Tag: pubmed

J Hum Lact. 2026 Apr 20:8903344261432421. doi: 10.1177/08903344261432421. Online ahead of print.

ABSTRACT

BACKGROUND: Neonatal hypernatremic dehydration (NHD) is a dangerous disease that can lead to hospitalization of the infant, serious complications, and death. Despite the significant advantages of breast milk for both the mother and the baby, some neonates who are exclusively breastfed experience malnutrition in the first few days.

RESEARCH AIM: This study aims to evaluate the clinical presentations, maternal and neonatal risk factors, and preventive strategies for hypernatremic dehydration in term and late-preterm infants who were exclusively breastfed.

METHODS: In this study, neonates who were hospitalised with the diagnosis of hypernatremic dehydration in the Neonatal Intensive Care Unit of Mardin Training and Research Hospital between 2019 and 2023, who were exclusively breastfed after birth, whose gestational age was 35 weeks and above, and whose serum sodium concentration was measured ≥150 mEq/L were retrospectively evaluated. Statistical analyses were performed using SPSS 25.0 software.

RESULTS: A total of 141 newborns diagnosed with hypernatremic dehydration were included in the study. The mean age at presentation was 4 (1-20) days, and 53% of the patients were male. The mean birth weight was 3248.16±491.05 g, while the mean admission weight was 2885.67±477.61 g, indicating a significant weight loss of 11.33±7.46%. The mean maternal age was 28.95±6.22 years, and 41% of deliveries were by caesarean section. Transcranial ultrasonography was normal in 97.2% of the patients, while 2.8% had signs of haemorrhage or oedema. The most common presenting complaint was malnutrition (46.8%), followed by jaundice (41.1%).

CONCLUSION: Awareness of NHD among both mothers and healthcare personnel is the most important factor. Calling babies for early postnatal check-ups, close monitoring of neonatal weight loss, and encouraging successful breastfeeding techniques may reduce hospitalization rates.

PMID:42007909 | DOI:10.1177/08903344261432421

Oper Neurosurg. 2026 Apr 20. doi: 10.1227/ons.0000000000002019. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Lateral interbody fusion represents a minimally-invasive approach to achieve indirect decompression via disc height restoration and alignment correction in patients with degenerative lumbar spondylolisthesis. If the surgeon opts for an anterior-to-psoas (“oblique”) corridor, the patient must be positioned in the lateral decubitus position to facilitate interbody placement, which may then be followed by posterior percutaneous pedicle screw placement in either the same lateral decubitus position or by repositioning to prone. It is presently unclear whether operative position significantly affects postoperative spondylolisthesis correction and alignment. We sought to determine the impact of patient positioning on radiographic outcomes and perioperative complications following single-position lateral vs dual-position lateral-then-prone oblique lumbar interbody fusion (OLIF).

METHODS: This is a retrospective cohort study at a tertiary academic center. All adult patients undergoing single-level OLIF for degenerative spondylolisthesis were identified and reviewed. Same-level revision cases, patients undergoing additional unrelated procedures, standalone interbody cases, or patients undergoing interbody placement in the prone position were excluded. The primary outcome measures were the percentage reduction in spondylolisthesis and changes in sagittal alignment; secondary outcomes included operative time, radiographic pedicle screw placement accuracy, and complications.

RESULTS: We identified 71 cases meeting criteria for the analysis, including 29 (40.9%) single-position and 42 (59.1%) dual-position procedures. Single-position lateral cases lasted on average 29.4 minutes shorter than dual-position cases (95% CI: 11.3-47.6 minutes). There were no statistically significant differences between cohorts in spondylolisthesis reduction, segmental/regional lordosis, or pedicle screw accuracy.

CONCLUSION: In this retrospective single-center analysis, single-position lateral OLIF was associated with shorter operative duration compared with dual-position lateral-then-prone OLIF with no significant impact on pedicle screw accuracy or spondylolisthesis reduction. In cases without need for posterior procedures beyond percutaneous instrumentation, surgeons may opt for either approach at their own discretion without clinically significant impact on postoperative alignment or complication rates.

PMID:42007755 | DOI:10.1227/ons.0000000000002019

Pediatr Emerg Care. 2026 Apr 17. doi: 10.1097/PEC.0000000000003609. Online ahead of print.

ABSTRACT

PURPOSE: Point-of-care ultrasound-guided fascia iliaca nerve block (POCUS-FINB) is an effective method for pain control in children with femur fractures. Many pediatric emergency medicine (PEM) providers have not been trained in this technique, and there is no standard curriculum. While other studies have evaluated in-person POCUS-FINB didactics, assessment of online educational interventions is lacking. We created and implemented a novel online POCUS-FINB module and evaluated its efficacy in knowledge, confidence, and technical skill acquisition among PEM physicians.

METHODS: This was a prospective presurvey and postsurvey study of PEM attendings and fellows. The curriculum was developed using the Kern 6-step framework and included an online module and a brief hands-on session. Confidence, knowledge, and technical skills were assessed using a Likert scale, multiple-choice tests, and an observation checklist, respectively. In addition, we reviewed the proportion of eligible patients who received POCUS-FINB at our institution precurriculum and postcurriculum implementation.

RESULTS: Twenty-seven PEM physicians in 2 pediatric emergency departments participated in the study. Twenty-two completed all assessments from January 2022 to July 2023. Physicians demonstrated improved confidence with POCUS-FINB methods after completion of the online curriculum, with 4% reporting being confident or very confident before and 71% after the module (P<0.001). On the knowledge test, there was a statistically significant improvement, with mean scores from 77% premodule to 95% postmodule (P<0.001). Immediately after the module, participants scored well in technical skills with a mean score of 92%. There was a significant increase in the proportion of eligible patients with femur fractures who received blocks over the study period, 19% during the premodule period and 38% during the postmodule period (P=0.046).

CONCLUSION: After completing a web-based curriculum for POCUS-FINB, PEM physicians showed improvement in confidence and knowledge and performed well in their technical skills.

PMID:42007732 | DOI:10.1097/PEC.0000000000003609

Acta Radiol. 2026 Apr 20:2841851261438071. doi: 10.1177/02841851261438071. Online ahead of print.

ABSTRACT

BackgroundT2* mapping provides objective data on chondromalacia. However, its reliability in evaluating both patellar and trochlear cartilages has not yet been established.PurposeTo evaluate the repeatability and reproducibility of T2* mapping of patellar and trochlear cartilage in patients with patellofemoral maltracking, and to compare the reliability of axial and sagittal imaging planes for early detection of chondromalacia.Material and MethodsThis retrospective study included 106 knees from patients aged 18-40 years presenting with anterior knee pain and MRI evidence of patellofemoral malalignment between January 2023 and August 2025. T2* mapping was performed on a 3 T MRI scanner using standardized protocols. Patellar and trochlear cartilage were manually divided into 12 compartments in axial and sagittal planes. Regions of interest were placed manually, and T2* relaxation times were measured independently by a musculoskeletal radiologist and an orthopedic surgeon. Intra- and inter-observer reliability were assessed using intraclass correlation coefficients (ICCs).ResultsMost compartments demonstrated good-to-excellent intra- and inter-observer agreement (ICC ≥0.75), particularly in the upper and mid patellar cartilage zones. Axial-plane measurements consistently showed higher ICC values than sagittal-plane measurements. The lowest reliability was observed in lower cartilage zones and in sagittal-plane measurements. All results were statistically significant (P <0.001).ConclusionT2* mapping of the patellofemoral joint provides reliable measurements, with superior performance in the axial plane and in mid-upper zones. Routine use of axial-plane T2* mapping may facilitate early detection of chondromalacia in young adults with anterior knee pain, potentially improving clinical decision-making and preventing irreversible cartilage damage.

PMID:42007709 | DOI:10.1177/02841851261438071

mSphere. 2026 Apr 20:e0008626. doi: 10.1128/msphere.00086-26. Online ahead of print.

ABSTRACT

Built environment surveillance is a proven approach for tracking disease burden of some viruses within hospitals and long-term care facilities. However, studies in clinical settings are lacking for simultaneously surveying targets in a built environment using targeted metatranscriptomics. We swabbed six discrete floor locations within an acute care center’s emergency department (ED) in Ottawa, Canada, and sequenced cDNA using a 132 viral taxa panel, identifying viral burden across sampling locations and time. The determined SARS-CoV-2 variant profile across time was matched to provincial variant prevalence. The correlation between metatranscriptomic read abundances and reported cases of influenza A, SARS-CoV-2, and RSV was assessed. We quantified these via qPCR and assessed the correlation of Cq versus metatranscriptomic reads for these viruses. We sequenced a median of 1,302,882 reads per sample from 38 floor swabs collected during peak respiratory viral season (November 2022-February 2023). Diversity of viral communities varied significantly across locations in the ED. SARS-CoV-2 variant abundance shifts matched the changing infection landscape concurrently reported in Ontario. Relationships between targeted metatranscriptomic read ratios and clinical burden were not statistically significant, although we found modest correspondence between qPCR signal and read depth for RSV and SARS-CoV-2. This approach characterized the viral communities and the within-species diversity within an ED. Correlating sequencing-derived data with disease burden for three key respiratory viruses was inconsistent, with the exception of significant correlation between metatranscriptomic reads and Cq data for SARS-CoV-2. We were able to recover the distribution of clinically reported SARS-CoV-2 variants from the floor swab data.

IMPORTANCE: Environmental surveillance is useful for estimating the disease burden for certain viruses. qPCR is commonly used for surveillance of wastewater and built environments, including during the COVID-19 pandemic, but single, multiplexed reaction targets are limited. Targeted metagenomic or metatranscriptomic approaches can accurately quantify microbial populations of interest in an environment, reduce off-target sequencing, and evaluate a broader number of targets than qPCR assays. Here, we assessed the capacity of a targeted viral metatranscriptomic panel to correlate viral abundance in the hospital built environment with key pathogens of interest, including influenza A, RSV, and SARS-CoV-2. Our results suggest that targeted metatranscriptomics may identify viral communities in healthcare facilities, including strain-level detection capability. However, this approach must be validated for its effectiveness in viral surveillance that accurately reflects disease burden. This work contributes to a growing toolkit for pathogen surveillance, a critical endeavor to safeguard against outbreaks of known and emerging pathogens.

PMID:42007699 | DOI:10.1128/msphere.00086-26

J Acoust Soc Am. 2026 Apr 1;159(4):3448-3463. doi: 10.1121/10.0042760.

ABSTRACT

Humans perceive non-linguistic sounds (NLSs) by associating auditory events with corresponding physical sources in a complex acoustic environment. However, previous studies have shown that cochlear implant (CI) users, vs normal hearing (NH) listeners, can face more severe challenges in identifying and tracking NLS. For CI listeners, this leads to limited autonomy, environmental awareness, safety, contextual navigation and daily engagement with individuals, society, and environmental situations. In earlier work, we studied NLS classification among CI and NH listeners and proposed a NLS enhancement solution to benefit CI/NH listeners. Building on this foundation, we propose here an experimental framework to investigate competing environmental sounds or NLS perception among CI and NH listeners. We introduce a two-source mixture model featuring “target” and “interference” source characteristics and develop an experimental setup for listener evaluation in three conditions: (i) mixed-baseline, (ii) source separation (SS) using the SUccessive DOwnsampling and Resampling of Multi-Resolution Features network, and (iii) source separation with non-linguistic sound enhancement (SSE) achieved by cascading SS output with our previously developed NLS enhancement technique. CI and NH listener evaluations were based on subjective ratings and forced-choice preference test based on perceptual measures: (i) interference, (ii) audio quality, and (iii) distortion. Our study shows a statistically significant improvement in interference reduction, with CI listeners demonstrating reduction for “nature” sounds with “category-matched” interference [F(2,21) = 4.935, p = 0.0175], and NH listeners exhibiting reductions across all NLS categories, with F-values ranging from [F(2,135) = 8.481, p = 0.000 339] to [F(2,135) = 32.37, p = 3.29 × 10-12]. Pairwise forced-choice test revealed preferences for SSE-processed nature and “domestic noises” among both CI and NH listeners. Our proposed experimental framework addresses key challenges in competing environmental sound perception among CI and NH listeners: (1) evaluation of SS for interference-characterized NLS mixture, (2) evaluation of environmental sound or NLS enhancement framework to improve perceptual outcomes with speech-targeted CI processing, and (3) perceptual measures to characterize NH and CI listener experience.

PMID:42007671 | DOI:10.1121/10.0042760

Birth Defects Res. 2026 Apr;118(4):e70032. doi: 10.1002/bdr2.70032.

ABSTRACT

INTRODUCTION: Small intestinal atresia (SIA) consists of a congenital obstruction of the lumen of the duodenum, jejunum, or ileum with varying severity. The aim of the investigation was to analyze the prevalence and mortality of SIA, using data from the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR).

METHODS: Data on SIA cases were collected from 25 ICBDSR members’ surveillance programs in 17 countries over 1974-2015. All pregnancy outcomes were included, but terminations of pregnancy were not available for 11 programs. Statistical analysis is descriptive, and the prevalence is established by the total of SIA cases divided by the total of births. The survival time was calculated, and mortality was analyzed individually using the Kaplan-Meier method for comparison.

RESULTS: The total prevalence of SIA was 2.1 per 10,000 births. Iran had the highest prevalence with 11.5 per 10,000 total births (95% CI: 9-14.1); on the other hand, the lowest prevalence of SIA was in Mexico-Nuevo Leon with 0.5 per 10,000 births (95% CI: 0.3-0.8), and Cali-Colombia had zero cases. In South America, a higher prevalence of SIA was estimated compared to what was reported in 2000. Most deaths occurred between Day 2 and 6, except in Bogotá-Colombia, Spain, UK-Wales, and Mexico, where the deaths occurred on Day 1. The mortality in the first year was 4.3%, but the specific causes of death were not determined in this study.

CONCLUSION: The prevalence of SIA was about 2.1 per 10,000 births during a 41-year period in 25 centers, with variations in prevalence according to geographical locations. Future research is suggested to analyze changes in trends and the impact of early diagnosis and treatment in mortality.

PMID:42007667 | DOI:10.1002/bdr2.70032

Vet Radiol Ultrasound. 2026 May;67(3):e70175. doi: 10.1111/vru.70175.

ABSTRACT

Portal vein velocity (PVV) is a useful indirect indicator of portal pressure. Reference values for PVV have been previously established in healthy, non-sedated dogs with reported ranges of 14.7 ± 2.5 and 18.1 ± 7.6 cm/s. PVV may be influenced by physiological and pathological factors; for example, a correlation between body weight and PVV has been documented; however, the effect of other factors is unknown. The primary aims of this prospective comparative study were to investigate the effect of standardized intravenous sedation protocol of medetomidine (2-3 µg/kg) and butorphanol (0.3 mg/kg) on PVV and to determine whether post-sedation PVV results would fall below the portal hypertension threshold of 10 cm/s. Six triplex-Doppler PVV measurements were obtained pre- and post-sedation on 15 client-owned dogs undergoing abdominal ultrasonography for conditions unrelated to primary liver disease. The mean PVV pre-sedation was 14.9 ± 3.98 cm/s and 3-min post-sedation was 10.4 ± 3.73 cm/s, representing a statistically significant reduction in PVV (p < 0.001). The mean PVV was below 10 cm/s in 3/15 (20%) dogs pre-sedation and below 10 cm/s in 9/15 (60%) dogs post-sedation. There was no effect of age, sex, or weight on PVV before and/or after sedation. Sedation with medetomidine and butorphanol caused a significant reduction in PVV at 3-min post-administration. This finding should be considered when evaluating hepatic and portal hemodynamics in dogs, as 60% (9/15) of the sedated cases with presumed normal hepatic function exhibited post-sedation PVV at levels seen with portal hypertension.

PMID:42007642 | DOI:10.1111/vru.70175

Semin Cardiothorac Vasc Anesth. 2026 Apr 20:10892532261446150. doi: 10.1177/10892532261446150. Online ahead of print.

ABSTRACT

The t-test is a mainstay statistical test that allows researchers to use the observed averages (arithmetic means) of data samples to draw evidence-supported conclusions about the corresponding averages in the populations they represent. This article serves as an introduction to this common and useful technique for clinicians with a limited statistical background, who seek to deepen their understanding of the t-test, its reasoning, and its implications in clinical research. We describe the three basic forms of the t-test, its applications and alternatives, and some related concepts while avoiding technical concepts and jargon as much as possible.

PMID:42007607 | DOI:10.1177/10892532261446150

Mutagenesis. 2026 Apr 20:geag017. doi: 10.1093/mutage/geag017. Online ahead of print.

ABSTRACT

Cardiovascular diseases (CVD) are the leading cause of death globally, posing a major public health challenge due to their increasing prevalence and complex etiology. Natural products from medicinal mushrooms have gained attention for their cardioprotective properties. To evaluate whether the aqueous extract of Lenzites betulinus can protect mononuclear cells of acute coronary syndrome (ACS) and heart failure (HF) patients from therapy-induced DNA damage and to determine its polyphenolic composition. The study included 30 healthy controls, 30 ACS and 30 HF patients. The genoprotective potential of aqueous mushroom extract at concentrations of 50, 100, 150, and 200 mg/mL was examined in vitro using the comet assay on human blood mononuclear cells. Total phenolic and flavonoid contents were determined spectrophotometrically, while polyphenolic profiling was performed using UHPLC-DAD-MS/MS. The mean level of DNA damage in treated cell cultures from healthy donors increased in a concentration-dependent manner compared with the negative control, but without statistical significance. The extract significantly reduced therapy-induced level of DNA damage in mononuclear cells of ACS and HF patients (p < 0.0005). DNA damage level was significantly higher in HF patients. In ACS patients, %DNA damage was significantly reduced at the three highest concentrations, while genetic damage index (GDI) decreased at all concentrations. In HF patients, %DNA damage decreased at the two highest concentrations, and GDI at all except the lowest. Phytochemical analysis revealed high levels of phenolics and flavonoids, with chlorogenic acid and quercetin as dominant compounds. L. betulinus possesses significant nutritional and functional value. Its rich phytochemical profile likely underlies its chemoprotective effects against therapy-induced DNA damage, suggesting potential as a natural agent for genome stability support in CVD patients.

PMID:42007559 | DOI:10.1093/mutage/geag017