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Evaluating the prognostic value of mutational signatures in small-cell lung cancer through reference-based signature assignment and continuous activity analysis

Front Genet. 2026 Jul 20;17:1776578. doi: 10.3389/fgene.2026.1776578. eCollection 2026.

ABSTRACT

BACKGROUND: Small-cell lung cancer (SCLC) is an aggressive malignancy with poor survival outcomes. Biomarkers that reliably capture tumor mutational burden (TMB), tumor immunogenicity, and prognosis could substantially improve clinical stratification. Prior studies have suggested that mutational signatures, including single-base substitution (SBS) 4 and 13, may be associated with TMB and survival in SCLC. We therefore evaluated these relationships using complementary analytical approaches.

METHODS: We evaluated associations among mutational signatures, TMB, and overall survival in a dataset examined in a prior study and an independent external cohort. To improve reproducibility and interpretability, we performed reference-based mutational signature assignment and analyzed signature activity, primarily as a continuous variable, while also evaluating binary stratifications using fixed thresholds. Signature-TMB relationships were assessed using continuous regression models, and associations with overall survival were evaluated pooling all clinically annotated samples using Kaplan-Meier analysis and Cox-proportional-hazards modeling.

RESULTS: Across both cohorts, SBS4 activity was positively associated with TMB, whereas SBS13 showed no consistent relationship with TMB. Neither SBS4 nor SBS13 was a statistically significant predictor of overall survival.

CONCLUSION: Our study clarifies the prognostic and immunogenomic relevance of SBS4 and SBS13 in SCLC and shows that analytical choices materially influence inference. Reference-based signature assignment provided a comprehensive, computationally efficient, and stable framework, while continuous measures of signature activity yielded more reliable inferences than arbitrary thresholds. These findings support more rigorous evaluation of mutational signatures and TMB as biomarkers in SCLC.

PMID:42544366 | PMC:PMC13429233 | DOI:10.3389/fgene.2026.1776578

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Corynebacterium in Granulomatous Mastitis: Clinical Features and Treatment Outcomes

Infect Dis Clin Microbiol. 2026 Jul 28;8(4):339-350. doi: 10.36519/idcm.2026.1044. eCollection 2026 Jul.

ABSTRACT

OBJECTIVE: Granulomatous mastitis (GM) is a chronic inflammatory breast disease with a heterogeneous clinical presentation and uncertain optimal management. Increasing evidence suggests a role for Corynebacterium species, particularly Corynebacterium kroppenstedtii, in its pathogenesis. This study aimed to evaluate the clinical characteristics, treatment strategies, and outcomes of granulomatous mastitis, with particular emphasis on cases associated with Corynebacterium species and the impact of antibiotic therapy.

MATERIALS AND METHODS: This retrospective cohort study included female patients with GM treated at a university hospital between January 2018 and January 2023. Patients were grouped according to Corynebacterium isolation. Clinical characteristics, microbiological findings, and treatment modalities-oral steroids, combined antibiotic-steroid therapy, antibiotics with intralesional steroids, and segmental mastectomy-were evaluated. The impact of lipophilic antibiotics (tetracyclines, linezolid, rifampin) combined with steroids was assessed. Recurrence rates and associated factors, including symptom duration, were -analyzed.

RESULTS: A total of 165 patients were included in the study, of whom 25 tested positive and 140 negative. Corynebacterium spp. were detected in 15.15% of cases, with C. kroppenstedtii identified in 8.48%. Patients with Corynebacterium-associated GM had more extensive abscess formation and required more interventional procedures. Multimodal treatment strategies combining steroids, antibiotics, and surgery resulted in favorable outcomes. Lipophilic antibiotics combined with steroids showed a positive but statistically non-significant effect. Recurrence occurred in 16.4% of patients and was associated with longer symptom duration.

CONCLUSION: Accurate microbiological identification is essential in GM, particularly in C. kroppenstedtii infections, to guide targeted antibiotic therapy and reduce recurrence. Tailored management strategies, including lipophilic antibiotics, may improve outcomes. Further studies are needed to define optimal treatment duration and the role of surgery in refractory GM.

GRAPHICAL ABSTRACT: Graphical Abstract.

PMID:42544365 | PMC:PMC13429223 | DOI:10.36519/idcm.2026.1044

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Fecal Incontinence as a Marker of Multisystem Cardiopulmonary-Kidney Disease and Mortality in US Adults: : A Nationally Representative Cohort Study

Dela J Public Health. 2026 Jul 31;12(3):101-107. doi: 10.32481/djph.2026.07.17. eCollection 2026 Jul.

ABSTRACT

OBJECTIVE: To determine whether fecal incontinence is associated with cardiovascular, pulmonary, and kidney disease, individually and in combination, and with all-cause mortality among community-dwelling US adults.

METHODS: Nationally representative cohort study using the National Health and Nutrition Examination Survey (NHANES) 2005-2010 with linkage to the National Death Index through December 31, 2019. The analytic cohort comprised 14,731 adults aged 20 years or older, with 14,718 eligible for mortality analysis. Fecal incontinence, defined as accidental leakage of mucus, liquid stool, or solid stool during the prior 30 days. A composite cardiopulmonary-kidney (CPK) burden was calculated as the count of three affected systems: cardiovascular disease (self-report), pulmonary disease (current asthma, emphysema, or chronic bronchitis), and kidney disease markers (estimated glomerular filtration rate <60 mL/min/1.73 m², urine albumin-creatinine ratio ≥30 mg/g, or self-reported kidney disease). Multisystem CPK burden was defined as ≥2 affected systems.

Survey-weighted prevalence ratios (PRs) for each cardiopulmonary-kidney outcome from modified Poisson regression and hazard ratios (HRs) for all-cause mortality from Cox proportional hazards models, with sequential adjustment for sociodemographic, cardiometabolic, and shared functional/mood/urinary factors.

RESULTS: Among 14,731 adults (weighted mean age 46.8 years; 51.2% women), the weighted prevalence of fecal incontinence was 8.4% (95% CI, 7.8%-9.0%). Adults with fecal incontinence were nearly a decade older than those without (mean age 55.6 vs 46.0 years) and had higher prevalences of urinary incontinence (62.0% vs 32.6%), depressive symptoms (17.4% vs 6.2%), and functional limitation (30.3% vs 13.8%) (all P<.001). After full adjustment, fecal incontinence remained associated with kidney disease markers (PR, 1.16; 95% CI, 1.02-1.32) and with simultaneous involvement of all three CPK systems (PR, 2.38; 95% CI, 1.47-3.86). During follow-up, 2,395 deaths occurred. Crude mortality was 80.8 per 1,000 person-years among adults with both fecal incontinence and multisystem CPK burden, versus 10.6 in adults with neither. After adjustment, multisystem CPK burden alone (HR, 1.80; 95% CI, 1.58-2.04) and combined fecal incontinence plus burden (HR, 2.14; 95% CI, 1.66-2.77) predicted mortality. Fecal incontinence alone did not (HR, 1.06; 95% CI, 0.87-1.28). With multisystem CPK burden as the reference, the combined group did not demonstrate a statistically significant mortality increment (HR, 1.19; 95% CI, 0.92-1.54; P=.18).

CONCLUSIONS AND RELEVANCE: Fecal incontinence in US adults is associated with disproportionate cardiopulmonary-kidney disease, functional impairment, and mortality, but the association with mortality was related to multisystem disease rather than to bowel symptoms themselves. Disclosure of fecal incontinence is a low-cost clinical signal that warrants integrated systemic assessment, including routine kidney function testing, rather than purely anorectal evaluation.

PMID:42544354 | PMC:PMC13429248 | DOI:10.32481/djph.2026.07.17

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Knowledge and Compliance With Universal Precautions Among Nurses at a Tertiary Care Teaching Hospital in Central India

Cureus. 2026 Jul 3;18(7):e111995. doi: 10.7759/cureus.111995. eCollection 2026 Jul.

ABSTRACT

Background Universal precautions are essential infection control measures aimed at preventing healthcare-associated infections and occupational exposure among healthcare workers (HCWs). However, compliance remains suboptimal, particularly in resource-limited settings. Objective The aim of this study was to assess the knowledge and compliance regarding universal precautions among the nursing staff at a tertiary care teaching hospital and identify gaps in infection control practices. Methods A hospital-based cross-sectional study was conducted from March to April 2026 among 40 nurses at Government Medical College, Datia, Madhya Pradesh, India. Participants were selected using simple random sampling. Data were collected using a validated structured questionnaire assessing knowledge (15 items) and compliance (20 items on a Likert scale). Statistical analysis was performed using Jamovi, version 2.6.44 (The jamovi Project, Sydney, NSW, Australia). Results Among the 40 nurses included in the study, 31 (77.5%) were aged 24-30 years, and 24 (60.0%) had 1.5-5 years of work experience. Adequate knowledge regarding universal precautions was observed among 31 (77.5%) nurses, while five (12.5%) demonstrated very good knowledge scores. Knowledge regarding key infection control practices was high, with 40 (100%) participants aware of hand hygiene between patients and 39 (97.5%) reporting correct knowledge regarding glove use for blood collection and avoidance of needle recapping. However, 34 (85.0%) nurses correctly recognized that the primary objective of universal precautions is not limited solely to protecting HCWs, while five (12.5%) believed that such precautions were required only for infected patients. Compliance with hand hygiene practices was high, with 36-38 nurses (90.0%-95.0%) consistently adhering to recommended practices. Similarly, adherence to glove use during high-risk procedures was observed among 37-39 nurses (92.5%-97.5%). Lower compliance was observed for glove use during injections among 22 (55.0%) nurses and for apron and cap/shoe-cover use among 26-27 nurses (65.0%-67.5%). Additionally, 4 (10.0%) nurses reported non-adherence to safe needle recapping and post-exposure management practices. Conclusion Despite adequate knowledge, a notable knowledge-practice gap exists among nurses. Strengthening training, ensuring personal protective equipment (PPE) availability, and reinforcing monitoring mechanisms are essential to improve compliance and enhance infection control practices.

PMID:42544350 | PMC:PMC13429165 | DOI:10.7759/cureus.111995

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Association between the natural bobtail phenotype and lumbosacral transitional vertebra in Brittany dogs and Danish-Swedish Farmdogs

Can Vet J. 2026 Aug 1;67(8):882-888. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Natural bobtail phenotypes, mostly caused by a mutation in the T-box transcription factor T-gene, occur in several dog breeds. Although generally considered benign, reduced tail length may co-occur with structural changes in the lumbosacral spine, raising potential welfare concerns.

OBJECTIVE: The objective of this study was to investigate whether natural bobtail phenotypes (short- and stumptails) are associated with the occurrence of lumbosacral transitional vertebra (LTV) in Brittany dogs and Danish-Swedish Farmdogs.

ANIMALS AND PROCEDURES: This retrospective, cross-sectional study included 1679 dogs [Brittany dogs (n = 744); Danish-Swedish Farmdogs (n = 935)] screened through the Norwegian Kennel Club’s hip dysplasia program. Standardized ventrodorsal pelvic radiographs were evaluated for LTV and tail phenotypes. Associations were assessed using chi-square tests, odds ratios (OR) with 95% confidence intervals (CI), and post-hoc standardized residuals. Tail phenotypes were analyzed as a binary variable (bobtail versus normal) in both breeds and as a 3-category variable (stump, short, normal) in Brittany dogs.

RESULTS: Lumbosacral transitional vertebra prevalence was 47.8% in Brittany dogs and 14.9% in Danish-Swedish Farmdogs, whereas the natural bobtail phenotype (stump + short) occurred in 26.7% of Brittany dogs and 11.0% (short) of Danish-Swedish Farmdogs. In Brittany dogs, bobtailed dogs had significantly increased odds of being LTV-positive compared with dogs having a tail of normal length (OR = 2.04, 95% CI: 1.47 to 2.85; P < 0.001), with the strongest association observed in stump-tailed individuals. In Danish-Swedish Farmdogs, the association was weaker and did not reach statistical significance (OR = 1.66, 95% CI: 0.99 to 2.76; P = 0.05).

CONCLUSIONS AND CLINICAL RELEVANCE: Natural bobtail phenotypes are associated with LTV in Brittany dogs, with stump-tailed dogs showing the strongest association. A similar, non-significant trend was observed in Danish-Swedish Farmdogs.

PMID:42544340 | PMC:PMC13429198

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Impact of an Intergenerational Service Learning Program on Goal Attainment Among Homebound Older Adults:: A Multi-Site Community Study

Dela J Public Health. 2026 Jul 31;12(3):84-89. doi: 10.32481/djph.2026.07.13. eCollection 2026 Jul.

ABSTRACT

OBJECTIVE: . More than two million older adults are homebound and five million need help leaving their homes. They often experience social isolation, food insecurity, and lack of connection to community resources. Affordable, adaptable, comprehensive home-based services for those aging in place are lacking. This study examined the benefits of an intergenerational home-based service-learning program on goal attainment in 1) social support, 2) home safety and cleanliness, 3) access to community resources, 4) food access, and 5) improving physical health.

METHODS: . 201 homebound and near-homebound older adults enrolled in Lori’s Hands in Newark, DE; Baltimore, MD; and Metro Detroit, MI were surveyed between December 2021 and May 2026. Descriptive and chi-square analyses were conducted to examine changes in domain-specific subjective assessment of goal attainment over time.

RESULTS: Findings indicated that 83% of clients reported positive changes in at least one of the five target service areas over six or more months of participation in the program. The majority of participants reported 1) home safety and cleanliness and 2) social support as their most important goals. Results from the chi-square test indicated statistically significant differences in goal attainment for all five service areas.

CONCLUSIONS: Results from this study suggest that intergenerational in-home support services can improve social support, home safety and cleanliness, physical activity, food access and nutrition, and access to community resources for homebound older adults, thereby supporting aging in place and reducing the load on informal caregivers.

POLICY IMPLICATIONS: . Policies and practice can support a pipeline of health professionals through innovative service-learning models to benefit older adults, caregivers, students, and the broader community.

PMID:42544333 | PMC:PMC13429250 | DOI:10.32481/djph.2026.07.13

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The effects of different velocity loss thresholds on post-activation performance enhancement in basketball players

PeerJ. 2026 Jul 30;14:e21550. doi: 10.7717/peerj.21550. eCollection 2026.

ABSTRACT

AIM: This study investigated the effects of different velocity loss (VL) thresholds during squat exercise at 80% of one-repetition maximum (1RM) on post-activation performance enhancement (PAPE) in basketball players.

METHODS: Nineteen male collegiate basketball players completed three familiarization sessions and four randomized crossover experimental sessions: control (passive rest), 5% VL, 10% VL, and 20% VL. Countermovement jump height (JH), peak power output (PPO), and reactive strength index modified (RSIm) were measured pre-test and at 3-min and 8-min post-squat. Linear mixed-effects models (LMMs) evaluated the effects of time, condition, and mean-centered relative strength on the outcome variables and repetition counts. To identify responders who exhibited meaningful improvements in jump height, the smallest worthwhile change (SWC) was calculated.

RESULTS: At the group level, no significant condition × time interactions or main effects of condition were observed for JH, PPO, or RSIm (p > 0.05), indicating no uniform PAPE effect across protocols. Furthermore, no statistically significant strength × time × condition interaction effects were observed. Repetition counts did not differ between the 5% and 10% VL conditions but were significantly lower in both conditions compared to the 20% VL condition (p < 0.01). Individual analysis showed the 20% VL condition yielded the highest number of responders (n = 11; 58%).

CONCLUSION: Squat protocols using 5-20% VL at 80% 1RM did not produce significant group-level CMJ performance improvements, suggesting that a comprehensive warm-up may create a performance ceiling. Furthermore, these responses were not moderated by relative strength. However, the high inter-individual variability and responder rates at higher VL thresholds highlight the importance of individualized PAPE programming.

PMID:42544330 | PMC:PMC13429104 | DOI:10.7717/peerj.21550

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Impact of Neonatal Intensive Care Unit (NICU) Environment on Maternal Breast Milk Utilization: : A Retrospective Study

Dela J Public Health. 2026 Jul 31;12(3):110-113. doi: 10.32481/djph.2026.07.18. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: Prematurity remains a significant cause of infant and childhood morbidity and mortality. Infants who are exclusively breastfed during the first 6 months of life have improved outcomes. A majority of premature infants are discharged home on formula. Neonatal Intensive Care Unit (NICU) design may influence parental involvement and, in turn, affect breast milk utilization. This study assesses breast milk utilization at discharge, before, and after transitioning from a traditional open-bay NICU to a private, single-family room (SFR) NICU.

METHODS: This is a retrospective observational study of infants born at <32 weeks gestation admitted to a level III NICU before and after a transition from a traditional open-bay to a SFR NICU. Infants who received care in both NICU environments were excluded. The primary outcome was breast milk utilization at discharge. Standard descriptive statistics were used.

RESULTS: A total of 276 infants were included in the analysis. Demographic and clinical variables did not differ except for increased socioeconomic disadvantage and eligibility for donor breast milk. There was a significant increase in overall breast milk utilization (p=.04) but not maternal breast milk (p=0.61) in the SFR. Infants admitted to the traditional open-bay unit were younger at first oral feeding attempt (34.2 weeks (2.9)) compared to infants in the SFR room (35.2 weeks (2.4), p=0.007).

CONCLUSION: Transition from a traditional open-bay model to a single-family room (SFR) model affected the time of oral feeding initiation but did not significantly impact breast milk exposure, breastfeeding attempts, or parental involvement in feeding. Breastfeeding outcomes may be more strongly influenced by clinical practices and support systems rather than by the physical environment. Understanding the impact of the NICU environment on feeding practices can inform institutional policies aimed at optimizing breast milk utilization.

PMID:42544328 | PMC:PMC13429254 | DOI:10.32481/djph.2026.07.18

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An NRIP1-Centric Monocyte Immunogenetic Bridge Between Heart Failure and Ischemic Stroke

J Inflamm Res. 2026 Jul 29;19:613632. doi: 10.2147/JIR.S613632. eCollection 2026.

ABSTRACT

BACKGROUND: Heart failure (HF) and ischemic stroke (IS) frequently co-occur and worsen each other. Circulating immune cells may act as a cross-organ inflammatory bridge, but the key immune lineage, genetically supported mediators, and druggable targets remain unclear.

OBJECTIVE: To identify the immune-cell lineage, candidate gene, and tractable intervention target linking HF and IS.

METHODS: Bidirectional Mendelian randomization (MR) of genome-wide association study summary statistics was used to assess causal links between HF and IS. Mouse single-cell transcriptomic datasets from HF and IS models were integrated to define a shared immune/stromal atlas and characterize Ly6C⁺ monocyte expansion. Ly6C⁺ monocyte marker genes were mapped to human orthologs and evaluated using peripheral-blood expression quantitative trait locus data for gene-level MR, followed by expression validation, colocalization, summary-data-based MR, and spatial transcriptomics. In HF single-cell data, Ly6C⁺ monocytes were stratified by Nrip1 expression for cell-cell communication, pathway enrichment, and pseudotime analyses. Candidate-drug prediction, druggability evaluation, molecular docking, molecular dynamics simulation, and in vitro validation were then performed.

RESULTS: MR supported a bidirectional positive association between HF and IS. Both diseases showed expansion of inflammatory Ly6C⁺ monocytes at single-cell resolution. Among MR-implicated genes, NRIP1 was prioritized as a key gene associated with reduced IS risk, and genetic and spatial evidence supported its monocyte-mediated role in HF-IS coupling. Nrip1-stratified and pseudotime analyses suggested a homeostatic role through modulation of inflammatory thresholds and communication patterns. Drug prediction and in silico analyses indicated that retinoic acid-related small molecules may bind NRIP1 and exhibit preliminary druggability. In vitro, tretinoin alleviated ischemia-like HMC3 cell injury and inflammation by modulating monocyte NRIP1.

CONCLUSION: An NRIP1-centered monocyte network may represent a tractable immune bridge in HF-IS comorbidity, and tretinoin provides an entry point for NRIP1-targeted intervention.

PMID:42544320 | PMC:PMC13429124 | DOI:10.2147/JIR.S613632

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Association Between Body Mass Index and Hypertension Among Indigenous Adults in Canada: A Cross-Sectional Analysis of the 2022 Canadian Community Health Survey

Cureus. 2026 Jul 3;18(7):e111994. doi: 10.7759/cureus.111994. eCollection 2026 Jul.

ABSTRACT

Background Hypertension and obesity remain important public health concerns among Indigenous populations in Canada because of their association with cardiovascular disease and related chronic conditions. Limited recent national evidence has examined the relationship between body mass index and hypertension among Indigenous adults in Canada. Objective To examine the association between body mass index classification and hypertension among Indigenous adults in Canada using data from the 2022 Canadian Community Health Survey. Methods This cross-sectional study analyzed data from the 2022 Canadian Community Health Survey Public Use Microdata File. The study included 1,632 Indigenous adults aged 18 years and older, representing a weighted population of 607,892 individuals. Survey-weighted descriptive statistics and multivariable logistic regression analyses were performed while accounting for the complex survey design and bootstrap variance estimation. Hypertension was the outcome variable, while body mass index classification was the primary exposure variable. Results Among participants with hypertension, 92,384 (87.03%) were classified as overweight or obese, compared with 351,946 (70.14%) among those without hypertension. Adults aged 50-64 years had significantly higher odds of hypertension compared with adults aged 18-34 years (adjusted odds ratio (aOR)=9.54, 95% confidence interval (CI): 2.70-33.69, p<0.001). Participants aged 65 years or older also had higher odds of hypertension (aOR=13.59, 95% CI: 3.68-50.14, p<0.001). High cholesterol was significantly associated with hypertension (aOR=2.40, 95% CI: 1.23-4.70, p=0.011). Overweight or obese participants had higher odds of hypertension compared with underweight or normal weight participants; however, the association did not reach statistical significance after adjustment for demographic, behavioral, and clinical factors (aOR=2.15, 95% CI: 0.95-4.88, p=0.066). Conclusion This study highlights the burden of hypertension among Indigenous adults in Canada. Older age and high cholesterol were significantly associated with hypertension. Although overweight or obese participants demonstrated higher odds of hypertension, the association did not reach statistical significance after adjustment. Further longitudinal studies are needed to better understand the relationship between body mass index and hypertension among Indigenous populations in Canada.

PMID:42544307 | PMC:PMC13429213 | DOI:10.7759/cureus.111994