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Nevin Manimala Statistics

Parental socioeconomic and perceptual determinants of early childhood caries amongst Myanmar preschool children

Eur Arch Paediatr Dent. 2026 May 25. doi: 10.1007/s40368-026-01227-6. Online ahead of print.

ABSTRACT

PURPOSE: To assess the updated prevalence and severity of early childhood caries (ECC) amongst preschool children, and examine associations with parental socioeconomic characteristics, perceptions and knowledge.

METHODS: In 2024, 815 children aged 4-5 years from 8 preschools in Yangon were examined using ICDAS II criteria. Parents completed a structured questionnaire assessing socioeconomic status, perceptions of child health, and knowledge across three domains. ECC prevalence (ICDAS d1-6) and severity (d0, d1-2, d3-6) in relation to parental factors were analysed using Chi-square tests, Kruskal-Wallis tests and logistic regressions.

RESULTS: ECC prevalence was 96.2%, with 8.2% presenting non-cavitated and 88.0% cavitated lesions. Paternal education was significantly associated with both ECC prevalence (p = 0.030) and severity (p = 0.024) and remained the only significant associated factor in adjusted models. Parents who rated their child’s oral health as “fair or poor” had children with higher ECC severity (p < 0.001). Parental perception was a significant factor in univariable models for both non-cavitated lesions (95% CI 1.03, 1.79) and cavitated lesions (95% CI 1.04, 4.48), although the association for cavitated lesions lost statistical significance after adjustment. Parental knowledge scores were not statistically significantly related to ECC outcomes.

CONCLUSION: ECC burden amongst Myanmar preschool children remains extremely high. Paternal education and parental perception of child oral health were key factors associated with ECC severity. Strengthening father-inclusive oral health education, enhancing parental awareness, and expanding preschool preventive programmes are recommended to address Myanmar’s severe ECC burden.

PMID:42183987 | DOI:10.1007/s40368-026-01227-6

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Psychometric evaluation of the L Test for functional mobility across EDSS-based severity levels in multiple sclerosis

Ir J Med Sci. 2026 May 25. doi: 10.1007/s11845-026-04463-3. Online ahead of print.

ABSTRACT

BACKGROUND: Functional mobility impairment is common in Multiple Sclerosis (MS) and affects daily functioning.

AIM: The present study aimed to examine the validity and reliability of the L Test, a measure commonly used to assess functional mobility, across different levels of disease severity in individuals with MS.

METHODS: A total of 35 individuals with clinically confirmed MS and Expanded Disability Status Scale (EDSS) scores ranging from 0-3.5 were recruited. Participants with EDSS scores between 0 and 1.5 were assigned to Group 1, while those with scores between 2-3.5 constituted Group 2. To determine inter-rater reliability, the L Test was administered on the same day by two independent physiotherapists.

RESULTS: Group 1 comprised 17 participants with a mean age of 40.82 ± 13.62 years, while Group 2 included 18 participants with a mean age of 48.44 ± 8.89 years. The test-retest reliability of the L Test was excellent, with an intraclass correlation coefficient (ICC) of 0.99 (95% CI: 0.999-1.000). Receiver operating characteristic (ROC) analysis demonstrated that the L Test had a very high discriminative ability in differentiating between the two groups (AUC = 0.997). Correlation analyses revealed a strong, positive, and statistically significant relationship between the L Test and the TUG Test in both groups (Group 1: r = 0.712, p = 0.001; Group 2: r = 0.856, p < 0.001).

CONCLUSION: The findings indicate that the L Test is a valid and reliable tool for assessing functional mobility in individuals with MS presenting with varying functional levels.

PMID:42183986 | DOI:10.1007/s11845-026-04463-3

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PopGenHelpR: An R Package to Streamline and Facilitate Informed Population Genomic Analyses and Visualization of Genetic Ancestry, Diversity and Differentiation

Mol Ecol Resour. 2026 May;26(4):e70142. doi: 10.1111/1755-0998.70142.

ABSTRACT

Analysing large population genomic datasets requires an interdisciplinary skillset. Beyond a knowledge base in genetics and population biology, population genomic analyses involve computer science and statistics, representing a barrier for researchers without experience in those fields. PopGenHelpR seeks to lower this barrier by enabling researchers to perform population genomic analyses and generate near-publication quality figures in a streamlined and informed fashion. PopGenHelpR allows users to estimate genetic diversity within populations as well as differentiation among populations and individuals from single nucleotide polymorphism data. PopGenHelpR includes commonly used measures such as observed heterozygosity and FST. PopGenHelpR also provides five previously unavailable measures of heterozygosity, including the proportion of heterozygous loci and homozygosity by locus. Additionally, PopGenHelpR integrates widely used visualization tools in population genomics that normally require additional software packages, such as ancestry bar charts, piechart maps, and genetic differentiation heatmaps. Moreover, PopGenHelpR is minimally dependent on other R packages, reducing its chance of being removed from public networks. The PopGenHelpR website also provides tutorials and educational resources. Altogether, PopGenHelpR provides resources for informed analyses and effective visualization, making PopGenHelpR a valuable tool for many researchers. PopGenHelpR is available on the Comprehensive R Archive Network and GitHub (https://github.com/kfarleigh/PopGenHelpR).

PMID:42183976 | DOI:10.1111/1755-0998.70142

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Nevin Manimala Statistics

A combined approach using environmental yeasts and microbial indicators to assess aquatic pollution

Environ Monit Assess. 2026 May 25;198(6):647. doi: 10.1007/s10661-026-15445-4.

ABSTRACT

Aquatic environments receiving anthropogenic inputs can act as reservoirs for opportunistic microorganisms and antifungal resistance, representing a potential environmental and public health concern. This study evaluated microbial contamination and antifungal susceptibility patterns in surface waters along a rural-urban gradient in a subtropical watershed using an integrated environmental monitoring approach. Physicochemical parameters and conventional microbial (Escherichia coli, Enterococcus spp., and heterotrophic bacteria) were quantified, and yeast abundance was determined using CHROMagar™ Candida. A total of 327 yeast isolates were evaluated for susceptibility to itraconazole (ITZ) and fluconazole (FCZ) using the CLSI M27-A4 broth microdilution method. Urban sites exhibited markedly higher microbial contamination compared with rural areas, with Enterococcus spp. reaching 36,000 colony-forming units (CFU)/100 ml and E. coli 19,863 most probable number (MPN)/100 ml. Yeast densities reached up to 351 CFU/100 ml in urban samples, exceeding concentrations typically reported for oligotrophic aquatic systems. Antifungal susceptibility testing revealed a high frequency of resistance among environmental isolates, ITZ (44.3%) compared with FCZ (24.46%). Statistical analyses indicated no significant spatial or seasonal differences in resistance patterns (p > 0.05), whereas resistance to ITZ was significantly higher than to FCZ (p < 0.001). The results indicate that anthropogenic pressure in urbanized watersheds may contribute to increased microbial contamination and the occurrence of antifungal-resistant yeasts in surface waters. This suggests a potential environmental pathway for the dissemination of resistance traits. The integration of conventional microbial indicators, environmental yeast monitoring, and antifungal susceptibility profiling provides a practical framework for environmental surveillance.

PMID:42183952 | DOI:10.1007/s10661-026-15445-4

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Weak bones, strong obsessions: a controlled study on Orthorexia nervosa, body image, and mood in postmenopausal osteoporosis

Arch Osteoporos. 2026 May 25;21(1):84. doi: 10.1007/s11657-026-01719-4.

ABSTRACT

Postmenopausal women with osteoporosis may show higher levels of orthorexic tendencies than healthy peers. These tendencies were associated with lower lumbar spine bone density but not with mood or body image measures. The findings suggest that maladaptive health-focused behaviors may be present in this population.

OBJECTIVE: This study aimed to evaluate orthorexic tendencies in postmenopausal women with osteoporosis compared to healthy controls and to investigate the associations between orthorexic tendencies, body appreciation, and mood-related symptoms.

METHODS: This cross-sectional study included 128 participants (64 postmenopausal women with osteoporosis and 64 healthy controls). Femoral neck and L1-L4 T-scores and bone mineral density (BMD) values were obtained from dual-energy X-ray absorptiometry (DXA) measurements performed within the previous six months. Orthorexic tendencies were assessed using the Orthorexia Nervosa Scale-11 (ORTO-11), symptoms related to depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale (HADS), and body satisfaction was assessed using the Body Appreciation Scale (BAS).

RESULTS: ORTO-11 scores were significantly lower in the osteoporotic group compared to healthy controls (p = 0.041), indicating more pronounced orthorexic tendencies. Although the prevalence of clinically significant orthorexic tendencies (ORTO-11 ≤ 27) was higher in the osteoporotic group (68.8%) than in controls (54.7%), this difference did not reach statistical significance. ORTO-11 scores showed positive correlations with lumbar spine T-scores (r = 0.202, p = 0.022) and BMD values (r = 0.210, p = 0.017), whereas no association was observed with femoral neck measurements. Orthorexic tendencies were not correlated with anxiety, depression, or body appreciation scores. In contrast, depressive and anxiety symptoms were negatively correlated with body appreciation.

CONCLUSION: Orthorexic tendencies may be more common in postmenopausal women with osteoporosis. These findings suggest that maladaptive healthy eating behaviors may be present in this population.

PMID:42183951 | DOI:10.1007/s11657-026-01719-4

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Prediction Error in Quality-Adjusted Life Years in Economic Evaluations of Immune Checkpoint Inhibitors: A Comparison Based on Projected and Observed Updated Survival

Pharmacoecon Open. 2026 May 25. doi: 10.1007/s41669-026-00660-z. Online ahead of print.

ABSTRACT

BACKGROUND: Survival data from pivotal clinical trials are critical for estimating quality-adjusted life years (QALYs). However, immature survival data require extrapolation beyond observed follow-up to project outcomes, introducing potential prediction error into QALY estimates used in economic evaluations. Immune checkpoint inhibitors (ICIs) present unique extrapolation challenges due to delayed responses and extended survival benefits. We therefore quantify the QALY prediction error of early extrapolations by benchmarking them against updated follow-up at a common time horizon.

METHODS: Using reconstructed individual patient data derived from published Kaplan-Meier curves of pivotal trials, this study assessed the accuracy of early survival extrapolations for ICIs approved in China by comparing early projections with QALYs obtained from updated data at the same horizon. A partitioned-survival framework using overall survival (OS) and progression-free survival (PFS) informed state occupancy, and QALYs were obtained via restricted mean survival time (RMST) integration of health-state utilities at the target horizon. Statistical analyses evaluated bias, precision, and agreement between extrapolated and updated QALY estimates. Linear regression and sensitivity analyses assessed the impact of target extrapolation horizon (T) on prediction error.

RESULTS: In total, 14 randomized controlled trials (4839 patients) were included for analysis. The mean deviation between extrapolated and observed QALYs was – 0.01 (95% CI – 0.03 to 0.01), with a mean absolute error (MAE) of 0.03 (95% CI 0.01 to 0.04). Strong agreement existed between extrapolated and updated QALYs (Spearman’s ρ = 0.98, 95% CI 0.94 to 0.99, P < 0.001). Consistently, OS extrapolations showed minimal deviation (MAE: 0.56 months), while PFS tended to be underestimated (MAE: 1.91 months). Moreover, predictive error increased significantly with longer extrapolation periods for QALY (MAE increase: 0.011 QALY/year, P = 0.004) and OS (MAE increase: 0.342 months/year, P = 0.010).

CONCLUSIONS: Near-horizon QALY prediction error was modest on average but increased with longer target extrapolation horizons. These findings support transparent reporting of extrapolation uncertainty and suggest that structured evidence reassessment may be particularly valuable as longer follow-up becomes available.

PMID:42183942 | DOI:10.1007/s41669-026-00660-z

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Add-on parsaclisib for patients with myelofibrosis and suboptimal response to ruxolitinib: a randomized phase 3 study

Oncologist. 2026 May 21:oyag201. doi: 10.1093/oncolo/oyag201. Online ahead of print.

ABSTRACT

BACKGROUND: Ruxolitinib (JAK1/JAK2 inhibitor) is indicated for adults with intermediate or high-risk myelofibrosis; however, a subset of patients may exhibit a suboptimal response due to persistent PI3K/AKT activation. The phase 3, randomized, double-blind, placebo-controlled LIMBER-304 study (NCT04551053) investigated the efficacy and safety of add-on parsaclisib (highly selective PI3Kδ inhibitor) in patients with myelofibrosis and suboptimal or declining response to stable ruxolitinib monotherapy.

PATIENTS AND METHODS: Adults with primary or secondary myelofibrosis who received ruxolitinib with palpable spleen and Myelofibrosis Symptom Assessment Form (MFSAF) total symptom score (TSS) ≥10 were eligible. Primary end point was proportion of patients achieving ≥25% spleen volume reduction (SVR; baseline to Week 24); key secondary end point was proportion of.

PATIENT: s with ≥50% MFSAF-TSS reduction (baseline to Week 24).

RESULTS: In total, 90 patients received parsaclisib/ruxolitinib; 87 received placebo/ruxolitinib. At Week 24, 16.7% of patients receiving parsaclisib/ruxolitinib achieved ≥25% SVR versus 9.7% for placebo/ruxolitinib; this difference was not statistically significant. By Week 24, ≥50% reduction in MFSAF-TSS was observed in 17.1% of patients receiving parsaclisib/ruxolitinib versus 14.1% for placebo/ruxolitinib. Higher rates of infections (including cytomegalovirus) and gastrointestinal disorders were observed with parsaclisib/ruxolitinib. Grade ≥3 treatment-emergent adverse events occurred in 60.0% of patients receiving parsaclisib/ruxolitinib versus 42.5% with placebo/ruxolitinib. The study was terminated early based on efficacy findings.

CONCLUSIONS: Study results suggested adding parsaclisib to stable-dose ruxolitinib was unlikely to offer clinically meaningful benefits. Further research is needed on the potential of JAK and PI3K inhibitor-based combination therapy for patients with myelofibrosis.

PMID:42179186 | DOI:10.1093/oncolo/oyag201

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Improving mental health literacy of frontline community health workers in a rural district of Pakistan: mPareshan project

BJPsych Open. 2026 May 25;12(3):e144. doi: 10.1192/bjo.2026.11051.

ABSTRACT

BACKGROUND: In low- and middle-income countries, four out of five people with mental illness do not receive specialised treatment. Utilising non-specialist frontline workers to deliver basic mental health services at the community level therefore warrants exploration.

AIMS: This study assessed improvement in the knowledge and skills of frontline community workers in identifying symptoms of anxiety and depression, making appropriate referrals and providing psychosocial counselling, in a rural district of Pakistan.

METHOD: Project mPareshan developed a training manual to enhance the mental health literacy of government-employed lady health workers (LHWs) and lady health supervisors (LHSs). Content was adapted from the World Health Organization’s Mental Health Gap Action Programme 2.0 intervention guide to suit the local context. A total of 72 participants (36 LHSs and 36 LHWs) from the Badin District, Sindh, Pakistan, received the training. Pre- and post-tests were conducted to assess changes in knowledge and skills, using the Wilcoxon signed-rank test.

RESULTS: There was a statistically significant improvement in both knowledge (p < 0.01, r = 0.85) and competency (p < 0.01, r = 0.81) median scores following the mPareshan training. LHSs demonstrated higher percentage increase in knowledge and competencies in domains requiring practical application, such as coping mechanisms, psychosocial support and referral pathways, compared with LHWs, highlighting the importance of their supervisory role and support in mental health service delivery.

CONCLUSIONS: The mPareshan mental health training has the potential to improve the knowledge and competencies of community health workers. Such initiatives can be scaled up to enable frontline workers to function as an effective workforce in the absence of specialist mental health services.

PMID:42179177 | DOI:10.1192/bjo.2026.11051

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The Effect of Kinesio Taping on Handgrip Strength and Functional Outcomes in Elderly Patients After Lower Extremity Surgery: A Retrospective Cohort Study

Physiother Res Int. 2026 Jul;31(3):e70243. doi: 10.1002/pri.70243.

ABSTRACT

BACKGROUND AND PURPOSE: This study aims to investigate the effects of increasing handgrip strength by applying Kinesio taping to the wrist extensors on the functional level in patients undergoing lower extremity surgery who ambulate with a walker.

METHODS: This retrospective study analyzed data from 100 patients aged 65 years and older who underwent lower extremity surgery and ambulated with a walker. The patients were divided into two groups: a control group (CG) that was kept under the standard rehabilitation program and a Kinesio taping group (KT) in which Kinesio taping was applied to the forearm extensor muscles in addition to the group being under standard rehabilitation program. The patients’ handgrip strength (HGS), pain, and functional levels (Functional Independence Measurements (FIM), Iowa Level of Assistance Scale (ILAS), and Iowa Walking Speed Scale (IWSS)) were retrospectively assessed before treatment and at discharge.

RESULTS: Compared to the CG group, the right and left HGS, functional levels, and IWSS of the patients increased significantly in the KT group, and their activity-related pain levels decreased significantly (p < 0.005). A significant positive correlation was observed between the change in HGS and the change in ILAS and FIM scores, and a statistically significant negative correlation was found between the change in HGS and the change in activity-related pain and IWSS (p < 0.05).

DISCUSSION: Our findings suggest that Kinesio taping application is a simple and cost-effective method that increases HGS in patients and is an effective method in controlling pain, improving walking speed, and enhancing functionality in patients undergoing lower extremity surgery.

TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT06072261.

PMID:42179169 | DOI:10.1002/pri.70243

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Performance of Non-Dental Professional Caregivers in Oral Health Assessment Using the Oral Health Screener: Caregiver-Dentist Agreement and Inter-Rater Reliability

Gerodontology. 2026 May 25. doi: 10.1111/ger.70093. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate caregiver-dentist agreement and inter-rater reliability of the Oral Health Screener (OHS) following its optimisation for use in long-term care and to examine the effect of different caregiver OHS training modalities.

METHODS: This prospective reliability and agreement study was nested within a 2-year cluster-randomised controlled trial in Flemish nursing homes (Belgium). Professional caregivers and dentists independently assessed residents’ oral health using the OHS every 6 months across five timepoints, blinded to each other’s assessments. Caregivers received either e-learning only (IG1) or e-learning combined with on-site training (IG2). Agreement was analysed using percent agreement, Cohen’s kappa, prevalence-adjusted bias-adjusted kappa (PABAK) and logistic generalised linear mixed models (GLMM).

RESULTS: Fifty-one caregivers from six facilities and eight dentists assessed 193 residents. Within groups, IG1 showed higher agreement with dentists for self-reported items (GLMM 0.46-0.58) than for inspection-based OHS items (GLMM 0.10-0.48), whereas this difference was less pronounced in IG2 (self-reported items: GLMM 0.45-0.95, inspection-based items: GLMM 0.35-0.92). Comparing groups, GLMM analyses indicated overall higher reliability in IG2 for most items, except for chewing difficulty. Exploratory analyses suggested that longitudinal patterns varied across items. Inter-caregiver reliability analyses were exploratory due to the limited number of paired assessments.

CONCLUSION: Non-dental professional caregivers showed acceptable agreement with dentists when assessing residents’ oral health using the OHS. Although agreement varied across items due to prevalence and marginal imbalances, the findings suggest the potential added value of training and support when using the OHS as a first-line screening tool in care-dependent older adults.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06536322 (July 23, 2024).

PMID:42179168 | DOI:10.1111/ger.70093