JAMA Netw Open. 2026 Mar 2;9(3):e260623. doi: 10.1001/jamanetworkopen.2026.0623.
NO ABSTRACT
PMID:41784965 | DOI:10.1001/jamanetworkopen.2026.0623
Eur Arch Paediatr Dent. 2026 Mar 5. doi: 10.1007/s40368-026-01187-x. Online ahead of print.
ABSTRACT
OBJECTIVE: To assess the prevalence of molar incisor hypomineralisation (MIH) and investigate whether residual yellow-brown enamel opacities coexisting on the same tooth surface as clinically advanced MIH lesions are associated with severe clinical outcomes, including post-eruptive breakdown, atypical restorations, and atypical caries lesions.
METHODS: This cross-sectional study examined 680 schoolchildren aged 6 to 10 years from Bauru, Brazil, for MIH. Two trained and calibrated examiners performed the assessments using a modified version of the extended MIH index (MIH_e), which allows the simultaneous recording of multiple clinical features on the same tooth surface. Examinations were conducted under artificial lighting using school chairs, a mouth mirror, and a WHO probe. Descriptive statistics were used to report MIH prevalence and characteristics. Chi-square tests evaluated the association between the colour of residual demarcated opacities and the presence of post-eruptive breakdown, atypical restorations, and atypical caries lesions. The statistical significance level was 5%.
RESULTS: MIH was detected in 24.8% of the participants. The most frequently observed feature was yellow-brown demarcated opacity (45.5%), followed by white-creamy opacity (35.1%), post-eruptive breakdown (9.2%), atypical restorations (5.9%), and atypical caries lesions (5.3%). A statistically significant association (p < 0.05) was found between the colour of opacities and the presence of severe clinical outcomes, with yellow-brown opacities more commonly associated with them.
CONCLUSION: MIH prevalence in Bauru was high (24.7%). Yellow-brown residual opacities were statistically significantly associated with clinical severity, reinforcing their usefulness as indicators of more advanced MIH.
PMID:41784923 | DOI:10.1007/s40368-026-01187-x
Sports Med. 2026 Mar 5. doi: 10.1007/s40279-026-02403-w. Online ahead of print.
ABSTRACT
BACKGROUND: A cardiopulmonary exercise test (CPET) provides the estimated lactate threshold (θLT) and respiratory compensation point (RCP) through visual identification of multivariate gas exchange and ventilatory profiles. Artificial intelligence tools, such as deep neural networks, can learn, replicate, and classify these patterns and potentially aid in θLT and RCP identification, removing the subjectivity of threshold detection. This study evaluated a set of deep learning models (Oxynet) pre-trained with more than 1200 CPET files and tested its performance against visual inspection of experts.
METHODS: Evaluation included three phases: In phase I, 50 simulated ventilatory and gas exchange CPET files were generated, mixed with 50 authentic files, presented sequentially and in randomized order to three independent evaluators, and judged to be real or fake. In phase II, a new set of 50 files were generated, θLT and RCP were identified by both Oxynet and the consensus of three experts, and these estimates were compared with known values. In phase III, a subset of 163 CPETs were used to fine-tune Oxynet, and its evaluation of 50 independent authentic ramp CPET files were compared with those of the three experts.
RESULTS: Experts correctly discriminated simulated from authentic data in 44% of cases (phase I). One-way ANOVA revealed no main effect of identified (known vs Oxynet vs human evaluators) for both θLT (p = 0.41) and RCP (p = 0.39) with ~ zero effect size for both θLT (ω2 = 0.00) and RCP (ω2 = 0.00) (phase II). Using real ramp-incremental data (phase III), the fine-tuned Oxynet identified the at 1944 ± 401 and 2555 ± 602 mL min-1 for θLT and RCP, respectively. Expert evaluators identified these at 1900 ± 469 and 2581 ± 625 mL min-1 with mean between-method biases of 45 mL min-1 (p = 0.087) and – 26 mL min-1 (p = 0.118).
CONCLUSIONS: Oxynet can be used as an accurate, reliable, and objective tool to identify or aid in the identification of exercise thresholds from gas exchange and ventilatory CPET data in healthy individuals.
PMID:41784915 | DOI:10.1007/s40279-026-02403-w
Infect Dis Ther. 2026 Mar 5. doi: 10.1007/s40121-026-01310-x. Online ahead of print.
ABSTRACT
INTRODUCTION: The incidence of herpes zoster (HZ) is increasing globally. Despite the availability of a highly effective recombinant zoster vaccine (RZV), vaccination rates are still low in the United States, especially among racially and ethnically minoritized (REM) and socially vulnerable groups. There is an urgent need to identify obstacles to vaccination in these communities and develop effective strategies to increase confidence in the RZV.
METHODS: From August 2024 to December 2024, we conducted a community-based educational intervention in San Bernardino County, California, partnering with five churches in neighborhoods with high Centers for Disease Control and Prevention (CDC) Social Vulnerability Index scores. The intervention included a 45-min presentation on HZ, its complications, and RZV recommendations. Participants aged 18 + completed pre- and post-surveys to assess attitudes, knowledge, and behaviors. Descriptive statistics summarized outcomes, while a two-proportion Z-test and Fisher’s exact test evaluated changes in vaccine literacy.
RESULTS: A total of 156 individuals completed the pre-intervention survey, and 134 completed the post-intervention survey. All identified as REM, with 99% in vulnerable neighborhoods. Sixty-three percent had at least one co-morbid illness, and 46% had received info about HZ or RZV before the session. At baseline, 57% believed they were at risk of HZ, but 75% found the education session “extremely effective” in reassessing their risk. Significant improvements in vaccine literacy, especially regarding disease and age-based recommendations, were observed, with correct responses increasing post-intervention (p < 0.05). Following the intervention, 82% reported a high likelihood of receiving RZV, and 90% a high likelihood of recommending it.
CONCLUSIONS: This study demonstrates the feasibility and acceptability of a faith-based, community-led educational intervention to address barriers to RZV uptake among vulnerable REM populations. Using trusted community infrastructure can support equitable expansion of adult immunization programs to reduce preventable HZ disparities.
PMID:41784913 | DOI:10.1007/s40121-026-01310-x
Infection. 2026 Mar 5. doi: 10.1007/s15010-026-02757-3. Online ahead of print.
ABSTRACT
BACKGROUND: Candida endocarditis (CE) is a rare but highly lethal complication of candidemia, comprising 1-2% of infective endocarditis cases, yet associated with disproportionately high mortality. Large-scale contemporary data on predictors of in-hospital death remain limited.
METHODS: We conducted a retrospective cohort study using the National Inpatient Sample (2016-2022) to identify adult CE hospitalizations. Weighted descriptive statistics described the cohort, and multivariable logistic regression identified predictors of in-hospital mortality. Secondary outcomes included length of stay (LOS) and hospitalization costs.
RESULTS: Among 1280 CE hospitalizations, in-hospital mortality was 18.8%. Predictors of higher mortality included age 45-64 years (aOR 2.61; 95% CI 1.57-4.41) and ≥ 75 years (aOR 2.11; 95% CI 1.06-4.19), hematologic malignancy (aOR 33.5; 95% CI 12.3-101), surgical ventricular assist devices (aOR 45.7; 95% CI 8.25-284), femoral (aOR 12.9; 95% CI 4.78-36.0) or subclavian (aOR 22.4; 95% CI 5.65-82.7) central venous catheters, septic shock (aOR 9.47; 95% CI 6.21-14.8), embolic stroke (aOR 10.5; 95% CI 4.72-23.9), cardiogenic shock (aOR 3.69; 95% CI 1.61-8.51), and acute kidney injury (aOR 1.64; 95% CI 1.04-2.60). Valve intervention significantly reduced mortality (aOR 0.04; 95% CI 0.01-0.09). Non-survivors had longer hospital stays (median 24 vs. 19 days) and nearly double the hospitalization costs ($117,808 vs. $61,178).
CONCLUSIONS: In this nationally representative cohort, CE remained highly lethal, with age, malignancy, invasive devices, and critical complications driving mortality. Valve intervention conferred substantial survival benefit, underscoring the importance of early recognition, multidisciplinary care, and timely surgical evaluation.
PMID:41784858 | DOI:10.1007/s15010-026-02757-3
Clin Exp Med. 2026 Mar 5. doi: 10.1007/s10238-026-02096-5. Online ahead of print.
ABSTRACT
Knee osteoarthritis (KOA) is a leading cause of chronic pain and disability. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a systemic metabolic disorder that influences extra-hepatic conditions. Although cross-sectional studies link MAFLD to KOA, prospective evidence remains limited. This study aimed to investigate the longitudinal association between MAFLD, and KOA and assess the mediating role of inflammation. This study included 303,604 participants from the UK Biobank without baseline osteoarthritis. MAFLD was defined using the fatty liver index alongside metabolic criteria, fibrosis severity was assessed using the Fibrosis-4 score, and MAFLD subtypes were categorized. Incident KOA was identified through linked health records. Cox proportional hazard regression model was used to estimate hazard ratios (HR) and 95% confidence interval (CI) for the association. Mediation analysis evaluated the potential role of high-sensitivity C-reactive protein (hs-CRP). Over a median follow-up of 13.67 years, 17,137 KOA cases occurred. MAFLD was associated with an 18% higher risk of KOA (HR 1.18, 95% CI 1.13-1.24), with risk increasing by fibrosis severity (P for trend < 0.001). Among subtypes, MAFLD-overweight/obesity showed a significant association with KOA (HR 1.19, 95% CI 1.14-1.25), while MAFLD-diabetes (HR 1.05, 95% CI 0.96-1.16) and MAFLD-lean (HR 1.23, 95% CI 0.93-1.62) did not reach statistical significance. Additionally, hs-CRP explained 8.94% of the association between MAFLD and KOA. MAFLD was independently associated with higher KOA risk; inflammation partially mediates this association. These findings suggest MAFLD as a systemic metabolic condition affecting musculoskeletal health, supporting integrated management strategies.
PMID:41784857 | DOI:10.1007/s10238-026-02096-5
J Robot Surg. 2026 Mar 5;20(1):318. doi: 10.1007/s11701-026-03243-6.
NO ABSTRACT
PMID:41784855 | DOI:10.1007/s11701-026-03243-6
Int J Colorectal Dis. 2026 Mar 5;41(1):76. doi: 10.1007/s00384-026-05110-0.
ABSTRACT
PURPOSE: Magnetoelectric biofeedback therapy (MEBFT) is an emerging intervention for moderate rectocele-associated obstructed defecation syndrome (ODS); however, its efficacy and mechanisms remain unclear. This study compared MEBFT with conventional biofeedback therapy (BFT) and developed a 3D high-resolution anorectal manometry (HR-ARM)-based predictive model for clinical decision-making.
METHODS: In this prospective, single-blind, randomized controlled trial, 68 female patients with defecography-confirmed moderate rectocele-associated ODS were treated in the outpatient department of Tianjin Union Medical Center from January 2019 to June 2024). Patients were randomly assigned in a 1:1 ratio to either the MEBFT or BFT group. Primary outcomes included 3D HR-ARM parameters, Glazer surface electromyography, and patient-reported outcomes (Cleveland Clinic Constipation and Patient Assessment of Constipation Quality of Life scores) at baseline and 3 months. The secondary outcomes included predictive indicators derived from the Hosmer-Rothman model and treatment response stratification.
RESULTS: MEBFT significantly improved fast-twitch fiber recruitment, anorectal function, and quality of life compared to BFT (all P < 0.01). The Hosmer-Rothman model identified a negative MRP-MTV interaction (synergy index = 0.20), with the R11 phenotype (MRP < 80 mmHg-MTV < 135 cc) predicting an 82.35% response to MEBFT after 3 months of treatment (area under the curve [AUC] = 0.72). Phenotypic stratification-guided management: R11 for MEBFT, R00 (elevated MRP-MTV) for surgical evaluation, and R10/R01 for extended MEBFT with surgical backup.
CONCLUSIONS: MEBFT demonstrated superior clinical effectiveness, anorectal functional recovery, and quality of life compared with BFT after 3 months of treatment. The exploratory Hosmer-Rothman model may provided a moderate-accuracy phenotype-based approach using 3D HR-ARM parameters to stratify treatment response and optimize the individualized management of moderate rectocele-associated ODS.
TRIAL REGISTRATION: 1. Date of registration (needs to be before the Date of the First Patient): December 26, 2023. 2. Date of initial participant enrollment: January 9, 2019. 3. Clinical trial identification number: ChiCTR2300079173. 4. URL of the registration site: http://www.chictr.org.cn/.
PMID:41784838 | DOI:10.1007/s00384-026-05110-0
Amino Acids. 2026 Mar 5. doi: 10.1007/s00726-026-03507-3. Online ahead of print.
ABSTRACT
Amino acid metabolic (AAM) reprogramming is a key characteristic of gastric cancer (GC) cells metabolic remodeling, which regulates cell growth, survival, immune cell activation and function to affect tumor immune escape. This study aims to systematically investigate AAM reprogramming in gastric cancer (GC) and construct prognostic model, and validate gene signatures for predictive value and clinical decision-making. This study leveraged data from TCGA and GEO to construct a prognostic model related to AAM and assess its clinical relevance in GC. We identified differentially expressed genes and conducted GO, GSEA, and GSVA enrichment analyses, along with constructing PPI networks and interaction networks of mRNA-miRNA, mRNA-TF, and mRNA-RBP. Additionally, immune infiltration analysis was performed and the relationships between eight hub-type amino acid metabolism-related genes (AAMRGs) and immune cells was investigated using scRNA-seq datasets. Lastly, we validated the elevated expression of these eight genes in GC cells through PCR. The study constructed a prognostic model for GC based on AAMRGs, identifying 16 key genes: ACLY, ADH4, COL1A1, F2, GADL1, GAMT, HBB, KYNU, MRI1, MTHFR, NR1D1, PDK4, SLC1A7, SLC25A15, SLC52A3, and SYCE2. Statistical analysis showed that 14 of these genes showed significant differential expression between tumor and normal tissues. Furthermore, the model demonstrated strong correlations with OS outcomes. Immune infiltration analysis indicated that various immune cell types were significantly associated with the expression of 8 hub genes, highlighting their potential role in the tumor microenvironment and immune response modulation. Furthermore, elevated expression of these genes in GC cells was validated through PCR, highlighting their relevance as potential biomarkers and therapeutic targets. Our AAMRGs prognostic model reveals AAMRGs as independent prognostic factors for GC, highlighting their association with prognosis and immune cell infiltration. These findings provide important insights for improving survival outcomes and advancing immunotherapy strategies in GC.
PMID:41784817 | DOI:10.1007/s00726-026-03507-3
Wien Klin Wochenschr. 2026 Mar 5. doi: 10.1007/s00508-026-02722-y. Online ahead of print.
ABSTRACT
BACKGROUND: Emergency physician-staffed emergency medical services (EMS) in Austria frequently attend low priority calls, raising concerns about over-triage and future workforce sustainability.
OBJECTIVE: To quantify the proportion of emergency physician-attended calls that could have been managed by advanced emergency medical technicians (AEMT), with or without telemedical physician support, and evaluate current AEMT practice and training needs.
METHODS: This prospective, nationwide audit collected data from public physician-staffed EMS in Austria over a 24‑h period. Emergency physicians documented call characteristics, NACA (National Advisory Committee for Aeronautics) severity scores, AEMT presence, actual and potential EMT or AEMT interventions, accuracy of severity assessment and their judgement regarding the necessity of on-scene physician involvement.
RESULTS: Out of 149 physician-staffed EMS, 88 (59.1%) participated recording 313 calls and 273 emergency calls, 25 interhospital transfers and 15 telemedical emergency physician consultations were included. Emergency physicians assessed that 53.4% (95% confidence interval, CI 46.8-60.0%) of emergency calls and 48.0% (95% CI 28.4-67.6%) of interhospital transfers could have been managed by AEMTs. Approximately one third of these would have required telemedical physician support. The AEMTs arrived on the scene before emergency physicians in 75.1% of emergency calls and correctly assessed disease severity in 88.4% of cases and one or more additional interventions could have been set by AEMTs before emergency physician arrival in 48.0% of emergency calls. Most physicians supported expanding AEMT competencies and telemedical physician services.
CONCLUSION: The results of this nationwide audit suggest that more than half of emergency calls and interhospital transfers attended by emergency physicians in Austria could have been managed by AEMTs with or without telemedical emergency physician support.
PMID:41784793 | DOI:10.1007/s00508-026-02722-y