Tag: nevin manimala

BMC Oral Health. 2026 Jun 1. doi: 10.1186/s12903-026-08754-0. Online ahead of print.

ABSTRACT

OBJECTIVES: This study evaluated the color adjustment potential (CAP) and translucency adjustment potential (TAP) of monoshade and polyshade composites, and the influence of opaquer/blocker use, before and after aging in anterior Class IV restorations.

METHODS: A total of 105 acrylic teeth in A1, A2, and A3 shades (Vita Classic) were restored across seven groups based on composite type: monoshade (Omnichroma, Omnichroma with Blocker, Zenchroma) and polyshade (Estelite Sigma Quick, Estelite Sigma Quick with Opaquer, Palfique, Palfique with Opaquer) (n = 5 per group). Specimens underwent 10,000 thermal cycles and coffee staining. Color measurements were performed using a spectrophotometer, and color differences were calculated using the CIEDE2000 formula.CAP and TAP were calculated at baseline (T0) and after aging (T1). Data were analyzed statistically (α = 0.05).

RESULTS: Aging produced material-specific significant changes in CAP, while TAP was not significantly affected by aging. Opaquer/blocker use did not significantly affect CAP values, while a significant effect on TAP was observed only at baseline (T0) in the Estelite comparison. Polyshade composites generally exhibited higher CAP and TAP values than monoshade materials, although these differences were not statistically significant at all evaluation time points.

CONCLUSIONS: Polyshade composites may be preferred in anterior restorations requiring improved color and translucency matching. Clinicians should carefully consider opaquer/blocker use, as it may influence optical outcomes depending on the composite type.

CLINICAL RELEVANCE: This study provides guidance to clinics on achieving the correct color and translucency in anterior fracture cases; it also presents information on the long-term color and translucency compatibility of the composite parts used.

PMID:42219478 | DOI:10.1186/s12903-026-08754-0

BMC Surg. 2026 Jun 1. doi: 10.1186/s12893-026-03903-2. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the clinical efficacy of oblique lumbar interbody fusion (OLIF) combined with unilateral pedicle screw fixation (OLIF-UPS) performed in a single lateral position for degenerative lumbar diseases.

METHODS: Clinical data of patients who underwent OLIF-UPS in a single lateral position were collected retrospectively. During the same period, patients who received OLIF combined with bilateral pedicle screw fixation (OLIF-BPS) requiring intraoperative position change were enrolled as the control group. Perioperative parameters, Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified MacNab criteria were recorded to assess clinical outcomes. Radiographic parameters, including disc height (DH), lumbar lordosis (LL), cage subsidence rate, and interbody fusion rate, were compared between the two groups.

RESULTS: The operative time in the OLIF-UPS group was significantly shorter than that in the OLIF-BPS group (p <0.001), whereas no significant differences were observed in intraoperative blood loss or postoperative hospital stay between the two groups (p >0.05). Postoperatively, VAS scores for back and leg pain and ODI scores were significantly improved in both groups compared with preoperative values (p <0.001), with a further improvement noted at 1 year postoperatively compared with 1 month postoperatively. Postoperative DH and LL were significantly increased in both groups relative to preoperative measurements (p <0.001). A slight reduction in DH and LL was observed at 1 year postoperatively compared with the immediate postoperative period, but this difference was not statistically significant (p >0.05). The interbody fusion rate was 92.2% in the OLIF-UPS group and 93.5% in the OLIF-BPS group. Both groups achieved favorable functional recovery and high patient satisfaction.

CONCLUSION: In patients with normal to near-normal bone density (T-score > -2.5), Grade I or no spondylolisthesis, no segmental instability, and BMI <30 kg/m2, single-position OLIF-UPS achieves short-term outcomes comparable to OLIF-BPS while significantly reducing operative time. Given the relatively short follow-up period, further long-term observation is warranted to verify its long-term clinical efficacy.

PMID:42219477 | DOI:10.1186/s12893-026-03903-2

BMC Musculoskelet Disord. 2026 Jun 1. doi: 10.1186/s12891-026-09999-0. Online ahead of print.

ABSTRACT

BACKGROUND: Osteoporotic vertebral fractures affect many elderly patients, and complications after common treatments such as vertebroplasty (VP) may reduce treatment satisfaction and radiographic stability. This study investigated whether the addition of posterior instrumentation with cement-augmented fenestrated pedicle screws (VP + PI) was associated with improved short-term radiographic outcomes compared with VP alone.

METHODS: We retrospectively analyzed 153 patients with osteoporotic vertebral fractures treated between 2017 and 2022. Patients underwent either VP alone or VP + PI. To reduce treatment-selection bias, propensity score matching was performed. Vertebral collapse was assessed on serial radiographs at 1, 3, and 6 months postoperatively, and statistical analyses were performed using SAS software.

RESULTS: After propensity score matching, the VP + PI group had significantly lower anterior column collapse rates at 3 and 6 months postoperatively. Multivariable logistic regression confirmed that VP + PI was independently associated with a reduced risk of anterior column collapse at 6 months (adjusted OR: 0.147, 95% CI: 0.043-0.502, p = 0.0022). At 6 months, screw loosening was observed in 6 of 75 patients in the VP + PI group, and none required revision surgery during the follow-up period.

CONCLUSIONS: VP + PI may provide better short-term radiographic stability than VP alone in selected patients with osteoporotic vertebral fractures. However, given the longer operation time and hospital stay, lack of functional outcome assessment, and limited follow-up duration, the clinical benefit and long-term safety of VP + PI require further investigation.

TRIAL REGISTRATION: Not applicable.

PMID:42219476 | DOI:10.1186/s12891-026-09999-0

BMC Oral Health. 2026 Jun 1. doi: 10.1186/s12903-026-08755-z. Online ahead of print.

ABSTRACT

BACKGROUND: Polymethyl methacrylate (PMMA) denture base materials are routinely exposed to chemical cleansers during daily use, yet the material effects of unconventional agents, such as oral probiotics, remain unclear.

OBJECTIVES: This study investigated the effects of experimental exposure to a BLIS M18 oral probiotic solution and conventional denture cleansers on the color stability and surface properties of conventionally processed, milled, and 3D-printed PMMA during simulated denture care for up to 90 days.

METHODS: One hundred and twenty PMMA discs were fabricated using conventional processing, CAD/CAM milling, and 3D-printing, and were then immersed in distilled water, an effervescent tablet cleanser, 1% sodium hypochlorite, or BLIS M18 oral probiotic solution (experimental). Color change (ΔE₀₀), surface roughness, and Vickers hardness were measured at baseline (T0) and after 90 days (T3), with additional color and hardness measurements at 30 (T1) and 60 (T2) days. Surface morphology was examined using scanning electron microscopy. Data were analyzed using mixed repeated-measures ANOVA with Bonferroni post hoc tests (α = 0.05).

RESULTS: Manufacturing techniques significantly influenced baseline and post-exposure material properties, with 3D-printed PMMA exhibiting higher roughness and lower hardness than milled and conventionally processed materials (p < 0.001). Simulated denture cleansing increased surface roughness Ra, with post-exposure values ranging from 0.31 to 0.46 μm and reduced hardness (5.8-30.7%) over time, whereas cleanser-related effects were statistically significant but small. Color changes remained limited for all groups (0.50-1.73). Experimental exposure to BLIS M18 resulted in minimal changes in color, roughness and hardness compared with conventional cleansers.

CONCLUSIONS: PMMA surface integrity is primarily determined by the manufacturing technique rather than the cleanser chemistry. Under simulated denture care conditions, experimental exposure to BLIS M18 demonstrated compatibility with PMMA denture base materials without compromising surface properties or color stability.

PMID:42219474 | DOI:10.1186/s12903-026-08755-z

BMC Prim Care. 2026 Jun 1. doi: 10.1186/s12875-026-03394-3. Online ahead of print.

ABSTRACT

BACKGROUND: Early diagnosis and prompt referral are critical for improving outcomes in systemic sclerosis (SSc), yet disparities in diagnostic capabilities between healthcare levels may delay treatment and impact survival. This study aimed to compare mortality risk among SSc patients based on their diagnostic pathway: initial diagnosis at a secondary care hospital before referral versus prompt referral and diagnosis at a tertiary center.

METHODS: Using National Health Security Office cohort data (fiscal years 2016-2023), we identified 17,036 patients aged ≥ 18 years with SSc (ICD-10 M34) diagnosed at tertiary or university hospitals. The primary outcome was mortality risk through December 31, 2024. Mortality rates (95% CI) were stratified by the initial diagnostic facility. Cox regression analysis with a time-dependent interaction term for age was used to evaluate factors associated with mortality.

RESULTS: A total of 4,404 patients with SSc from 102 tertiary care hospitals were referred from secondary care hospitals. Patients first diagnosed at secondary care hospitals exhibited a significantly higher mortality rate (0.89 per 100 person-months; 95% CI 0.85-0.93) compared to those first diagnosed at tertiary care hospitals (0.67 per 100 person-months; 95% CI 0.65-0.69; p < 0.001). Increased mortality risk was associated with older age (HR 1.055), referral duration > 180 days vs. ≤ 7 days (HR 1.300), acute myocardial infarction (HR 1.895), and primary pulmonary hypertension (HR 1.654). An interaction between age and log(time) demonstrated that the effect of age on mortality decreased by approximately 0.5% per month of follow-up.

CONCLUSION: The initial diagnosis of SSc at tertiary care hospitals was associated with a better prognosis than that at secondary care hospitals. A longer referral duration was associated with poorer survival. Advanced age and coexisting cardiopulmonary diseases were significantly associated with mortality in patients with SSc. These findings highlight the need for standardized referral criteria and “red flag” checklists to facilitate earlier specialized care.

PMID:42219459 | DOI:10.1186/s12875-026-03394-3

BMC Anesthesiol. 2026 Jun 1. doi: 10.1186/s12871-026-03949-y. Online ahead of print.

ABSTRACT

BACKGROUND: Antimicrobial resistance (AMR) is a global public health threat associated with poor patient outcomes; however, there are major gaps in routine surveillance and reporting. In low-income countries like Ethiopia, antibiotics tend to be misused, particularly in intensive care units (ICU).

AIM: To determine the bacterial profile, antimicrobial resistance patterns, and associated clinical outcomes among ICU patients at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa.

METHODS: An institution-based, six-month (May 1, 2023-October 31, 2023) retrospective cross-sectional study was conducted in the ICU of TASH on 216 patients. Data regarding sociodemographic and clinical characteristics, antimicrobial susceptibility testing (AST), and patient outcomes were collected from the health management information system (HMIS). Statistical Package for the Social Sciences (SPSS) version 27 was used for data analysis. Bivariate and multivariate logistic regression analysis were performed to assess the association between AMR and intra-ICU mortality. A p-value of < 0.05 was considered statistically significant.

RESULTS: Eighty nine point four percent of infections were due to Gram-negative bacteria. Of the Gram-negative isolates, the most commonly isolated pathogen was Acinetobacter baumannii (31.5%), followed by Klebsiella pneumoniae (22.7%), and Escherichia coli (14.8%). Acinetobacter baumannii was predominantly carbapenem resistant. Eighty point one percent of bacterial isolates exhibited multidrug resistance. The lowest level of resistance was observed with amikacin across all microorganisms. Bloodstream infections (BSIs) were the most frequently reported infection type. Intra-ICU mortality was determined to have a significant association with BSI (AOR 2.89, 95% CI 1.11, 3.94), septic shock (AOR 5.34, 95% CI 2.32, 12.25), CRAB infection (AOR 2.22, 95% CI 1.11, 4.43), and surgical intervention (AOR 0.46, 95% CI 0.24, 0.88).

CONCLUSION: The study demonstrates a high burden of multi-drug resistant gram-negative infections in the ICU. The findings also show the clinical impact of AMR on mortality, particularly in critically ill patients with septic shock and BSI. The study highlights the urgent need to strengthen antimicrobial stewardship programs, enhance infection prevention and control practices, and improve microbiological surveillance systems in ICU settings.

PMID:42219453 | DOI:10.1186/s12871-026-03949-y

Appl Health Econ Health Policy. 2026 Jun 1. doi: 10.1007/s40258-026-01051-5. Online ahead of print.

ABSTRACT

BACKGROUND: Universal health coverage has become central to health policy debates, particularly as a strategy to protect households from financial hardship and impoverishment related to out-of-pocket (OOP) spending. Many low- and middle-income countries (LMICs), including India, have relied predominantly on publicly funded health insurance (PFHI) to improve financial protection against OOP spending. PFHI generally covers low-frequency, high-cost hospitalization expenses, even though non-hospitalization expenses are the main contributors to OOP. Global evidence suggests that stronger primary health care (PHC) provision is crucial for reducing catastrophic health expenditure (CHE). This issue becomes particularly important in the context of climate-sensitive diseases (CSDs), whose incidence is increasing due to more frequent and extreme weather events, which may increase the risk of CHE.

OBJECTIVE: This study estimates the causal impact of publicly provided PHC and PFHI on CHE arising from CSDs.

METHODS: Using district-level data for all 640 Census districts in India, we applied propensity score matching and inverse probability weighting to compare the effects of PHC and PFHI on CHE associated with CSDs.

RESULTS: The findings show that strengthened PHC substantially reduces OOP spending and CHE associated with CSDs, whereas PFHI shows no statistically significant effect.

CONCLUSION: These results highlight the need to prioritize climate-resilient PHC systems to address the escalating health impacts of climate change and advance equitable progress toward universal health coverage in LMICs.

PMID:42219435 | DOI:10.1007/s40258-026-01051-5

Drugs Aging. 2026 Jun 1. doi: 10.1007/s40266-026-01304-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Multi-dose dispensing (MDD) is a medication management system in Sweden that pre-packages regularly used prescription medicines into unit doses. Despite widespread use, there are no recent national estimates of MDD prevalence in Sweden, and little is known about how use evolved through the coronavirus disease 2019 (COVID-19) pandemic or which patient groups account for most MDD utilisation.

OBJECTIVE: The purpose of this study was to describe the prevalence of multi-dose dispensing in older adults in Sweden from 2014 to 2023, spanning the COVID-19 pandemic, and describe trends by patient subgroups.

METHODS: We conducted a repeated cross-sectional study of older adults aged ≥ 70 years old in Sweden, 2014-2023. We used nationwide data from the Swedish Prescribed Drug Register linked at the individual level with several other administrative and healthcare registers. The primary outcome was annual period prevalence of MDD, stratified by age, sex, education level, living status, civil status, health status and geography.

RESULTS: Prevalence of MDD amongst adults aged 70 years or older increased by 1.5 percentage points between 2014 and 2023, reaching 12.1% in 2023, and there was no additional increase during the COVID-19 pandemic (2020-2022). In nursing home residents, MDD use approached near-universal levels (from 84.2 to 96.1%). Uptake also increased across other subgroups, most notably amongst people with a dementia diagnosis (+ 45.3 percentage points), those receiving home help services (+ 21.4 percentage points) and those with five or more chronic conditions (+ 15.3 percentage points). Over time, the characteristics of MDD users shifted towards community-dwelling adults receiving home help services, younger older adults (70-79 years old) and individuals with higher education.

CONCLUSIONS: Our nationwide study indicates that MDD has become an established standard of medication management in Swedish nursing homes and is progressively extending into community settings amongst older adults with complex health needs. Prescribing of MDD remained stable during the COVID-19 pandemic. Future studies should quantify risks and benefits of MDD use especially in vulnerable, older, and frail populations.

PMID:42219430 | DOI:10.1007/s40266-026-01304-x

Eur Heart J Cardiovasc Pharmacother. 2026 Jun 1:pvag037. doi: 10.1093/ehjcvp/pvag037. Online ahead of print.

ABSTRACT

Two contemporary randomized trials of β-blocker therapy after myocardial infarction (MI) reached apparently conflicting conclusions. REBOOT, conducted in Spain and Italy, found no reduction in death or major cardiovascular events among patients with preserved ejection fraction. In contrast, the BETAMI-DANBLOCK study, conducted in Scandinavia, reported a modest but statistically significant reduction in a composite endpoint. The prevailing response has been to reconcile this divergence by elevating left ventricular ejection fraction-particularly the 40-49% range-as the decisive explanatory variable. This interpretation offers analytic simplicity but rests on fragile statistical and conceptual grounds. Drawing on Nancy Cartwright’s account of causal capacities and Judea Pearl’s transportability framework, this paper argues that β-blockers exhibit stable physiological effects whose clinical benefits depend on the causal environment. Randomization secures internal validity within trials but cannot homogenize genetic, systemic, or environmental contexts. Meta-analysis, by averaging across heterogeneous environments and individual treatment effects, risks obscuring rather than clarifying dependencies. The divergence between REBOOT and BETAMI-DANBLOCK does not represent a failure of evidence-based medicine but exposes the limits of reductionist interpretation. Rather than seeking universal truths, cardiovascular medicine should map the causal environments in which therapeutic capacities become manifest.

PMID:42219422 | DOI:10.1093/ehjcvp/pvag037

Sci Rep. 2026 Jun 1. doi: 10.1038/s41598-026-54695-7. Online ahead of print.

ABSTRACT

College students face a higher risk of depression than their non-college peers. However, the predictors of depressive symptoms among college students and their relative importance remain inconclusive. This study aimed to develop predictive models for depressive symptoms among Chinese undergraduate students using a four-year longitudinal dataset and to explore the importance ranking of predictive factors. A cohort of 1,500 college students from Sichuan University was recruited and followed annually for four years. Computer-based questionnaires were used to collect demographic, behavioral and psychological data. Using a recurrent neural network (RNN), four predictive models were constructed to capture the temporal dynamics of depression risk as students progressed through college. The prevalence of depressive symptoms ranged from 3.60% to 6.27% across the four waves. All RNN models demonstrated strong predictive performance (AUC: 0.921-0.952), with sensitivity improving over longer follow-up periods, outperforming traditional models, such as multilevel linear regression, k-nearest neighbor and support vector machines. Analysis of feature importance revealed that family relationship issues were key predictors of early-stage depressive symptoms. Childhood traumatic experiences and preexisting mental health conditions had lasting impacts, while health-related factors, such as subjective sleep quality, sleep disorders, and self-rated health, were consistent indicators across years. These findings have important practical implications for university mental health programs, suggesting that early identification of high-risk students could enable targeted interventions such as family-based support, trauma-informed counseling, and sleep health education tailored to students’ developmental stages. Such data-driven strategies may improve prevention efforts and promote student well-being.

PMID:42219415 | DOI:10.1038/s41598-026-54695-7