Tag: pubmed

Front Nutr. 2026 Jul 23;13:1868410. doi: 10.3389/fnut.2026.1868410. eCollection 2026.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide, highlighting an urgent need for non-invasive early biomarkers. The cholesterol, high-density lipoprotein, and glucose index (CHG) is a novel composite marker reflecting disturbances in glucose and lipid metabolism. However, the independent association between CHG and MASLD, and the potential statistical mediating effect of visceral adiposity, as represented by the body roundness index (BRI), remains unclear, especially in non-diabetic individuals.

METHODS: This cross-sectional study included 13,682 non-diabetic Japanese adults. Multivariable logistic regression, generalized additive models, and two-piecewise linear regression were used to explore the association, nonlinear relationship, and threshold effect between CHG and MASLD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate CHG’s discriminatory performance. Exploratory mediation analysis was performed to statistically decompose the association between CHG and MASLD via BRI.

RESULTS: The prevalence of MASLD was 15.25%. After full adjustment, each 1-unit increase in CHG was independently associated with a higher risk of MASLD (OR = 4.46, 95% CI: 3.00-6.64). A significant dose-response trend was observed across CHG quartiles (Q4 vs. Q1: OR = 4.09, 95% CI: 2.83-5.91). A nonlinear threshold effect was identified at CHG = 5.52. CHG showed excellent discriminatory performance (AUC = 0.84), with an optimal cutoff at 5.23 (sensitivity = 0.81, specificity = 0.73), and retained robust discriminatory capacity in non-obese and young individuals. BRI showed a significant statistical mediating effect in the CHG-MASLD association, accounting for 46.15% of the total observed association. Subgroup mediation analyses revealed that this mediating effect was more pronounced in non-obese and normotriglyceridemic individuals.

CONCLUSION: In non-diabetic Japanese adults, CHG is independently and nonlinearly associated with MASLD risk, with BRI as a potential statistical mediator. This mediating effect exhibits heterogeneity and is more pronounced in non-obese individuals. The causal direction of this pathway remains to be verified in prospective studies. CHG shows potential as a low-cost indicator for early MASLD risk stratification, especially in non-obese and younger populations who are often missed by conventional screening.

PMID:42564740 | PMC:PMC13446269 | DOI:10.3389/fnut.2026.1868410

Front Ophthalmol (Lausanne). 2026 Jul 23;6:1755069. doi: 10.3389/fopht.2026.1755069. eCollection 2026.

ABSTRACT

PURPOSE: To evaluate visual and refractive outcomes of the Alcon Clareon^® T2 toric IOL (1.00 D cylinder at the IOL plane, ~ 0.65 D at the corneal plane) versus the Clareon^® non-toric IOL.

SETTING: Single ophthalmology clinic in Haugesund, Norway.

METHODS: This was an exploratory single site randomized, unmasked, prospective clinical trial. The study was registered with clinicaltrials.gov (NCT06717607, registered retrospectively on 12/5/2024). Patients presenting for routine cataract surgery in one or both eyes, where at least one eye qualified for implantation of the T2 lens, were enrolled. Qualifying eyes were randomized to a T2 lens or a non-toric lens. Subjects were evaluated monocularly before surgery and three months postoperative. Testing included uncorrected and corrected distance visual acuity (VA), the manifest refraction, low contrast VA (photopic and mesopic, with and without glare) and contrast sensitivity (photopic and mesopic). These latter two tests were conducted with the distance correction in place.

RESULTS: Fifty eyes of 43 subjects were successfully enrolled from 6/2022 to 5/2024, including 30 eyes (25 subjects) randomized to the toric IOL and 20 eyes (18 subjects) to the non-toric IOL. Analysis included all enrolled eyes. Subjects were matched for age (p = 0.59), sex (p = 0.30), mean keratometry (p = 0.44), anterior corneal astigmatism (p = 0.97), axial length (p = 0.12) and anterior chamber depth (p = 0.40). Postoperatively, there was no statistically significant difference in the spherical equivalent refraction (p = 0.08). Residual refractive cylinder was statistically significantly lower in the T2 group (0.22 ± 0.22 D vs. 0.59 ± 0.28 D, p < 0.01). The T2 group also had statistically significantly better uncorrected logMAR distance VA than the non-toric group (0.00 ± 0.08 vs. 0.09 ± 0.13, p < 0.01). Low contrast VA was not statistically significantly different between the two lens types under any test condition (p = 0.49 or higher in all cases), nor were photopic or mesopic contrast sensitivity (p = 0.71 and p = 0.63, respectively).

CONCLUSIONS: Use of the low cylinder power toric IOL provided significantly better UDVA, with no significant differences in distance-corrected contrast sensitivity or low contrast acuity. The achieved cylinder correction was consistent with expectations.

CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/, identifier NCT06717607.

PMID:42564736 | PMC:PMC13444364 | DOI:10.3389/fopht.2026.1755069

iScience. 2026 Jul 25;29(8):116915. doi: 10.1016/j.isci.2026.116915. eCollection 2026 Aug 21.

ABSTRACT

Cryptic transcription is an aberrant form of transcription that initiates from non-canonical, non-promoter regions within the gene. In mammals, a repressive chromatin state effectively inhibits cryptic transcription, preserving transcriptional fidelity. Aging-induced loss of trimethylated lysine 36 on histone H3 reduces DNA methylation, and accumulation of promoter-like histone modifications renders gene bodies permissive to spurious initiation by RNA polymerase II. This allows previously repressed intragenic regions to acquire promoter-like chromatin features. Cryptic transcription produces aberrant RNAs that interfere with normal gene expression, leading to truncated proteins or nonfunctional mRNAs. The aberrant RNA and protein products impair stem cell self-renewal and differentiation, thereby contributing to the development of aging and disease. This review summarizes the mechanisms underlying age-related cryptic transcription, focusing on the function of H3K36me3, DNA methylation, H3K4me3, H3K27ac, and transcription factors. In addition, we discuss the effects of cryptic transcription on aging stem cells and aged tissues.

PMID:42564700 | PMC:PMC13444477 | DOI:10.1016/j.isci.2026.116915

Laryngoscope Investig Otolaryngol. 2026 Aug 6;11(4):e70530. doi: 10.1002/lio2.70530. eCollection 2026 Aug.

ABSTRACT

OBJECTIVES: Total parotidectomy (TP) has been advocated to ensure complete tumor clearance and removal of intraparotid lymph nodes; however, less-than-total parotidectomy (LTT) may offer comparable oncologic control with superior functional outcomes. In this systematic review and meta-analysis, we compared oncologic and functional outcomes between LTT and TP for patients with T1-2 low-grade parotid malignancies.

METHODS: A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four retrospective cohort studies of T1-2 low-grade parotid cancer were included. Patients underwent either LTT or TP. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Pooled hazard ratios with 95% confidence intervals were calculated using random-effects models. Heterogeneity was assessed using I ² statistics and the Cochran’s Q test.

RESULTS: The pooled analysis demonstrated no significant difference in OS between LTT and TP based on three studies. Across the four studies, RFS was comparable between the two surgical approaches, and statistical heterogeneity was negligible for both OS and RFS. No evidence of publication bias was detected.

CONCLUSION: In selected patients with T1-2 low-grade parotid malignancies confined to the superficial lobe, LTT showed no statistically significant disadvantage in OS or RFS compared with TP based on the available retrospective evidence. However, the high risk of bias across included studies limits causal interprettion. Surgical strategy should therefore be individualized and should prioritize negative margins and functional preservation when oncologically appropriate. Prospective studies with standardized oncologic and functional outcome reporting are warranted.

LEVEL OF EVIDENCE: 3.

PMID:42564699 | PMC:PMC13445257 | DOI:10.1002/lio2.70530

Front Digit Health. 2026 Jul 23;8:1877420. doi: 10.3389/fdgth.2026.1877420. eCollection 2026.

ABSTRACT

BACKGROUND/OBJECTIVES: Multimodal large language models are increasingly being explored for medical image interpretation, but their performance in thyroid nodule ultrasound assessment remains uncertain. This study compared ChatGPT-5.4 and DeepSeek-VL2 for C-TIRADS-based risk stratification of thyroid nodules using static ultrasound images.

METHODS: This single-center retrospective diagnostic accuracy study included 206 pathologically confirmed thyroid nodules, including 117 benign and 89 malignant nodules. For each nodule, paired transverse and longitudinal ultrasound images were analyzed by both models using the same standardized English prompt. The models generated structured outputs for C-TIRADS-related ultrasound features and estimated C-TIRADS category. Pathology served as the reference standard for malignancy, and expert-assigned C-TIRADS served as the imaging reference standard. Model-assigned C-TIRADS categories were used as ordinal risk scores. The primary analysis used C-TIRADS ≥4B as the binary positive threshold for predicting pathology-confirmed malignancy, and a sensitivity analysis used C-TIRADS ≥4A.

RESULTS: At the ≥4B threshold, ChatGPT-5.4 achieved higher accuracy, sensitivity, and specificity than DeepSeek-VL2: 70.9%, 61.8%, and 77.8% vs. 57.8%, 50.6%, and 63.2%, respectively. Its non-diagnostic rate was also lower (6.3% vs. 15.5%). In the valid-output ROC analysis, AUCs were 0.903 for expert assessment, 0.790 for ChatGPT-5.4, and 0.757 for DeepSeek-VL2; model-based ROC analyses excluded indeterminate outputs and should be interpreted as per-protocol estimates. At the C-TIRADS category level, ChatGPT-5.4 showed higher exact agreement with expert assessment than DeepSeek-VL2 (45.6% vs. 36.4%) and higher within-one-category agreement (87.6% vs. 82.2%). Feature-level analysis showed that both models performed best on echogenicity but poorly on margin and echogenic foci. At the ≥4A threshold, sensitivity increased but specificity decreased substantially for both models.

CONCLUSIONS: ChatGPT-5.4 showed a more favorable performance profile than DeepSeek-VL2, but differences in sensitivity and valid-output AUC were not statistically significant. Both models remain investigational adjunctive tools and should not be used for unsupervised clinical decision-making or standalone triage.

PMID:42564679 | PMC:PMC13444745 | DOI:10.3389/fdgth.2026.1877420

S Afr J Psychiatr. 2026 Jul 30;32:2634. doi: 10.4102/sajpsychiatry.v32i0.2634. eCollection 2026.

ABSTRACT

BACKGROUND: Childhood traumatic experiences are known to have profound and lasting effects on mental health; however, there are limited data on the relationship between types of childhood trauma and social anxiety in non-clinical populations.

AIM: This study aimed to explore the associations between types of childhood trauma and social anxiety symptoms in non-clinical young adults.

SETTING: The study was conducted at the Faculty of Health Sciences of a university in Istanbul, Turkey.

METHODS: This cross-sectional study included 486 university students. Sample size was determined via G*Power analysis to ensure statistical power. Participants completed the Liebowitz Social Anxiety Scale (LSAS) and the Childhood Trauma Questionnaire (CTQ) to assess childhood trauma types and social anxiety symptoms. Data were analysed using stepwise multiple regression.

RESULTS: The mean age of the participants was 21.8 ± 4.0 years, and 81% were female, with emotional abuse and neglect scoring highest in both genders. The sample’s LSAS total mean score was 63.87 ± 11.68. When the subscales were compared by gender, females had significantly higher mean fear and avoidance scores than males (p < 0.05). The results show that childhood abuse and neglect were significant predictors of social anxiety and explained 23% of the social anxiety variance.

CONCLUSION: Childhood abuse and neglect are clearly associated with social anxiety symptoms. Interventions and treatments for individuals with social anxiety should incorporate a detailed assessment of childhood trauma history, with a particular focus on emotional abuse and neglect.

CONTRIBUTION: This study contributes to the literature by clarifying the associations between specific types of childhood trauma and social anxiety symptoms in a non-clinical young adult population.

PMID:42564676 | PMC:PMC13444311 | DOI:10.4102/sajpsychiatry.v32i0.2634

Health SA. 2026 Apr 27;31:3197. doi: 10.4102/hsag.v31i0.3197. eCollection 2026.

ABSTRACT

BACKGROUND: Despite the high academic ratings of South African universities, research on burnout in academia, particularly among health professional academics, is limited. This gap in scholarly knowledge underscores the need for immediate studies in this area.

AIM: The study assesses the burnout dimensions and demographics of health professional academics.

SETTING: Faculty of Medicine and Health Sciences, Walter Sisulu University, Eastern Cape, South Africa.

METHODS: A quantitative, descriptive, cross-sectional research design was followed. Respondents were recruited via the census (n = 56). The Modified Maslach Burnout Inventory (MMBI) Likert scale questionnaire was used. Statistical Package for the Social Sciences was used to analyse the data: Analysis of variance (ANOVA) was employed to compare mean burnout scores across multiple categorical independent variables. The chi-square test was used for associations between categorical variables. The significance level was set at p < 0.05.

RESULTS: Respondents experienced moderate levels of emotional exhaustion (EE; 46.8%), low-to-moderate levels of depersonalisation (DP; 40.4%) and moderate levels of personal accomplishment (PA; 42.6%). There is no statistically significant difference in burnout dimensions across age groups (p = EE: 0.466, DP: 0.414, PA: 0.467), gender (p = EE: 0.917, DP: 0.593, PA: 0.952), type of degree (p = EE: 0.909, DP: 0.657, PA: 0.939), academic position (p = EE: 0.982, DP: 0.907, PA: 0.430), work experience (p = EE: 0.730, DP: 0.951, PA: 0.905).

CONCLUSION: The findings suggest that health professional academics are either at risk for burnout or are experiencing moderate levels of burnout.

CONTRIBUTION: Staff welfare can be improved through strategies to reduce work-related stress, provide mental health support, and promote a healthy work-life balance.

PMID:42564672 | PMC:PMC13443551 | DOI:10.4102/hsag.v31i0.3197

Mult Scler J Exp Transl Clin. 2026 Aug 5;12(3):20552173261472661. doi: 10.1177/20552173261472661. eCollection 2026 Jul-Sep.

ABSTRACT

BACKGROUND AND OBJECTIVES: Family planning and treatment management in women with multiple sclerosis (MS) require complex decision-making. In most cases, patients express their intention to start a family, giving physicians time to monitor their MS and align treatment plans accordingly. However, not all pregnancies are planned, which can make timely communication with healthcare providers challenging. This study explores the dynamics between patients and healthcare professionals in MS care, focusing on family planning and treatment decisions before, during, and after pregnancy.

METHODS: People with MS aged 20-50 in the Swedish MS register (SMSreg) were invited to participate in an online survey in 2021. Responses of 3078 women were linked to SMSreg and other national register datasets. Descriptive statistics and multinomial logistic regression explored information sources, care, family planning discussion, treatment satisfaction, and its impact on their disease and breastfeeding decisions.

RESULTS: Women with MS reported receiving annual care from a neurologist (88%), nurse (68%) or general practitioner (46%), with satisfaction ranging from 40-77%. Most were treated with high efficacy (HE) disease-modifying treatments (DMTs) (66%), of whom 49% used rituximab. Treatment satisfaction was higher among younger women, milder EDSS, and those on HE DMTs. Women who became pregnant after their MS diagnosis (41%) were more likely to have discussed family planning with a physician (78%) compared to those who had not been pregnant post-diagnosis (59%).

DISCUSSION: In Sweden, women with MS generally have regular contact with healthcare professionals, though satisfaction varies. Family planning discussions were more frequent among women who became pregnant after diagnosis, highlighting the importance of proactive communication. Treatment choices influence both satisfaction and reproductive decisions, underscoring the need for clear guidance and shared decision-making. Real-world data also indicate that rituximab is commonly used during peripregnancy, likely due to its favourable safety profile and long-lasting effect.

PMID:42564659 | PMC:PMC13443254 | DOI:10.1177/20552173261472661

Depress Anxiety. 2026 Aug 6;2026:9727081. doi: 10.1155/da/9727081. eCollection 2026.

ABSTRACT

BACKGROUND: Depressive symptoms (DSs) are highly prevalent among medical students and may adversely affect both student well-being and future healthcare quality. Although personality traits (PTs) are closely associated with mental health, the psychological processes underlying these associations remain incompletely understood. This study examined the associations between the five PT dimensions and DS and explored whether psychological capital (PsyCap) and perceived stress (PS) statistically mediated these associations.

METHODS: A multicenter cross-sectional survey was conducted among 583 third-year undergraduate clinical medicine students from three medical universities in China. Standardized questionnaires were administered to assess PTs, PsyCap, PS, and DS. Correlation, regression, and sequential mediation analyses were performed.

RESULTS: Correlation analyses showed that neuroticism was negatively correlated with PsyCap and positively correlated with PS and DS, whereas extraversion, openness to experience, agreeableness, and conscientiousness demonstrated the opposite pattern (all p < 0.001). Regression analyses indicated that neuroticism, openness to experience, agreeableness, and conscientiousness were significantly associated with DS (β = 0.39, -0.14, -0.15, -0.10, respectively, all p < 0.001), whereas the direct association between extraversion and DS was not statistically significant (β = -0.05). Mediation analyses supported statistically significant indirect associations through PsyCap alone, PS alone, and the proposed sequential pathway through PsyCap and PS. Among the five PT dimensions, the association between extraversion and DS was primarily reflected through the indirect pathways.

CONCLUSION: The findings suggest that PTs may be associated with DS through psychological resources and stress appraisal. By integrating PsyCap and PS into a sequential mediation framework, this study provides an expanded perspective on the psychological processes linking PTs and DS among medical students. Given the cross-sectional design, the proposed mediation pathways should be interpreted as statistical associations rather than causal relationships. Future longitudinal and intervention studies are needed to further evaluate these associations.

PMID:42564616 | PMC:PMC13444726 | DOI:10.1155/da/9727081

Cureus. 2026 Jul 6;18(7):e112190. doi: 10.7759/cureus.112190. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: High-resolution pelvic magnetic resonance imaging (MRI) is essential for local staging of primary rectal carcinoma and for communicating surgically relevant risk factors before multidisciplinary treatment planning. Free-text MRI reports may describe the primary tumor but may inconsistently document key management-relevant findings, including mesorectal fascia and circumferential resection margin status, depth of extramural spread, extramural vascular invasion, lateral pelvic lymph nodes, and low rectal sphincter complex involvement. This retrospective audit assessed whether use of a structured MRI reporting template was associated with improved completeness of primary rectal cancer staging reports.

METHODS: This retrospective audit included 60 pelvic MRI reports performed for suspected or biopsy-proven primary rectal carcinoma at a tertiary care radiology department. Thirty consecutive reports prepared before template implementation were assigned to the free-text reporting group, and 30 reports prepared after template implementation were assigned to the structured reporting group. Reports were assessed using a predefined checklist of essential MRI staging elements, including tumor location, distance from the anal verge, craniocaudal tumor length, circumferential tumor position, relationship to the anorectal junction and anterior peritoneal reflection, MRI T category, depth of extramural spread, mesorectal fascia/circumferential resection margin status, extramural vascular invasion, mesorectal nodes, tumor deposits, lateral pelvic lymph nodes, sphincter complex involvement, levator ani involvement, adjacent organ invasion, and final MRI-based risk summary. The primary and only measured outcome was report completeness.

RESULTS: The mean completeness score was higher in the structured reporting group than in the free-text group, with mean scores of 91.3% and 58.6%, respectively. Structured reports showed more complete documentation of several clinically important staging domains that were inconsistently recorded in free-text reports, including mesorectal fascia/circumferential resection margin relationship, depth of extramural spread, extramural vascular invasion, lateral pelvic nodal assessment, and low rectal sphincter complex assessment. Structured reports also more frequently included a concise MRI-based risk summary integrating tumor level, T stage, nodal status, margin risk, extramural vascular invasion, and anticipated surgical relevance. No formal statistical hypothesis testing was performed; therefore, these findings should be interpreted descriptively rather than inferentially.

CONCLUSIONS: Implementation of a structured MRI reporting template was associated with higher report completeness in this descriptive retrospective audit of primary rectal cancer staging reports. The structured template was associated with more complete documentation of clinically relevant reporting elements, particularly margin status, extramural spread, extramural vascular invasion, lateral pelvic nodes, and low rectal sphincter complex involvement. However, report completeness was the only measured outcome, and no formal statistical testing was performed. Further studies with statistical testing, reviewer blinding, and assessment of diagnostic accuracy or clinical outcomes are needed.

PMID:42564594 | PMC:PMC13443989 | DOI:10.7759/cureus.112190