Tag: pubmed

Acta Odontol Scand. 2026 Jul 2;85:408-415. doi: 10.2340/aos.v85.46336.

ABSTRACT

OBJECTIVE: The objective of this study was to compare self-reported treatment preferences related to pulpectomy prior to prosthetic treatment, restoration selection for vital teeth, and impression-taking methods between Lithuanian general dentists (GDs) and prosthodontists (Ps).

MATERIAL AND METHODS: A questionnaire-based survey was conducted among 386 dentists in Lithuania, including GDs (62.4%) and Ps (37.6%). Data were analyzed using descriptive statistics and inferential tests (Chi-square and Fisher’s exact test), with a significance level of p < 0.05.

RESULTS: Most indications for pulpectomy were reported similarly by both groups; however, significant differences were observed for extensive coronal structure loss (> 50%) and deep caries, cervical lesions, gingival recession, short clinical crown, insufficient retention, enamel hypoplasia, and external root resorption (p < 0.05). Ps also more frequently reported using indirect restorations, including porcelain-fused-to-metal crowns, lithium disilicate ceramic inlays and onlays, and polymethyl methacrylate crowns. Conventional impressions were more common among GDs, whereas digital or combined workflows were more common among Ps.

CONCLUSIONS: Lithuanian GDs and Ps reported broadly similar preferences regarding preservation of tooth vitality, but differed in selected pulpectomy indications, restorative options, and impression-taking methods. These differences may reflect variation in specialist training, clinical experience, and access to prosthetic workflows.

PMID:42389859 | DOI:10.2340/aos.v85.46336

Haematologica. 2026 Jul 2. doi: 10.3324/haematol.2026.301126. Online ahead of print.

ABSTRACT

Oral decitabine/cedazuridine plus venetoclax offers a fully oral regimen for older or unfit patients with acute myeloid leukemia (AML). We previously reported outcomes from a phase II study; here we present extended follow-up of the frontline cohort. In this single-center phase II study, adults with AML ineligible for intensive induction received oral decitabine/cedazuridine (35 mg/100 mg, days 1-5) plus venetoclax in 28-day cycles. This analysis included newly diagnosed (ND) AML. Endpoints included overall response rate (ORR), overall survival (OS), relapse-free survival (RFS), duration of response (DOR) and safety. Outcomes were compared between de novo and secondary AML. Between March 2021, and January 2026, 68 patients were treated, including 32 de novo and 36 secondary AML; median age was 79 years. The cohort was high risk, with >50% ECOG ≥2, less favorable genomics and 16% prior hypomethylating agents exposure. ORR was 75% in de novo AML and 58% in secondary AML. Among responders, MRD negativity was 58% and 56%. With median follow-up of 32 months, median OS was 12.7 months (95% CI, 9.1-20.3) vs 7.2 months (95% CI, 3.6-29.9) (P = 0.61). Median RFS was 9.2 months vs 11.7 months (P = 0.56). No statistically significant differences were observed in survival, relapse or non-relapse mortality. Oral decitabine/cedazuridine plus venetoclax is an effective oral treatment for older or unfit patients with ND AML. Response rates were higher in de novo AML, while survival outcomes were not statistically significant. These findings highlight the need for improved therapeutic strategies particularly in secondary AML.

PMID:42389833 | DOI:10.3324/haematol.2026.301126

J Ultrasound Med. 2026 Jul 2. doi: 10.1002/jum.70356. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare the efficacy of microvascular flow imaging (MVFI) and ultrasound viscoelasticity imaging (UVI) in assessing renal allograft stability, and to evaluate their potential as noninvasive diagnostic tools for early dysfunction detection and biopsy guidance.

METHODS: A total of 61 renal transplant recipients (37 stable, 24 unstable) were ultimately included. All participants underwent conventional ultrasonography, MVFI, and UVI. Quantitative parameters included entire color pixel percentage (eCPP), cortical color pixel percentage (cCPP), and viscoelastic metrics (elasticity, viscosity, and dispersion). Group differences were assessed using appropriate statistical tests; correlations with estimated glomerular filtration rate (eGFR) and serum creatinine were evaluated; and receiver operating characteristic (ROC) curves were generated to assess diagnostic performance. Intra- and inter-observer consistency was calculated to ensure measurement reliability.

RESULTS: Significant differences in color pixel percentage and multiple cortical viscoelastic parameters (eg, mean elasticity and viscosity) were observed between stable and unstable groups (p < .05). cCPP correlated strongly with eGFR (r = 0.715, p < .001) and serum creatinine (r = -0.731, p < .001), whereas other viscoelastic metrics showed weaker correlations. ROC analysis revealed that cCPP had superior diagnostic accuracy compared to the combined viscoelastic model. Both modalities exhibited excellent reproducibility (ICC >0.87 for all parameters).

CONCLUSION: MVFI provides high diagnostic accuracy for distinguishing stable and unstable renal allografts (cCPP AUC = 0.95), outperforming UVI parameters. UVI provides complementary microstructural information, and combining MVFI and UVI may enhance noninvasive monitoring and optimize biopsy decision-making in renal transplant recipients.

PMID:42389817 | DOI:10.1002/jum.70356

Circ Arrhythm Electrophysiol. 2026 Jul 2:e014420. doi: 10.1161/CIRCEP.125.014420. Online ahead of print.

ABSTRACT

BACKGROUND: Current guidelines recommend regular screening for first-degree relatives of gene-elusive arrhythmogenic right ventricular cardiomyopathy (ARVC) patients using a similar regimen as for genotype-positive/phenotype-negative relatives. However, the multifactorial nature of gene-elusive ARVC may necessitate a different approach. This study aimed to determine the yield of cardiac screening in first-degree relatives of ARVC probands without a validated genetic cause.

METHODS: We included all first-degree relatives of probands who (1) met the 2010 Task Force Criteria, (2) underwent next-generation sequencing that included all genes with at least moderate evidence for ARVC causation per Clinical Genome Resource appraisal (validated ARVC genes), and (3) had no pathogenic/likely pathogenic (P/LP) variants identified in these genes. The primary and secondary end points were definite ARVC by the 2010 Task Force Criteria and ventricular arrhythmia, respectively.

RESULTS: We included 44 relatives (39.0 [22.3-45.8] years; 36% male) from 24 families. In 4 (17%) families, a P/LP variant was identified in a different cardiomyopathy/arrhythmia gene (SCN5A, LMNA, CDH2, FLNC). Overall, 10 (23%) relatives had definite ARVC at baseline evaluation. Of the 20 relatives without definite ARVC who had follow-up available, 8/20 (40%) relatives progressed to definite ARVC during 9.0 (5.8-14.4) years of follow-up. No statistical difference in the yield of baseline screening or serial evaluation between relatives from families with a P/LP variant and relatives from families without a P/LP variant was observed. Of the 27 relatives who had follow-up available, ventricular arrhythmia was observed in 2/27 (7%) relatives and occurred 6.3 and 13.8 years after definite ARVC diagnosis. Both of those relatives were from families without a P/LP variant.

CONCLUSIONS: These findings highlight the importance of managing first-degree relatives of ARVC probands without a validated genetic cause similarly to genotype-positive ARVC relatives. Furthermore, using a broad cardiomyopathy and arrhythmia gene panel in ARVC probands, rather than limiting testing to validated ARVC genes alone, is warranted.

PMID:42389803 | DOI:10.1161/CIRCEP.125.014420

Circ Popul Health Outcomes. 2026 Jul 2:e013687. doi: 10.1161/CIRCOUTCOMES.126.013687. Online ahead of print.

ABSTRACT

BACKGROUND: Previous studies showed that the Pooled Cohort Equations substantially overestimate atherosclerotic cardiovascular disease (ASCVD) risk in older adults, and the recently published PREVENT equation offers better performance. Identifying markers that can further refine risk estimates is essential for personalized prevention in this age group. This study evaluates the clinical utility of 6 markers for reclassifying intermediate-risk older adults (10-year PREVENT-estimated ASCVD risk, 7.5% to 20%), with a focus on de-escalation.

METHODS: This post hoc analysis evaluated intermediate-risk older adults aged ≥70 years using data from ASPREE (Aspirin in Reducing Events in the Elderly; URL: https://www.clinicaltrials.gov; Unique identifier: NCT01038583). ASPREE was a randomized trial of low-dose aspirin versus placebo in healthy older adults who were free of prior cardiovascular events at enrollment. Six markers were evaluated: the lowest quartile (Q1) of NT-proBNP (N-terminal pro-B-type natriuretic peptide), hs-TnI (high-sensitivity troponin I), and hs-CRP (high-sensitivity C-reactive protein), polygenic risk for lipoprotein(a) and polygenic risk for coronary artery disease, and absence of family history of ASCVD. Incident ASCVD events were adjudicated by expert panels. Statistical performance of each marker was assessed using diagnostic likelihood ratios, change in Harrell C statistic (ΔC), and net reclassification index relative to a baseline model incorporating variables included in the PREVENT equation.

RESULTS: The study included 7764 participants (48% female; median age, 74 years [interquartile range, 72-77]), with a median follow-up of 10.3 years. During follow-up, 725 participants (9.3%) experienced ASCVD events. Q1 polygenic risk for coronary artery disease was the most powerful marker for down-grading risk, providing 37% risk reduction (diagnostic likelihood ratio: 0.627) and improving discrimination (ΔC: +1.44%; P=0.004) when compared with the baseline model, and correctly reclassifying 25.9% of nonevents downward (net reclassification index: 0.101). Q1 hs-TnI showed second-best performance (diagnostic likelihood ratio: 0.727; ΔC: +0.71%, net reclassification index: 0.075).

CONCLUSIONS: Adding polygenic risk for coronary artery disease to the PREVENT equations may further personalize risk estimates and support clinical decision-making for older adults at intermediate risk for ASCVD events.

PMID:42389765 | DOI:10.1161/CIRCOUTCOMES.126.013687

Front Physiol. 2026 Jun 17;17:1854908. doi: 10.3389/fphys.2026.1854908. eCollection 2026.

ABSTRACT

INTRODUCTION: The glenohumeral joint plays a key role in force generation during tennis strokes. Neuromuscular adaptations in this joint are critical for performance and injury prevention, particularly during rapid phases of movement. However, there is limited research on these adaptations in young female tennis players. Therefore, this study aimed to examine differences in glenohumeral neuromuscular performance between female tennis players and untrained girls aged 11-14 years.

METHODS: A cross-sectional study included 67 participants: 33 female tennis players (aged 11-12 and 13-14) and 34 age-matched controls. Isometric peak torque (PKTQ), rate of torque development (RTD), and surface electromyography (SEMG) were assessed for internal (IR) and external (ER) rotation. A two-way ANOVA and MANOVA were used for statistical analysis.

RESULTS: Tennis players showed significantly higher normalized PKTQ during IR (18.1%, p < 0.01) and ER (10.1%, p < 0.05), and greater RTD during ER (absolute: 28.4%, p < 0.01; normalized: 32.2%, p < 0.01) compared to controls. A group-by-age interaction showed greater normalized peak RTD during ER in 11-12-year-old tennis players compared with their untrained counterparts. SEMG revealed greater posterior deltoid activation during ER at 50% MVIC (+15.7%, p < 0.05) and lower pectoralis major coactivation during ER at 50% MVIC (-40.4%, p < 0.01) in tennis players. Additionally, tennis players exhibited a higher IR/ER ratio (13.3%, p < 0.05).

CONCLUSIONS: Long-term tennis training may be associated with specific neuromuscular adaptations in the glenohumeral joint, particularly higher RTD during ER in younger athletes. These findings may be relevant to stroke velocity and shoulder stability and highlight the importance of age-specific training for the development of optimal glenohumeral strength and injury prevention.

PMID:42389756 | PMC:PMC13318655 | DOI:10.3389/fphys.2026.1854908

Parkinsons Dis. 2026 Jun 30;2026:1443255. doi: 10.1155/padi/1443255. eCollection 2026.

ABSTRACT

BACKGROUND: There is limited literature describing rehabilitation utilization among the Parkinson’s disease (PD) population across the world and especially in Africa, despite ample evidence and clinical guidelines in support of rehabilitation for persons with PD (PwPD).

OBJECTIVES: To describe the characteristics of PwPD, the types of rehabilitation services and treatment parameters used, and the factors associated with rehabilitation utilization in southern Ghana.

METHODS: A descriptive cross-sectional survey was conducted among PwPD receiving care at one primary and two tertiary hospitals selected from southern Ghana. The MDS-UPDRS Part III, PDQ-8, and modified ICF Checklist Clinician Form were used to assess motor function, health-related quality of life, and rehabilitation use. Descriptive and inferential statistics were conducted with significance set at p < 0.05.

RESULTS: Seventy-five PwPD were included, with 61.3% being males. Engagement in physiotherapy and/or gymnasium activities was reported by 40.0% of participants. The most common indication for physiotherapy was gait difficulties. No participant had used occupational therapy or speech therapy. Nonreferral by neurologists and participants’ poor knowledge of rehabilitation benefits and needs were the main reasons for nonuse of rehabilitation. Gait retraining and strengthening exercises were the most common physiotherapy interventions received by 73.7% of the participants. Longer PD duration was associated with physiotherapy utilization. A total of 42.4% of participants discontinued physiotherapy services, primarily due to transportation challenges and high treatment cost.

CONCLUSION: Rehabilitation services are underutilized by PwPD in southern Ghana due to limited referrals, poor awareness of benefits, and related barriers. This highlights the need for more accessible and integrated services.

PMID:42389742 | PMC:PMC13318674 | DOI:10.1155/padi/1443255

Bone Rep. 2026 Jun 22;30:101934. doi: 10.1016/j.bonr.2026.101934. eCollection 2026 Sep.

ABSTRACT

BACKGROUND: Concomitant use of vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) and bone resorption inhibitors (BRIs) may increase the risk of medication-related osteonecrosis of the jaw (MRONJ). The relative contribution of VEGFR-TKI, BRI type, and patient-related risk factors remains unclear.

METHODS: We retrospectively reviewed patients treated with BRIs, with or without concomitant VEGFR-TKIs. The primary endpoint was MRONJ-free survival, defined as time from BRI initiation to MRONJ diagnosis. Secondary endpoints included MRONJ incidence and skeletal-related events (SREs).

RESULTS: Overall, 233 patients received BRI/VEGFR-TKI combination (study group) and 986 received BRI alone (control group). Median MRONJ-free survival was shorter in the study group than in controls (79 vs 202 months). However, after adjustment for smoking status, age, sex, and BRI type, concomitant VEGFR-TKI use was not independently associated with MRONJ-free survival (HR 1.3, 95% CI 0.8-2.1; p = 0.2), whereas denosumab use and active smoking remained independent predictors. VEGFR-TKI therapy was associated with earlier MRONJ occurrence among BP-treated patients (adjusted HR 3.22, 95% CI 1.08-9.56; p = 0.03), but not among denosumab-treated patients. MRONJ-incidence did not differ between BRI/VEGFR-TKI and BRI groups (14.6% vs 12.0%; p = 0.3), but BRI-exposure was shorter in the combination group. SRE occurrence was 69.5%, similar between BP- and denosumab-treated patients; however, denosumab-treated patients had longer exposure, resulting in a lower SRE rate (0.13 vs 0.39 events/month).

CONCLUSION: MRONJ risk depends on BRI type and individual patient profile. VEGFR-TKIs may accelerate MRONJ onset in BP-treated patients, whereas denosumab showed higher MRONJ risk independently of VEGFR-TKI use. Treatment choices should balance MRONJ risk against skeletal disease burden.

PMID:42389736 | PMC:PMC13320502 | DOI:10.1016/j.bonr.2026.101934

Front Nutr. 2026 Jun 17;13:1865377. doi: 10.3389/fnut.2026.1865377. eCollection 2026.

ABSTRACT

BACKGROUND: The bladder health rehabilitation process depends on dietary choices and drinking patterns, which determine diet quality and hydration levels. Previous studies have suggested that dietary patterns and hydration levels affect urodynamic measurements, yet research on how combined dietary and fluid intake affects bladder rehabilitation outcomes remains limited.

OBJECTIVE: The study aims to assess the effects of dietary quality and fluid intake on urodynamic outcomes, symptom reduction, and functional recovery in patients undergoing a structured bladder rehabilitation program.

METHODOLOGY: The study tracked 2,400 bladder rehabilitation patients in a retrospective cohort study, which divided participants into three dietary quality groups (low, moderate, and high) and three fluid intake groups (low, moderate, and high). The study collected data on baseline demographics and clinical characteristics, as well as nutritional intake and urodynamic parameters. Post-rehabilitation outcomes included bladder capacity, detrusor pressure, compliance, urinary frequency, urgency, incontinence, nocturia, and quality-of-life (QoL) measures. The study analyzed nutrient-specific associations, diet-fluid interactions, and adherence rates. The researchers used multivariate regression analysis to determine which factors predicted functional improvement.

RESULTS: The post-rehabilitation study showed major urodynamic and symptomatic advancements, which included increased bladder capacity of 34 mL (p < 0.001) and decreased detrusor pressure of 3.4 mmHg (p = 0.002) and reduced urinary frequency of 1.3 episodes per day (p < 0.001) and improved quality of life by 5.8 points (p < 0.001). The study found that high diet quality, combined with moderate-to-high fluid intake, led to greater functional improvement, with both factors statistically significant (β = +0.21, p = 0.004; β = +0.18, p = 0.009). The combined high-diet and moderate-fluid groups achieved the best results, with improved bladder compliance, reduced urgency, and higher clinical success rates. The nutrient-specific analysis showed that fiber, potassium, and protein intake were positively associated with improvements in capacity and flow, whereas sodium and evening fluid timing were negatively associated.

CONCLUSION: The bladder rehabilitation process requires both dietary quality and fluid intake, as these factors determine functional improvement. The study found that optimizing nutrition, hydration, and compliance with behavioral interventions led to better urodynamic results, improved symptom management, and enhanced quality of life. The findings demonstrate that individual lifestyle-change methods are essential components of bladder rehabilitation programs.

PMID:42389697 | PMC:PMC13318740 | DOI:10.3389/fnut.2026.1865377

Front Vet Sci. 2026 Jun 17;13:1816115. doi: 10.3389/fvets.2026.1816115. eCollection 2026.

ABSTRACT

Artificial intelligence (AI), especially generative AI and large language models, is increasingly influencing higher education and health professions training. However, there is still limited empirical evidence about what veterinary students know about AI, how they use it, and how they perceive it. The aim of this study was to evaluate self-perceived AI-related knowledge, use, and attitudes among veterinary students in Spain and Portugal, and to analyze the influence of institutional context, prior AI training, and digital engagement. A cross-sectional survey was conducted during the 2023-2024 academic year with 340 undergraduate and postgraduate veterinary students from public and private institutions in Spain and Portugal. The questionnaire included sociodemographic questions and nine Likert-scale items assessing self-perceived AI knowledge, use, and attitudes. Composite scores were calculated and transformed using the Percentage of Maximum Possible (POMP) method (0-100 scale). Internal consistency of the instrument was high (ω = 0.842; α = 0.835). Data was analyzed using MANOVA, one-way ANOVA, independent samples t-tests, and Pearson correlation analyses. Significant differences were observed between institutions in self-perceived AI knowledge, use, and attitudes. Students who had received prior AI training showed higher self-perceived knowledge and use scores (p < 0.001) and more positive attitudes toward AI (p < 0.001). Although formal AI training was limited in many institutions, students with any type of prior exposure-self-directed, university-based, or external-reported greater engagement and felt more prepared to use AI tools. Daily social media use showed a small but statistically significant positive correlation with self-perceived AI knowledge and use (r = 0.115, p = 0.034) and with positive attitudes (r = 0.157, p = 0.004). Categorized analyses showed a gradual increase in AI-related outcomes with higher levels of digital engagement. Veterinary students in the Iberian Peninsula are already using AI, mainly through informal learning pathways, while structured institutional integration remains uneven. Structured exposure to AI is consistently associated with higher self-perceived knowledge, greater use, and more positive attitudes. These results suggest that deliberate curricular integration and guided AI literacy initiatives are important to prepare future veterinarians for responsible and effective use of AI technologies.

PMID:42389691 | PMC:PMC13318702 | DOI:10.3389/fvets.2026.1816115