Tag: pubmed

Mov Disord. 2026 Mar 18. doi: 10.1002/mds.70275. Online ahead of print.

ABSTRACT

BACKGROUND: Perinatal hypoxic-ischemic encephalopathy (HIE) is a severe condition resulting from impaired oxygen delivery to the developing brain, often leading to both motor deficits and dystonia-dyskinetic syndromes (DDS). In selected cases, deep brain stimulation of the globus pallidus internus (GPi-DBS) may provide a therapeutic option. However, predicting outcomes remains challenging because of clinical heterogeneity and variable responses.

OBJECTIVES: This retrospective study aims to identify preoperative imaging predictors of GPi-DBS efficacy in patients with DDS secondary to HIE, focusing on putaminal atrophy as a potential criterion.

METHODS: We retrospectively analyzed 73 patients with DDS secondary to HIE who underwent GPi-DBS at our institution from 2003 to 2023. Clinical outcomes were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and Barry-Albright Dystonia Scale (BADS) at baseline and up to 15 years post-surgery. Preoperative magnetic resonance imaging scans were qualitatively and quantitatively evaluated to assess putaminal atrophy. Statistical analyses explored the relationships between imaging findings, clinical severity, and DBS outcomes.

RESULTS: Patients with severe putaminal atrophy exhibited significantly higher preoperative BFMDRS motor and disability scores, correlating with a limited response to DBS at 1-year follow-up (P < 0.05). Volumetric analysis confirmed that greater putaminal atrophy was associated with poorer motor improvements post-surgery. The predictive value of putaminal volume for long-term outcomes remained significant at 5-year follow-up.

CONCLUSIONS: Putaminal atrophy is a key predictor of suboptimal outcomes following GPi-DBS in patients with HIE-related DDS. These findings highlight the importance of preoperative imaging in candidate selection and underscore the need for alternative strategies in patients with severe post-anoxic basal ganglia damage. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

PMID:41851006 | DOI:10.1002/mds.70275

Sci Bull (Beijing). 2026 Mar 4:S2095-9273(26)00234-3. doi: 10.1016/j.scib.2026.03.002. Online ahead of print.

ABSTRACT

The disordered quantum systems host three classes of quantum states, the extended, localized, and critical, which bring up seven distinct fundamental phases in nature: three pure phases and four coexisting ones with mobility edges, yet a unified theory built on universal mechanism and full realization of all these phases has not been developed. Here we propose a unified framework based on a spinful quasiperiodic (QP) system which realizes all the fundamental localization phases, with the exact and universal results being obtained for their characterization. First, we show that the pure phases are obtained when the chiral(-like) symmetry preserves in the proposed spinful QP model, giving a criterion for emergence of the pure phases and otherwise the coexisting ones. Further, we uncover a novel mechanism for the critical states that their emergence is protected by the generalized incommensurate matrix element zeros in the spinful QP model, which considerably broadens rigorous realizations of the exotic critical states. We then show criteria of exact solvability for the present spinful QP system, with which we construct various exactly solvable models for all distinct localization phases. In particular, we propose two novel models, dubbed spin-selective QP lattice model and QP optical Raman lattice model, to achieve all basic types of mobility edges and all the seven fundamental phases of Anderson localization physics, respectively. The experimental scheme is proposed and studied in detail to realize these models with high feasibility. This study establishes a complete and profound theoretical framework which enables an in-depth exploration of the broad classes of all fundamental localization phenomena in QP systems, and offers key insights for constructing their exactly solvable models with experimental feasibility.

PMID:41850988 | DOI:10.1016/j.scib.2026.03.002

J Prosthet Dent. 2026 Mar 17:S0022-3913(26)00139-3. doi: 10.1016/j.prosdent.2026.02.034. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: The accuracy of complete arch implant scans acquired using intraoral scanners (IOSs) has been extensively examined; however, these evaluations often disregard the influence of the scanning technique used to capture implant positions.

PURPOSE: The purpose of this systematic review was to assess the trueness and precision of complete arch implant scans recorded using nonsplinting techniques.

MATERIAL AND METHODS: A literature search was completed in 5 databases: PubMed/Medline, Scopus, Embase, Web of Science, and Cochrane. A manual search was also conducted. Studies analyzing the accuracy of complete arch scans using commercially available nonsplinting techniques recorded with IOSs were included. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. The mean and standard deviation of the accuracy values reported were extracted, and a meta-analysis was performed. The mean difference between the analog and nonsplinting groups was calculated using the random effect model (a=.05). The I-squared (I²) statistic and its associated P value were used to assess the heterogeneity between studies. Publication bias was assessed using a funnel plot. The Egger test was used to determine the significance of the funnel plots.

RESULTS: A total of 100 articles were included. The linear discrepancy ranged from 22 to 1050 µm, with a mean linear discrepancy of 117 µm. The angular discrepancy values ranged from 0.01 to 1.75 degrees, with a mean angular discrepancy of 0.48 degrees. The reported linear trueness ranged from 41 to 557 µm, with a mean linear trueness of 153 µm. The linear precision ranged from 7 to 166 µm, with a mean linear precision of 57 µm. The angular trueness ranged from 0.20 to 1.69 degrees, with a mean angular trueness of 0.65 degrees. The angular precision ranged from 0.05 to 1.69 degrees, with a mean angular precision of 0.41 degrees. The mean RMS discrepancy ranged from 9 to 408 µm, with a mean RMS error of 101 µm. The RMS trueness ranged from 27 to 366 µm, with a mean RMS error of 60 µm. Lastly, the RMS precision ranged from 5 to 251 µm, with a mean RMS error of 35 µm. The funnel plots and Egger regression asymmetry tests revealed significant publication bias (P<.001).

CONCLUSIONS: Nonsplinting implant scanning techniques demonstrated high variability in the scanning accuracy outcomes. Further clinical studies are needed to evaluate the accuracy of implant scans, as substantial heterogeneity was observed among the included studies.

PMID:41850947 | DOI:10.1016/j.prosdent.2026.02.034

Curr Probl Diagn Radiol. 2026 Mar 11:S0363-0188(26)00042-3. doi: 10.1067/j.cpradiol.2026.03.001. Online ahead of print.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) is increasingly integrated into radiology across multiple workflow levels, with its role as a simultaneous second reader holding particular promise.

METHODS: We performed an umbrella review of systematic reviews and meta-analyses reporting pooled diagnostic accuracy of AI models using clinician (including radiologist) interpretation as the reference standard. References were identified through queries of Pubmed, Scopus, Embase, and Google Scholar (last updated January 7th, 2025). Data were analyzed using metaumbrella tool within R statistical software with stratification of evidence by Ioannidis criteria. Study quality was assessed using the AMSTAR-2 tool.

RESULTS: From 1,719 unique references, ten meta-analyses met inclusion criteria, encompassing 147 primary studies with over 722,000 case and 3.6 million control images. Diagnostic odds ratios ranged from 30.67 (95% CI; 10.06-102.87), fracture detection on X-ray, to 273.60 (95% CI; 130.51-573.58), pulmonary nodule detection on CT. Most meta-analyses (n = 9) provided Class II evidence, reflecting highly suggestive findings limited by invariably substantial heterogeneity (I² = 89.9%-99.9%). The quality was assessed as critically low in nine reviews and low in one.

DISCUSSION: AI models have shown strong diagnostic performance across various radiologic applications. Due to our inclusion criteria requiring clinician/radiologist interpretation as the reference standard, these findings reflect AI-human agreement rather than AI accuracy using a more definitive ground truth (e.g. histopathology). Furthermore, the strength of this evidence is limited by substantial heterogeneity, variability in imaging modalities, and differences in model development and validation.

PMID:41850944 | DOI:10.1067/j.cpradiol.2026.03.001

J Formos Med Assoc. 2026 Mar 17:S0929-6646(26)00170-1. doi: 10.1016/j.jfma.2026.03.017. Online ahead of print.

ABSTRACT

BACKGROUND: In Taiwan, prolonged mechanical ventilation (PMV) has long imposed a substantial burden on healthcare systems, characterized by high ICU occupancy and escalating costs. To address these challenges, an Integrated Delivery System for PMV patients (PMV-IDS) was implemented in 2000, featuring stepwise care and payment reform. This study aimed to examine longitudinal trends in clinical outcomes and national health indicators associated with the PMV-IDS program.

METHODS: In this retrospective, longitudinal, population-based study, we analyzed aggregate data from patients receiving mechanical ventilation between 2005 and 2023, sourced from the Ministry of Health and Welfare and the National Health Insurance Administration. Patients ventilated for ≥21 consecutive days were defined as PMV; those ventilated for >63 days were considered ventilator-dependent. Trends in weaning success, mortality, ICU resource utilization, and healthcare expenditures were assessed using descriptive statistics and linear regression.

RESULTS: From 2005 to 2022, newly ventilated patients increased by 15%. The proportion receiving prolonged ventilation (>63 days) decreased from 24% to 15%, and mortality declined from 25% to 18%. The weaning success rate within 21 ventilator days reached 70% in 2022. Mean ICU days decreased, and RCC occupancy stabilized after 2015. Home-based ventilator care increased from 3500 in 2013 to 4700 in 2023. Medical expenditures rose from 25.1 to 30.6 billion points.

CONCLUSIONS: This study describes epidemiological trends and associated healthcare utilization among patients receiving long-term mechanical ventilation under Taiwan’s PMV-IDS framework. These findings provide a descriptive benchmark for this population. Given data limitations, future studies are warranted to refine these observations.

PMID:41850921 | DOI:10.1016/j.jfma.2026.03.017

Stat Med. 2026 Mar;45(6-7):e70352. doi: 10.1002/sim.70352.

ABSTRACT

Systematic review and meta-analysis are widely accepted approaches for evaluating treatment effectiveness. Meta-analysis generally addresses statistical aspects of systematic reviews, such as the pooling of treatment effect sizes, assessment of heterogeneity, and statistical inference. To complement treatment effectiveness, cost-effectiveness is often conducted to encompass both clinical and economic perspectives. However, there are few statistical methods proposed for meta-analyses of cost-effectiveness, and none is used widely. In fact, meta-analysis is currently not encouraged for cost-effectiveness due to methodological and statistical complexities. In this paper, we propose simple meta-analytic methods for cost-effectiveness, which may serve as a starting point for future work. We illustrate the methods using two examples from systematic reviews on wound interventions and mental illness.

PMID:41850900 | DOI:10.1002/sim.70352

Low Urin Tract Symptoms. 2026 Mar;18(2):e70055. doi: 10.1111/luts.70055.

ABSTRACT

OBJECTIVES: Urinary incontinence (UI) in the first 3 months after robot-assisted radical prostatectomy (RARP) frequently impairs work performance, yet its quantitative impact on presenteeism remains unclear. This prospective cohort study longitudinally evaluated how early postoperative UI influences presenteeism among employed Japanese men undergoing RARP.

METHODS: We consecutively enrolled 92 employed male patients scheduled for RARP and assessed them preoperatively, at discharge, and at 1- (PS-1) and 3-month (PS-3) post-surgery. Outcomes were the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), WHO Health and Work Performance Questionnaire (HPQ)-Presenteeism Scale, King’s Health Questionnaire (KHQ), and Kessler Psychological Distress Scale (K6).

RESULTS: Of the 92 eligible participants, 85 (92.4%) completed the PS-1 and 80 (87.0%) completed the PS-3 assessment. Median ICIQ-SF total scores increased from 0 (IQR 0-2) preoperatively to 9 (6-12) at PS-1, remaining elevated at 7 (4-10) at PS-3 (p < 0.001). Mean HPQ-presenteeism declined from 81.4% ± 13.9% preoperatively to 64.9% ± 18.8% at PS-1, partially recovering to 75.3% ± 16.1% at PS-3 (p < 0.001). At PS-1, UI impact on daily life (ρ = -0.45) and ICIQ-SF total (ρ = -0.43) were moderately associated with lower presenteeism; at PS-3, correlations persisted and extended to multiple KHQ subscales (ρ = -0.41 to -0.53).

CONCLUSIONS: Early postoperative UI after RARP produces a clinically meaningful reduction in work productivity, greatest at PS-1 and still evident at PS-3. Targeted continence care and occupational support during this window may mitigate productivity loss and facilitate sustainable return to work.

PMID:41850893 | DOI:10.1111/luts.70055

J Prosthodont Res. 2026 Mar 18. doi: 10.2186/jpr.JPR_D_25_00209. Online ahead of print.

ABSTRACT

PURPOSE: Commercially pure titanium (CP-Ti) is ideal for removable partial denture (RPD) frameworks owing to its biocompatibility and corrosion resistance; however, conventional casting can introduce defects and dimensional errors. This study compared the shape accuracy, surface roughness, microstructure, and internal pores of CP-Ti RPD frameworks prepared using four CAD-CAM fabrication methods: (1) Ti-resin: casting from a three-dimensional (3D)-printed resin pattern; (2) Ti-wax: casting from a milled wax pattern; (3) Ti-milling: direct milling from a CP-Ti disc; and (4) Ti-SLM: selective laser melting.

METHODS: Forty frameworks were prepared for each group (N = 10). Shape accuracy was assessed using 3D data-inspection software, surface roughness was analyzed using laser microscopy, the microstructure was determined using X-ray diffraction, and internal pores were examined using micro-computed tomography. Nonparametric statistics (Kruskal-Wallis and Steel-Dwass tests) were used (P < 0.05).

RESULTS: Ti-SLM achieved the highest trueness (median: 0.00 mm; IQR: 0.09 mm) and precision (median: 0.01 mm; IQR: 0.02 mm), while Ti-milling yielded the lowest surface roughness (median arithmetic mean height: 0.61 µm; IQR: 0.05 µm). Internal pores were absent in Ti-milling and minimal in Ti-SLM (0-1), whereas Ti-resin and Ti-wax produced 319 and 171 pores (median), respectively. Significant inter-method differences were found in shape accuracy, surface roughness, and pore counts (P < 0.05).

CONCLUSIONS: The fabrication method affected the dimensional accuracy, surface conditions, crystalline features, and internal pores of the CP-Ti frameworks. Ti-milling and Ti-SLM outperformed the casting-based methods (Ti-resin and Ti-wax) in terms of accuracy and defect reduction. These digital approaches may improve the reproducibility and precision of clinical fabrication of CP-Ti RPD frameworks.

PMID:41850866 | DOI:10.2186/jpr.JPR_D_25_00209

J Prosthodont Res. 2026 Mar 18. doi: 10.2186/jpr.JPR_D_25_00115. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the current systematic review was to compare the internal fit of lithium disilicate crowns, fabricated using conventional heat-pressing versus CAD-CAM milling techniques.

STUDY SELECTION: A comprehensive literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Library up to December 2025, following PRISMA guidelines and registered in the Open Science Framework. Eleven studies met the inclusion criteria (nine in vitro studies and two clinical trials), of which nine were included in the quantitative synthesis.

RESULTS: The random-effects meta-analysis demonstrated no statistically significant difference in internal fit between heat-pressed and CAD-CAM-milled crowns, although substantial heterogeneity was observed (I²=95%). Sensitivity analysis excluding five methodologically heterogeneous studies revealed a statistically significant pooled effect favoring heat-pressed crowns (MD=-18.92 μm; 95% CI: -29.77 to -8.07; P = 0.008), with markedly reduced heterogeneity (I²=19%). Subgroup analysis suggested that elastomeric impressions may be associated with better internal fit compared with digital workflows, although heterogeneity remained high.

CONCLUSIONS: The current evidence does not demonstrate a consistent difference in internal fit between heat-pressed and CAD-CAM-milled lithium disilicate crowns. Further well-designed, standardized clinical studies are needed to confirm these findings.

PMID:41850865 | DOI:10.2186/jpr.JPR_D_25_00115

J Oral Sci. 2026 Mar 17. doi: 10.2334/josnusd.25-0425. Online ahead of print.

ABSTRACT

PURPOSE: Teachers frequently serve as primary first responders when traumatic dental injuries (TDIs) occur in schools. Immediate management is critical for prognosis, particularly in avulsion cases. This study aimed to assess preschool and primary school teachers’ knowledge of emergency TDI management and their awareness of the ToothSOS mobile application, a resource providing evidence-based guidance.

METHODS: A descriptive cross-sectional study was conducted among 427 preschool and primary school teachers in Turkey between May and June 2025. An online questionnaire, based on international guidelines and validated by expert review, collected data on demographics, TDI management knowledge, and ToothSOS awareness. Statistical analyses were performed using non-parametric tests (P < 0.05).

RESULTS: The median knowledge score was 3 (range: 0-8). Few teachers correctly identified immediate replantation or storage in milk as appropriate actions for avulsed permanent teeth. Although awareness of the ToothSOS was extremely low, over half of the participants expressed willingness to use it. Significantly higher knowledge scores were observed among teachers with prior trauma education.

CONCLUSION: Teachers demonstrated insufficient knowledge of emergency management of TDIs and limited awareness of digital support tools. Incorporating structured trauma education and accessible educational technologies into teacher training may support teachers’ preparedness and decision-making in dental trauma emergencies.

PMID:41850852 | DOI:10.2334/josnusd.25-0425