Tag: pubmed

Clin Implant Dent Relat Res. 2026 Jun;28(3):e70160. doi: 10.1111/cid.70160.

ABSTRACT

AIM: To compare one-year prosthetic, technical, and esthetic outcomes of screw-retained, implant-supported all-ceramic single crowns placed on two-piece zirconia (ZrO₂) versus titanium implants.

MATERIALS AND METHODS: In this randomized, prospective, multicenter clinical trial, patients received screw-retained, implant-supported all-ceramic single crowns placed either on a two-piece zirconia implant with a titanium base connection or on a titanium implant with a conventional titanium base (implant diameters: 4.1 mm). Restoration survival and technical complications were systematically recorded. Peri-implant soft-tissue parameters, including plaque index (PI), papilla bleeding index (PBI), and papilla index (PaI), were assessed at baseline and at the one-year follow-up. Baseline was set at three weeks after crown insertion. Statistical analyses were performed using descriptive statistics. Chi-square tests were used to compare outcomes between the zirconia and titanium implant groups, with the level of significance set at p < 0.05.

RESULTS: A total of 117 implants were restored, and 112 restorations were available for analysis after one year of function. Restoration survival was 100% in both the zirconia and titanium implant groups. No statistically significant differences were observed between groups with regard to overall technical complication rates. Veneered zirconia crowns exhibited significantly higher complication rates compared with monolithic restorations, irrespective of the supporting implant material. Peri-implant soft-tissue parameters, including PI, PBI, and PaI, did not differ significantly between groups.

CONCLUSION: Within the limitations of this prospective randomized clinical trial, restorations supported by zirconia implants with a screw-retained titanium base connection demonstrated short-term clinical performance comparable to that of restorations placed on titanium implants. Both groups showed a 100% restoration survival rate, with no significant differences in technical complications or peri-implant soft-tissue parameters. These findings should be interpreted considering the one-year follow-up, the study design primarily powered to detect differences in marginal bone loss, and the exclusive use of regular-diameter implants. Overall, the results support the favorable short-term clinical performance at 1 year.

TRIAL REGISTRATION: The study is registered at the German Clinical Trial Register (https://drks.de/search/de/trial/DRKS00013209) as well as at the Federal Office of Public Health’s (FOPH) portal for human research in Switzerland (kofam.ch).

PMID:42206453 | DOI:10.1111/cid.70160

Acta Derm Venereol. 2026 May 28;106:adv44309. doi: 10.2340/actadv.v106.44309.

ABSTRACT

Bullous pemphigoid (BP) is the most common autoimmune blistering disease and has been linked to increased mortality, although previous studies have generally relied on small populations and no data have been available specifically for the Swedish population. This study aimed to evaluate the 1- and 10-year mortality rates and all-cause mortality in Swedish patients with BP compared with the general population. Using the National Patient Register, we conducted a retrospective cohort study and identified all BP cases in Sweden from 1 January 2005, to 31 December 2016. Age, sex, and county of residence matched controls without BP were drawn from the general population, and mortality data were obtained from the Swedish Cause of Death Register. In total, 5,738 patients with BP and 17,167 controls were included. BP patients had a significantly higher all-cause mortality (HR 2.15, 95% CI 2.06-2.24) than controls, with 1- and 10-year mortality rates of 21.2% and 80.2%, respectively. Cardiovascular diseases accounted for the largest proportion of deaths (25.3%). Notably, improved survival was observed among BP patients treated with methotrexate (MTX), prednisolone, and potent topical corticosteroids (HR 0.76, 95% CI 0.69-0.83). To our knowledge, this is the first nationwide Swedish study on BP mortality and one of the largest to date, confirming a significantly increased mortality risk in BP patients, particularly due to cardiovascular causes, while also suggesting that combined MTX, prednisolone, and potent topical steroid treatment may improve survival outcomes.

PMID:42206441 | DOI:10.2340/actadv.v106.44309

Dermatol Reports. 2026 May 28. doi: 10.4081/dr.2026.10293. Online ahead of print.

ABSTRACT

Aging is characterized by a progressive decline in physiological functions, including skin integrity and regeneration, with visible signs of skin aging typically emerging from the fourth decade of life onward. Extrinsic factors can accelerate this process. Retinoic acid has long been used as a standard anti-aging treatment, although it is associated with various side effects. L-ascorbic acid (LAA) 15% serum has emerged as a potential alternative with minimal side effects, yet its efficacy and safety in comparison to retinol 0.1% serum remain insufficiently studied. This double-blind, split-face, randomized clinical trial aimed to evaluate the effectiveness and safety of LAA relative to retinol in treating skin aging. Using the modified Dermoscopy Photo Aging Scale (DPAS) and JANUS-III, assessments were conducted on participants’ cheeks. Results indicated significant improvements in both the LAA and retinol groups at weeks 2 and 4. However, no statistically significant differences were observed between the two interventions at these time points. Both treatments demonstrated similar safety profiles, suggesting that LAA is as effective and safe as retinol for anti-aging therapy.

PMID:42206438 | DOI:10.4081/dr.2026.10293

Health Informatics J. 2026 Apr-Jun;32(2):14604582261456059. doi: 10.1177/14604582261456059. Epub 2026 May 28.

ABSTRACT

BackgroundNon-metastatic, castration-resistant prostate cancer (nmCRPC) is an advanced state of prostate cancer with variable prognosis; early identification of patient risk is crucial, so that clinicians can recommend optimal treatment.ObjectiveCompare predictive models in identifying patient risk; evaluate the value of electronic healthcare record (EHR) time-series (TS) information in prediction.MethodsWe evaluated SurvTRACE, Weibull Time to Event Recurrent Neural Network (WTTE-RNN), and traditional Cox proportional hazards (CPH) models’ performance on EHR data from 12,819 nmCRPC patients in the Veterans Health Administration, using area under the receiver operating characteristic curve and Brier score.ResultsWTTE-RNN, which intrinsically uses EHR TS information, outperformed the other models without TS information. Feature-engineered TS information improved performances of CPH and especially SurvTRACE; with TS information, SurvTRACE outperformed WTTE-RNN.ConclusionDeep learning methods, whether intrinsically able to handle TS data or enhanced with TS information, can outperform traditional survival analysis in predicting risk.

PMID:42206427 | DOI:10.1177/14604582261456059

Psych J. 2026 Jun;15(3):e70107. doi: 10.1002/pchj.70107.

ABSTRACT

Neurodevelopmental disorders (NDD) represent a heterogeneous group of conditions that are thought to be related to impaired brain development, which often leads to significant functional difficulties across various domains. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and Related Health Problems (ICD), conventional diagnostic frameworks mainly focus on categorical classifications for identifying and supporting children with NDD. Despite their merit throughout the history of special and inclusive education, various stakeholders revealed the imperfections of this categorical diagnostic system. One aim of this perspective review, thus, is to promote a transdiagnostic approach for understanding NDDs as a possible supplementation of the current categorical diagnosis system. At the same time, there is limited relevant research on psychological and ecological domains beyond the symptomatic and neurocognitive domains of NDD. We propose to extend the transdiagnostic approach within the framework of a biopsychosocial approach that integrates neurocognitive, psychological, and socioecological factors and aims to enhance the understanding of NDD and the broader context of inclusive education.

PMID:42206411 | DOI:10.1002/pchj.70107

JMIR Cardio. 2026 May 22;10:e89480. doi: 10.2196/89480.

ABSTRACT

BACKGROUND: Accurate identification of clinical symptoms and signs (S&S) is essential for the early detection of high-burden cardiorespiratory conditions, including lung cancer, chronic obstructive pulmonary disease, and heart failure. Although symptom data play a central role in diagnostic reasoning and predictive modeling, most S&S information remains embedded in unstructured electronic health record notes, limiting their use in automated phenotyping, surveillance, and clinical decision support. Traditional natural language processing systems struggle with domain variability and contextual nuance in clinical text. Recent advances in large language models (LLMs) offer a promising alternative, yet challenges remain in hallucinations, overinference, and safe deployment. This study evaluated whether locally deployed open-source models could reliably extract cardiorespiratory S&S and map them to ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes using optimized prompting strategies.

OBJECTIVE: This study aims to assess the accuracy of open-source LLMs in extracting explicitly stated cardiorespiratory S&S from clinical notes and mapping them to ICD-10-CM codes (R00-R09) and to compare performance across 4 prompt-engineering strategies, including a multimodule LLM framework.

METHODS: A total of 593 clinical notes from the MTSamples database were manually reviewed, with 93 notes used for prompt development and comparison using Llama 3.3-70B, and 500 notes used as testing data for the final best prompt setting using both Llama 3.3-70B and gpt-oss-120B. Four prompting conditions were evaluated: (1) instruction-only, (2) ICD-10-CM definition-based prompts, (3) assumption-free prompts, and (4) a multimodule LLM framework with postprocessing. Performance was measured using precision, recall, and F1-score for both S&S extraction and ICD-10-CM code generation.

RESULTS: Across all prompt strategies, model performance improved as more structure and constraints were added. Instruction-only prompting demonstrated high recall but poor precision. Incorporating ICD-10-CM definitions improved coding accuracy, and assumption-free prompting further balanced precision and recall. The multimodule approach with postprocessing achieved the highest performance during prompt development. On the independent test corpus, entity-level microaveraged evaluation showed that gpt-oss-120B outperformed Llama 3.3-70B in both tasks. For S&S extraction, Llama 3.3-70B achieved a precision of 0.63, a recall of 0.86, and an F1-score of 0.73, whereas gpt-oss-120B achieved a precision of 0.89, a recall of 0.87, and an F1-score of 0.88. For ICD-10-CM code mapping, Llama 3.3-70B achieved a precision of 0.59, a recall of 0.83, and an F1-score of 0.69, whereas gpt-oss-120B achieved a precision of 0.90, a recall of 0.84, and an F1-score of 0.87.

CONCLUSIONS: Locally deployed LLMs, when paired with optimized prompting and multimodule orchestration, can accurately extract cardiorespiratory S&S and generate ICD-10-CM codes from unstructured clinical notes. This approach increases the level of data safety by enabling on-premises processing without external data transmission and demonstrates strong potential for scalable, domain-adaptive symptom extraction pipelines in biomedical informatics. Future work should expand datasets and evaluate generalizability across clinical domains.

PMID:42206405 | DOI:10.2196/89480

Public Health Nutr. 2026 May 28:1-27. doi: 10.1017/S1368980026102791. Online ahead of print.

ABSTRACT

OBJECTIVE: Dietary diversity is associated with health benefits. However, food biodiversity has been understudied. Therefore, we aim to evaluate the associations between dietary species richness (DSR), i.e., the number of species consumed by individuals, and dietary sustainability dimensions, including environmental pressures, diet quality and monetary cost.

SETTING: The study was carried out among the NutriNet-Santé cohort.

PARTICIPANTS: 29,173 volunteers were included.

DESIGN: Participants completed a 264-item food frequency questionnaire. Food items were linked to the corresponding species. ANCOVA models were fitted to evaluate the associations between total, plant, animal DSR, and dietary sustainability dimensions. The dietary share of organic food was computed.

RESULTS: Higher DSR was associated with lower overall environment impact, captured by the pRecipe, an indicator including greenhouse gases emissions (GHGe), land occupation (LO) and cumulative energy demand (CED) (pRecipe, Q5 vs Q1, -8.5%), better diet quality, reflected by the level of adherence to the French dietary guidelines (sPNNS-GS2, Q5 vs Q1: +44.8%), and stable dietary cost. Higher plant DSR was related with lower environmental impacts, better diet quality, and higher monetary cost. Higher animal DSR was associated with higher environmental pressures, lower diet quality and monetary cost. The amount of organic food consumed was positively associated with plant DSR, and negatively associated with animal DSR.

CONCLUSIONS: Overall, more biodiverse diets were related with better diet quality and lower environmental pressures. The associations seemed to be driven by plant biodiversity. Further studies are warranted to better understand the relationship between food biodiversity and sustainability dimensions across settings.

PMID:42206388 | DOI:10.1017/S1368980026102791

Eur J Heart Fail. 2026 May 28:xuag110. doi: 10.1093/ejhf/xuag110. Online ahead of print.

ABSTRACT

AIMS: In patients with heart failure with reduced ejection fraction (HFrEF) and sleep-related breathing disorders, the predominant apnoea type may influence prognosis. The ADVENT-HF trial, which enrolled stable HFrEF patients with newly diagnosed obstructive (OSA) or central (CSA) sleep apnoea, provides a unique opportunity to perform a post-hoc analysis to test this hypothesis. We aimed to compare event rates between those with OSA and those with CSA following randomisation over the course of the trial.

METHODS: Cox-proportional hazard ratios (HR) were compared for: the primary composite endpoint (PE); all-cause; and cardiovascular mortality. Proportional-hazards assumption was assessed by Schoenfeld residuals’ method.

RESULTS: Relative to OSA (n = 533), in unadjusted analyses, over the trial duration, the PE rate was greater in those with CSA (n = 198) (HR 1.38, 95%CI 1.10-1.73; P = .01), as were rates of all-cause (HR 1.72, 95%CI 1.26-2.36; P < .001) and cardiovascular mortality (HR 2.00, 95%CI 1.40-2.85; P < .001). These HRs were not statistically significant after adjustment for clinical characteristics associated with worse prognosis. Importantly, HRs varied over time, with an inflection point at one year. Adjusted HRs before and after 1 year were respectively 1.41 (95%CI 1.00-2.01, P = .051) and .91 (95%CI .65-1.26, P = .562) for the PE, 3.44 (95%CI 1.61-7.36, P = .001) and .89 (95%CI .58-1.37, P = .603) for all-cause mortality and 3.58 (95%CI 1.58-8.12, P = .002) and .92 (95%CI 0.56-1.51, P = 0.741) for cardiovascular mortality.

CONCLUSION: Detection of CSA in patients with stable HFrEF identifies a population at increased 1-year risk of adverse events who may benefit from earlier evaluation for advanced therapies or transplantation.

PMID:42206383 | DOI:10.1093/ejhf/xuag110

Philos Trans R Soc Lond B Biol Sci. 2026 May 28;381(1951):20250111. doi: 10.1098/rstb.2025.0111.

ABSTRACT

Understanding how urbanization affects plant interactions with pathogens and herbivores is important for clarifying how changes in land use, climate and biodiversity affect ecological and evolutionary processes, and for managing urban plants to maximize ecosystem services. We performed a systematic literature review of relationships between urbanization and pathogens or pests of wild and cultivated plants. We identified k = 171 relationships from n = 54 studies in which pathogen or pest abundance was quantified in both urban and non-urban areas and summarized their distribution across taxa, geographic regions and directions and mechanisms of effects proposed by the authors. Most studies featured tree hosts and their arthropod pests or fungal pathogens. Grasses and forbs were the next most commonly studied hosts, followed by crops and shrubs. We then performed a meta-analysis limited to trees, which had the most studies with sufficient statistical information (k = 55 relationships, n = 14 studies). In that meta-analysis, we found no overall effect of urbanization on tree pest or pathogen abundance. However, there was a significant effect of pest/pathogen, with arthropod pests trending towards lower abundance in urban areas and fungal pathogens trending towards higher abundance. Drawing on literature from the broader fields of urban ecology, disease ecology and plant pathology, we synthesize our findings and offer insights into mechanisms by which urbanization influences disease and herbivory in wild and cultivated plants. We conclude by identifying research gaps, with the goal of informing management strategies that prioritize food security, environmental health and global biodiversity. This article is part of the theme issue ‘Wild plant pathosystems’.

PMID:42206332 | DOI:10.1098/rstb.2025.0111

Philos Trans R Soc Lond B Biol Sci. 2026 May 28;381(1951):20250110. doi: 10.1098/rstb.2025.0110.

ABSTRACT

Plant diseases occurring across wild and crop plants present modelling and management challenges. Wild plant and crop pathosystems differ in ecological structure, evolutionary dynamics and responsiveness to human intervention. At the interface, pathogens may spill over, spill back, persist or evolve, shaped by host diversity, dispersal processes and landscape connectivity. The potential importance of factors including pathogen dispersal, host life history and spatial configuration are examined through a qualitative comparison of case studies: Puccinia graminis, Phakopsora pachyrhizi, Xylella fastidiosa, Pyricularia oryzae Triticum lineage and Austropuccinia psidii. These examples illustrate how wild hosts may function as reservoirs, recombination partners or spillover targets, and how their role influences management efficacy and evolutionary risk. We explore the consequences of this wild-crop interface through two central questions: (i) how should plant diseases involving wild and cultivated pathosystems be managed, and (ii) what proportion of management effort should be allocated to each system? We show the principles underpinning answers to these questions via a conceptual framework based on a generic compartmental model incorporating asymmetric transmission and system-specific interventions, thereby accounting for key aspects of pathogen spread within and between wild host and crop populations. Finally, we identify critical data needs and modelling directions to better inform disease management on the wild plant-crop interface and argue for a more integrative approach bridging ecological and anthropogenic drivers of epidemics. This article is part of the theme issue ‘Wild plant pathosystems’.

PMID:42206329 | DOI:10.1098/rstb.2025.0110