Tag: nevin manimala

J Contemp Dent Pract. 2026 Feb 1;27(2):117-123. doi: 10.5005/jp-journals-10024-4019.

ABSTRACT

AIM: The current study aimed to evaluate the efficacy of vibration and external cooling in contrast to counter-stimulation with audiovisual (AV) distraction in reducing pain and anxiety during inferior alveolar nerve block (IANB).

MATERIALS AND METHODS: The participants in the study included 36 children aged 6-10 years who needed dental work on their mandibular posterior teeth that called for IANB usage. A pulse oximeter was used for the objective measure, which was pulse rate. The patient selected the Wong-Baker FACES Pain Rating Scale (WBFPRS), and the observer recorded the face, leg, activity, cry, and consolability (FLACC) scale among the subjective measures. The participants were randomly assigned to three groups: Group A: Buzzy, group B: Counter-stimulation with AV distraction group, and group C: Control group (IANB without intervention).

RESULTS: Comparison between groups revealed that the differences in pulse rates between the groups were statistically significant during the procedure (p = 0.035). Group B showed the highest mean pulse during the procedure. Regarding Wong-Baker scale results, after the procedure, group A (Buzzy) showed the lowest mean pain score, followed by group C, while group B showed the highest mean pain score, but the difference between groups did not reach a level of statistical significance (p = 0.19). Group B had the highest mean FLACC score, but the groups did not differ significantly.

CONCLUSION: Buzzy was more successful in lowering pediatric dental patients’ perceptions of IANB pain as compared to counter-stimulation with AV distraction and conventional technique, but this effect was not statistically significant.

CLINICAL SIGNIFICANCE: Children with dental anxiety have exaggerated expectations of pain. The use of the Buzzy device during IANB aids in improving comfort and cooperation in pediatric dental patients, supporting effective chairside pain and anxiety management. How to cite this article: Abdel Lattif NA, Abd-Alla NF, Alfadhli HA, et al. Buzzy vs Counter-stimulation with Audiovisual Distraction for Pain and Anxiety Control during Inferior Alveolar Nerve Block in Children: A Randomized Controlled Trial. J Contemp Dent Pract 2026;27(2):117-123.

PMID:42145159 | DOI:10.5005/jp-journals-10024-4019

J Contemp Dent Pract. 2026 Feb 1;27(2):105-116. doi: 10.5005/jp-journals-10024-4020.

ABSTRACT

AIM: The purpose of this study was to assess the clinical performance of recently introduced multilayered ultra-translucent zirconia as a laminate veneer material lithium disilicate laminate veneers in terms of modified United States Public Health Service (USPHS) criteria for assessing dental restorations.

MATERIALS AND METHODS: The minimum estimated sample size was 21 veneers. The sample size was increased to 26 veneers (13 veneers per group) to compensate for a dropout rate of 25%. Healthy patients with normal occlusion and with no parafunctional habits, severe discoloration or rotation, and having sufficient sound enamel thickness, who met the inclusion criteria, were randomly assigned to two groups. In the intervention group, 16 laminates were fabricated from ultra-translucent multilayered (UTML) zirconia. In the control group, 16 laminates were fabricated from lithium disilicate. All preparations were confined to the enamel with chamfer finish line and butt-joint incisal margins. Zirconia veneers were sandblasted and surface-treated with zirconia primer. Acid-etched lithium disilicate veneers were surface-treated with ceramic primer. Both groups were adhesively cemented to the tooth structure with light-cured resin cement. Veneers were assessed immediately after cementation and at 3, 6, 12, and 18 months. United States Public Health Service criteria were used to evaluate each veneer, where retention was specified as the primary outcome. The secondary outcome was the restoration of integrity. The third outcome was color match, and marginal adaptation of the restoration was determined to be the fourth outcome. Data were recorded and statistically analyzed.

RESULTS: Results of multiple follow-ups over 18 months were analyzed using Fisher’s exact test for statistical comparison and showed no statistically significant difference between the two groups. Results of retention at baseline showed that both groups had identical 100% Alpha scores. At 3 months, the lithium disilicate group maintained consistent Alpha scores (100%), while UTML zirconia showed a slight decrease with 93.7% Alpha and 6.3% Bravo scores, with no significant difference between groups (p = 0.31). At 6 months, the lithium disilicate group maintained consistent Alpha scores (100%), while UTML zirconia declined to 81.3% Alpha and 18.7% Bravo scores with an insignificant difference between groups (p = 0.069). Finally, after 12 and 18 months, both groups had identical 100% Alpha scores. Regarding restoration integrity, color matching, and marginal adaptation, both groups recorded Alpha scores throughout the entire follow-up intervals.

CONCLUSION: Although the lithium disilicate group showed better retention results, no significant difference was found in retention, color stability, restoration integrity, and marginal adaptation between the groups.

CLINICAL SIGNIFICANCE: This trial provides evidence-based guidance for selecting materials for conservative restorations. It investigates a new, potentially stronger material for esthetic cases by assessing its clinical performance as a veneer.

TRIAL REGISTRATION NUMBER: https://www.

CLINICALTRIALS: gov. Protocol Registration and Results System, NCT04598737 (22/10/2020). How to cite this article: Elkady MA, Taymour MA, Anwar EM. Clinical Assessment of Teeth Restored with Ultra-translucent Multilayered Zirconia vs Lithium Disilicate Laminates-18-month Follow-up: A Randomized Controlled Trial. J Contemp Dent Pract 2026;27(2):105-116.

PMID:42145158 | DOI:10.5005/jp-journals-10024-4020

Cancer Cytopathol. 2026 Jun;134(6):e70097. doi: 10.1002/cncy.70097.

ABSTRACT

BACKGROUND: Proficiency in cytopathologic diagnosis depends heavily on extensive hands-on practice and immediate error correction. Traditional teaching models, however, are constrained by limited practice opportunities and delayed feedback, which fails to meet the core skill-development needs of residents.

METHODS: In total, 45 pathology residents were enrolled and assigned to two groups. The experimental group (n = 20) adopted a tripartite teacher-artificial intelligence-resident collaborative teaching model, whereas the control group (n = 25) received conventional instruction. Both groups underwent an identical 8-week teaching cycle.

RESULTS: The questionnaire results from the experimental group indicated that 19 of 20 residents (9%) deemed the new model highly necessary, and 15 of 20 (75%) believed it significantly improved their diagnostic competence. Semistructured interviews further revealed that the model enhanced diagnostic ability, facilitated personalized learning, and alleviated learning anxiety. For objective metrics, the experimental group demonstrated a significantly higher postintervention concordance rate for gray-zone cell identification (78.65%) compared with both their preintervention baseline (64.38%) and the contemporaneous control group (66.84%; t = 8.962; p < .001). In addition, the experimental group exhibited a markedly faster diagnostic speed (mean ± standard deviation, 3.05 ± 0.52 minutes per case) compared with their preintervention performance (5.92 ± 0.85 minutes per case) and the control group (5.63 ± 0.79 minutes per case; t = 14.821; p < .001). No statistically significant changes were observed in the control group (p > .05).

CONCLUSIONS: This study demonstrates that artificial intelligence technology integrated with real-time visual interaction effectively improves the cytopathologic diagnostic skills of residents and merits wider promotion in pathology education.

PMID:42145147 | DOI:10.1002/cncy.70097

Dev Neurorehabil. 2026 May 18:1-6. doi: 10.1080/17518423.2026.2674765. Online ahead of print.

ABSTRACT

BACKGROUND: Family-centered care is a foundational principle of early developmental neurorehabilitation; however, family-related outcomes are rarely assessed using instruments specifically developed for this context. The Family Outcome of Early Intervention Questionnaire (FOEI) is an interdisciplinary, family-reported outcome measure currently under development.

OBJECTIVE: To examine selected psychometric properties of the developmental version of the FOEI in a methodological pilot study to inform further instrument refinement, and to provide preliminary evidence that should be interpreted in light of the instrument’s developmental status.

METHODS: In this methodological pilot study with a test-retest design, parents of infants and young children receiving ambulatory early neurorehabilitation completed the FOEI twice within an interval of 7-10 days. Test-retest reliability was assessed using intraclass correlation coefficients (ICC(2,1)). Discriminative validity was explored by comparing families receiving Coping with and Caring for Infants with Special Needs (COPCA®) – based family-centered intervention with those receiving conventional physiotherapy. Convergent validity was examined through correlations with the Family Empowerment Scale (FES). Ceiling effects were assessed using descriptive statistics.

RESULTS: Test – retest reliability of the FOEI total score was moderate in the full sample (ICC(2,1) = 0.58, 95% CI 0.35-0.74) and higher after exclusion of two cases with implausible response patterns (0.79, 95% CI 0.64-0.88). FOEI scores were consistently higher in the COPCA® group, with small to moderate effect sizes, although no differences reached statistical significance after Bonferroni – Holm correction. Convergent validity with the FES was low (ρ = 0.06-0.27).

CONCLUSION: The developmental FOEI version shows preliminary temporal stability in this pilot sample. Further refinement of items and response scaling is required, particularly in light of observed ceiling effects and limited discriminative performance, as part of an ongoing instrument development process.

PMID:42145091 | DOI:10.1080/17518423.2026.2674765

Circulation. 2026 May 18. doi: 10.1161/CIRCULATIONAHA.125.078320. Online ahead of print.

ABSTRACT

BACKGROUND: The optimal transfusion strategy in patients with acute myocardial infarction (AMI) and anemia may be influenced by sex differences in pathophysiology and cardiovascular outcomes. The Myocardial Ischemia and Transfusion trial (MINT) randomized patients with AMI and anemia to restrictive or liberal transfusion thresholds, but sex-stratified outcomes remain undefined. The objective was to evaluate whether the clinical effect of restrictive versus liberal red blood cell transfusion strategies differs by sex in patients hospitalized with AMI and anemia.

METHODS: In this prespecified secondary analysis of the MINT trial, we examined outcomes by sex and transfusion strategy. The primary outcome was 30-day composite death or MI. Secondary outcomes included heart failure, stroke, cardiac death, and 180-day mortality. Adjusted relative risks (RRs) and hazard ratios (HRs) were estimated accounting for sex differences at baseline. Interactions between sex and transfusion effects were assessed.

RESULTS: There were 3504 study participants, of whom 1593 (45.4%) were women. Women received fewer transfusions on average. Primary outcome occurred in 15.4% of women and 15.4% of men and occurred in 16.5% of women and 17.1% of men in the restrictive arm, versus 14.9% and 14.2% in the liberal arm, respectively. Women had a lower 180-day mortality (11.0% versus 13.5%; P=0.04). There were no statistically significant interactions between sex and transfusion strategy for the primary outcome (interaction P=0.60). For 30-day cardiac death, a higher RR in men was observed in the restrictive transfusion arm (RR, 2.34; 95% CI, 1.48-3.70; interaction P=0.05).

CONCLUSIONS: For MINT patients with anemia and AMI, women comprised nearly half of the study population, and randomization to a restrictive or liberal transfusion strategy resulted in comparable outcomes in women and men. These findings support sex-neutral transfusion thresholds.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02981407.

PMID:42145087 | DOI:10.1161/CIRCULATIONAHA.125.078320

Biom J. 2026 Jun;68(3):e70124. doi: 10.1002/bimj.70124.

ABSTRACT

In this paper, we present a Monte Carlo method for estimating a nonlinear function of the mean of a multivariate normal distribution. Building on this method, we propose a parametric estimation procedure for unimodal regression models, assuming that the response variable follows a gamma distribution while some covariates are contaminated with normal measurement error. Compared to existing approaches, the proposed method accommodates multivariate covariates and features a tractable bias-corrected likelihood function, enabling faster computation and more accurate estimation when the data distribution is correctly specified. To enhance the applicability of the proposed method, we also explore various model adequacy diagnostic tools and evaluate its robustness against distributional misspecifications. Notably, we introduce a goodness-of-fit test based on a unique characterization of the gamma distribution, designed to assess the validity of the distributional assumption for the response variable. Numerical studies and real-world data applications are conducted to evaluate the finite-sample performance of the proposed methods.

PMID:42145084 | DOI:10.1002/bimj.70124

Clin Transl Med. 2026 May;16(5):e70687. doi: 10.1002/ctm2.70687.

ABSTRACT

BACKGROUND AND AIMS: Existing imaging and serum-marker assays miss many early liver cancers, especially in high-risk chronic liver disease carriers. We aimed to create a highly accurate, non-invasive, methylation-based liquid biopsy for early detection.

METHODS: We used a comprehensive, multi-platform, multi-cohort strategy for marker discovery, starting with methylation profiling of hepatocellular carcinoma samples from TCGA and in-house cohorts. From 30 initial candidates, nine highly liver-specific methylation markers were shortlisted, and three optimal cfDNA markers (RNF135, CHFR, PAX5) were selected to develop a robust diagnostic model, tuned in a training set (N = 280) and locked in an internal testing set (N = 124). The model was then validated in a prospective, large-scale trial conducted at four geographically distinct Chinese centres.

RESULTS: The clinical trial included 1097 participants from two groups, (i) a diagnosing group (N = 646) that prospectively enrolled individuals without prior diagnostic results and represented a real-world high-risk population, and (ii) a diagnosed group recruited after pathology confirmation. Overall, the model achieved 94.43% (95% confidence interval, 92.12-96.09%) sensitivity and 95.16% (92.78-96.78%) specificity for liver cancer, with stage-I sensitivity of 93.10% (89.78-95.40%). Within the diagnosing group, overall sensitivity was 93.99% (91.28-95.90%), and for the 267 stage-I cases, it reached 92.88% (89.15-95.39%). As for specificity, it remained high across confounders: 92.78% (85.84-96.46%) in cirrhosis, 91.74% (85.46-95.45%) in other-cancer interference samples. Besides, the model outperformed the traditional liver cancer biomarker AFP and showed changes in methylation signals before and after surgery, suggesting a possible role in perioperative monitoring. Each centre independently reported sensitivities and specificities exceeding 90%, demonstrating robust geographic performance.

CONCLUSIONS: Using a systematic marker-discovery pipeline and a multi-centre prospective cohort, we developed a methylation-based liquid biopsy that reliably detects early liver cancer in high-risk populations.

CLINICAL TRIAL NUMBER: Chictr.org identifier: ChiCTR2400092883.

KEY POINTS: Three cfDNA methylation markers, RNF135, CHFR and PAX5, were identified for liver cancer liquid biopsy. A three-marker diagnostic model based on qMSP was established for highly accurate non-invasive detection of liver cancer. The LC-HMC model achieved 94.43% sensitivity and 95.16% specificity in the clinical trial. The model detected stage-I liver cancer with a sensitivity of 93.10%.

PMID:42145083 | DOI:10.1002/ctm2.70687

Am J Clin Pathol. 2026 May 5;165(5):aqag033. doi: 10.1093/ajcp/aqag033.

ABSTRACT

OBJECTIVES: To study and classify electronic safety reports assigned to the clinical laboratory of a large academic medical center, focusing on types of reporters, event classification, and severity of reported events.

METHODS: We performed a retrospective review of laboratory/pathology safety reports in 2023 at the Massachusetts General Hospital. Data included types of events, where the error occurred, the level of harm to the patient, and reporting patterns.

RESULTS: A total of 2334 reports were filed, with nearly three-fourths involving specimen/testing errors (76%). Most events (72%) originated in the preanalytical phase of testing, including labeling, collection, and transport issues. Of all reports, 56.7% indicated they did not reach the patient, 36.4% caused no harm but impacted the patient, 6% led to minor harm, and 0.6% resulted in permanent or major harm/damage. One case was severity level 4 (death). Laboratory technologists/technicians submitted most reports, while nursing was the primary reporter for events that pathology was required to resolve.

CONCLUSIONS: A large number of safety reports are generated in our large academic medical center. Most involve the preanalytical phase but do not result in direct patient harm. Despite improvements in information technology to improve the reliability of the preanalytical phase of testing, most reports reflect incidents outside the clinical laboratory.

PMID:42145078 | DOI:10.1093/ajcp/aqag033

J Nurs Manag. 2026;2026(1):e9254720. doi: 10.1155/jonm/9254720.

ABSTRACT

OBJECTIVE: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence-based practice (EBP) and identified factors that affect its implementation in clinical environments.

BACKGROUND: EBP is essential for enhancing healthcare quality; however, there are still gaps between theoretical knowledge and its practical application. Nursing leaders are crucial in promoting EBP, yet their competence levels and obstacles have not been thoroughly examined in Spain.

MATERIAL AND METHODS: A cross-sectional study surveyed 159 nurse managers across 16 autonomous communities in Spain, utilizing the validated EBP-COQ Prof tool. The questionnaire assessed four competency domains-attitude, knowledge, skills, and utilization-using a 1 to 5 Likert scale. Predictors of EBP competency, including training, mentorship, and organizational affiliation, were analyzed using multivariate linear regression.

RESULTS: Participants demonstrated a strong overall EBP competence, with an average total score of 143.77 out of 175. The highest scores were in the attitude domain (36.26/40) and knowledge (43.09/55), whereas utilization scores were relatively lower (37.57/50). This indicates that applying EBP in practice still lags behind positive attitudes and knowledge. Key factors predicting higher EBP competence included EBP training, consistent reading of scientific literature, mentoring nursing students, and working in a BPSO center. These results also imply that organizational constraints may continue to impede the integration of EBP competence into routine managerial practice.

CONCLUSIONS: Spanish nurse managers possess strong EBP knowledge but continue to encounter difficulties in applying it clinically. The study highlights four adjustable factors of EBP competency that could guide focused interventions.

IMPLICATIONS FOR NURSING MANAGEMENT: Healthcare institutions should implement (1) training programs for addressing knowledge-to-practice gaps, especially for nonspecialist managers; (2) mentorship systems pairing EBP-competent leaders with novices; (3) protected time for EBP activities; and (4) expanded BPSO accreditation to institutionalize evidence-based care. Future initiatives should include EBP metrics in performance evaluations, and research should explore factors such as leadership styles and the impact of resource allocation on patient outcomes through longitudinal designs.

PMID:42145075 | DOI:10.1155/jonm/9254720

Ann Pharmacother. 2026 May 18:10600280261447319. doi: 10.1177/10600280261447319. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe nerandomilast, a preferential phosphodiesterase 4B inhibitor indicated for the treatment of idiopathic pulmonary fibrosis and progressive pulmonary fibrosis.

DATA SOURCES: A PubMed search was conducted from origin to mid-April 2026 using the terms nerandomilast, Jascyd, BI 1015550, idiopathic pulmonary fibrosis (IPF), progressive pulmonary fibrosis, and interstitial lung disease. Phase 2 and 3 clinical trials, prescribing information, pooled analyses, and relevant guideline documents were included.

STUDY SELECTION AND DATA EXTRACTION: Two phase 3 randomized controlled trials evaluating nerandomilast in IPF and progressive pulmonary fibrosis were reviewed, along with regulatory prescribing information.

DATA SYNTHESIS: In the FIBRONEER-ILD and FIBRONEER-IPF trials, nerandomilast reduced forced vital capacity decline at 52 weeks compared with placebo. Treatment effects were observed in patients receiving background antifibrotic therapy and those treated with nerandomilast alone. Secondary time-to-event outcomes were not statistically significant. Diarrhea was the most common adverse event and occurred more frequently with nerandomilast, while serious adverse events were similar across treatment groups.Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:Nerandomilast targets inflammatory and profibrotic pathways distinct from currently available antifibrotic therapies and may be used as monotherapy or in combination with existing agents. Its role is best understood as disease stabilization rather than reversal of established fibrosis.

CONCLUSION AND RELEVANCE: Nerandomilast represents an additional therapeutic option for patients with IPF and progressive pulmonary fibrosis. Ongoing long-term and real-world data will further clarify its place in clinical practice.

PMID:42145068 | DOI:10.1177/10600280261447319