Tag: nevin manimala

BMC Cardiovasc Disord. 2026 Feb 11. doi: 10.1186/s12872-026-05594-2. Online ahead of print.

ABSTRACT

BACKGROUND: Despite statin therapy, achieving target low-density lipoprotein cholesterol (LDL-C) levels remain suboptimal in high-risk patients with atherosclerotic cardiovascular disease (ASCVD). This study evaluated efficacy and safety of early addition of ezetimibe (EZ) with atorvastatin (AS), prior to reaching the maximally tolerated dose of statin, in very high-risk patients.

METHODS: This phase 4 (NCT05761444), multicenter, randomized, open-label, active-controlled study enrolled patients (≥ 30 years) with very high-risk of ASCVD. Eligible patients had LDL-C ≥ 70 mg/dL with low/moderate intensity statin monotherapy or statin-naïve or not been on stable statin regimen prior to enrollment. Patients were randomized 1:1 to EZ10/AS40 mg combination therapy or AS40 mg statin alone for 12 weeks. Primary endpoint was percentage change in LDL-C from baseline to week 6.

RESULTS: Patients (N = 137) received EZ/AS (n = 67) or AS (n = 70) once a day. The EZ/AS lipid-lowering effect was statistically greater than AS monotherapy at week 6 (LSMD: -21.2; P < 0.0001) and week 12 (LSMD: -16.0; P < 0.0001). At week 12, higher proportions of patients who received EZ/AS achieved target LDL-C < 55 mg/dL (55.0% vs. 15.4%; P < 0.0001) and LDL-C < 70 mg/dL (85.0% vs. 58.5%; P = 0.0009) than in AS group. Higher reduction from baseline was observed for lipid parameters in EZ/AS group than AS monotherapy. Incidence of adverse events were comparable between EZ/AS and AS groups.

CONCLUSIONS: Early combination of EZ with AS, rather than a stepwise approach, significantly reduced LDL-C levels and improved LDL-C reduction target achievement compared to AS monotherapy in very high-risk patients with dyslipidemia with no new safety issues.

TRIAL REGISTRATION: NCT05761444; Registration date: March 9, 2023.

PMID:41673582 | DOI:10.1186/s12872-026-05594-2

BMC Pregnancy Childbirth. 2026 Feb 11. doi: 10.1186/s12884-026-08760-8. Online ahead of print.

ABSTRACT

BACKGROUND: Gestational diabetes mellitus (GDM), a prevalent pregnancy complication, can adversely impact both maternal and neonatal health post-delivery due to poor glycemic control. Although numerous studies highlight the close association between blood lipids and GDM, the specific correlation between lipid profiles and the prognosis of GDM remains ambiguous.

METHODS: This study was conducted at the Women and Children’s Hospital of Ningbo University, with data collected between December 2017 and December 2018. A total of 841 GDM participants were categorized into good glycemic control (GGC, N = 524) and poor glycemic control (PGC, N = 317) groups based on ACOG and ADA criteria. Blood lipid indices were analyzed using univariate and multivariate logistic regression analyses, with further stratification by maternal age, parity, and pre-pregnancy BMI.

RESULTS: In the third trimester, the PGC group exhibited significantly lower levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) (P < 0.05). Multivariate analysis revealed that a 1 mmol/L increase in HDL-c during late pregnancy reduced the risk of PGC by 54% (OR = 0.46, 95% CI = 0.24-0.89), while a higher triglyceride (TG)/HDL-c ratio increased the risk by 23% (OR = 1.23, 95% CI = 1.02-1.48). Stratified analysis confirmed that among women aged ≤ 35 years, multiparas, and those who were overweight or obese, higher HDL-c served as a protective factor, whereas a greater TG/HDL-c ratio posed a significant risk.

CONCLUSION: These findings underscore the critical role of blood lipid metabolism in maintaining glycemic control in GDM, particularly in high-risk populations, such as multiparas and overweight/obese women.

PMID:41673574 | DOI:10.1186/s12884-026-08760-8

BMC Geriatr. 2026 Feb 11. doi: 10.1186/s12877-026-07100-x. Online ahead of print.

ABSTRACT

BACKGROUND: This study evaluates the impact of the SOCAV program on promoting self-direction of individuals with dementia in nursing homes and examines the behavioral changes in care staff when trained and coached to implement the program. SOCAV is a longitudinal training and coaching intervention designed to enhance person-centered care and support self-direction in individuals with dementia.

METHODS: This mixed-methods longitudinal pilot study was conducted in two long-term care units and one day activity center of a nursing home. Participants included 61 individuals with dementia, 48 caregivers, and 85 care staff members. Qualitative data were collected from reflective coaching diaries, while quantitative data were gathered using the Canadian Occupational Performance Measure (COPM) from the perspectives of individuals with dementia, their caregivers, and care staff.

RESULTS: Thematic analysis revealed four positive changes in care staff: acceptance of reflective coaching, focus on self-direction, improvement in communication and interaction, and enhanced team collaboration. Statistically significant improvements in COPM performance and satisfaction were observed in individuals with dementia, as reported by all stakeholders, providing quantitative validation of the observed behavioral changes adopted by the care staff. Initial resistance from staff, linked to fears of criticism and discomfort with change, diminished through supportive peer coaching and emphasis on positive experiences.

CONCLUSIONS: The SOCAV program was associated with meaningful improvements in care staff attitudes and behaviors that support self-direction among individuals with dementia. Key facilitators, including peer coaching, team cohesion, and the realization of staff impact on residents’ self-direction, were instrumental in establishing these changes. Future research is needed to assess potential benefits of the SOCAV program in other settings and populations.

PMID:41673572 | DOI:10.1186/s12877-026-07100-x

BMC Plant Biol. 2026 Feb 12. doi: 10.1186/s12870-026-08295-2. Online ahead of print.

ABSTRACT

Soil salinity is a major constraint on global crop productivity, driving the need for salt-tolerant varieties. While CRISPR-Cas genome editing offers targeted solutions for trait improvement, significant biological and technical bottlenecks limit its application in conferring salt stress resilience. This systematic summarizes findings from 83 peer-reviewed studies (2015-2024) employing CRISPR/Cas technologies to improve salt tolerance in five major crops (rice, wheat, maize, sorghum, barley). Our systematic review reveals that early single-gene edits achieved modest gains (30-50% Na⁺ exclusion) but often showed limited yield gains in field settings, potentially due to compensatory regulation and environmental variation. The literature suggests that multiplex designs spanning ion homeostasis, osmoprotection, and ROS management can improve salt-tolerance outcomes and help maintain yield under severe salinity; however, the magnitude of benefit varies with crop, genotype, and transformation/regeneration context. Protein-protein interaction networks identified 12 hub genes and three functional modules, highlighting SOS3 and MPK6 as critical bottlenecks whose disruption risks pleiotropic effects. Spatial expression analysis underscored tissue-specific trade-offs, constitutive editing of root-dominant genes in shoots reduced yields by 15-28%, while tissue-optimized promoters minimized physiological conflicts. Persistent challenges include genotype-dependent transformation inefficiencies, epigenetic drift and environmental interactions under salt stress. Collectively, our synthesis consolidates and refines current best practices for salt-tolerance genome editing and highlights major bottlenecks-particularly regeneration/transformability, genotype dependence, and epigenetic constraints-that should be explicitly considered in experimental design and reporting.

PMID:41673558 | DOI:10.1186/s12870-026-08295-2

J Prosthodont. 2026 Feb 11. doi: 10.1111/jopr.70106. Online ahead of print.

ABSTRACT

PURPOSE: To assess the adhesive bond strength of two provisional screw-retained computer-aided design and computer-aided manufacturing (CAD-CAM) crowns bonded to titanium bases (TiB) following artificial aging, tensile testing, and failure mode analysis.

MATERIALS AND METHODS: Ninety CAD-CAM hybrid abutment crowns (HAC) were evaluated: poly(methyl)-methacrylate ([PMMA], n = 40), polymer-infiltrated ceramic network ([PICN], n = 40), and lithium disilicate ceramic ([LS₂], n = 10, control). HACs were cemented to TiB (internal hex, 4.3 mm diameter, 4 mm height, n = 90) using two permanent resin-based cements. Artificial aging was performed via thermocycling (5000 cycles, 5°C-55°C). Tensile bond strength (TBS) was assessed, and failure mode distribution was analyzed using loupes magnification and scanning electron microscopy. Non-parametric tests were used due to non-normal data. Mann-Whitney and Kruskal-Wallis tests compared cement and crown type impact on TBS. Chi-square tests analyzed differences in failure mode and dominant cement location.

RESULTS: All specimens withstood artificial aging. One LS₂ sample was excluded after exceeding the testing limit (>1118 N). PICN demonstrated the highest median TBS (749.8 N), significantly outperforming PMMA (p < 0.001) and LS₂ (p = 0.029, unadjusted pairwise Mann-Whitney U). Cement type was not a statistically significant factor within material groups. Mixed failure modes (79.8%) were predominant, and adhesive failures accounted for 20.2%. Cement remnants were primarily localized on the TiB surface (49.4%).

CONCLUSION: PICN exhibited superior bonding performance, indicating its suitability for immediate loading in implant-supported restorations. In contrast, PMMA may require modified cementation protocols to achieve optimal retention. These findings provide critical insights for material selection in prosthetic rehabilitation.

PMID:41673548 | DOI:10.1111/jopr.70106

JDR Clin Trans Res. 2026 Feb 11:23800844251408849. doi: 10.1177/23800844251408849. Online ahead of print.

ABSTRACT

INTRODUCTION: Periodontal disease (PD) is closely linked to systemic health, with established associations with chronic conditions (eg, diabetes, cardiovascular disease). However, most predictive models rely solely on dental data, limiting the consideration of systemic factors such as medical conditions.

OBJECTIVES: This study aimed to enhance PD risk prediction by using linked electronic dental records (EDRs) with electronic health records (EHRs) and machine learning (ML).

METHODS: We used EDR data from 20,946 adult patients at Temple University School of Dentistry’s (2022-2023) axiUm®, linked with medical data (physician documented) from the Pennsylvania Health Share Exchange. The dataset includes demographics, dental diagnoses, medical history, medications, procedures, and social determinants of health. The target variable was PD. Because EHR data are not research ready, extensive preprocessing was required (eg, 1 patient may have 400+ medical codes, which ML/statistical models cannot process directly). To prepare for artificial intelligence/ML, we developed 5 automated feature reduction approaches to retain rich information while reducing variables. After preprocessing, 106 features were retained as independent variables. ML models (Gaussian Naive Bayes, Random Forest, LightGBM, XGBoost) were trained using cross-validation across 5 experimental strategies, including (1) features selected via chi-square test, (2) raw data (without extensive processing), (3) aggregated data, (4) systemic disease complexity system, and (5) EHR-only data. Model performance was assessed using sensitivity, specificity, and area under the curve (AUC).

RESULTS: The chi-square-selected features yielded the best performance: 85% specificity, 67% sensitivity, and 84% AUC. Although adding medical conditions did not significantly improve overall performance, key conditions (eg, cardiovascular diseases, endocrine/metabolic disorders, renal diseases, respiratory conditions, hematologic disorders, etc) contributed meaningfully to PD risk prediction. EDR factors (oral hygiene, periodontal treatment, brushing, flossing, smoking, and American Society of Anesthesiologists classification) dominated prediction.

CONCLUSION: Although dental factors remained dominant predictors, strong systemic-oral health associations were observed. Future studies should validate these findings by integrating medical and dental records.Knowledge Transfer Statement:The results of this study can guide clinicians and policymakers in identifying patients at increased risk of periodontitis by integrating medical and dental records. This approach supports earlier interventions and highlights the importance of systemic health in oral disease management. It also demonstrates the potential of artificial intelligence-based prediction models to improve personalized care and promote interdisciplinary collaboration for better overall health outcomes.

PMID:41673528 | DOI:10.1177/23800844251408849

Endocrinol Diabetes Metab. 2026 Mar;9(2):e70172. doi: 10.1002/edm2.70172.

ABSTRACT

INTRODUCTION: Major depressive disorder (MDD) commonly co-occurs with diabetes, but comparative risk across type 1 diabetes (DM1), type 2 diabetes (DM2) and non-diabetic groups-and the role of body mass index (BMI)-remains uncertain.

METHODS: Using All of Us Research Program data, adults were classified as DM1, DM2 or non-diabetic. Multivariable logistic regression estimated odds of MDD adjusting for age, sex at birth, race and ethnicity; BMI was added in secondary models. Effect modification by sex and race was tested. Structural equation modelling (SEM) assessed whether BMI statistically explained group differences.

RESULTS: In models excluding BMI, both DM1 and non-diabetic participants had higher odds of MDD than DM2 (DM1 vs. DM2: OR = 1.53, 95% CI 1.17-1.99; non-diabetic vs. DM2: OR = 1.20, 95% CI 1.16-1.25). Interactions by sex and race were significant; contrasts were stronger among females and heterogeneous across race strata. Adding BMI yielded directionally consistent group estimates and confirmed an independent association of higher BMI with higher MDD odds. SEM indicated statistical suppression for the non-diabetic vs. DM2 contrast: non-diabetic status related to lower BMI, while higher BMI related to higher MDD, producing a small indirect effect (~8%). The indirect path for DM1 vs. DM2 was non-significant.

CONCLUSIONS: Compared with DM2, both DM1 and non-diabetic groups show higher adjusted odds of MDD. BMI is independently related to MDD but only modestly-and partly suppressively-accounts for the non-diabetic vs. DM2 contrast. Findings support subgroup-aware screening and the need for longitudinal data to clarify mechanisms.

PMID:41673527 | DOI:10.1002/edm2.70172

J Prosthodont. 2026 Feb 11. doi: 10.1111/jopr.70107. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated film thickness, diametral tensile strength (DTS), and crown retentive strength of hydraulic fast-set calcium silicate cement (fast-set CSC) compared to conventional luting cements.

MATERIALS AND METHODS: Fast-set CSC was compared to zinc phosphate cement and glass ionomer cement. Film thickness was measured according to ISO 9917-1:2007. DTS was evaluated using cylindrical samples (n = 6 per group), which were kept in a humid environment for 7 days. Crown retentive strength was evaluated by cementing metal crowns onto prepared extracted molars (n = 21 per group), followed by 10,000 thermal cycling and a pull-off test. Failures were classified as adhesive, cohesive, or mixed.

RESULTS: All cements exhibited film thicknesses below 25 µm: 10 ± 4 µm for glass ionomer, 14 ± 6 µm for zinc phosphate, and 22 ± 2 µm for fast-set CSC. Zinc phosphate cement demonstrated a statistically significant lower DTS value (4.8 ± 1.7 MPa) than glass ionomer cement (8.7 ± 3.1 MPa), while fast-set CSC (7.1 ± 0.8 MPa) showed no significant difference compared with either material. Crown retentive strength did not significantly differ among the cements (p = 0.11), with zinc phosphate cement showing the lowest value (2.7 ± 1.1 MPa), without a statistically significant difference with glass ionomer (3.6 ± 1.9 MPa) and fast-set CSC (3.5 ± 1.3 MPa). Mixed failures were predominant in all groups.

CONCLUSION: Fast-set CSC demonstrated acceptable film thickness with DTS and crown retentive strength comparable to zinc phosphate and glass ionomer cements, showing promise for clinical potential in crown cementation, warranting further studies.

PMID:41673526 | DOI:10.1111/jopr.70107

HIV Med. 2026 Feb 11. doi: 10.1111/hiv.70207. Online ahead of print.

ABSTRACT

OBJECTIVE: The Dat’AIDS score was developed to predict 5-year mortality risk in people living with HIV aged 60 and older. However, its validity in people living with HIV aged 70 years and older needed confirmation.

METHODS: This was a multicentre prospective cohort study in the Dat’AIDS French cohort. We calculated the Dat’AIDS score and Veterans Aging Cohort Study (VACS) indices 1.0 and 2.0 in people living with HIV aged 70 or older, at their first medical visit between 01/06/2014 and 31/12/2017. Participants were followed until 31 December 2019 (before the COVID-19 era). Discrimination and calibration of the Dat’AIDS score were assessed using Harrell’s C-statistic and comparisons of predicted versus observed survival probabilities. The comparison of the discriminative capacity of the Dat’AIDS score with the VACS indices was performed.

RESULTS: A total of 1330 participants (75.5% male, median age: 73.7 years, median time since HIV diagnosis: 21.7 years, median time under combination antiretroviral therapy (cART): 19.9 years, median CD4 cell count: 553 cells/μL, HIV-1 RNA ≤50 copies/mL: 88.7%) were included. Overall, 221 (16.6%) deaths were recorded during 5598 patient-years of follow-up. The Dat’AIDS score showed good discrimination (C-statistic: 0.72; 95% confidence interval [CI; 0.68-0.75]). Calibration was good except for the moderate-risk group (5% difference). The Dat’AIDS score showed better discrimination than VACS 1.0 and 2.0 with albumin, aspartate aminotransferase (AST) and alanine transaminase (ALT) normal value imputation (C-statistic: 0.72 vs. 0.69 for both) and was similar to VACS 2.0 without imputation (0.72 vs. 0.71), that could be calculated in 99.1%, 98.6% and 34.0%, respectively.

CONCLUSIONS: The Dat’AIDS score showed good discrimination and calibration in people living with HIV aged 70 years and older, providing an easy and valuable tool for clinical decision-making and research.

PMID:41673495 | DOI:10.1111/hiv.70207

Mol Psychiatry. 2026 Feb 11. doi: 10.1038/s41380-026-03484-9. Online ahead of print.

ABSTRACT

Mendelian Randomization (MR) has become an essential tool in psychiatric research offering valuable insights into the causal relationships underlying risks and consequences of psychiatric conditions. This method utilizes genetic data to infer causal effects, effectively reducing biases commonly encountered in traditional observational studies. By leveraging genetic information, MR helps to identify potential risk factors for psychiatric conditions, paving the way for more effective interventions. However, to draw reliable and meaningful conclusions from MR studies, several critical concepts must be carefully evaluated. These include instrument selection, the magnitude of effect, the strength of the causal evidence, generalizability across diverse populations, and the clinical relevance of findings. This review will explore these key concepts in depth with illustrative examples providing a comprehensive and accessible guide for clinicians and scientists to understand and interpret psychiatric MR findings. Additionally, we will discuss novel emerging techniques, such as advanced statistical methods and the integration of high-dimensional genomic data, highlighting their potential impact on the progression of MR studies. The overall aim of this review is to foster a deeper understanding of its application in psychiatric research, ultimately enhancing its ability to unravel the intricacies of psychiatric disorders and inform personalized treatment strategies.

PMID:41673464 | DOI:10.1038/s41380-026-03484-9