J Ultrasound Med. 2026 Jun 11. doi: 10.1002/jum.70331. Online ahead of print.
NO ABSTRACT
PMID:42277487 | DOI:10.1002/jum.70331
Doc Ophthalmol. 2026 Jun 12. doi: 10.1007/s10633-026-10117-7. Online ahead of print.
ABSTRACT
PURPOSE: To evaluate the impact of pharmacologic pupil dilation (PD) on biometric measurements and intraocular lens (IOL) power calculation using different generation formulas in patients undergoing cataract surgery.
METHODS: This prospective study included 126 eyes from 75 patients. Biometric data were obtained before and after pharmacologic dilation using the Anterion Swept-Source OCT biometer (Heidelberg Engineering). Parameters recorded included axial length (AL), mean keratometry (Km), anterior chamber depth (ACD), lens thickness (LT), and white-to-white (WTW) distance. IOL power was calculated using six formulas: SRK/T, Haigis, Barrett Universal II (BUII), Kane, Hoffer QST, and Okulix. Statistical comparisons of biometric values and predicted IOL power before and after dilation were conducted using mixed-effects models.
RESULTS: No significant changes were observed in AL, CCT, LT or Km after dilation. However, ACD, WTW distance and PD showed statistically significant increases (both p < 0.01). IOL power estimations based on SRK/T, Haigis, Hoffer QST, BUII and Kane were not significantly affected after dilation. In contrast, Okulix formulas demonstrated statistically significant variations in calculated IOL power post-dilation (p < 0.0001).
CONCLUSIONS: Pharmacologic pupil dilation induces changes in ACD and WTW measurements obtained using the Anterion Swept-Source biometer, thereby influencing IOL power estimation in formulas incorporating these parameters. Ray-tracing Okulix formula is more sensitive to dilation, whereas third-generation formulas remain more stable. Consistency in pupil status during biometry acquisition is essential to ensure refractive predictability.
PMID:42277479 | DOI:10.1007/s10633-026-10117-7
Langenbecks Arch Surg. 2026 Jun 11. doi: 10.1007/s00423-026-04102-6. Online ahead of print.
ABSTRACT
PURPOSE: Patients with primary unilateral indirect inguinal hernias and large internal inguinal rings have a higher incidence of seroma formation following laparoscopic transabdominal preperitoneal (TAPP) hernia repair. This study aims to investigate the clinical efficacy of suturing and closing the internal inguinal ring during the TAPP procedure to reduce the postoperative seroma rate.
METHODS: A retrospective analysis was conducted on the clinical data of 162 patients with primary unilateral indirect inguinal hernias and an internal ring defect diameter of ≥ 3.0 cm, who were treated at Kunshan First People’s Hospital from December 2023 to November 2024. All patients underwent the TAPP procedure with hernia sac transection. Based on whether the internal inguinal ring was sutured closed intraoperatively, patients were divided into two groups: an experimental group (internal ring closure, n = 81) and a control group (no internal ring closure, n = 81).The study compared the incidence of postoperative seromas, perioperative indicators (operative time, incision size, blood loss, length of hospital stay, etc.), and other related complications (postoperative pain, sensory abnormalities, infection, urinary retention, testicular edema, etc.) between the two groups, as well as short-term recurrence rates.
RESULTS: There were no statistically significant differences in the baseline characteristics between the two groups, and all surgeries were completed successfully. The incidence of seroma in the experimental group at 7 days and 1 month postoperatively was significantly lower than in the control group [8.64% (7/81) vs. 28.40% (23/81), P = 0.002; and 2.47% (2/81) vs. 13.58% (11/81), P = 0.018, respectively]. Regarding severity (Morales-Conde classification), the experimental group recorded 5 Grade I and 2 Grade II cases, with zero Grade III events; whereas the control group observed 12 Grade I, 8 Grade II, and 3 Grade III events. There were no significant differences in seroma incidence between the two groups at 3 months and 6 months postoperatively (P > 0.05). The operative time for the experimental group [(63.67 ± 9.26) min] was slightly longer than that of the control group [(60.21 ± 10.23) min] (t = 2.255, P = 0.025). There were no statistically significant differences in other perioperative indicators, other related complications, or short-term recurrence rates between the two groups (P > 0.05).
CONCLUSION: For primary unilateral indirect inguinal hernias with an internal ring defect diameter of ≥ 3.0 cm, suturing and closing the internal ring defect during the TAPP procedure was associated with a lower rate of seroma formation.
PMID:42277471 | DOI:10.1007/s00423-026-04102-6
Support Care Cancer. 2026 Jun 11;34(7):644. doi: 10.1007/s00520-026-10841-5.
ABSTRACT
BACKGROUND: Chemotherapy-induced neutropenia (CIN) is the most common type of myelosuppression in patients undergoing chemotherapy. It can lead to chemotherapy dose reduction, treatment delays, diminished antitumor efficacy, reduced quality of life, and increased healthcare burden. Although various guidelines have been established domestically and internationally to standardize the management of CIN, their effectiveness in controlling its incidence remains limited.
PURPOSE: This study aimed to evaluate the role of a standardized management pathway in the management of CIN and its impact on chemotherapy-related adverse events and satisfaction among gynecological cancer patients.
METHODS: A total of 230 patients receiving conventional management from July to December 2024 were selected as the control group, while 230 patients managed under the CIN standardized pathway from January to June 2025 were enrolled as the intervention group. The CIN standardized management pathway integrated functions such as febrile neutropenia (FN) risk calculation, visual risk stratification alerts, intelligent decision support for prophylactic medication, multi-approach health education, and cloud-based follow-up. Comparisons were made between the two groups regarding hematological toxicity markers (ANC, WBC), incidence of chemotherapy-related adverse events (FN, chemotherapy delay, and dose reduction), FN risk assessment compliance rate, and patient satisfaction.
RESULTS: After three chemotherapy cycles, unadjusted comparisons showed more favorable ANC and WBC distributions in the intervention group than in the control group (all P < 0.001). However, adjusted analyses did not show statistically significant associations with grade 3-4 ANC reduction or grade 3-4 WBC reduction. The FN risk-assessment compliance rate reached 100% in the intervention group, higher than the 54.6% observed in the control group (P < 0.001). The observed incidence of FN was lower in the intervention group than in the control group (1.4% vs. 8.3%; P = 0.002), although FN was analyzed descriptively. The intervention was associated with lower adjusted odds of chemotherapy delay and dose reduction and with higher adjusted patient satisfaction scores.
CONCLUSION: The standardized CIN management pathway was associated with favorable changes in hematologic toxicity indicators, chemotherapy-related adverse events, and patient satisfaction. Further multicenter randomized or cluster-randomized studies are needed to confirm these findings.
PMID:42277458 | DOI:10.1007/s00520-026-10841-5
Aesthetic Plast Surg. 2026 Jun 11. doi: 10.1007/s00266-026-05959-0. Online ahead of print.
ABSTRACT
BACKGROUND: Labiaplasty has experienced growing popularity, with over 10,800 procedures performed annually in the USA. Discussions about this surgery are shifting to social media, particularly TikTok, where health information is often presented with limited regulation or oversight. This raises concerns about the accuracy, quality, and influence of labiaplasty-related content.
METHODS: We conducted a cross-sectional observational study analyzing the 110 most relevant TikTok videos under the term “labiaplasty” (July-August 2025). Video characteristics, engagement metrics (likes, shares, comments), and creator types were recorded. Content quality was assessed using the Global Quality Scale (GQS) by human reviewers and an AI model (ChatGPT-4.5-turbo). Sentiment analysis of video comments was performed by two human raters and the AI model. Statistical analyses included Wilcoxon signed-rank and Mann-Whitney U tests.
RESULTS: Surgeons (52%) and patients (40%) produced most videos, primarily on educational (39%) or postoperative (28%) content. Overall, median human-rated GQS was 3.5 [IQR, 2.13-4.88], while the AI median was 3 [IQR, 2-4]. Videos with ≥2000 likes were more often created by patients (52% vs. 32%, p=0.012) and had significantly lower GQS scores (human: 2.5 vs. 4, p=0.003; AI: 2 vs. 3, p<0.001). Human inter-rater reliability for sentiment classification was slight (κ=0.161), with minimal agreement between AI and humans (κ=0.077).
CONCLUSION: Labiaplasty content on TikTok is predominantly generated by surgeons and patients, yet lower-quality videos achieve higher engagement. Surgeons should proactively create accurate, relatable content to counterbalance misinformation. Refinement of AI tools is needed for reliable quality and sentiment assessment on social media.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
PMID:42277420 | DOI:10.1007/s00266-026-05959-0
Sci Rep. 2026 Jun 11. doi: 10.1038/s41598-026-57779-6. Online ahead of print.
ABSTRACT
This study analyzes panel data from 31 provinces in China spanning 2013 to 2022, employing the entropy value approach and the coupling coordination degree model to assess the coupling coordination level between intangible cultural heritage and rural development. Data sourced from the China Cultural Heritage and Tourism Statistical Yearbook, the National Bureau of Statistics of China, and other official data. This study analyzes the dynamic development and spatial relationship between the two with the help of the Moran’s I index, kernel density estimation, and Markov chains. Second, using the variable indicators of both as targets, a random forest model was employed to predict the results. Stability recommendations were derived by altering the number of seeds and splitting the training set. The results indicate the following: (1) Analysis of the coupling model reveals that the coordination level between intangible cultural heritage and rural development exhibits a high degree of alignment. Spatially, the results show a pattern of “higher in the east, lower in the west, with central and northeastern regions in between” across provinces. (2) The Moran’s I index indicates stable spatial hierarchy, though it also generates mobility similar to other adjacent tiers. (3) The kernel density model shows narrowing and widening states after peaking in 2022, revealing a trend of diminishing differentiation. (4) The random forest analysis demonstrates that intangible cultural heritage inheritors rank first in density metrics. Both indicators will continue to show positive growth, albeit at high speeds with slow development margins.
PMID:42277411 | DOI:10.1038/s41598-026-57779-6
Sci Rep. 2026 Jun 11. doi: 10.1038/s41598-026-57682-0. Online ahead of print.
ABSTRACT
Automated ICD-10-CM coding is critical for hospital reimbursement under Diagnosis-Related Group (DRG) payment systems, yet standard metrics weight all errors equally. This study evaluated 11 models on MIMIC-IV under heterogeneous conditions (the full 7942-code space, top-50 self-trained baselines, and 200-admission zero-shot LLM samples) and proposed two revenue-sensitive metrics: the Revenue Sensitivity Index (RSI) and Coding Reimbursement Score (CRS). Performance was compared across US Medicare Severity DRG (MS-DRG) and Taiwan DRG (Tw-DRG) systems, with five human-AI review strategies simulated. PLM-ICD achieved the highest micro-averaged F1 (0.5934), while open-source zero-shot LLMs performed markedly worse in this exploratory comparison. A 26.5% CRS gap separated the best and worst fine-tuned models. Rankings were identical under both DRG schemes (Spearman ρ = 1.00), indicating stability under a tiered Tw-DRG approximation (93.9% coverage), not the official grouper. At a 20% review rate, revenue-targeted prioritization achieved 43.2% CRS reduction versus 20.0% for random sampling, reaching 91% of the oracle bound. Revenue-aware evaluation captures financially meaningful differences missed by standard metrics, and revenue-guided human-AI collaboration emerges as a candidate deployment framework requiring prospective validation.
PMID:42277410 | DOI:10.1038/s41598-026-57682-0
Hypertens Res. 2026 Jun 11. doi: 10.1038/s41440-026-02707-4. Online ahead of print.
ABSTRACT
Prior research has established a positive correlation between blood pressure (BP) and ischemic stroke in the general population; however, this association has not been investigated in dementia patients. A population-based cohort of 73,130 individuals with newly diagnosed dementia who underwent a Korean national health checkup after diagnosis was followed up until the end of 2019. Individuals were classified according to their systolic (SBP) and diastolic BP (DBP) during health checkups. Multivariable Cox proportional hazards regression was performed, calculating the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident ischemic stroke. During a mean follow-up of 3.6 years, 4446 (6.1%) patients developed ischemic stroke. In all-cause dementia patients, the risk of ischemic stroke increased after SBP/DBP exceeded 130/90 mmHg compared with SBP 120-129 mmHg and DBP 70-79 mmHg (reference) (both P for trend <0.001). Similar trends were observed in patients with Alzheimer’s disease and vascular dementia. In particular, SBP/DBP ≥ 140/90 mmHg and SBP 100-109 mmHg were associated with incrementally higher risks of ischemic stroke and a decreased risk of Alzheimer’s disease, respectively (both P for trend <0.001). The positive linear association of SBP and DBP with ischemic stroke in all-cause dementia remained after stratification by sex and antihypertensive medication use, and the association between SBP and ischemic stroke was greater among younger individuals (40-79 years old). In conclusion, both SBP and DBP showed positive linear relationships with the risk of incident ischemic stroke in dementia patients. Achievement of the target BP may be important for stroke prevention in individuals with dementia.
PMID:42277407 | DOI:10.1038/s41440-026-02707-4
Ir J Med Sci. 2026 Jun 12. doi: 10.1007/s11845-026-04482-0. Online ahead of print.
ABSTRACT
BACKGROUND: Prostate cancer (PCa) diagnosis relies heavily on PSA screening, which suffers from low specificity, leading to unnecessary biopsies and overdiagnosis. Distinguishing PCa from benign prostatic hyperplasia (BPH) remains a significant clinical challenge. Extracellular vesicles (EVs) protect molecular cargo, such as microRNAs (miRNAs), from degradation and reflect the physiological state of their parental cells. Given their stability and accessibility in biological fluids, EV-associated miRNAs represent ideal liquid biopsy candidates to overcome the limitations of current diagnostic markers and improve risk stratification.
AIMS: This study investigated the potential of a specific plasma EV-derived miRNA panel (miR-16, miR-141, miR-10b, miR-373, miR-409, miR-34a, miR-205, miR-145, and miR-550a) to differentiate between healthy controls, BPH, localized PCa (LPCa), and metastatic PCa (MPCa).
METHODS: Plasma EVs were isolated using a precipitation-based method, followed by total RNA extraction. EV-derived miRNA expression profiles were quantified via qRT-PCR. Statistical analyses were performed to compare expression levels across clinical groups and to assess their diagnostic potential.
RESULTS: Significant differential expression was observed for EV-derived miR-141, miR-10b, and miR-550a. miR-141 was significantly downregulated in BPH and LPCa compared to healthy controls (p < 0.05). Notably, EV-derived miR-10b and miR-550a levels were significantly lower in the MPCa group compared to BPH. When comparing all PCa cases (LPCa+MPCa) against non-cancerous groups (BPH+Control), EV-derived miR-10b and miR-550a were significantly downregulated, while miR-16 showed upregulation in the cancer cohort.
CONCLUSION: Our findings demonstrate that specific plasma EV-derived miRNA signatures can distinguish prostate pathologies and disease stages. These results suggest that EV-derived miR-10b, miR-141, miR-16 and miR-550a hold promise as non-invasive biomarkers for differentiating PCa from BPH, potentially reducing overdiagnosis and informing clinical management.
PMID:42277406 | DOI:10.1007/s11845-026-04482-0
J Magn Reson Imaging. 2026 Jun 11. doi: 10.1002/jmri.70377. Online ahead of print.
ABSTRACT
BACKGROUND: Muscle mass decline, associated with strength decline, is a hallmark of aging. Yet, strength decline greatly exceeds mass decline. This indicates that aspects of muscle quality and architecture-not reflected by mass-also influence force generating capacity. Additionally, shape modeling enables analysis of the shape variations of muscles beyond size.
PURPOSE: To predict muscle strength using muscle features beyond muscle quantity.
STUDY TYPE: Retrospective cross-sectional study.
POPULATION: Twenty-four healthy subjects normally distributed over an age range between 30 and 79 years old with a balanced sex distribution (12 female).
FIELD STRENGTH/SEQUENCE: 3 T MRI using multi-echo Dixon and Stejskal-Tanner DTI.
ASSESSMENT: Shape-only and shape + architecture models were generated using water-only and DTI images of the quadriceps. Multiple linear mixed-effects models were produced using (1) volume, (2) shape-only, and (3) shape + architecture. Volume was not added to the shape-only and shape + architecture models. Features reaching statistical significance within the models were retained for further analysis. Models’ performance was evaluated using leave-one-subject-out (LOSO) cross-validation (CV).
STATISTICAL TESTS: Pairwise, subject-level bootstrapping comparison was conducted and ∆R2 and ∆RMSE with 95% confidence interval (CI) were calculated. The improvement was considered statistically significant when both ∆R2 and ∆RMSE are positive and the 95% CI did not contain zero. Positive ∆R2 and ∆RMSE indicate an increase in R2 and a decrease in RMSE values.
RESULTS: Shape-only features demonstrated an improvement in the model performance compared to muscle volume. Models were significantly improved for the vastus lateralis to predict eccentric torque-∆R2 = 0.16 (0.01-0.29), ∆RMSE = 5.0 (0.4-9.7); and for the vastus intermedius predicting isometric torque-∆R2 = 0.19 (0.02-0.36), ∆RMSE = 6.5 (0.7-12.0). Shape + architecture features did not significantly improve the performance (all p ≥ 0.131).
DATA CONCLUSION: Shape-only models are promising to quantify variations of muscle shape related to force production, and have the potential to develop imaging-based biomarkers for muscle strength in diseases.
EVIDENCE LEVEL: 3.
TECHNICAL EFFICACY: Stage 2.
PMID:42277391 | DOI:10.1002/jmri.70377