Tag: pubmed

BMC Pediatr. 2026 Jun 27. doi: 10.1186/s12887-026-07197-4. Online ahead of print.

ABSTRACT

BACKGROUND: Non-allergic rhinitis syndrome (NAR) is a chronic rhinitis characterized by the significant absence of an allergy history, negative skin prick test results, and normal serum IgE levels. Nasal cytology is a valuable diagnostic method that enables qualitative and quantitative assessment of inflammatory cells – including eosinophils, neutrophils, mast cells, and lymphocytes – in the nasal mucosa. This study aimed to evaluate the levels of nasal eosinophilia in a pediatric NAR population and to evaluate the correlation of this local inflammatory biomarker with clinical severity scales such as ARIA and PRQLQ.

METHODS: This prospective, cross-sectional study included 103 children aged 5-18 years: 53 with NAR and 50 healthy controls. Symptom duration and severity were classified according to ARIA 2019 criteria. The Paediatric Rhinitis Quality of Life Questionnaire (PRQLQ) was used for quality of life assessment. Nasal cytology specimens were collected by nasal swab from the middle meatus and the eosinophil percentage was calculated by counting a total of 100 cells in the area of highest cell density.

RESULTS: A total of 103 children were enrolled: 53 NAR patients and 50 healthy controls. Median age was 10 (8-13) years in the study group and 11 (8-14) years in the control group. Family history of allergy was significantly higher in the study group (30.2%) compared to controls (12.0%) (p = 0.024). Median nasal eosinophil level was 7.0 (3.5-15.5) in the study group and 0 (0-3.0) in controls; the difference was statistically significant (p < 0.001). The nasal eosinophil cut-off value was determined as 3.5%. No significant difference was found between nasal eosinophil groups (< 3.5% and ≥ 3.5%) and any PRQLQ subscale or total score (p > 0.05).

CONCLUSIONS: Nasal cytology may serve as a simple, non-invasive diagnostic tool to identify NAR subtypes and to determine clinical severity in pediatric patients.

PMID:42365301 | DOI:10.1186/s12887-026-07197-4

BMC Oral Health. 2026 Jun 27. doi: 10.1186/s12903-026-08999-9. Online ahead of print.

ABSTRACT

BACKGROUND: Dental caries is a highly prevalent chronic childhood condition, yet longitudinal evidence linking early oral hygiene behaviours to long-term outcomes remains limited. This study estimated whether twice-daily toothbrushing at age 2-3 years was associated with lower incident dental caries through adolescence, under a target trial emulation framework.

METHODS: Data were from the Longitudinal Study of Australian Children (LSAC) B-cohort (N = 5,107). Children with caries at or before Wave 2 (age 2-3) were excluded, yielding an incident sample of 2,970. Associations were estimated using multivariable logistic regression, propensity score matching, inverse probability of treatment weighting (IPTW), targeted maximum likelihood estimation (TMLE), and g-computation. The outcome was carer-reported dental caries. Confounders were identified via directed acyclic graph (DAG) analysis. Effect modification by area-level socioeconomic position (SEP) was assessed through a pre-specified equity analysis.

RESULTS: Among 2,941 children in the analytic sample, 1,559 (53.0%) developed carer-reported caries by age 14-15. Caries incidence was lower among children who brushed twice daily: 660 of 1,359 (48.6%) versus 899 of 1,582 (56.8%) in the less frequent group. The primary adjusted odds ratio (aOR) was 0.73 (95% CI: 0.63-0.85, p < 0.001). A dose-response gradient was observed (p-trend < 0.001). Effect estimates were similar across analytical approaches (OR range: 0.72-0.75). In non-disadvantaged areas, protective associations were observed (aOR = 0.65, 95% CI: 0.54-0.79). In disadvantaged areas, the association was weaker and not statistically significant (aOR = 0.91, 95% CI: 0.71-1.17; interaction p = 0.035). An exploratory falsification analysis using dental pain yielded a null result (aOR = 1.06, 95% CI: 0.91-1.23, p = 0.47), but this outcome was interpreted cautiously because dental pain may lie downstream of caries.

CONCLUSIONS: Twice-daily toothbrushing by age 2-3 years was associated with a lower risk of incident adolescent caries. Estimates from multiple causal inference approaches were consistent with an absolute risk reduction of approximately 8% points (NNT ≈ 13), under assumptions of no unmeasured confounding, adequate positivity, and correct model specification. Protective associations appeared concentrated in non-disadvantaged areas, suggesting that oral hygiene promotion should be combined with broader preventive strategies addressing structural determinants of oral health.

PMID:42365300 | DOI:10.1186/s12903-026-08999-9

Subst Abuse Treat Prev Policy. 2026 Jun 27. doi: 10.1186/s13011-026-00742-5. Online ahead of print.

ABSTRACT

BACKGROUND: Substance Use Disorder represents a complex global public health challenge, yet the effectiveness of treatment centers remains debated due to lack of consensus on standardized international indicators and heterogeneity of treatment modalities. This systematic review aimed to identify and synthesize key international indicators for measuring treatment success, compare effectiveness of different modalities, and assess impact on social reintegration.

METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Population, Intervention, Comparison, Outcome frameworks, we conducted systematic searches of PubMed, Scopus, Web of Science, and Cochrane Library. Two reviewers independently screened 4,234 records, extracted data from 28 included studies, and assessed quality using Cochrane Risk of Bias 2 and Newcastle-Ottawa Scale. Heterogeneity was quantified using I-squared and tau-squared statistics.

RESULTS: Core indicators emerged in three domains: physiological (abstinence, daily functioning), psychological (reduced anxiety/depression, craving reduction), and social (employment, family relations). Medication-Assisted Treatment with methadone and buprenorphine demonstrated consistent effectiveness in reducing substance use and preventing relapse. Psychosocial interventions, particularly Cognitive Behavioral Therapy and Mindfulness-Based Relapse Prevention, significantly enhanced quality of life. Integrated models combining pharmacological and psychosocial approaches outperformed single-modality treatments. However, 78.6% of studies originated from four high-income countries, and only 17.9% reported outcomes beyond 12 months.

CONCLUSIONS: Effective Substance Use Disorder treatment requires integrated models with standardized, multidimensional outcome indicators. Future research must prioritize long-term outcomes and address the substantial evidence gap in low- and middle-income countries.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42365295 | DOI:10.1186/s13011-026-00742-5

BMC Med Educ. 2026 Jun 27. doi: 10.1186/s12909-026-09811-6. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare professionals other than dietitians are widely perceived as credible sources of nutrition information by patients, despite many of these professionals having received limited nutrition training. Little is known about where healthcare professionals obtain nutrition information and how reliance on various sources of nutrition information relates to their self-perceived nutrition competence. This study aimed to investigate the association between the frequency of accessing nutrition information from evidence-based and non-evidence-based sources and healthcare professionals’ self-perceived nutrition competence.

METHODS: A cross-sectional online survey was conducted using a questionnaire adapted from the NUTrition COMPetence (NUTCOMP) tool. Independent variables included self-reported frequencies of accessing various nutrition information sources in the preceding 30 days, measured by Likert-scale questions. The primary outcome was self-perceived nutrition competence assessed by NUTCOMP scores. A robust linear regression model was created to evaluate associations between NUTCOMP scores and frequencies of accessing different nutrition information sources, adjusting for age, sex, profession, education level, workplace, and previous nutrition education. The statistical significance level was set at 0.05.

RESULTS: A total of 450 healthcare professionals working in healthcare facilities across China were enrolled, including 302 (67.11%) nurses and 124 (27.56%) doctors. The median NUTCOMP score was 120 (interquartile range 102-141). The most popular information sources were colleagues (n = 293), social media (n = 222), and professional websites (n = 121). More frequent access to nutrition information from colleagues (β = 3.75, p < 0.001), friends or family members (β = 2.71, p = 0.02), and academic webinars or continuing education (β = 3.92, p = 0.002) were significantly associated with higher NUTCOMP scores.

CONCLUSIONS: Healthcare professionals in China frequently accessed nutrition information from both evidence-based and non-evidence-based sources. Frequencies of accessing nutrition information from colleagues, friends or family members, and academic webinars or continuing education were positively associated with self-perceived nutrition competence. The association observed with non-evidence-based sources highlights the need to better understand how information-seeking behaviors influence professional confidence and clinical practice. Future research is needed to develop strategies to strengthen evidence-based nutrition information sharing that may enhance nutrition competence.

PMID:42365293 | DOI:10.1186/s12909-026-09811-6

Health Qual Life Outcomes. 2026 Jun 27. doi: 10.1186/s12955-026-02565-1. Online ahead of print.

ABSTRACT

BACKGROUND: Although visual impairment (VI) is known to affect children’s development, there is limited evidence on how VI influences health-related quality of life (HRQoL) among children in Ghana. This study aimed to assess the relationship between childhood VI and HRQoL.

METHODS: A cross-sectional study was conducted among children aged 2 to 18 years in selected districts of the Ashanti Region, Ghana. Comprehensive ocular assessments including visual acuity (VA), refraction, and anterior and posterior segment evaluations were performed. Health-related quality of life was measured using the PedsQL 4.0 across physical, emotional, social, and school functioning domains. Data were analyzed using descriptive statistics, independent-sample t-tests, and linear regression.

RESULTS: A total of 581 children participated (mean ± SD age: 8.64 ± 4.00 years), with females representing 53.0% of the sample. Both child-reported and parent-reported scores showed significantly reduced HRQoL among children with VI across all PedsQL domains compared with children without VI, with school (p < 0.001) and emotional (p = 0.005) functions of child-reported showing statistical significance. Presenting VI was a significant predictor of poor overall HRQoL in both simple (β= -10.351, p < 0.001) and multiple linear regression models (β= -5.650, p = 0.016). No significant associations (p > 0.05) were found between HRQoL and sociodemographic variables, including sex, age, ethnicity, work status, and health insurance.

CONCLUSIONS: Childhood VI is associated with substantial reductions in multiple dimensions of HRQoL. These findings underscore the need to strengthen early detection, clinical management, and school-based vision support services to improve pediatric eye care in Ghana.

PMID:42365291 | DOI:10.1186/s12955-026-02565-1

BMC Oral Health. 2026 Jun 27. doi: 10.1186/s12903-026-08978-0. Online ahead of print.

ABSTRACT

BACKGROUND: Sufficient information is not available regarding the selection of ideal post and core types or the preferred method to access the subgingival margin to achieve optimal marginal integrity in the reconstruction of teeth with deep cervical lesions. This study aimed to evaluate how the position of the finish line and different post and core types, combined with deep marginal elevation (DME) and crown lengthening (CL) procedures, affect the marginal integrity of monolithic zirconia crowns in endodontically treated premolars.

METHODS: In the present laboratory experiment, 60 endodontically treated maxillary first premolars were assigned to six groups (n = 10): composite core supported by prefabricated fiber post (FP/CC) with DME (FP/CC-DME), composite core reinforced with polyethylene fiber (PEF/CC) with DME (PEF/CC-DME), cast post and core (CPC) with DME (CPC-DME), FP/CC-CL, PEF/CC-CL, and CPC-CL. Marginal integrity was assessed at the TheraCem-core, core-tooth, TheraCem-dentin, and TheraCem-enamel interfaces. Data were analyzed statistically (α = 0.05).

RESULTS: In the DME approach, the lowest marginal integrity was noted at the TheraCem-core and core-tooth interfaces in the CPC group, followed by FP/CC and PEF/CC (P < 0.05). In the CL approach, there was no significant variation among the groups (P > 0.05). With FP/CC, TheraCem-core, core-tooth, and TheraCem-dentin interfaces showed comparable marginal integrity (P > 0.05). With PEF/CC, the least marginal integrity was recorded at the TheraCem-dentin interface, followed by the TheraCem-core and core-tooth interfaces. With CPC, the TheraCem-core and core-tooth interfaces showed lower marginal integrity than dentin (P < 0.05).

CONCLUSIONS: The type of post and core significantly affected the marginal integrity in the DME approach (PEF/CC > FP/CC > CPC) but not in the CL approach. DME, compared with CL, increased the marginal integrity with PEF/CC, decreased the marginal integrity with CPC, and did not affect the marginal integrity with FP/CC.

PMID:42365290 | DOI:10.1186/s12903-026-08978-0

Pregnancy Hypertens. 2026 Jun 27;45:101490. doi: 10.1016/j.preghy.2026.101490. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify latent trajectories of blood pressure throughout pregnancy and evaluate their associations with body mass index (BMI), physical fitness (estimated via oxygen uptake), and serum relaxin levels in a cohort of healthy pregnant women.

STUDY DESIGN: Prospective inception cohort study. Group-based trajectory modelling was used to characterize systolic and diastolic blood pressure patterns across gestation. Multiple logistic regression analyses were conducted to identify predictors of trajectory group membership.

MAIN OUTCOME MEASURES: Longitudinal trajectories of systolic and diastolic blood pressure during pregnancy.

RESULTS: A total of 492 women were included in early pregnancy. Three distinct and stable trajectories were identified for both systolic and diastolic blood pressure. Nulliparous women and those with BMI >25 kg/m² had significantly increased odds of belonging to the highest blood pressure trajectory group (adjusted odds ratio [aOR] 2.47; 95% CI: 1.58-3.86 and aOR 1.61: 95% CI 1.04-2.49), respectively). No significant associations were observed between trajectory group membership and maternal age, physical fitness, or early-pregnancy serum relaxin concentrations.

CONCLUSIONS: Early pregnancy blood pressure may serve as a clinically relevant marker for gestational hypertension risk. Women with lower baseline readings may require less frequent antenatal monitoring, whereas those with elevated initial values could benefit from closer surveillance. Nulliparity and overweight status were associated with higher blood pressure trajectories, highlighting their relevance in antenatal risk stratification. Physical fitness and relaxin levels did not demonstrate predictive value in this context.

PMID:42364312 | DOI:10.1016/j.preghy.2026.101490

J Electrocardiol. 2026 Jun 25;98:154400. doi: 10.1016/j.jelectrocard.2026.154400. Online ahead of print.

ABSTRACT

Sudden cardiac arrest (SCA) remains a leading cause of mortality, accounting for 300,000-400,000 deaths annually in the United States. Despite advances in device therapy, current approaches to risk stratification remain limited in both sensitivity and specificity. This reflects a broader challenge in medicine: predicting low-incidence, high-consequence events, where traditional statistical frameworks often fail to achieve meaningful clinical utility. In this review, SCA is examined as a model problem highlighting key conceptual and methodological challenges, including class imbalance, heterogeneity of mechanisms, ambiguity in defining cases and controls, and temporal variability in risk. Electrocardiography (ECG) is emphasized as a scalable modality capable of capturing important components of the substrate-trigger-autonomic triad. However, existing ECG-based markers have not translated into robust clinical tools and recent machine learning approaches have not yet overcome this translational gap. We argue that the central translational gap is not the absence of stronger predictors, but insufficient specification of the clinical decisions, target populations, and performance thresholds against which model utility should be evaluated. Within this framework, ECG feature selection should be matched to the mechanistic target: depolarization markers index structural substrate, repolarization markers capture dynamic electrical instability, and autonomic markers reflect modulatory state, each operating on distinct timescales. Population decomposition into mechanistically coherent subproblems, rather than pursuit of a single overarching prediction model, is likely to accelerate both performance and clinical translation. Lessons learned from SCA may extend broadly to other high-impact, low-frequency conditions in medicine.

PMID:42364311 | DOI:10.1016/j.jelectrocard.2026.154400

Prev Vet Med. 2026 Jun 27;254:106947. doi: 10.1016/j.prevetmed.2026.106947. Online ahead of print.

ABSTRACT

Bovine astrovirus (BoAstV) has been frequently detected in the feces of bovine calves irrespective of presence or absence of diarrhea. However, information on its epidemiological determinants, such as associations with host-level factors, diarrhea, age or species susceptibility, and farm-level factors such as housing, feed, disinfection, and weaning, remains limited. The present study aimed to identify potential animal- and farm-level risk factors associated with BoAstV and animal-level risk factors for diarrhea in cattle and buffalo calves. A total of 134 rectal swab samples (67 from diarrheic and 67 from healthy animals) were collected from 44 dairy farms in 13 districts in northern India. Data on farm management and animal health practices were obtained from farm owners using structured questionnaires. Of the screened calves, 23.1% were positive for BoAstV, and 34% of the farms were positive for BoAstV. Statistical analysis indicated a higher BoAstV detection in dewormed calves (34.9%) than in non-dewormed calves (12%), identifying this as a statistically significant risk factor (p < 0.05). Dairy farms that practiced early weaning had a statistically higher occurrence of BoAstV (66.7%) than those that did not (28.9%) (p < 0.05). This study found no association between the presence of BoAstV and diarrhea (p > 0.05). Furthermore, no significant associations were identified between age, sex, species, housing type, feeding practices, vaccination, or disinfection methods. When comparing the occurrence of diarrhea in bovine calves, age was identified as a potential risk factor (P < 0.05); however, the presence of diarrhea was not influenced by sex, species, or deworming status. These findings emphasize that BoAstV may circulate subclinically within dairy herds of North India, with deworming identified as a significant risk factor for viral presence. The findings support a multifactorial etiology of calf diarrhea involving complex interactions between management practices and multiple enteric pathogens.

PMID:42364303 | DOI:10.1016/j.prevetmed.2026.106947

Drug Alcohol Depend. 2026 Jun 24;286:113238. doi: 10.1016/j.drugalcdep.2026.113238. Online ahead of print.

ABSTRACT

BACKGROUND: The association between cultural identity and substance use varies across studies, highlighting the need to quantify this relationship and identify sources of variability. This meta-analysis quantified the relationship between cultural identity and substance use among North American Indigenous youth, tested potential moderators, and described measurement approaches and tribal nation representation.

METHOD: A systematic literature search identified 18 studies reporting a quantifiable association between cultural identity and substance use with samples of at least 75% Indigenous youth between the ages of 10 and 20 years. Random effects models were used to calculate pooled effect sizes (Pearson’s r), and meta-regressions assessed for potential moderating effects of age, sex, measurement approach, and living on a reservation.

RESULTS: Overall, there was no significant pooled association between cultural identity and substance use in Indigenous youth (r = -0.003, p = .86). Effects were similar across alcohol, tobacco, and cannabis. However, heterogeneity was high (I²=72%), and funnel plot asymmetry suggested possible publication bias (p = .04). Age, sex, living on a reservation, and measurement approach did not moderate the overall effect (p’s > .49). Tribal affiliation was largely not reported.

CONCLUSIONS: This is the first meta-analysis to quantify the association between cultural identity and substance use among Indigenous youth. Although the overall pooled association was not statistically significant, this likely reflects limitations in how cultural identity is operationalized within quantitative research, leaving the question as to how cultural identity may impact substance use among Indigenous youth as of yet unanswered. Identifying which components of cultural identity are most relevant for Indigenous youth substance use will yield a better understanding of this relationship to inform the development of culturally sensitive interventions.

PMID:42364285 | DOI:10.1016/j.drugalcdep.2026.113238