Tag: pubmed

Age Ageing. 2026 Aug 3;55(8):afag234. doi: 10.1093/ageing/afag234.

ABSTRACT

BACKGROUND: Social isolation, loneliness and frailty commonly emerge in later life, yet understanding of how their interrelationships relate to all-cause death remains limited. This longitudinal study aimed to examine the associations between social isolation and loneliness and risk of all-cause death and to examine the mediating role of frailty in these associations.

METHODS: This study analysed data from four large international cohorts (Health and Retirement Study, China Health and Retirement Longitudinal Study, Survey of Health, Ageing and Retirement in Europe and Mexican Health and Ageing Study) covering 31 countries. Cox proportional hazards models were used to estimate the associations of social isolation and loneliness with frailty and all-cause death. A random-effects meta-analytic model was used to pool cohort-specific estimates. Finally, mediation analysis was conducted to quantify the mediating effect of frailty in the associations between social isolation, loneliness and all-cause death.

RESULTS: Over a mean follow-up of 7.07 years, there were 20 504 (25.61%) participants who developed frailty and 6212 (7.76%) all-cause death among total of 80 050 participants. Social isolation was associated with increased risks of frailty (pooled HR = 1.26, 95% CI: 1.09-1.44) and all-cause death (pooled HR = 1.33, 95% CI: 1.12-1.56). Loneliness was associated with an increased risk of frailty (pooled HR = 1.19, 95% CI: 1.00-1.41) and all-cause death (pooled HR = 1.25, 95% CI: 1.10-1.41). Frailty mediated 24.43% (17.35%-34.43%) of the association between social isolation and all-cause death and 55.18% (47.12%-64.43%) of the association between loneliness and all-cause death.

CONCLUSION: In later life, social isolation and loneliness increased risks of all-cause death and frailty served as a key mediator. These findings underscore the urgent need for public health policies and clinical practice to prioritise systematic identification and intervention targeting social isolation and loneliness, while integrating frailty screening and management into healthy ageing strategies.

PMID:42572000 | DOI:10.1093/ageing/afag234

Eval Rev. 2026 Aug 9:193841X261476152. doi: 10.1177/0193841X261476152. Online ahead of print.

ABSTRACT

Scholarly publications in social sciences have increased sharply and continue to expand in the era of big data and artificial intelligence. However, comprehensive syntheses of quantitative research methods remain scarce, presenting significant challenges for early-career researchers and graduate students in selecting appropriate research methods for their studies. To address this gap, we propose a conceptual framework that provides a structured guide to quantitative techniques, thereby enhancing methodological literacy and supporting informed decision-making in academic publishing. By integrating applied statistics and operations research-spanning basic to advanced analytics along a static-dynamic continuum, this framework empowers novice scholars to navigate technique selection effectively and mitigates the dominance of a few methodological choices in economics, business, and management research.

PMID:42571994 | DOI:10.1177/0193841X261476152

Diabetes Obes Metab. 2026 Aug 9. doi: 10.1111/dom.71212. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate and recalibrate commonly used 10-year cardiovascular disease (CVD) risk prediction models in two Chinese cohorts: the general population and adults with type 2 diabetes.

METHODS: We analysed data from the Wuzhong subcohort of the China Kadoorie Biobank (CKB) and the Jiangsu Biobank for the Prevention and Control of Diabetes (JBPCD). After excluding participants with baseline CVD, baseline diabetes in CKB or missing predictors, 42 937 CKB participants and 14 125 JBPCD participants were included. We evaluated CKB-CVD, Globorisk, Framingham General CVD and WHO 2019 in both cohorts, and SCORE2-Diabetes in JBPCD. Performance of original and recalibrated models was assessed by 10-year inverse probability of censoring weighting (IPCW) C-statistic, calibration measures including the expected-to-observed (E/O) event ratio and Brier score. In JBPCD, overlap in high-risk classification was examined using a 20% predicted 10-year risk threshold.

RESULTS: During a median follow-up of 11.96 years in the general population cohort and 10.03 years in the type 2 diabetes cohort, 3740 and 2794 ischemic heart disease or stroke events occurred, with 10-year risks of 6.04% and 19.72%, respectively. Discrimination was higher in the general population cohort than in the type 2 diabetes cohort (C-statistic 0.723-0.778 vs. 0.584-0.629). Original models were poorly calibrated, with systematic overprediction in the general population cohort (E/O 1.47-3.78) and heterogeneous miscalibration in the type 2 diabetes cohort (E/O 0.32-2.70). Recalibration markedly improved calibration and reduced Brier scores, with little change in discrimination. In the type 2 diabetes cohort, recalibrated CKB-CVD classified 48.4% as high risk, with an observed 10-year risk of 25.7%.

CONCLUSION: Widely used 10-year CVD risk models showed acceptable or modest discrimination but substantial miscalibration in Chinese populations, especially among adults with type 2 diabetes. Recalibration is essential before threshold-based clinical or public-health use.

PMID:42571983 | DOI:10.1111/dom.71212

Zhonghua Yi Xue Za Zhi. 2026 Aug 11;106(29):3033-3039. doi: 10.3760/cma.j.cn112137-20260519-01340.

ABSTRACT

Objective: To explore the clinical efficacy and application value of O-arm navigation-assisted zoning laminectomy in the treatment of severe thoracic ligamentum flavum ossification (TOLF). Methods: A retrospective cohort study was conducted to analyze 83 patients with severe TOLF admitted to Zhengzhou Orthopedic Hospital from May 2019 to August 2023. There were 48 males and 35 females, the age was (50.1±6.0) years. Preoperative three-dimensional reconstruction of the ossified ligamentum flavum in the thoracic spine was performed using Mimics 21.0 software for preoperative planning. According to different treatment methods, patients were divided into the O-arm navigation-assisted zoning laminectomy group (navigation group, n=41) and the simple zoning laminectomy group (control group, n=42). The baseline data, operation time, intraoperative blood loss and total hospital stay of the two groups were compared. The modified Japanese Orthopaedic Association (mJOA) score and improvement rate were used to evaluate the changes in neurological function before the operation, 1 month, 3 months after the operation and at the last follow-up. The occurrence of complications in the patients was recorded. Results: The 83 patients were followed up for (20.3±6.9) months. There was no statistically significant differences in gender, age, lesion involved segments and disease duration between the two groups (all P>0.05). The operation time of the navigation group was significantly shorter than that of the control group [(134.4±29.9) vs (152.9±30.2) min, P=0.006]. There were no statistically significant differences in intraoperative blood loss [(412.2±98.6) vs (433.3±80.1) ml] and total hospital stay [(7.8±1.5) vs (7.8±1.4) d] between the navigation group and the control group (both P>0.05). The mJOA scores of the navigation group at 1 month, 3 months after the operation and the last follow-up were significantly higher than the preoperative mJOA score (all P<0.001). There was no significant difference in mJOA scores between the two groups at each time point (all P>0.05). There was no statistically significant difference in therapeutic effect between the two groups (P=0.616). There was no significant difference in the improvement rate of mJOA between two groups [(67.8%±19.9%) vs (69.8%±19.3%), P=0.760]. There were 7 cases of cerebrospinal fluid leakage after the operation in the navigation group. In the control group, there were 11 cases of cerebrospinal fluid leakage and 1 case of transient neurological dysfunction. The incidence of postoperative complications in the navigation group was lower than that in the control group [(7/41, 17.1%) vs (12/42, 28.6%), P=0.035]. Conclusion: O-arm navigation-assisted technology helps achieve precise decompression during surgery, shortens the operation time and enhance the surgical safety.

PMID:42571970 | DOI:10.3760/cma.j.cn112137-20260519-01340

Zhonghua Yi Xue Za Zhi. 2026 Aug 11;106(29):3026-3032. doi: 10.3760/cma.j.cn112137-20260306-00626.

ABSTRACT

Objective: To analyze the influencing factors associated with cirrhosis in patients with indeterminate-phase chronic hepatitis B (CHB). Methods: CHB patients in the indeterminate phase who did not receive antiviral treatment at the Senior Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital between January 2020 and June 2025 were retrospectively included. According to whether cirrhosis had occurred, the patients were divided into the cirrhosis group (patients diagnosed with cirrhosis) and the non-cirrhosis group (patients not diagnosed with cirrhosis). Differences in demographic characteristics, virological indicators, routine blood parameters, and liver function-related clinical indicators were compared between the two groups. Restricted cubic spline analysis was used to determine the threshold values of platelet and age in relation to cirrhosis risk. A multivariate logistic regression model was used to analyze factors associated with cirrhosis in patients with indeterminate-phase CHB. Results: A total of 422 patients was included. There were 182 patients in the cirrhosis group with 128 males and 54 females, aged (47±9) years; and 240 patients in the non-cirrhosis group with 146 males and 94 females, aged (43±11) years. Patients in the cirrhosis group were older than those in the non-cirrhosis group (P<0.001). The distribution of HBV DNA differed statistically between the two groups (P=0.002). Compared with the non-cirrhosis group, the cirrhosis group had a lower proportion of low HBV DNA load (<2×10³ U/ml) [14.8% (27/182) vs 29.6% (71/240), P<0.001] and a higher proportion of intermediate HBV DNA load (2×10³-<2×10⁷ U/ml) [67.6% (123/182) vs 57.5% (138/240), P=0.032], whereas the proportion of high HBV DNA load (≥2×10⁷ U/ml) did not differ significantly [17.6% (32/182) vs 12.9% (31/240), P=0.160]. Platelet count [M (Q₁, Q₃), 158 (94, 199)×10⁹/L vs 205 (171, 244)×10⁹/L] and HBsAg levels (log HBsAg) [2.9 (2.5, 3.2) vs 3.1 (2.7, 3.6) U/ml] were lower in the cirrhosis group than those in the non-cirrhosis group (both P<0.001). Restricted cubic spline analysis showed non-linear associations of platelet count and age with cirrhosis risk in patients with indeterminate-phase CHB (P<0.05). The corresponding threshold values were 45 years and 180×10⁹/L of age and platelet count, respectively. Multivariate logistic regression analysis showed that decreased HBsAg levels (log HbsAg) (OR=1.99, 95%CI: 1.35-2.93), HBV DNA between 2×10³ and<2×10⁷ U/ml (OR=2.12, 95%CI: 1.18-3.81), HBV DNA≥2×10⁷ U/ml (OR=4.02, 95%CI: 1.80-9.00), age≥45 years (OR=2.06, 95%CI: 1.32-3.24), and platelet count<180×10⁹/L (OR=3.99, 95%CI: 2.55-6.23) were associated with cirrhosis in patients with indeterminate-phase CHB. Conclusion: Age≥45 years, platelet count<180×10⁹/L, HBV DNA≥2×10³ U/ml and decreased HBsAg are influencing factors for the progression to cirrhosis in patients with indeterminate-phase CHB who did not receive antiviral treatment.

PMID:42571969 | DOI:10.3760/cma.j.cn112137-20260306-00626

Zhonghua Yi Xue Za Zhi. 2026 Aug 11;106(29):3020-3025. doi: 10.3760/cma.j.cn112137-20251211-03264.

ABSTRACT

Objective: To investigate the current application status of detection methods and reagents for islet autoantibodies in domestic medical institutions, and to assess their detection proficiency. Methods: From October 15, 2024 to March 15, 2025, a total of 175 questionnaires were distributed to core network member units of the National Clinical Research Center for Endocrine and Metabolic Diseases, member units of the Chinese Diabetes Society and the Chinese Society of Endocrinology, member units of the China Type 1 Diabetes Alliance, and other relevant institutions. After collection, statistical analysis of detection methods for islet autoantibodies and the proportion of domestic reagents. Ten representative institutions were selected, and each was provided with 150 blinded and coded standardized evaluation samples (including 50 new-onset type 1 diabetes samples and 100 healthy donor samples). After each institution completes testing and submits the results, the national center uniformly analyzes the sensitivity, specificity and accuracy, as well as the consistency between test results from participating laboratories and those of the”gold standard”[radioligand assay (RLA) or electrochemiluminescence (ECL)]. Spearman correlation analysis was adopted to assess the correlation between the test results of participating laboratories and the gold standard measurements. Results: A total of 127 valid questionnaires were collected from all 31 provinces, municipalities, and autonomous regions in China. The proportion of institutions adopting chemiluminescence immunoassay(CLIA) was 76.6%(95/124), and that of domestic reagents used was 91.7%(121/132). Results from 10 institutions showed the following results: the median sensitivity values for glutamic acid decarboxylase autoantibody (GADA), protein tyrosine phosphatase-2 autoantibodies (IA-2A), insulin autoantibody (IAA), zinc transporter 8 autoantibody (ZnT8A) were 76.0%(range:38.0%-90.0%), 36.0%(range:8.0%-66.0%),24.0%(range:2.0%-50.0%), and 46.0%(range:0-54.0%), respectively; the median specificity values were 100.0%(range:98.0%-100.0%),100.0%(range:99.0%-100.0%), 98.0%(range:95.0%-100.0%),99.0%(range:98.0%-100.0%), respectively; the median accuracy values were 92.0%(range:78.0-96.7%), 78.7%(range:69.3-88.7%), 72.7%(range:66.0-83.3%), and 80.7%(range:66.0%-84.7%), respectively. The median concordance rates between test results from institutions and the “gold standard” were 95.7% (range:82.7%-100.0%) for GADA, 88.3% (range:80.7%-96.7%) for IA-2A, 87.3% (range:82.7%-92.0%) for IAA, and 94.4% (range:81.3%-96.0%) for ZnT8A. The median correlation coefficients (ρ) were 0.857 (range:0.780-0.905) for GADA, 0.829 (range:0.507-0.871) for IA-2A, 0.781 (range:0.601-0.811) for IAA, and 0.805 (range:0.448-0.887) for ZnT8A. Conclusions: At the present stage in China, the mainstream detection method for islet autoantibodies is CLIA, and reagents have basically achieved localization. Overall, the detection quality for GADA is relatively satisfactory; however, the detection levels of IA-2A, InT8A, and particularyl IAA, still need further improvement.

PMID:42571968 | DOI:10.3760/cma.j.cn112137-20251211-03264

J Yeungnam Med Sci. 2026;43:53. doi: 10.12701/jyms.2026.43.53. Epub 2026 Aug 10.

ABSTRACT

BACKGROUND: Middle adulthood (45-64 years) represents a critical window for the primary prevention of cognitive decline and chronic diseases, with physical activity capable of reducing later cognitive decline by 20% to 35%. However, most evidence on mobile health (mHealth) interventions for physical activity originates from Western populations, with limited evaluations of culturally adapted approaches for Asian middle-aged adults, particularly in rapidly aging societies such as South Korea.

METHODS: This 12-week, single-arm, pre-post pilot feasibility study enrolled 304 community-dwelling adults aged 45 to 64 years from Dobong-gu, Seoul, South Korea. The intervention combined a Samsung Galaxy Watch 6 with a custom mobile application incorporating culturally adapted features (mountain-climbing gamification based on famous Korean peaks, adaptive goal setting, and context-aware notifications) developed through systematic focus groups. The primary outcomes were weekly step count and moderate-to-vigorous physical activity (MVPA), while the secondary outcomes included subjective cognitive function assessed using a validated self-report scale, exercise behavior stages, depressive symptoms, and app usability.

RESULTS: Of the 304 participants, 302 (99.3%) completed the intervention. Weekly step count increased by 16.9% from 78,334 to 91,531 (p<0.001) and weekly MVPA increased by 83.3% from 56.0 to 102.6 minutes (p<0.001). The proportion of participants meeting the World Health Organization physical activity guidelines increased from 23.2% to 42.1% (p<0.001). Selective improvements were observed in executive function-related cognitive domains and depressive symptoms, and a dose-response relationship emerged between app engagement and step count gains.

CONCLUSION: This culturally adapted wearable mHealth intervention demonstrated high feasibility and acceptability for promoting physical activity in Korean middle-aged adults, supporting its further evaluation as a scalable strategy for the primary prevention of cognitive decline and chronic diseases.

PMID:42571925 | DOI:10.12701/jyms.2026.43.53

Pharmacoepidemiol Drug Saf. 2026 Aug;35(8):e70438. doi: 10.1002/pds.70438.

ABSTRACT

PURPOSE: In 2019, the Innovative Medicines Initiative funded the ConcePTION project to enhance monitoring of medication safety in pregnancy and breastfeeding. This paper describes how the ConcePTION Pregnancy Algorithm (PA) identified pregnancies in 10 diverse European electronic healthcare data sources and estimated their duration.

METHODS: Data sources from six European countries were mapped to the ConcePTION Common Data Model. Any pregnancy-related record was retrieved from various available data banks, including birth register, primary care records, and hospital records, and reconciled into episodes of pregnancy (starting between 01/2015 and 12/2019), each with start date, end date, and type of end. A random forest model was used to estimate missing gestational ages for incomplete records. Parameters were tailored to data sources to address local variations in data availability, collection, and governance. Model performance was evaluated using cross-validated Root Mean Squared Error (RMSE).

RESULTS: The PA identified ~2.7 million pregnancies, in over 2.2 million individuals. Most ended in live births (50%-83%), 1%-15% in elective terminations, and 4%-10% in spontaneous abortions, depending on data sources. Pregnancies with unknown type of end were also retrieved (2%-34%). Gestational age was predicted for 6%-89% of records (RMSE: 17-50 days). The median gestational age at first identified pregnancy record ranged from 47 to 280 days.

CONCLUSIONS: We developed an open-source algorithm to identify and date pregnancies, including early-stage pregnancies with unknown end and/or ongoing at the time of data extraction. This algorithm may facilitate multinational studies, improving generation of timely real-world evidence about use and safety of medicinal products in pregnancy.

PMID:42571911 | DOI:10.1002/pds.70438

Am J Dent. 2026 Aug;39(4):201-205.

ABSTRACT

PURPOSE: To investigate whether the amount of dentifrice (dose) used per brushing affects the abrasion of the hard tooth tissues.

METHODS: Enamel and dentin specimens were subjected to simulated brushing with two commercial dentifrices (Prodent, Smyle dentifrice in tablet form) and positive as well as negative controls at varying amounts of dentifrices (standard dose, half, and double dose). Brushing without dentifrice (with water) functioned as a negative control. Tooth wear was quantified using profilometry, and statistical analysis was performed using one-way ANOVA and Tukey’s post hoc test (α= 0.05).

RESULTS: For enamel, dose variations had minimal impact. However, dentin wear increased significantly with higher doses, particularly for the positive control and Smyle at double dose (P< 0.05). Dilution reduced abrasivity inconsistently across brands.

CLINICAL SIGNIFICANCE: The amount of dentifrice used for brushing has a significant, dose-dependent effect on dentin abrasion, whereas enamel is relatively unaffected, and brushing without dentifrice does not cause wear. While dentifrice in tablet form provides a manufacturer‑defined standard amount per brushing, this is not the case for dentifrice in paste form. Because the amount of dentifrice used influences dentin wear, it is advisable that manufacturers clearly define the recommended quantity of dentifrice for a single brushing.

PMID:42571899

Am J Dent. 2026 Aug;39(4):193-200.

ABSTRACT

PURPOSE: To evaluate in the laboratory the effect of an in-office whitening agent on color change, translucency, and surface roughness of leucite-reinforced CAD-CAM material with different surface finishes exposed to different beverages [cola, tea, fruit juice, coffee, distilled water (Control)].

METHODS: All the IPS Empress CAD-CAM ceramic block specimens were treated with a glaze layer (n=75) and then randomly divided into three groups. The samples (n=25) in Group 1 (Control) were not treated (glaze layer remained). The glaze layer of the other samples (n=50) was abraded by the same researcher. While the samples in Group 2 were treated with Optrafine (Optrafine after glazing) (n=25), those in Group 3 were subjected to surface treatment with Eve polishing kits (Eve kit after glazing) (n=25). The samples were then immersed in five different beverages (cola, coffee, tea, fruit juice and distilled water) (n=5) and clinic-type bleaching was applied. Color measurements were recorded by spectrophotometer and surface roughness (Ra) values were recorded by profilometer. Color change (ΔE₀₀) values were calculated using the CIE2000 formula. The data were statistically analyzed using Shapiro-Wilk test, ANOVA and Bonferroni test (P< 0.05).

RESULTS: Regardless of the surface finishing process and beverage, the mean values of color change (ΔE₀₀) did not differ according to time (P= 0.148). As a result of the ANOVA, surface finishing process, beverage, and time interaction were found to be very significant (P< 0.001). Regardless of the surface finishing process and beverage, it was determined that the mean roughness values differed according to time (P= 0.019).

CLINICAL SIGNIFICANCE: Although bleaching glass ceramic restorations with bleaching agents containing 40% hydrogen peroxide was effective to remove stains, maintaining the glaze surface finish is critical for color stability and surface integrity of CAD-CAM ceramics.

PMID:42571898