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Journal of Dental Research

○ SAGE Publications

Preprints posted in the last 30 days, ranked by how well they match Journal of Dental Research's content profile, based on 13 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

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Performance of Contemporary Large Language Models on the National Prosthodontic Resident Examination: A Multi-Year Comparative Study

Chen, Y.-w.; Bhunyanaphakul, V.; Kosago, P.; Finkelman, M.; Lee, D. J.

2026-10-21 dentistry and oral medicine 10.64898/2026.10.19.26365937 medRxiv
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Purpose: To compare the performance of three large language models (LLMs), ChatGPT-o1, Grok 3, and Gemini 2.0 Pro, on the American College of Prosthodontists' National Prosthodontic Resident Examination (NPRE). Materials and Methods: Official NPRE examinations from years 2015-2024 were retrieved from the American College of Prosthodontists website and used to prompt each LLM. Paid access tiers and advanced reasoning were enabled. Responses from LLMs were recorded and compared against the official answer keys for accuracy, variability across years, and consistency of responses. Duplicate questions were retained for the primary analysis and removed in a sensitivity analysis. Accuracy (percent correct) was compared using generalized estimating equations binary logistic regression (primary); Cochran's Q with Bonferroni-adjusted McNemar tests (sensitivity). Year-to-year variability (SD of annual accuracy) was compared using weighted Levene tests. Consistency across duplicate items was quantified as the percentage of perfect matches and compared using Cochran's Q with Bonferroni-adjusted McNemar tests. Results: Across 1,487 questions, overall accuracy differed among models (global P < 0.001). ChatGPT-o1 achieved 78.4% correct, Grok 3 76.4%, and Gemini 2.0 Pro 73.2%; ChatGPT-o1 and Grok 3's accuracy significantly exceeded Gemini 2.0 Pro (both P [&le;] 0.016), with no significant difference between ChatGPT-o1 and Grok 3 (P = 0.099). After removing duplicates (n = 1,200), results were similar: ChatGPT-o1, Grok 3, and Gemini 2.0 Pro were 77.1%, 76.6%, and 71.5% correct, respectively; ChatGPT-o1 and Grok 3's accuracy was significantly higher than Gemini 2.0 Pro (both P < 0.001). Variability across years did not differ significantly (P [&ge;] 0.097). Grok 3 showed significantly higher perfect-match consistency (79.2%) than ChatGPT-o1 (69.4%) and Gemini 2.0 Pro (64.5%) (P [&le;] 0.010). Conclusions: Contemporary LLMs showed 70-80% accuracy on postgraduate prosthodontic multiple-choice content. While promising for educational support, residual error and inconsistency warrant human oversight and transparent methods reporting before curricular adoption.

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A Unified and Interpretable Geometric Optimization Framework for Intelligent Automated Implant Planning in CBCT from Single to Consecutive Multiple Missing Teeth

Zeng, Z.; Jiang, Y.; Li, J.; Cao, H.; Lu, Y.; Zhu, H.; Xiong, J.; Tang, Z.; Hu, N.; Ma, H.

2026-10-05 dentistry and oral medicine 10.64898/2026.10.03.26364640 medRxiv
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Automated dental implant planning using artificial intelligence (AI) faces challenges in interpretability, safety assurance, and applicability beyond single-tooth cases. This paper presents a unified explainable framework for cone-beam computed tomography (CBCT) that handles both single-tooth and consecutive multiple missing teeth. The method combines nnU-Net-based anatomical segmentation with a transparent geometric optimization pipeline. Implant placement is formulated as a lexicographic multi-objective constrained optimization problem that enforces clinical safety margins while balancing bone engagement, mesiodistal spacing, and buccolingual position. For multi-tooth cases, a global coordination strategy ensures inter-implant parallelism, minimum spacing, and a common insertion path. The framework was validated on 20 single-tooth and 9 consecutive multi-tooth cases. The AI plans achieved a centroid distance of 1.60+/-1.05 mm for single-tooth cases and 1.22+/-0.32 mm for multi-tooth cases, with approximately 7 degrees axial angle difference. All plans achieved 100% compliance with predefined safety thresholds. In a Turing-style test, experts were unable to distinguish AI from human intelligence (HI) plans under blinded conditions. By decoupling perception from reasoning and embedding clinical knowledge as explicit constraints, the framework offers an interpretable and clinically trustworthy solution for computer-aided implant dentistry.

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Extracellular matrix stiffness in oral squamous cell carcinoma: a systematic review and meta-analysis of associations with tumor progression and prognosis

Lima, I. F. P.; Toebe Silva, A. C.; Engler, A. J.; Bittencourt, L. d. S.; Lamers, M. L.

2026-10-05 dentistry and oral medicine 10.64898/2026.09.28.26363990 medRxiv
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Objective: To critically evaluate the influence of extracellular matrix stiffness on tumor progression, prognosis, and clinical implications in patients with oral squamous cell carcinoma. Design: This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and the protocol was registered in PROSPERO (CRD420251156429). Five databases (PubMed, Scopus, Embase, Web of Science, and OATD) were searched without restrictions on publication year or language. Human studies that evaluated extracellular matrix stiffness in oral squamous cell carcinoma, either as an assessment method or as a prognostic factor, were included; in vitro and animal studies were excluded. Results: Eight human studies involving 436 patients were included. Elastography was the most frequent measurement method, employed in four studies. Mean tumor thickness was reported in three studies and ranged from 3.0 to 4.4 mm. Extracellular matrix stiffness was expressed in various units (e.g., 37.7 gf, 23.5 kPa) and was consistently higher in tumor tissue than in normal mucosa in all studies. Three studies demonstrated a significant positive correlation between stiffness and tumor thickness. One study identified predictive cut-off values for lymph node metastasis and reported that high matrix stiffness was an independent predictor of worse overall survival (HR = 4.022; 95% CI: 1.294-12.495; p = 0.016) and recurrence-free survival (HR = 5.680; 95% CI: 1.146-28.143; p = 0.033). A meta-analysis of five studies (307 patients) showed a significantly higher standardized stiffness in oral squamous cell carcinoma compared with normal oral mucosa (standardized mean difference = 5.28; 95% CI: 2.61-7.94; p < 0.001), with substantial heterogeneity (I2= 98.6%). Conclusions: Extracellular matrix stiffness is elevated in oral squamous cell carcinoma and is associated with greater tumor thickness, lymph node metastasis and, in one study, worse survival. These findings support extracellular matrix stiffness as a potential biomechanical marker, pending further validation in standardized prospective studies.

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Attention Is All You Need: A Universal Augmented Reality Surgical Navigation Framework

Zhao, D.; Qiu, Y.; Guo, Y.; Luo, X.; Liu, Y.; Li, X.; Chen, H.; Cai, X.; Tian, T.

2026-09-25 dentistry and oral medicine 10.64898/2026.09.20.26363284 medRxiv
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Hard-tissue surgery requires precise spatial control, while conventional computer-assisted navigation presents guidance separately from the operative field. Augmented reality can bring navigation information closer to the surgeon, but how best to translate this information into intuitive intraoperative guidance remains underexplored. We therefore developed an augmented reality navigation system (ANS) that translates real-time deviations from the planned trajectory into co-located holographic action cues. Evaluation comprised typodont and ex vivo porcine experiments, a randomized crossover study in 40 dental trainees, and eight clinical cases. In porcine mandibles, ANS showed lower angular deviation than static and dynamic navigation (1.78 vs 6.42 and 4.02 degrees). Among trainees, accuracy was comparable with dynamic navigation, while workload was lower (29.18 vs 33.15), usability higher (73.13 vs 68.88), and visual-focus ratings improved (3.55 vs 2.28). Clinical cases supported feasibility. These findings support co-located action guidance as an alternative interface paradigm for surgical navigation.

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Investigating the oral and dental effects of nicotine pouches: findings from a patient and professional survey with in-person assessment.

Holliday, R.; Currie, C.; Jackson, J.; Allison, J.; Ash, E.; Lansdowne, N.; Basta, P.; Tapon, R.; Atkinson, N.; Fucile, A.; Padgett, E.; Warner, S.; Miluna-Meldere, S.; Crombie, L.; Toma, Z.; Nile, C.; Jakubovics, N.; Kist, R.; Robinson, M.

2026-10-05 dentistry and oral medicine 10.64898/2026.09.29.26364219 medRxiv
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Background: Nicotine pouches (NPs) are increasingly popular tobacco-free nicotine products, particularly among young people. Despite growing use, evidence regarding their oral health effects remains limited. Methods: We employed a mixed-methods approach comprising: (1) a national cross-sectional survey of NP users, (2) a survey of UK dental professionals, and (3) in-person clinical assessments of NP users. Survey data explored patterns of NP use, oral and dental side effects, and perceptions of risk. Clinical assessments included comprehensive oral examinations, periodontal assessments, and histopathological investigation of lesions where indicated. Results: A total of 3,659 NP users completed the public survey. Participants were predominantly male (89%) and aged 16-22 years (78%). Overall, 45% reported at least one oral or dental side effect. The most commonly reported effects were gingival recession (60%), burning sensations (41%), white patches (30%), and dry mouth (29%). Higher nicotine exposure was associated with increasing numbers of reported side effects. Among 126 dental professionals, oral lesions associated with NP use were commonly observed clinically, while only 17% reported seeing no oral or dental effects. Thirty-three NP users underwent in-person assessment. Ten lesions were biopsied; six demonstrated hyperkeratosis and four showed oral epithelial dysplasia (three mild, one moderate). All dysplastic lesions occurred at pouch placement sites. In two cases, clinical follow-up demonstrated partial or complete resolution of lesions following cessation of NP use. Periodontal assessments demonstrated generally low levels of periodontal disease and gingival recession across the cohort. Conclusions: Oral and dental side effects associated with NP use were commonly reported by users and observed by dental professionals. Histopathological assessment identified biopsy-confirmed oral epithelial dysplasia in lesions occurring at pouch placement sites, representing, to our knowledge, the first such report associated with NP use. Evidence of lesion improvement following discontinuation of use suggests that at least some NP-associated oral changes may be reversible. Although causality cannot be established, these findings highlight the need for vigilance among dental professionals and urgent longitudinal research to determine the incidence, progression, and reversibility of NP-associated oral lesions.

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Documented Dental Disease in Patients With Staphylococcus aureus Bacteremia

Ssentongo, P.; Peacock, W. F.; Durieux, J. C.; Colovos, C.

2026-10-20 dentistry and oral medicine 10.64898/2026.10.18.26365833 medRxiv
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Importance: Clinicians often look for a dental source in Staphylococcus aureus bacteremia (SAB), but how often dental disease is found, compared with other bacteremias, is unclear. Objective: To compare documented dental disease in adults with SAB, Escherichia coli bacteremia, and a general population cohort. Design, Setting, and Participants: Retrospective cohort study in the Protege database of 48 975 adults with bacteremia from January 1, 2015, through December 31, 2023, assigned by earliest in-window organism, and 81 945 general population adults. Exposures: SAB, with E coli bacteremia as the primary comparator and the general population as the secondary comparator. Main Outcomes and Measures: Documented dental disease from 7 days before through 30 days after index, defined by a qualifying dental procedure or disease-specific note text and adjusted for age, sex, race, and documentation intensity. Results: Dental disease occurred in 528 of 16 435 patients with SAB (3.21%) and 179 of 24 942 patients with E coli bacteremia (0.72%). The adjusted odds ratio was 3.86 (95% CI, 3.23 to 4.63). By the pathology-only definition, disease occurred in 517 patients with SAB (3.15%) and 399 general population patients (0.49%). The adjusted odds ratio was 3.71 (95% CI, 3.08 to 4.46). Within SAB, rates were highest with prior infective endocarditis (9.8%), opioid use disorder (6.2%), injection drug use (5.3%), and prosthetic valve (5.0%). Prevalence ranged from 0.49% in the general population to 7.98% in other streptococcal bacteremia. Of 437 patients with SAB and an assignable first finding date, 333 (76.2%) had the finding after the index date. Conclusions and Relevance: Dental disease was documented more often in SAB than in E coli bacteremia after adjustment. Most findings were first recorded after bacteremia was recognized, during SAB evaluation. These data do not show that dental disease caused the bacteremia.

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Dental Anxiety in Oral-Systemic Health: Empirical Evaluation of a Published Conceptual Model

Kajita, M.; Yada, A.; Ylostalo, P.; Pohjola, V.; Sipila, K.; Humphris, G.; Auvinen, J.; Lahti, S.

2026-09-28 dentistry and oral medicine 10.64898/2026.09.25.26364045 medRxiv
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Objectives: A previously published conceptual mapping review integrated fragmented evidence on dental anxiety (DA) into a broader conceptual model of potential causes and consequences. This study focused on consequences, extending from oral health-related behaviours through oral disease to systemic health, and empirically evaluated these hypothesized relationships on the population level. Methods: Cross-sectional data from the 46-year follow-up of the Northern Finland Birth Cohort 1966 (n = 1,859) were analysed using structural equation modelling. DA was modelled as a latent construct; delayed/problem-oriented dental attendance and home oral care as behavioural proxies; periodontal disease burden as the percentage of sites with probing pocket depth >=4 mm; and cardiovascular risk as a Framingham-based risk score. Generalized anxiety, sex, and education were covariates. Smoking-stratified multigroup analyses assessed model robustness. Results: The prespecified associations were observed across behavioural, periodontal, and systemic-risk domains. Higher DA was associated with more delayed/problem-oriented attendance and poorer home care; both were associated with greater periodontal disease burden, which in turn was associated with higher cardiovascular risk. Model fit was good (chi-square(119) = 529.98, CFI = 0.962, TLI = 0.951, RMSEA = 0.043, SRMR = 0.051). The overall association between DA and cardiovascular risk was small (beta = 0.066, p = .004), with a small decomposed indirect association (beta = 0.013, p = .006) and a remaining direct association (beta = 0.053, p = .022). Smoking-stratified multigroup comparisons found no differences in the structural associations by smoking status. Conclusions: This population-based evaluation provides preliminary empirical support for the conceptual model. Findings extend the relevance of DA beyond dental attendance and oral health outcomes to a broader oral-systemic public-health context. Cross-sectional data cannot establish temporal or causal ordering; longitudinal replication is needed.

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An investigation of dental-related emergency department presentations and patient characteristics in Victoria, Australia.

Adam, R.; Nguyen, J.; Keating, A.; Lin, C.; Nguyen, T. M.

2026-09-30 dentistry and oral medicine 10.64898/2026.09.24.26363871 medRxiv
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Objective Describe the profile of consumers utilising Emergency Departments (ED) across Victorian hospitals for dental conditions between financial year 2018-19 to 2022-23. Methods Dental conditions were grouped according to the diagnosis categories using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM). Presentations for non-dental conditions were classified as 'Other'. Dependent variables included age, sex, Aboriginal and Torres Strait Islander (Aboriginal) background, language other than English, interpreter required, remoteness, and socio-economic disadvantage according to the Index of Relative Socio-economic Disadvantage (IRSD). The primary outcome evaluated is the relative risk ratio (RRR) of having a hospital ED presentation for a dental condition compared to a non-dental condition and age-specific rates per 100,000 population. Multinomial logistic regression was performed following the backwards elimination method. Results Over the years 2018-19 to 2022-23, 0.55% (n=44,382) of ED presentations across Victorian hospitals by Victorian residents were due to dental conditions. Patients aged 20-44 years have the highest RRR compared to other age groups for dental-related ED presentations. Patients experiencing social inequity in terms of demographic factors such as Aboriginal background, requiring an interpreter, not living in a major city and living in areas of greater disadvantage (IRSD) have statistically significant increased RRR for dental-related ED presentations. Conclusion Patient characteristics were useful for identifying the relative risk of dental-related ED presentations between socio-economic and demographic groups to inform relevant public policy design focus on preventing dental-related ED.

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Multi-omic Characterization of the Oral Ecosystem and Assessment of Dental Health and Dental Hygiene Metadata in the Participants from a Large Randomized Double-Blinded Clinical Study

Moglowsky, H.; Ringold, S.; Jones, R.; Wall, N.; Gudjonsson, A.; Gravert, T.; Moll, J. M.; ODonnell, A.; Lee, K.; Stein, E.

2026-09-27 dentistry and oral medicine 10.64898/2026.09.24.26363963 medRxiv
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Increasing evidence highlights the important role the oral ecosystem plays in systemic health. Despite the fact that oral diseases affect nearly 3.5 billion people globally, our understanding of the precise drivers of these diseases remains limited. To bridge this gap and provide broader understanding of oral public health, a clinical study involving 595 participants 20-78 years of age was conducted over 8 weeks. Characterization of the oral ecosystem using metabolomics, metagenomics, and targeted immune markers were analyzed in conjunction with demographic, lifestyle, and medical history metadata. This comprehensive approach allowed for the identification of specific links between microbial and metabolic signatures and overall wellness, providing a contemporary baseline to enable the development of personalized prevention and treatment strategies to help safeguard oral and systemic public health.

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Peritumoral SULF1 Transcript Signal Is Associated with Disease-Specific Survival in Oral Squamous Cell Carcinoma

Furletti, G.; Guerrero, T. C.; Schrom, E.; Davidson, B.; Kallakury, B.; Goldman, R.

2026-10-12 pathology 10.64898/2026.10.09.26364914 medRxiv
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The prognostic relevance of peritumoral SULF1 transcript signal in oral squamous cell carcinoma (OSCC) is unclear. We assembled a retrospective cohort of 133 patients with 218 primary-site tissue-microarray cores; 131 patients had evaluable boundary features. Multiplex fluorescence imaging combined RNAscope SULF1, CK-pan, and DAPI. Tumor-stroma boundaries were annotated with the SULF1 channel hidden. We screened 50 exported boundary features across cumulative stromal bands of 35-300 um against recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS), with false-discovery-rate correction. The strongest DSS association was signal SD within 150 um (n = 107; 23 disease-specific deaths; HR = 2.20 per SD; 95% CI, 1.64-2.94; q = 2.1 x 10^-6). In 50 repeated 5-fold cross-validations with feature selection repeated within training folds, adding a boundary feature to AJCC stage increased mean held-out DSS c-index from 0.613 to 0.754 (delta C = +0.141; 2.5th-97.5th percentiles across repeats, +0.105 to +0.192). These percentiles describe split variability, not confidence intervals. The 150-um SD feature was selected in 39.2% of DSS training folds. The DSS association persisted after adjustment for mean signal, although the measurements were strongly correlated. Peritumoral SULF1 signal dispersion was associated with outcome beyond an ordinal AJCC-stage model; independent validation is required.

11
Evaluation of Human Norovirus Replication in Salivary Gland Cells

Harlow, J.; Briggs, S.; Pothier, E.; Pham, K.; Nasheri, N.

2026-10-01 microbiology 10.64898/2026.09.29.755260 medRxiv
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Human noroviruses (HuNoVs) are the most common cause of non-bacterial foodborne illnesses worldwide. HuNoVs are notoriously difficult to culture, and current cell culture systems, such as human intestinal enteroids have limitations in efficiency and scalability, which has limited their applications in food safety studies. Recently, it has been shown that transformed salivary gland cell lines (including NS-SV-TT-DC) allow for replication and passaging of norovirus GII.4. Herein, we examined whether we can independently observe viral replication in salivary gland cells and if other strains of human norovirus can replicate in these cells. For this purpose, we first evaluated the replication of several norovirus strains in NS-SV-TT-DC cells by either infecting them with vesicle-cloaked viruses or total viruses in stool filtrates. Low levels of viral replication was observed and vesicle isolation did not improve viral replication. Next, we screened for replication of 50 norovirus samples from 9 genotypes, and 14 isolates demonstrated over a two-fold viral replication. We observed that the initial viral load in the samples does not have a significant effect on replication efficiency. We were also able to passage several isolates. Subsequently, we examined whether interferon inhibitors such as Ruxolitinib, TPCA-1, and BX795 would improve viral replication and observed negligible effects. Finally we tested multiple supplements including MgCl2, bile salt, ceramide, and TAK-779. Most supplements had little or no effect on HuNoV replication in NS-SV-TT-DC cells. Bile salt and TAK-779 showed limited, genotype-specific benefits. Altogether these results indicate that salivary gland cells allow limited replication of certain HuNoV isolates.

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Experimental model of VZV reactivation reveals vaccine-induced mechanisms of protection against herpes zoster

Johnson, M. J.; Vu, T.; Ford, E. S.; Jing, L.; Jordan, K.; Brown, M.; Li, S.; Schedin, T.; Crotteau, M.; Canniff, J.; Bennett, A.; Weaver, N.; Laing, K. J.; Frietze, S.; Koelle, D. M.; Levin, M. J.; Weinberg, A.

2026-09-25 allergy and immunology 10.64898/2026.09.22.26363709 medRxiv
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Herpes zoster (HZ), caused by varicella zoster virus (VZV) reactivation, is common in older adults with declining cell-mediated immune protection. A modestly efficacious live attenuated (ZVL) and a highly efficacious recombinant adjuvanted (RZV) zoster vaccine protect against HZ. To uncover the mechanism(s) associated with the superior efficacy of RZV, we developed a controlled human infection model consisting of intradermal administration of attenuated vOka VZV to older adults previously vaccinated with RZV or ZVL. Infiltration of VZV-specific CD4+ and CD8+ T cell clonotypes at the infection site was quicker and higher in RZV than ZVL recipients [&ge;]5 years post-immunization due to the persistence of RZV-induced gE-reactive CD4+ and CD8+ T cell clonotypes in blood. High CD4+ cytotoxic T lymphocyte frequencies in blood on Day 1 post-inoculation predicted control of VZV replication. Persistence of circulating RZV-induced CD4+ and CD8+ CTL and rapid migration to sites of VZV replication are potential mechanisms underlying durable protection against HZ.

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A frameshift mutation in PRICKLE1 causes skeletal dysplasia in Cheviot sheep

Matika, O.; Davey, M. G.; del Pozo, J.; Finlayson, H. A.; Farquharson, C.; Headon, D. J.; Kijas, J. W.; McTeir, L.; Bathos-Samblas, C.; Watson, E.; Riggio, V.; Schoenebeck, J. J.; Schwarz, T.; Staines, K. A.; Pong-Wong, R.; Lu, Z. H.; Bishop, S. C.; Woolliams, J. A.; Archibald, A. L.

2026-10-09 genetics 10.64898/2026.10.07.757262 medRxiv
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Skeletal dysplasias can occur in animals, including humans, and are attributed to both environmental and genetic causes. As our understanding of the distinguishing phenotypes of different skeletal dysplasias improves, alongside elucidation of the mechanisms and genetic networks that contribute to skeletal development, identifying and controlling genetic mutations in livestock populations has become increasingly possible, including approaches beyond selective breeding alone. Within Scotland an 'achondroplasia' syndrome that was first described in the South Country Cheviot breed of sheep (OMIA 000004-9940), has continued to occur periodically within the same geographical locations, despite culling of affected lambs over many decades. Affected lambs exhibit rounded heads, short legs, a loss of hooves, abnormal stance and short twisted tails. As the condition has been observed in flocks and as progeny from specific ram and ewe matings, and cases have been co-twinned to normal siblings, this suggests a syndrome caused by a recessive genetic condition rather than environmental factors. Through homozygosity mapping and whole genome sequence analyses, we identified a 10 bp deletion in the open reading frame of the PRICKLE1 gene that encodes prickle planar cell polarity protein 1 and is essential for normal vertebrate embryonic development. We identified additional phenotypes present in affected lambs, including a loss of phalanges, neural tube defects, vertebral and articular chondrocyte defects, hair orientation differences and polycystic kidneys, consistent with a loss of PRICKLE1 function based on comparisons to mouse mutant lines. These findings enabled the development of a simple DNA test for the identified PRICKLE1 mutation that was made commercially available to facilitate the elimination of this genetic disease from sheep flocks.

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Macrophages from Holstein and Normande cows respond differently to Escherichia coli and Streptococcus uberis

Ferter, M.; Gitton, C.; Bamu, D. F.; Gaborit, M.; Germon, P.

2026-10-06 pathology 10.64898/2026.09.29.755538 medRxiv
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Macrophages, alongside mammary epithelial cells, are major contributors to the innate immune response triggered by bacterial invasion of the mammary gland. To investigate breed-specific immune mechanisms, we stimulated monocyte-derived macrophages from Holstein and Normande cattle with Escherichia coli and Streptococcus uberis, two major mastitis pathogens. We monitored bacterial survival using [methode] and profiled gene expression via RNA-seq. E. coli exhibited significantly higher survival 6 hours post-infection compared to S. uberis (p < 0.05). Moreover, E. coli induced a robust transcriptional response, with 4403 differentially expressed genes (FDR < 0.05, |log2FC| > 1), versus only 813 for S. uberis. Qualitative differences were also observed: genes such as CCL2 and CSF1 were uniquely induced by S. uberis. Additionally, macrophages from Holstein and Normande cattle showed distinct expression profiles: 185, 45, and 174 genes were differentially expressed at steady state or after E. coli or S. uberis stimulation, respectively. These genes were enriched in immune-related pathways. Overall, our results demonstrate a stronger response to E. coli, although S. uberis specifically induces a subset of genes. The observed breed-specific differences may reflect underlying immune mechanisms that could influence disease susceptibility, warranting further functional validation.

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Safety, usability, patient comfort, and exploratory biofilm outcomes of the superhydrophilic antifouling LubriShield(R) Foley catheter: a randomised controlled trial

Romero, A. I.; Madhusudhan, S.; Krishnakumar, M.; Sambasivam, R.; Surkov, S.; Wirsen, P.; Bergström, L.; Brookes, G.; Leire, K.; Andersson, J.

2026-10-05 urology 10.64898/2026.09.29.26364294 medRxiv
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Background: Indwelling urinary catheters can cause pain, urethral irritation and trauma and provide surfaces for microbial colonisation and biofilm formation. The LubriShield(R) Foley catheter incorporates a covalently bonded, superhydrophilic antifouling hydrogel designed to reduce surface friction and limit biofilm accumulation without releasing an antimicrobial agent. This study evaluated its safety and clinical performance compared with an uncoated silicone Foley catheter, including usability and patient comfort, and explored catheter-associated microbial colonisation and biofilm formation. Methods: This prospective, randomised, single-blind, single-centre controlled clinical investigation enrolled 33 adults requiring indwelling urinary catheterisation for 72 hours to 14 days. Participants received either the LubriShield(R) Foley catheter (n = 16) or an uncoated Sterimed all-silicone Foley catheter (n = 17). The primary endpoint was safety based on adverse-event reporting; the prespecified safety criterion was the absence of a serious adverse device effect in the LubriShield(R) group. Secondary endpoints included investigator-rated ease and functionality of catheter insertion and removal and participant-reported pain and irritation/discomfort assessed using 0-10 numerical rating scales. Urine microbiology, catheter colonisation and catheter-level biofilm measurements were exploratory endpoints. Analyses were performed in the as-treated population. Numerical rating scale outcomes were compared using two-sided Mann-Whitney U tests; exploratory biofilm analyses used permutation tests with bootstrap confidence intervals. Results: No serious adverse events or serious adverse device effects occurred. Nine non-serious adverse events were reported and resolved completely. At least one adverse event occurred in 4/16 (25.0%) participants in the LubriShield(R) group and 4/17 (23.5%) participants in the control group. The prespecified safety criterion, defined as the absence of a SADE in the LubriShield(R) group, was met. LubriShield(R) was rated more favourably for ease of insertion (p = 0.0096), functionality during insertion (p = 0.0051), ease of removal (p = 0.0037) and functionality during removal (p = 0.0085). Participants reported significantly less pain and irritation/discomfort during insertion, while the catheter was indwelling and during removal (all p < 0.05). Outcomes 7 {+/-} 1 days after catheter removal were similar between groups. Absolute biofilm biomass and bacterial and fungal loads did not differ significantly. In a post hoc exploratory normalised analysis, the biofilm-to-bacterial-load ratio was lower with LubriShield(R) (median 0.052 vs 0.080; permutation p = 0.043), although the bootstrap 95% confidence interval for the between-group difference included zero. Conclusions: The LubriShield(R) Foley catheter demonstrated a favourable short-term safety profile and was associated with improved investigator-rated usability and participant-reported comfort compared with an uncoated silicone Foley catheter. A post hoc exploratory analysis was compatible with reduced biofilm accumulation relative to bacterial load, but this finding is hypothesis-generating only and requires confirmation in larger, adequately powered studies with prespecified biofilm endpoints.

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Mapping the response of primary human chondrocytes to an osteoarthritis-relevant stimulus by single-cell RNA sequencing

Stuppy, S. R.; Shine, J.; D'Costa, S.; Fernandez Davila, J. G.; Yanke, A. B.; Loeser, R. F.; Burgess, J. D.; Phanstiel, D. H.; Diekman, B. O.

2026-09-29 genetics 10.64898/2026.09.24.754148 medRxiv
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Objective: To determine how fibronectin fragment (Fn-f), a matrikine that induces an osteoarthritis (OA)-like phenotype, reshapes chondrocyte states and transcriptional programs at single-cell resolution. Design: Primary human ankle chondrocytes from two cadaveric donors without OA were treated with PBS or purified recombinant Fn-f for 18 hours and profiled by single-cell RNA sequencing. Transcriptional states were characterized by marker genes and functional enrichment, compared with classifications used for OA chondrocytes, and evaluated for Fn-f-dependent changes in abundance and transcriptional programs. Results: Five transcriptionally distinct populations were identified with features that matched previous classifications of effector, inflammatory, pre-hypertrophic/fibrochondrocyte, reparative, and homeostatic chondrocytes. Fn-f markedly redistributed cells among these states, enriching inflammatory chondrocytes while reducing effector and reparative populations. Within transcriptional states, Fn-f differentially altered matrix/cartilage, inflammatory, and stress/immediate-early programs. These responses did not uniformly correspond to assigned subtype identities, demonstrating that transcriptional programs can be dynamically deployed across chondrocyte states. Conclusions: Controlled perturbations of healthy chondrocytes complement observational OA atlases by resolving stimulus-dependent changes in chondrocyte state abundance and transcriptional programs. Discordance between subtype annotations and dynamic functional programs further highlights the need for harmonized definitions of chondrocytes across phenotypic states.

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Islet size and spatial organization govern endocrine cell composition throughout the human pancreas

Dufault-Hunter, S. D.; Periwal, V.; Hara, M.

2026-10-08 pathology 10.64898/2026.10.01.756003 medRxiv
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Stem cell-derived (SC) islets hold promise as a transformative therapy for type 1 diabetes (T1D). To enhance graft uniformity, SC-islet organoids are often dissociated and reaggregated into standardized sizes. However, how endocrine cell composition varies with islet size in native human islets remains largely unknown. Defining this relationship is essential for establishing physiological benchmarks for islet engineering for transplantation. In this study, we examined the relationships among islet size, endocrine cell composition, and spatial distribution throughout whole pancreata from 10 age-matched, non-diabetic male subjects. Insulin-, glucagon-, and somatostatin-positive endocrine cells were identified as single-, double-, and triple-hormone populations ranging from non-islet single endocrine cells and small clusters (niSSCs) to large islets. Approximately 80% of the total endocrine area was contained in islets positive for all three hormones. Islet size strongly correlated with endocrine composition. Specifically, larger islets had increased alpha-cell fractions and reduced beta-cell fractions, while delta-cell fractions were consistent across sizes. Spatial analysis revealed that niSSCs, mono-, and tri-hormone islets frequently exhibit a clustered distribution. Additionally, tri-hormone islets were positioned near the core of the pancreas, whereas mono-somatostatin islets were often localized in the periphery. These findings were consistent across all three pancreatic regions (head, body and tail).

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Toll-like receptor expression across histological states of Epidermodysplasia Verruciformis

Froes Junior, L. A. R.; Pereira, C. C. d. A.; Silva, L. L. d. C.; Saldanha, M. G.; Pereira, N. V.; Pereira de Oliveira, W. R.; Sotto, M. N.

2026-10-04 pathology 10.64898/2026.09.29.755296 medRxiv
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Epidermodysplasia verruciformis (EV) is characterized by susceptibility to cutaneous {beta}-human papillomaviruses, persistent viral lesions and an increased risk of cutaneous squamous cell carcinoma (cSCC). We investigated whether expression of Toll-like receptors 3, 4, 5 and 9 (TLR3, TLR4, TLR5 and TLR9) differs across histological states within EV. Immunoreactivity was quantified by digital H-score using QuPath in 97 specimens from 28 patients, comprising 13 lesion-free skin samples, 15 flat warts and 69 cSCCs. Prespecified comparisons evaluated flat wart versus lesion-free skin, cSCC versus non-neoplastic tissue and invasive versus in situ cSCC, with invasive tumour differentiation assessed secondarily. Patient-clustered generalized estimating equations and false-discovery-rate (FDR) correction were used for inference. After correction for multiple testing, TLR9 H-scores were higher in flat warts than in lesion-free skin ({beta}=60.58; q=0.0332). Compared with non-neoplastic tissue, cSCC showed lower TLR3 ({beta}=-81.40; q=0.00745), higher TLR4 ({beta}=55.59; q=0.04793) and lower TLR9 expression ({beta}=-34.80; q=0.03412). TLR5 showed a nominal increase in cSCC that did not meet the FDR threshold. None of the four receptors differed significantly between invasive and in situ cSCC, and no differentiation trend remained significant after FDR correction. These findings show receptor-specific differences in TLR expression across histological states of EV, particularly involving TLR3, TLR4 and TLR9, although the diagnostic and prognostic significance of these tissue patterns remains to be established.

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Relative humidity differentially modulates decay of structurally distinct respiratory viruses in deposited human saliva particles

Olive, M.; Broemmel, Z.; Knight, S.; Rockey, N. C.

2026-09-24 microbiology 10.64898/2026.09.23.753914 medRxiv
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Respiratory viruses pose a major threat to human health. Environmental virus persistence in respiratory secretions is essential for successful spread, yet studies have focused largely on a select few viruses in non-physiological matrices. Here, we compared the stability of structurally distinct human respiratory viruses, adenovirus, influenza virus, and rhinovirus, in deposited particles of pooled human saliva under indoor-relevant relative humidity (RH) conditions. Adenovirus exhibited <2.2-log10 decay over 6 h regardless of RH, while rhinovirus exhibited significantly greater degradation (>3.8-log10, at 50% and 80% RH). Influenza virus showed minimal decay at 20% and 50% RH but degraded significantly more (3-log10) at 80% RH. To distinguish aspects of human saliva that are key determinants in driving virus decay, we recapitulated saliva composition using the inorganic solute and protein concentrations determined via ion-coupled plasma mass spectrometry and proteomics, respectively. Rhinovirus was significantly more stable in simulated saliva than in human saliva at 50% RH, while influenza virus and adenovirus behaved similarly in both matrices. These findings emphasize virus-specific environmental persistence and highlight limitations of relying on a single virus and particle matrix for defining public health strategies. Ultimately, these insights will contribute to approaches for mitigating environmental transmission of distinct respiratory pathogens.

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Generation of a transgenic cephalopod

Montague, T. G.; Gibbons, C. J.; Barlow, G. T.; Bashkirova, E. V.; Xu, Y.; Castagna, E. C.; Mungioli, T. J.; Patrick, K. A.; Nemes, A.; Varma, A.; Looger, L. L.; Albertin, C. B.; Lomvardas, S.; Axel, R.

2026-09-28 genetics 10.64898/2026.09.23.753964 medRxiv
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Coleoid cephalopods (cuttlefish, octopus, and squid) are marine mollusks with elaborate nervous systems that support a diverse repertoire of complex behaviors. These include the neural control of the color, pattern, and texture of the skin, facilitating both adaptive camouflage and innate patterning that may reflect internal state. The development of transgenic cephalopods expressing fluorescent proteins, optogenetic actuators, and reporters of neural activity would contribute a new and important technology to cephalopod biology. The generation of transgenic cephalopods, however, has remained a major challenge. Here, we report the development of stable transgenic dwarf cuttlefish (Ascarosepion bandense) expressing ubiquitous nuclear-localized mScarlet, a red fluorescent protein. We evaluated multiple strategies for transgenesis, and established cuttlefish lines using both CRISPR and the transposons Sleeping Beauty and Minos. The stable expression of transgenes enabled live imaging of cell dynamics during embryonic development. The Minos transposon emerged as the most efficient transgenesis strategy and is adaptable to promoters and transgenes of choice. These strategies now enable the generation of diverse genetic tools for mechanistic studies of cephalopod biology.