Tag: pubmed

Turk J Anaesthesiol Reanim. 2026 Aug 28;54(4):282-290. doi: 10.4274/TJAR.2026.262473.

ABSTRACT

OBJECTIVE: This study evaluated gender representation among speakers, session chairs, and society leadership roles at the Turkish Society of Anaesthesiology and Reanimation (TARK) Congresses between 2015 and 2024, focusing on temporal patterns and subspecialty-based variation.

METHODS: This retrospective observational analysis of conference sessions included all scientific sessions listed in official TARK congress programmes from 2015 to 2024. Names, roles, and session topics were extracted from publicly available documents. In the absence of self-identified gender data, participants were categorised as women or men using names, academic titles, congress documents, and publicly accessible institutional or professional information, when clarification was required. Gender proportions were compared using chi-square tests. Temporal patterns were evaluated using logistic regression analyses, and subspecialty-specific analyses were performed using intensive care as the reference category. The leadership composition of the society was evaluated descriptively.

RESULTS: A total of 2,627 congress roles were analysed, including 966 session chairs and 1,661 speakers. Women accounted for 50.3% of session chairs and 50.8% of speakers, with no statistically significant temporal change during the study period. Marked variation was observed across subspecialties. Women were least represented in intensive care sessions (30.9%) and most represented in obstetric and paediatric anaesthesia sessions (82.1%), reflecting a higher relative representation of women speakers in the latter than in intensive care. Leadership composition varied across terms, with no persistent predominance of either gender according to the descriptive assessment.

CONCLUSION: Gender representation at TARK congresses remained numerically balanced over the ten-year study period; however, the absence of a significant temporal increase and the presence of persistent subspecialty clustering suggest a stable but uneven distribution across academic areas.

PMID:42664424 | DOI:10.4274/TJAR.2026.262473

J Sex Med. 2026 Aug 5;23(9):qdag268. doi: 10.1093/jsxmed/qdag268.

ABSTRACT

INTRODUCTION: Vaginoplasty is a high benefit but technically complex procedure that is associated with reduced gender dysphoria, improved quality of life, and high patient satisfaction. Despite increasing utilization of gender-affirming vaginoplasty, national data identifying predictors of perioperative morbidity remain limited. This study evaluates patient risk factors and morbidity following gender-affirming vaginoplasty to inform patient counseling and optimize perioperative care.

METHODS: This retrospective cohort study utilizes the American College of Surgeons National Surgical Quality Improvement Program database (2011-2023) to characterize patient profiles, operative factors, and outcomes for vaginoplasty. Patients were identified using ICD-9/10 codes for gender dysphoria and relevant CPT codes. Multivariable analyses were performed to identify factors independently associated with surgical complications, readmissions, and reoperations.

RESULTS: A total of 978 vaginoplasty procedures were identified. Procedure volumes increased rapidly from under 15 operations a year through 2015, to a peak of 156 procedures in 2017. Most procedures were performed by plastic surgeons (82.6%), followed by urologists (16.2%).Overall, 16.0% of patients experienced an adverse event within 30 days, including 13.0% with recorded complications, 3.6% with an unplanned readmission, and 4.9% with an unplanned reoperation.On multivariable analysis, Black race (relative risk [RR] 1.59, 95% confidence interval [CI] 1.12-2.27 relative to White patients), obese BMI (RR 1.56, 95% CI 1.04-2.34), and procedures attributed to urology (RR 1.52, 95% CI 1.09-2.11 relative to plastic surgery) were associated with higher recorded risk of adverse events, while hypertension was associated with increased risk of readmission or reoperation (RR 2.04, 95% CI 11.05-3.96).

CONCLUSIONS: Vaginoplasty is a complex but rapidly growing surgical procedure with low rates of serious adverse outcomes in the 30-day postoperative period. This study characterizes short-term outcomes and risk factors in one of the largest national cohorts of gender-affirming vaginoplasty to date. Although procedures attributed to urology as the primary specialty were associated with higher recorded adverse event rates, this finding may reflect differences in case complexity or multidisciplinary practice patterns rather than surgeon specialty itself. Observed differences across patient characteristics and operative contexts highlight the importance of preoperative optimization, multidisciplinary collaboration, and standardized perioperative care.

PMID:42664394 | DOI:10.1093/jsxmed/qdag268

J Prim Care Community Health. 2026 Jan-Dec;17:21501319261485526. doi: 10.1177/21501319261485526. Epub 2026 Aug 28.

ABSTRACT

ObjectivesPulse-oximeter oxygen saturation (SpO₂) is widely used in outpatient respiratory care because it is fast and noninvasive, but arterial blood gas (ABG) testing provides a more direct measure of arterial oxygen saturation (SaO₂). Prior studies show that pulse oximeters may overestimate oxygen saturation in individuals with darker skin tones, potentially leading to missed recognition of clinically meaningful hypoxemia. However, limited research has examined measurement agreement in outpatient occupational lung disease settings.MethodsA retrospective agreement analysis was conducted using paired ABG-derived SaO₂ and pulse-oximeter SpO₂ measurements from the same outpatient visit at a rural West Virginia Black Lung Clinic. Paired measurements were defined as SaO₂ and SpO₂ readings recorded during the same clinical encounter. Agreement was evaluated using the Bland-Altman approach, which quantifies the average difference between two methods (mean bias) and the range within which most individual differences are expected to fall (limits of agreement). Hidden hypoxemia was defined as SaO₂ ≤ 88% with concurrent SpO₂ ≥ 90% or ≥ 92%.ResultsThirty-five participants were included; all male and self-identified as African American. Mean age was 70.7 years (SD 8.9). At rest, pulse oximetry overestimated SaO₂ by an average of 1.29 percentage points (SD 3.74), with 95% limits of agreement from -6.04 to +8.62 percentage points. Following exercise, mean bias was +0.75 percentage points (SD 3.68), with limits of agreement from -6.46 to +7.96. Although average differences were modest, individual discrepancies were sometimes several percentage points higher or lower than ABG values. ABG-defined hypoxemia occurred in 1/35 participants at rest and 1/34 post-exercise; in both cases, SpO₂ remained ≥ 90% and ≥ 92%, consistent with hidden hypoxemia. Regression analysis did not demonstrate statistically significant proportional bias at either timepoint.ConclusionsIn this outpatient Black Lung Clinic sample, pulse oximetry averaged only modest overestimation of SaO₂, but individual readings varied widely. This matters because oxygen and disability-related decisions are made one patient at a time, and differences of several percentage points can change classification near common thresholds. These findings support cautious interpretation and use of pulse-ox values in outpatient occupational lung disease care and justify larger, multi-site studies.

PMID:42664382 | DOI:10.1177/21501319261485526

Dent Med Probl. 2026 Jul-Aug;63(4):875-883. doi: 10.17219/dmp/200179.

ABSTRACT

BACKGROUND: Hypertension (HTN) is a prevalent condition affecting a significant proportion of the population. It requires careful management due to its potential systemic complications. While the overall effects of HTN are well documented, its specific impact on implant dentistry procedures, such as sinus augmentation, remains less clear.

OBJECTIVES: The present study aimed to investigate the influence of HTN and antihypertensive medications on early implant failure (EIF) following sinus augmentation.

MATERIAL AND METHODS: A retrospective cohort study was conducted at a tertiary referral center between 2013 and 2021. Data from 425 implants in 152 patients were analyzed. The primary outcome was EIF. Univariate and multivariable analyses were performed to identify potential risk factors. A p-value <0.05 was considered statistically significant.

RESULTS: Hypertension did not significantly affect EIF. However, beta-blocker therapy was identified as an independent risk factor at both the patient and implant levels (OR (odds ratio) = 4.05; p = 0.018 and OR = 3.13; p = 0.045, respectively). A higher number of implants per patient and tobacco smoking were also associated with an increased risk of EIF (OR = 1.49; p = 0.039 and OR = 8.52; p < 0.001, respectively). Other antihypertensive medications were not significantly associated with EIF.

CONCLUSIONS: Hypertension was not a significant risk factor for EIF following sinus augmentation. However, beta-blocker therapy was associated with an increased risk of failure, whereas other antihypertensive agents, including diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and calcium channel blockers (CCBs), were not significantly associated with EIF.

PMID:42664374 | DOI:10.17219/dmp/200179

Dent Med Probl. 2026 Jul-Aug;63(4):893-906. doi: 10.17219/dmp/202926.

ABSTRACT

BACKGROUND: Clear aligner treatment (CAT) may induce masticatory muscle tenderness and trigger temporomandibular disorders (TMD). Considering that CAT may interfere with the masticatory system, it is important to understand the relationship between CAT and occlusal changes.

OBJECTIVES: This study aimed to analyze occlusal changes during CAT and assess the influence of postorthodontic occlusion on masticatory performance. A secondary objective was to determine whether the case complexity, the facial biotype and malocclusion were associated with occlusal alterations, masticatory performance, or the onset of TMD signs and symptoms during CAT.

MATERIAL AND METHODS: Forty-two individuals who underwent and completed CAT were evaluated at 3 time points: before treatment (T0); at the end of treatment (T1); and 3 months after treatment, during which time clear aligners (CAs) were used only at night (T2). Temporomandibular disorders were assessed using Axis I of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) at T0, T1 and T2. Masticatory performance was evaluated at T1 and T2 using a two-colored chewing gum test and colorimetric analysis. Occlusal area and anterior and posterior occlusal contacts were evaluated digitally. Non-parametric statistical tests were used, with the significance level set at p < 0.05.

RESULTS: The occlusal area decreased significantly from T0 to T1 (p = 0.016). At T1, normodivergent individuals had significantly more anterior contacts than hyperdivergent patients (p = 0.013). Masticatory performance increased with the number of posterior occlusal contacts (p < 0.05), and individuals with Class I molar relationship had more anterior contacts than Class II patients (p = 0.004). At T2, Class III individuals showed higher values than Class II patients (p = 0.011).

CONCLUSIONS: The number of occlusal contacts and occlusal contact area decreased during treatment. Nighttime use of CAs slightly enhanced occlusal contact recovery. Complex cases presented more posterior contacts at T0; simple cases presented a greater occlusal area at the end of CAT. Class I individuals presented more anterior contacts at T0. These movements increased the anterior contacts in Class III molar cases at the end of treatment and 3 months later. No significant differences in masticatory performance were found according to the molar relationship, the facial biotype or the case complexity; no TMD signs and symptoms were found during or after CAT.

PMID:42664370 | DOI:10.17219/dmp/202926

Sci Adv. 2026 Aug 28;12(35):eaed4172. doi: 10.1126/sciadv.aed4172. Epub 2026 Aug 28.

ABSTRACT

Behavior modulates the activity of sensory systems in multiple ways: from gain changes in individual neurons to changing interactions in neural populations. These effects are not universal; while movement has a strong influence on sensory coding in rodents, its impact on primates is less prominent. The diversity of effects that locomotion exerts on sensory neurons, as well as disparities between species, raises questions about the existence of universal principles that may underlie sensation during behavior. We propose that sensory systems are internally modulated to match systematic changes in stimulus statistics caused by locomotion, to facilitate an accurate and efficient sensory code. We find that model neurons, adapted to stimuli recorded during movement in natural environments, predict and reproduce a broad spectrum of experimental observations in rodents and primates. This simple principle of maintaining coding efficiency across behavioral states reconciles the diversity of ways in which locomotion modulates visual coding in different animal species.

PMID:42664357 | DOI:10.1126/sciadv.aed4172

PLoS One. 2026 Aug 28;21(8):e0353752. doi: 10.1371/journal.pone.0353752. eCollection 2026.

ABSTRACT

With the rapid growth of digital data transmission, secure image encryption has become a critical requirement for protecting visual information against unauthorized access and cryptanalytic attacks. Existing chaotic-based encryption schemes often suffer from limited resistance to statistical and differential attacks due to weak key dependence, low-dimensional chaotic behavior, or the partial use of image features during encryption. To overcome these limitations, this study proposes a novel four-dimensional (4D) hyperchaotic image encryption mechanism that is independent of image statistical features and semantic information, thereby making cryptanalysis highly infeasible. The proposed algorithm utilizes a 4D Lorenz hyperchaotic system to generate the primary pseudo-random key sequences, which are then processed using mathematical and modular operations to produce dynamic subkeys for each encryption stage. The encryption process consists of three structured phases: (1) initial pixel sorting based on the first and second keys; (2) Circular Radius-Angle Transformation (CRAT) using the third and fourth keys to remap pixel positions in a nonlinear circular coordinate space; and (3) a final diffusion phase using the fifth key to perform XOR-based confusion. Experimental evaluations confirm that the proposed approach achieves high key sensitivity, a vast key space, and strong resistance to statistical, differential, and chosen-plaintext attacks. Furthermore, the encrypted images demonstrate uniform histograms, minimal pixel correlation, high information entropy, and excellent computational efficiency, highlighting the algorithm’s robustness and applicability for secure image transmission in real-world scenarios.

PMID:42664317 | DOI:10.1371/journal.pone.0353752

PLOS Digit Health. 2026 Aug 28;5(8):e0001554. doi: 10.1371/journal.pdig.0001554. eCollection 2026 Aug.

ABSTRACT

The multiple sclerosis (MS) therapeutic landscape has evolved over time. We conducted a knowledge graph-guided analysis of MS-specific disease-modifying therapy (DMT) prescription trends using longitudinal real-world clinical data. We analyzed registry-linked electronic health record (EHR) data from two large independent healthcare systems between 2004 and 2022, including both academic and community practices. We developed an unsupervised phenotyping algorithm that leverages a publicly available knowledge graph and informative EHR features to identify patients with MS. After identifying MS cases, we combined the two cohorts and constructed annual time-varying knowledge graphs that capture co-occurrence patterns between DMTs and MS diagnosis. For each year, we analyzed co-occurrence patterns between DMTs and MS diagnosis using Shifted Positive Pointwise Mutual Information transformation and singular value decomposition to generate embeddings. We computed patient-wise cosine similarities and confidence intervals to quantify MS-specific DMT usage patterns. The phenotyping algorithm achieved robust performance in predicting MS diagnosis (AUROC: MGB = 0.994, UPMC = 0.922), identifying 29,169 MS patients in the combined dataset. Among commonly used standard-effectiveness DMTs, MS-specific prescriptions declined after 2011 for interferon-beta (DMT-MS cosine similarity slope = -0.019 ± 0.011, p = 0.002) and glatiramer acetate (slope = -0.013 ± 0.012, p = 0.026), from 2013-2020 for fumarates (slope = -0.028 ± 0.015, p = 0.004), and after 2014 for S1P receptor modulators (slope = -0.026 ± 0.016, p = 0.005). Among commonly used higher-effectiveness DMTs, B-cell depletion therapies (slope = 0.051 ± 0.027, p = 0.001), particularly ocrelizumab (slope = 0.020 ± 0.016, p =0.032), showed a marked increase since 2018. Natalizumab usage peaked in 2011 (slopepre-2011 = 0.063 ± 0.013, ppre-2011 < 0.001; slopepost-2011= -0.027 ± 0.008, ppost-2011 < 0.001). Other DMT classes such as cell proliferation inhibitors and chemotherapy agents, showed low usage during follow-up. These findings provide real-world evidence from two large EHR-based MS cohorts, highlighting distinct temporal shifts in the complex MS therapeutic landscape toward higher-effectiveness DMTs, particularly B-cell depletion therapy.

PMID:42664299 | DOI:10.1371/journal.pdig.0001554

Jpn J Clin Oncol. 2026 Aug 28:hyag145. doi: 10.1093/jjco/hyag145. Online ahead of print.

ABSTRACT

BACKGROUND: Currently, there are no large cohort studies comparing the clinical outcomes of triplet therapy with those of androgen receptor pathway inhibitor (ARPI)-based doublet therapy for patients with metastatic castration-sensitive prostate cancer (mCSPC) representing real-world practice. Therefore, the present study aimed to compare whether triplet or doublet therapy is more effective in patients with mCSPC.

METHODS: This large-scale retrospective cohort study used TriNetX electronic medical record data from August 2018 to July 2026, enrolling patients with mCSPC categorized as receiving triplet [darolutamide + docetaxel + androgen deprivation therapy (ADT)] or doublet therapy (enzalutamide or apalutamide + ADT). The primary outcome was overall survival (OS), while the secondary outcome was the proportion of patients achieving a PSA level ≤ 0.2 ng/ml. Propensity score matching (PSM) (1:1) was conducted to adjust for confounding variables between groups.

RESULTS: Overall, 1841 patients met the eligibility criteria. Following PSM (n = 329), triplet therapy was associated with a statistically significant improvement in OS compared with doublet therapy (hazard ratio: 0.601; 95% confidence interval: 0.420-0.862; log-rank P = .005). The proportions of patients achieving PSA ≤0.2 ng/ml were 26.4% vs. 17.0% at 3 months (P = .003), 37.4% vs. 27.7% at 6 months (P = .008), 43.8% vs. 35.9% at 12 months (P = .038), and 50.5% vs. 40.1% at any time (P = .008) in the triplet and doublet groups, respectively.

CONCLUSIONS: In this real-world analysis using the TriNetX database, triplet therapy including darolutamide significantly improved OS and PSA decline compared with ARPI-based doublet therapy.

PMID:42664274 | DOI:10.1093/jjco/hyag145

PLoS One. 2026 Aug 28;21(8):e0357123. doi: 10.1371/journal.pone.0357123. eCollection 2026.

ABSTRACT

BACKGROUND: Suicidality is a critical public health concern among LGBTQ+ youth, yet evidence from Vietnam remains limited. This study estimated the prevalence of suicidal ideation, plans, and attempts and examined associated sociodemographic and psychological factors among Vietnamese LGBTQ+ youth.

METHODS: We conducted a community-based, online cross-sectional survey from February to April 2025. Participants included 384 LGBTQ+ individuals aged 18-24 years residing in Vietnam. Participants were recruited through the LGBTQ+ -led or LGBTQ+ -supportive social media and community networks. Suicidality was assessed alongside symptoms of depression, anxiety, and stress using the Depression Anxiety Stress Scales (DASS-21). Monthly income was self-reported and categorized into USD bands. Multivariable logistic regression models were employed to identify factors associated with lifetime suicidal outcomes.

RESULTS: The lifetime prevalence of suicidal ideation, plans, and attempts was 56.5%, 32.1%, and 16.9%, respectively. Recent (past 12 months) prevalence was 5.5%, 3.6%, and 3.1%. In multivariable analyses, stress [AOR = 4.52 (95% CI: 2.35-8.72)] and anxiety [AOR = 2.12 (95% CI: 1.03-4.34)] were associated with higher odds of suicidal ideation and plans. Anxiety emerged as the sole independent predictor of suicide attempts [AOR = 4.30 (95% CI: 1.28-14.41)]. Conversely, higher income (≥USD 386/month) and rural residence were associated with lower odds of suicidal ideation.

CONCLUSIONS: Suicidality is highly prevalent among this accessible, predominantly urban, and connected subpopulation of LGBTQ+ youth in Vietnam. Anxiety and stress are the most robust proximal correlates of suicidal behaviors. Suicide prevention strategies for this population must incorporate routine screening for anxiety and stress, deliver LGBTQ + -affirming care, and address underlying economic vulnerabilities.

PMID:42664272 | DOI:10.1371/journal.pone.0357123