Tag: pubmed

BMC Cardiovasc Disord. 2026 Jun 8. doi: 10.1186/s12872-026-06073-4. Online ahead of print.

ABSTRACT

BACKGROUND: Early identification of individuals at risk for hypertension is essential for effective cardiovascular disease. Physiological and activity metrics derived from consumer smartwatches may offer a practical, noninvasive approach to identify individuals at increased risk before the clinical onset of hypertension.

METHODS: In this 12-month prospective observational study, 230 normotensive adults aged 30-60 years were followed using consumer smartwatches. Baseline wearable predictors were calculated as the mean of the first 30 days of valid data after enrollment and included heart rate variability, resting heart rate, and time spent in moderate-to-vigorous physical activity. Incident hypertension was defined according to current European guidelines using standardized office blood pressure measurements obtained at follow-up.

RESULTS: During follow-up, 28 participants (12.2%) developed hypertension. Individuals who developed hypertension exhibited lower baseline heart rate variability and spent less time in moderate-to-vigorous physical activity compared with those who remained normotensive. In multivariable logistic regression analysis, lower heart rate variability, lower levels of physical activity, and higher body mass index were independently associated with incident hypertension. An interaction between autonomic variability and physical activity was observed, indicating that individuals with both reduced autonomic regulation and low physical activity had the highest predicted risk. Machine-learning models showed improved statistical discrimination compared with clinical variables alone and were used as complementary exploratory analyses.

CONCLUSIONS: Smartwatch-derived autonomic and physical activity metrics were independently associated with the development of hypertension over a 12-month period. These findings from an observational study suggest a potential role for wearable-derived physiological parameters as digital biomarkers for early hypertension risk stratification, although further validation in larger and externally replicated cohorts is required.

PMID:42252402 | DOI:10.1186/s12872-026-06073-4

Echo Res Pract. 2026 Jun 8;13(1):21. doi: 10.1186/s44156-026-00118-2.

ABSTRACT

BACKGROUND: To improve standardization, the 2025 American Association of Echocardiography (ASE) guidelines revised the definitions of right ventricular (RV) basal and mid diameters, revising the 2010 ASE and European Society of Cardiology (ESC) definitions.

OBJECTIVES: (1) To quantify differences in right ventricular (RV) diameter measurements between the 2010 and 2025 ASE guidelines, (2) to determine its impact on the diagnosis of RV enlargement (RVE), and (3) to compare these findings with a novel automated non-linear centerline-based approach.

METHODS: We analyzed 208 healthy volunteers and 221 patients with pulmonary arterial hypertension (PAH). Using custom cardiac contour analysis (C2A) software, RV diameters were measured across three definitions. The 2010 ASE/ESC defines diameters as the maximal dimension in the basal and mid segments. In contrast, the 2025 ASE defines the basal diameter just below the tricuspid valve and the mid diameter at ~ 50% of RV inflow, both parallel to the annulus. The C2A method uses a non-linear RV centerline as a reference to standardize measurement locations: the mid-point is taken at 50% along the centerline, and the basal diameter is defined as the maximum perpendicular distance within the proximal third of the RV. We quantified nominal and relative definition differences and compared sex-specific RVE prevalence in healthy controls. Diagnostic performance (ROC) and outcome prediction (Cox models) are presented.

RESULTS: The median age was 63 years in healthy volunteers (52% male) and 48 years in patients with PAH (22% male), with a median pulmonary vascular resistance index (PVRI) of 22 Wood units·m². Compared to ASE/ESC 2010 definitions, ASE 2025 diameters were 15% (basal) and 20% (mid) lower. Using the 2025 definition in healthy controls, basal RVE was observed in 1% of females and 22% of males, while mid-RVE was present in 6% of females and 35.8% of males. The 2010 definition showed slightly better discrimination for PAH (AUC 0.937 vs. 0.898, p < 0.001). However, the prediction of outcomes was similar between the two definitions, with C-statistics of 0.59 (0.53-0.65) and 0.59 (0.53-0.66), respectively.

CONCLUSION: Differences in guideline definitions of RV diameters are important to consider when implementing them in clinical practice.

PMID:42252391 | DOI:10.1186/s44156-026-00118-2

Matern Health Neonatol Perinatol. 2026 Jun 8;12(1):22. doi: 10.1186/s40748-026-00272-9.

ABSTRACT

BACKGROUND: Preterm birth remains a critical global health issue, contributing to approximately one-third of neonatal deaths worldwide. In Rwanda, complications of preterm birth contributed to the second cause on neonatal mortality with specifically two district hospitals (i.e. Kiziguro and Ngarama) located in Gatsibo district reported threefold higher preterm neonatal mortality as compared to national average. We aimed to determine the proportion and determinants of preterm neonatal mortality in two rural hospitals in Gatsibo district, Rwanda.

METHODS: We conducted a retrospective cross-sectional study using records of all preterm neonates admitted to Kiziguro and Ngarama hospital neonatal units, between January 2020 and December 2024. Data were extracted from neonatal files and maternity registers. Descriptive statistics were used to describe the study variables. Bivariate and multivariable logistic regression analyses were conducted to identify the determinants of preterm neonatal mortality. We reported odds ratios, 95% CIs, and p values, and we set the significance at the 95% confidence level.

RESULTS: The majority of preterm deaths occurred at Kiziguro district hospital (21.0%, n = 1217). The determinants of preterm neonatal mortality were early gestational age (aOR = 2.47, 95% CI: 1.30-4.65), neonatal sepsis (aOR = 3.35, 95% CI: 1.98-5.69), hypothermia (aOR = 1.72, 95% CI: 1.12-2.66), need for special care unit services (aOR = 5.32, 95% CI: 2.61-11.96), poor respiratory support (aOR = 7.63; 95% CI: 3.69-15.80), poor bilirubin management (aOR = 2.82, 95% CI: 1.50-5.27), and inadequate kangaroo mother care practices (aOR = 51.82, 95% CI: 31.77-84.51).

CONCLUSION: The proportion of preterm mortality was approximately similar to the national figures. Key determinants associated with preterm neonatal mortality included: early gestational age, maternal infections, inadequate kangaroo mother care (KMC), neonatal sepsis and inadequate respiratory support. Thus, continuous neonatal capacity building, improved KMC practices, appropriate use of neonatal equipment and regular cleanliness are recommended.

PMID:42252389 | DOI:10.1186/s40748-026-00272-9

J Behav Health Serv Res. 2026 Jun 7. doi: 10.1007/s11414-026-10004-8. Online ahead of print.

ABSTRACT

Evidence suggests that 10-30% of youth have co-occurring physical and mental or neurodevelopmental disorders (multimorbidity) and that up to 40% of youth with multimorbidity that require mental health services report unmet mental health care needs. This study examined mental health service use (i.e., perceived need or utilization) and access barriers among youth with multimorbidity (n = 3307) in comparison to youth with mental or neurodevelopmental disorders only (n = 2391). Data come from the 2019 Canadian Health Survey on Children and Youth (youth aged 5-17 years). Physical health conditions and mental and neurodevelopmental disorders were measured using a standard checklist. Participants were asked about the reasons for youth mental health services, professional consults, and among those who endorsed need/use of services if they had experienced barriers to access. Overall, 66.1% of youth in the sample perceived a need for or used services related to focusing/controlling behaviors, mental health, or learning difficulties; of these, 39.5% experienced barriers to accessing services. Compared to youth with mental or neurodevelopmental disorders only, those with multimorbidity were more likely to perceive need for services for mental health (AOR = 1.29 [1.10, 1.48]), and to consult psychiatrists (AOR = 1.32 [1.14, 1.62]). There was no significant difference in the overall difficulty in accessing services (AOR = 1.11 [0.92, 1.28]); however, youth with multimorbidity were more likely to experience barriers due to service unavailability (AOR = 1.48 [1.09, 2.13]). Findings underscore the importance for health systems to adopt models of care that integrate physical and mental health services, and for policies that eliminate mental health service barriers for youth with multimorbidity.

PMID:42252379 | DOI:10.1007/s11414-026-10004-8

Obes Surg. 2026 Jun 8. doi: 10.1007/s11695-026-08762-7. Online ahead of print.

ABSTRACT

BACKGROUND: Recurrent weight gain (RWG) after metabolic and bariatric surgery (MBS) is common, but clinically relevant thresholds remain debated. Health-related quality of life (HRQL) may provide a more patient-centered long-term outcome measure.

OBJECTIVE: To evaluate long-term HRQL trajectories according to eventual RWG phenotype, defined as < 30% versus ≥ 30% RWG after MBS.

METHODS: Prospective multicenter cohort study at two Dutch hospitals. HRQL was assessed using six BODY-Q scales and minimal important differences (MIDs) preoperatively, at 4 months and 1-5 years postoperatively. Patients were retrospectively stratified by eventual RWG phenotype. Analyses were performed separately for laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG).

RESULTS: Overall, 337 patients were included (LRYGB: 206 < 30% vs 19 ≥ 30%; LSG: 81 < 30% vs 31 ≥ 30%). Five-year HRQL data were available for 37-55% of patients across procedures and RWG groups. After LRYGB, longitudinal analyses showed no significant time × RWG interactions, although cross-sectional differences in physical function were observed at multiple time points (p = 0.005-0.033). After LSG, a significant time × RWG interaction was observed for physical function (p = 0.043), whereas differences in body image and psychological well-being at year 4 (p = 0.018) were isolated findings. MID achievement was largely similar between groups.

CONCLUSION: Long-term HRQL improvements and MID-based indicators of patient-perceived benefit were sustained after MBS in both eventual RWG groups. Physical function showed a significant time × RWG interaction after LSG, whereas longitudinal HRQL trajectories after LRYGB were comparable between RWG groups. Findings should be interpreted as associations with eventual RWG phenotype, particularly given the small ≥ 30% RWG subgroup after LRYGB (N = 19).

KEY POINTS: • Both patients who eventually developed < 30% and ≥ 30% RWG sustained HRQL improvements over five years; • Associations between RWG and physical function differed between procedures, with cross-sectional differences after LRYGB and longitudinal interaction effects after LSG; • Absolute BODY-Q scores and MIDs provide complementary insights, underscoring the importance of evaluating both statistical and patient-perceived benefits after MBS.

PMID:42252373 | DOI:10.1007/s11695-026-08762-7

CJEM. 2026 Jun 8. doi: 10.1007/s43678-026-01178-3. Online ahead of print.

ABSTRACT

BACKGROUND: Vertebral compression fractures are a common ED presentation in older adults and often lead to significant pain and functional decline. Oligoanalgesia can worsen morbidity. We aimed to describe pain assessment and management practices for older adults presenting to the ED with fragility vertebral compression fractures.

METHODS: We conducted a retrospective health records review of adults ≥ 65 years presenting to two tertiary EDs with acute thoracic or lumbar fragility vertebral compression fractures between August 2017 and August 2022. Patients with polytrauma, pathologic, or age-indeterminate fractures were excluded. Eligible cases were identified by ICD-10-CA codes, and data were abstracted using a standardized form. Primary outcomes were initial pain assessment, pain reassessment, and analgesic administration. Secondary outcomes included use of consultant and allied health services, discharge prescriptions, disposition, and 30-day return ED visits. Descriptive statistics were used.

RESULTS: Of 646 screened patients, 296 met inclusion criteria. Mean age was 81.4 (SD 8.3) years; 69.0% were female. An initial pain assessment was documented in 65.5%, but only 4.1% had a discharge pain score documented. Of those who had an initial pain assessment, 51.7% had pain reassessments during their ED care. 10.1% of patients received no analgesia. Acetaminophen (68.6%), opioids (54.7%), and NSAIDs (25.7%) were most frequently used. Consultants were contacted for 45.3% of patients. Allied health services were consulted for 23.3% of patients. Nearly one-third (30.4%) were admitted, primarily for pain management (62.2%); 19.3% of discharged patients returned within 30 days.

CONCLUSION: Emergency department care of older adults presenting with acute fragility compression fractures is suboptimal. Nearly one in three older adults did not have a pain assessment and one in ten received no analgesia during their ED visit. Identifying and overcoming barriers to quality care is crucial to ensure effective pain management for this population.

PMID:42252368 | DOI:10.1007/s43678-026-01178-3

Int J Legal Med. 2026 Jun 8. doi: 10.1007/s00414-026-03858-2. Online ahead of print.

ABSTRACT

BACKGROUND: Determining the shooting distance is one of the most crucial factors in firearm injuries and fatalities. When determining distance, it is important to carefully consider the barrel length, cartridge and fuse structures, extension, and environmental conditions. This study aims to measure the distance and ascertain the effects of extensions on pellet dispersal.

RESULTS: It was determined that there were noticeable differences in the pellet distributions between rounds fired at the same distance without extensions and those fired with 5-10-15 cm extensions. The diameter of the pellet dispersion decreased statistically as the choke length increased at distances greater than 100 cm (p < 0,05). It was also seen that the diameter of the pellet entry hole shrank in rounds fired between 200 and 400 cm due to an increase in extension length. Statistics showed that the differences were significant (p < 0.05). The largest satellite entrance hole distance decreased with extension length at 200 and 300 cm. There were statistically significant differences in satellite entrance hole distance (p < 0.05).

CONCLUSIONS: The study’s findings showed that the shotgun extensions directly impact pellet dispersal. It was acknowledged that the shot distance should not be calculated solely on the basis of target features without carefully analyzing the weapon and cartridge used in the incident.

PMID:42252364 | DOI:10.1007/s00414-026-03858-2

Sci Rep. 2026 Jun 7. doi: 10.1038/s41598-026-57333-4. Online ahead of print.

ABSTRACT

Mango fruits undergo various biochemical changes and ripen rapidly after harvest. This study evaluated the effects of salicylic acid (SA) and hot water treatment (HWT) on the maintenance of postharvest quality of mango cv. Dashehari under ambient storage conditions. Physiologically mature fruits were subjected to different treatments, including SA 1 mM, SA 2 mM, HWT, HWT + SA 1 mM, HWT + SA 2 mM, and distilled water (control). Compared with untreated fruits, the combined treatments HWT + SA 1 mM and HWT + SA 2 mM significantly reduced weight loss, decay incidence, electrolyte leakage, reactive oxygen species accumulation, and activities of fruit softening enzymes, while better maintaining fruit firmness, soluble solids content, titratable acidity, and ascorbic acid during storage. The responses of these two combined treatments were statistically comparable for most quality attributes; however, fruits treated with HWT + SA 1 mM exhibited significantly lower malondialdehyde content after storage. These findings suggest that the integration of SA with HWT is an effective strategy for delaying ripening and preserving the postharvest biochemical quality of mango fruits under ambient conditions.

PMID:42252351 | DOI:10.1038/s41598-026-57333-4

Eur J Nucl Med Mol Imaging. 2026 Jun 8. doi: 10.1007/s00259-026-07925-z. Online ahead of print.

ABSTRACT

PURPOSE: Numerous clinical features of Dementia with Lewy Bodies (DLB) are attributed to dysfunction in subcortical anatomy. Despite this, [¹⁸F]FDG PET imaging as a diagnostic tool for DLB largely relies on the metabolic signature of the occipital lobe, precuneus, and posterior cingulate cortex. This study aimed to assess subcortical brain metabolism in patients with DLB using [¹⁸F]FDG PET imaging.

METHODS: Patients diagnosed with probable DLB were included from both a prospectively maintained regional database (n = 33), and the ADNI database (n = 43). Using statistical parametric mapping (SPM) analysis, metabolic activity was compared with a cohort of subjects exhibiting normal brain metabolism (n = 19). A sub-analysis was conducted with disease progression included as a covariate.

RESULTS: Hypermetabolism was observed in various subcortical regions, notably in the dentate nucleus, anterolateral thalamus, and regions of the superior cerebellar peduncle. Increased metabolism was also detected in the mesencephalic tectum, likely representing heightened activity in the superior colliculus. All findings were reproduced in the ADNI cohort and were found to be dependent on the DLB disease stage. Additionally, the well-established cortical hypometabolic signature of DLB pathology was evident, validating our methods and findings.

CONCLUSION: Increased metabolic activity is evident in a variety of brainstem, cerebellar, and subcortical regions in patients with DLB. The dentatorubrothalamic tract, in particular, emerges as a structure of interest that connects these structures and potentially helps in understanding DLB pathophysiology. Correction for disease stage eliminated this pattern, suggesting a driver associated with disease progression.

PMID:42252350 | DOI:10.1007/s00259-026-07925-z

Bull Math Biol. 2026 Jun 7;88(6):105. doi: 10.1007/s11538-026-01668-6.

ABSTRACT

High-resolution imaging provides dense trajectories of migrating cells, flocking animals, and synthetic active particles, from which interaction laws can be determined with a wide variety of methods. Yet, distinguishing whether front-back or lateral biases seen in such data reflect intrinsic anisotropy in the interaction kernel or emergent correlations that are nevertheless produced by isotropic pairwise interaction forces remains an open challenge. We resolve this ambiguity by deriving a linear partial differential equation that connects measurable two-point velocity correlations to an unknown, distance- and angle-dependent interaction kernel. Turing-like instabilities can occur which allows for dipolar or quadrupolar patterns to arise even when agents interact according to an underlying attraction-repulsion law that is angle-independent. We then show that incorporating a weak velocity-alignment force can interfere with anisotropic pattern formation by suppressing dipolar patterns. We validate these predictions with agent-based simulations and provide design guidance for experiments that seek to discriminate intrinsic anisotropy from emergent effects.

PMID:42252345 | DOI:10.1007/s11538-026-01668-6