility decline was observed in the age-specific fertility rates for women under 35 years. In Puerto Rico, findings suggest that fertility decline accelerated after the onset of the economic crisis.

PMID:42604459 | DOI:10.1080/19485565.2026.2716716

Med J Aust. 2026 Aug;224(8):e70253. doi: 10.5694/mja2.70253.

ABSTRACT

OBJECTIVE: To estimate population-level eligibility for glucagon-like peptide-1 receptor agonist (GLP-1RA) medications among adults in Australia, according to Therapeutic Goods Administration-approved indications for chronic weight management and secondary prevention of cardiovascular disease in individuals with overweight or obesity.

STUDY TYPE: Cross-sectional analysis of data from the Australian Bureau of Statistics 2022 National Health Survey.

SETTING, PARTICIPANTS: Non-pregnant adults aged ≥ 18 years who were residents of Australia living in a private dwelling.

MAIN OUTCOME MEASURES: Total number of adults eligible for GLP-1RA medications according to approved indications for chronic weight management and secondary prevention of cardiovascular disease in individuals with overweight or obesity, across subgroups defined by body mass index, weight-related comorbidities and/or sociodemographic factors.

RESULTS: Overall, 39.7% (95% confidence interval [CI], 38.4%-41.0%) of adults were eligible for GLP-1RA use for chronic weight management, accounting for 7.8 million (95% CI, 7.6-8.1 million) individuals. Among those eligible, 2.9 million (95% CI, 2.7-3.1 million) adults had no weight-related comorbidities, 3.3 million (95% CI, 3.1-3.4 million) adults had one weight-related comorbidity and 1.7 million (95% CI, 1.6-1.8 million) adults had at least two weight-related comorbidities. The proportion of adults eligible under this indication varied across clinical and sociodemographic factors. Among those eligible under the chronic weight management indication, up to 338.9 thousand (95% CI, 271.3-406.5 thousand) adults also met the indication criteria for secondary prevention of cardiovascular disease.

CONCLUSION: About 7.8 million Australian adults are eligible to access GLP-1RAs for chronic weight management, with up to 338.9 thousand adults also qualifying according to the indication for established cardiovascular disease. This study provides a valuable reference for policymakers to understand the number of adults in Australia who may access GLP-1RA medications based on approved indication criteria and under various coverage scenarios.

PMID:42604458 | DOI:10.5694/mja2.70253

J Esthet Restor Dent. 2026 Aug 16. doi: 10.1111/jerd.70252. Online ahead of print.

ABSTRACT

PURPOSE: Current denture liner materials suffer from low tear strength, poor abrasion resistance, weak bond strength to denture material, and increasing risk of denture stomatitis due to adherence of Candida albicans. The aim of this study was to evaluate the effects of the addition of cellulose nanofibers (CNFs) to commercial soft denture liner material on the adherence of Candida albicans and physical and mechanical properties.

MATERIALS AND METHODS: CNFs at concentrations of 0.0, 0.5, and 1.0 wt.% were incorporated into a soft liner material. Antifungal effects were assessed by quantifying the adherence of Candida albicans. The Shore A hardness, tensile strength, peel bond strength, and surface roughness tests were employed to assess the properties of the denture liner materials. Chemical interactions between the fibers and liner material were confirmed by Fourier Transform Infrared (FTIR) spectroscopy, and a Scanning Electron Microscope (SEM) was used to assess the CNFs particles and fractured surface morphology.

RESULTS: There was a statistically significant decrease in the adherence of Candida albicans in both experimental CNFs groups. FTIR spectroscopic analysis confirmed the existence of strong hydrogen bonding between the CNFs and the liner polymer matrix. The hardness, surface roughness, peel bond strength and tensile strength increased significantly due to the addition of CNFs, most notably at 0.5 wt.%.

CONCLUSION: The addition of CNFs to the denture liner material improved mechanical properties and reduced Candida albicans adherence even with increased surface roughness above the established threshold of Ra ≥ 0.2 μm. The 0.5 wt.% CNFs concentration provided the most favorable balance of enhanced antifungal activity and mechanical properties, which suggests that CNFs may have altered surface interactions or adhesion sites and have the potential for clinical use in the mitigation of denture stomatitis.

PMID:42604436 | DOI:10.1111/jerd.70252

J Esthet Restor Dent. 2026 Aug 16. doi: 10.1111/jerd.70244. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the marginal and internal adaptation and to evaluate the clinical performance and patient satisfaction of CAD/CAM-fabricated all-ceramic crowns produced from lithium disilicate (LDS) and lithium disilicate-reinforced lithium aluminosilicate (LAS) over a 24-month follow-up period.

MATERIALS AND METHODS: This randomized controlled, single-blinded clinical trial included 59 posterior single crowns placed in 37 patients. Twenty-nine crowns were fabricated from LDS (IPS e.max CAD; Ivoclar Vivadent), and 30 crowns were fabricated from LAS (n!ce Blocks; Institut Straumann AG). Marginal and internal adaptation were assessed before cementation using an in vivo silicone replica technique. Clinical performance was evaluated at baseline and after 6, 12, and 24 months using the modified United States Public Health Service (USPHS) criteria together with the Gingival Index (GI), Plaque Index (PI), and patient satisfaction assessed using a visual analogue scale (VAS). Statistical analyses were performed at a significance level of p < 0.05.

RESULTS: No statistically significant differences were observed between the LDS and LAS groups regarding marginal, rounded shoulder, or occlusal gap measurements (p > 0.05). A statistically significant difference was observed at the axial measurement site (p = 0.014), with the LDS group exhibiting significantly greater axial internal gap values than the LAS group. During the 24-month follow-up period, six restorations failed because of fracture or debonding, including three LDS and three LAS crowns, resulting in survival rates of 89.7% for LDS, 90.0% for LAS, and 89.8% overall. Gingival and plaque index scores remained low and stable throughout the observation period, and patient satisfaction remained high in both groups, with no statistically significant differences between materials (p > 0.05). All clinically surviving restorations received Alpha or Bravo scores according to the modified USPHS criteria.

CONCLUSIONS: Within the limitations of this study, CAD/CAM-fabricated LDS and LAS crowns demonstrated comparable marginal adaptation, favorable clinical performance, and high patient satisfaction after 24 months of clinical service. The fully crystallized LAS ceramic appears to be a clinically acceptable and time-efficient alternative for posterior single-crown restorations. Nevertheless, long-term randomized clinical studies with larger sample sizes are required to confirm these findings.

PMID:42604435 | DOI:10.1111/jerd.70244

Microsc Res Tech. 2026 Aug 16. doi: 10.1002/jemt.70173. Online ahead of print.

ABSTRACT

Histological image classification plays a critical role in biomedical research and diagnostic processes. Advances in the field of deep learning present significant opportunities for enhancing diagnostic accuracy and developing automated decision support systems. This study aims to comparatively evaluate the out-of-distribution generalization and cross-domain classification performance of different deep neural network encoders. In this study, models were trained on an internal dataset of 4307 hematoxylin and eosin (H&E) stained images of male rat lung, cerebellum, and adipose tissues, obtained under ethical committee approval (Ege University, HADYEK 2026-06). To evaluate genuine generalization, testing was conducted on a separate, diverse external cohort of 600 mixed human-and-animal images. Nine different deep learning architectures-MobileNetV3-S, MobileNetV3-L, DenseNet121, DenseNet201, ConvNeXt-S, ConvNeXt-B, DINOv3 ViT-S, DINOv3 ViT-H+, and the pathology foundation model UNI2-h-were evaluated using frozen feature extraction combined with a linear probe. For performance evaluation, accuracy, sensitivity, specificity, F1 score, Cohen’s κ, and ROC-AUC metrics were analyzed along with per-image inference times. While all models achieved near-perfect results during internal cross-validation, their performance diverged significantly on the external dataset, confirming that the observed differences reflect genuine cross-domain generalization capabilities rather than under-fitting. All competitive models demonstrated high performance in classifying adipose and cerebellum tissues, achieving an F1 score of 95% or higher for these tissues. In distinguishing the lung tissue, which has the most diverse structure and is the most difficult to classify, the UNI2-h model emerged as the most successful, achieving an F1 score of 97.4% and a recall of 95.0%. When evaluated in terms of computational efficiency, the MobileNetV3-Small model stood out as having the lowest processing time among all scenarios, demonstrating an inference time of 9.4 ms on the CPU and 12.5 ms on the GPU. In conclusion, while the pathology foundation model UNI2-h achieved the highest accuracy values across all metrics, the ConvNeXt-Small model was identified as the system providing the optimal balance between speed and accuracy. These findings indicate that although UNI2-h stands out for the most precise results in cross-domain classifications, the ConvNeXt-Small architecture emerges as an ideal alternative, particularly in practical applications where computational efficiency is critical and resources are constrained.

PMID:42604434 | DOI:10.1002/jemt.70173

Arch Iran Med. 2026 Feb 1;29(2):69-76. doi: 10.34172/aim.36812. Epub 2026 Feb 1.

ABSTRACT

INTRODUCTION: The 8-item Inflammatory Bowel Disease control Questionnaire-8 (IBDcQ-8) is a patient-reported measure designed to capture the core domains of disease control and quality of life. The aim of this study was to evaluate the validity and reliability of the Persian version of the IBDcQ-8 in the Iranian IBD population.

METHODS: A standardized forward-backward translation procedure was employed to adapt the questionnaire into Persian. Content validity was evaluated through structured interviews with a panel of 10 evaluators. Construct validity was examined by structured interview and clinical visits of 101 patients. Harvey Bradshaw Index (HBI), partial Mayo score, and IBD Questionnaire (IBDQ) were used as comparator instruments. Patients’ responses were compared with clinical global assessment, Harvey Bradshaw Index (HBI), partial Mayo score, IBDQ score , and laboratory markers using Spearman’s rank correlation. Test-retest reliability was evaluated by calculating the intraclass correlation coefficient (ICC) between the two subsequent interviews. A P-value<0.05 was considered statistically significant.

RESULTS: Half of the subjects (n=51 (50.5%)) were female. The mean age was 38 years (SD=14). Sixty-seven patients (66%) had UC. IBDcQ-8 scores showed strong correlations with HBI and IBDQ, and moderate correlations with the partial Mayo score, CRP, and clinical evaluation at the first visit (P-value<0.05). Agreement was excellent for one-day follow-up (ICC=0.82, 95% CI: 0.71-0.89, P<0.001), and moderate for two-week follow-up (ICC=0.61, 95% CI: 0.44-0.73, P<0.001).

CONCLUSION: The Persian version of the IBDcQ-8 questionnaire demonstrated robust validity and acceptable reliability even when administered by telephone interview, supporting its usefulness for evaluating disease-specific quality of life in patients with IBD and its applicability in future studies.

PMID:42604425 | DOI:10.34172/aim.36812

Arch Iran Med. 2026 Feb 1;29(2):62-68. doi: 10.34172/aim.34939. Epub 2026 Feb 1.

ABSTRACT

INTRODUCTION: Cerebrovascular disorders (CeVDs) are among the leading causes of death worldwide. This study aims to analyze the trends in mortality due to CeVDs in northern Iran between 2016 and 2023.

METHODS: In this cross-sectional study, we included all documented Deaths due to CeVDs in Babol County, north of Iran, from 2016 to 2023. The crude mortality rate (CMR) and age-standardized mortality rate (ASMR) were used to assess the trends in CeVDs mortality. The Cochran-Armitage trend test and Joinpoint regression were employed to analyze the changes in disease trends.

RESULTS: During the study period, a total of 1,798 deaths from CeVDs were reported, with a mean age of 76.8±13.2 years. The CMR and ASMR for CeVDs decreased from 38.4 and 28.3 per 100,000 population in 2016 to 30.9 and 23.3 per 100,000 in 2023 (P<0.001). The trend decreased in both genders and urban and rural populations (P<0.05). Joinpoint regression indicated a break point in 2018. Between 2018 and 2023, the ASMR trend decreased, with an annual percentage change of -7.98% (95% CI, -18.72% to -4.88%).

CONCLUSION: This study reveals a significant decrease in CeVDs mortality in the region, indicating progress in therapeutic interventions. However, death rates in rural areas remain high. Addressing this condition requires targeted approaches and increased resource allocation.

PMID:42604424 | DOI:10.34172/aim.34939

Arch Iran Med. 2026 Jan 1;29(1):1-11. doi: 10.34172/aim.34141. Epub 2026 Jan 1.

ABSTRACT

BACKGROUND: Major depressive disorder (MDD), a major cause of the burden of diseases, is associated with a considerable rate of inadequate treatment and high costs. We assessed the pattern of service use, quality, and costs of healthcare for MDD in Iran.

METHODS: We assessed a national sample of 265 patients in the acute phase of MDD recruited from outpatient/inpatient settings at baseline and in three follow-up points of one, three, and six months. The pattern of service use and selected quality indicators were assessed, and the costs of care for an episode of MDD were estimated using the bottom-up approach.

RESULTS: The subjects were primarily female (73.6%), with a mean age of 43.3 years (±13.8). Of 173 respondents at the end of the study, 65.3% were on treatment for at least six months. Regarding quality indicators, the majority of the patients (97.7%) were prescribed antidepressants. However, only 71.2% of the patients initiated their antidepressants following prescription at the initial visit. At the end of the study, 40.1% were in remission and 58.1% had at least a 50% improvement in depressive symptoms. However, no standardized process or outcome measures were documented on the patients’ medical records. The average out-of-pocket and total costs for an episode of MDD per patient were estimated at Int$ 1331.4 and 2107.4, respectively.

CONCLUSION: We recommend establishing an infrastructure for monitoring the clinical evaluation and treatment, and proper documentation based on standard quality of care, especially for ambulatory clinical practice.

PMID:42604415 | DOI:10.34172/aim.34141

Med Care Res Rev. 2026 Aug 16:10775587261471942. doi: 10.1177/10775587261471942. Online ahead of print.

ABSTRACT

Hospitals spend billions of dollars annually on major construction projects and facility upgrades, but limited research to date has examined whether this expenditure benefits patients. Using a novel dataset of California hospital construction projects opening between 2010 and 2019, we estimate the effect of project opening on patient experience and clinical measures using a difference-in-differences framework. We find sizable, statistically significant improvements in patient experience-cleanliness, quietness at night, and likelihood to recommend-with effects persisting for at least 2 years after opening. We find no measurable impact on clinical outcomes, 30-day mortality, and readmission for heart attacks and heart failure. These results suggest infrastructure investments meaningfully affect perceived care environments but may not translate into near-term changes in clinical performance. Policymakers and hospital leaders should weigh these returns when evaluating capital expenditures and potential support for hospital construction.

PMID:42604414 | DOI:10.1177/10775587261471942

Int J Methods Psychiatr Res. 2026 Sep;35(3):e70100. doi: 10.1002/mpr.70100.

ABSTRACT

BACKGROUND: Secondary depression frequently develops in people with chronic diseases, and it may hinder disease progress and treatment outcomes. This study aimed to examine the construct validity and measurement invariance of the Arabic version of the Patient Health Questionnaire-9 (PHQ-9) among patients with chronic physical conditions.

METHODS: This cross-sectional study used confirmatory factor analysis (CFA) and multigroup CFA to evaluate the Arabic PHQ-9 in a convenience sample comprising patients with cancer, heart failure (HF), and renal failure (RF) from Oman and Yemen.

RESULTS: Out of eight models, the unidimensional PHQ-9 (depression) displayed satisfactory fit when three pairs of error were correlated whereas a similar fit was exhibited by a three-factor (somatic, cognitive/affective, and concentration/motor) solution, which was modified into (somatic, affective, and cognitive-psychomotor) solution based on partial scalar analysis tests. This structure was invariant across all sociodemographic characteristics, with better values of reliability coefficients, average variance extracted, and heterotrait-monotrait ratios of correlation.

CONCLUSION: The Arabic PHQ-9 is a reliable and psychometrically stable tool that may differentiate depressive symptoms in people with chronic disorders into three symptom groups. Meaningful comparisons between countries support higher psychological burden of physical disorders in Yemen than Oman.

PMID:42604413 | DOI:10.1002/mpr.70100