Tag: pubmed

Traffic Inj Prev. 2026 May 20:1-17. doi: 10.1080/15389588.2026.2663051. Online ahead of print.

ABSTRACT

OBJECTIVE: The 50 year trends were determined for societal costs and injury HARM from motor vehicle crashes in the U.S. The injury and fatality HARM provides a basis to set priorities and for cost-benefit analyses in automotive safety. The over- and under-counting of injuries and deaths was analyzed, and the costs for injury fraud, malingering, victim psychology, and product liability were evaluated.

METHODS: NHTSA published eight studies since 1970 showing societal costs for motor vehicle crashes, including medical costs, property damage, productivity losses, insurance administration, losses to other individuals, employer losses, funeral costs, community service losses, pain and suffering, and miscellaneous accident costs. The trend in costs was determined for: (1) total societal costs, (2) injury HARM, (3) fatalities, (4) nonfatal injuries, (5) MAIS 4 + F, and (6) MAIS 1-3 injuries. The costs were adjusted for inflation to 1971 dollars (’71$) based on the annual CPI (Consumer Price Index). A linear trend line was fit to the various costs with the goodness of fit given by the correlation coefficient (R).

RESULTS: The societal cost (C) of motor vehicle crashes was $339.8B in 2019 up from $46.0B in 1971. This was a 7.39-fold increase, or 13.0%/yr annual increase. The linear fit gave C = $6.19B (yr – 1,967), R = 0.978. The compound increase was 4.14%/yr. The injury HARM cost (H) from fatal and nonfatal injuries was $309.1B in 2019 up from $38.1B in 1971. This was an 8.01-fold increase, or 14.3%/yr annual increase. The linear fit gave H = $5.63B (yr – 1,968), R = 0.972. The compound increase was 4.64%/yr. After adjusting for inflation, the societal cost was ’71$52.5B in 2019. This was a 1.142-fold increase or 0.291%/yr annual increase. The linear fit gave C (’71$) = $0.283B (yr – 521), R = 0.554. The ’71$ compound increase was 0.200%/yr. HARM cost increased to ’71$47.8B in 2019. This was a 1.238-fold increase or 0.486%/yr annual increase. The linear fit gave H (’71$) = $0.333B (yr – 625), R = 0.62. The ’71$ compound increase was 0.644%/yr. The greatest increase in injury costs was for MAIS 2-4 injuries with only a modest increase in a fatality cost from $200,700 in 1971 to ’71$247,442 in 2019. NHTSA added quality of life costs to the economic costs giving a high value for a statistical life (VSL), increasing the value of life in cost-benefit analyses.

CONCLUSIONS: The societal cost and injury HARM from motor vehicle crashes increased above inflation over the past 50 years. NHTSA should set 5-year targets and track long-term trends for fatalities and HARM. Cost-benefit analyses depend on VSL, which is based on a willingness to pay. VSL over-values a life. NHTSA over- and under-counts injuries and deaths. The societal costs do not adequately address criminal and insurance fraud, like the Queens and helpful wave schemes, malingering, manipulation of medical imaging and treatments, victim psychology, Lithuanian experiences, and product liability.

PMID:42160709 | DOI:10.1080/15389588.2026.2663051

Folia Morphol (Warsz). 2026;85:e01726095. doi: 10.5603/fm.112025.

ABSTRACT

BACKGROUND: Accurate characterization of fetal thoracic development is essential for improving prenatal assessment and early detection of structural abnormalities. The aim of this study was to evaluate the morphometric and proportional characteristics of the fetal thoracic cavity during mid and late gestational periods.

MATERIALS AND METHODS: A total of 32 fetal specimens (16 mid gestation, 16 late-gestation) were included. Crown-rump length (CRL), transverse diameter (TD), anteroposterior diameter (AP), and thoracic circumference (TC) were measured and analyzed using descriptive statistics, between-group comparisons, correlation, and regression methods.

RESULTS: All parameters increased significantly from mid to late gestation (p < 0.001). The greatest relative growth was observed in TD (≈55%), indicating that transverse expansion represents the dominant pattern of thoracic development. Regression analysis demonstrated that in mid gestation, TC could be reliably predicted by TD alone, whereas in late gestation the inclusion of AP improved predictive accuracy, reflecting increasing structural complexity. Minimal clinically important difference (MCID) analysis confirmed that these changes were not only statistically significant but also clinically meaningful.

CONCLUSIONS: Fetal thoracic development follows stage-specific growth patterns with important clinical implications. The findings provide preliminary data that may support improved prenatal evaluation, the establishment of population-specific normative data, and enhanced prediction of fetal respiratory system maturity.

PMID:42160706 | DOI:10.5603/fm.112025

Folia Morphol (Warsz). 2026;85:e01726096. doi: 10.5603/fm.111811.

ABSTRACT

BACKGROUND: Failure of inferior alveolar nerve block may be attributable to anatomical variations in the location of the mandibular foramen. This study aimed to determine the 3D location of the mandibular foramen (MF) using cone-beam computed tomography (CBCT) and compare the measurements across different sagittal facial types in Asians.

MATERIALS AND METHODS: CBCT scans of 60 mandibles (10 retrognathic, 10 normal, 10 prognathic per gender) were analyzed. The injection pathway was simulated as a line through MF and contralateral lower premolar (MF-cL4). The distances from MF to ramus borders and the angles between MF-cL4 and the mid-sagittal plane (MSP), the mandibular plane (MP) and the lower occlusal plane (LOP) were measured. Data analysis was conducted using descriptive statistics and two-way ANOVA.

RESULTS: Distances from MF to the ramus borders were significantly greater in males than in females (p < 0.05). The distance between MF and the sigmoid notch of prognathic mandibles was greater than in normal/retrognathic types (p < 0.05). Angle MF-cL4-MSP was highly stable at 50.9° ± 2.9°, whereas angle MF-cL4-LOP exhibited significant individual variation with a coefficient of variation (CV) of 63.9%.

CONCLUSIONS: In Asians, MF was consistently located within the upper posterior quadrant of the ramus. Its anteroposterior position remains stable when referenced to MSP and cL4. In prognathic mandibles, MF positioned inferiorly relative to normal and retrognathic mandibles.

PMID:42160705 | DOI:10.5603/fm.111811

J Trop Pediatr. 2026 Apr 11;72(3):fmag031. doi: 10.1093/tropej/fmag031.

ABSTRACT

Preterm birth remains a leading cause of neonatal mortality, disproportionately affecting low-and middle-income countries (LMICs). Surfactant replacement therapy (SRT) is a key intervention for neonatal respiratory distress syndrome (RDS). However, due to cost and differing guidelines there are likely differences in SRT in different parts of the world. This study compared surfactant use, timing of administration, and associated neonatal outcomes in very low birth weight (VLBW) infants born in high-income countries (HICs) versus middle-income countries (MICs), with further analysis of public and private centers within MICs. This secondary analysis of prospectively collected data using the Vermont Oxford Network database included 271 826 inborn VLBW infants from 2018 to 23. Data were stratified by country income classification and ownership (public center vs. private center) in MICs. Surfactant use was highest in private MIC centers (64.1%), followed by HICs (55.3%), and public MIC centers (43.5%). Median time to first surfactant dose was shortest in private MIC centers (60 min) and longest in public MIC centers (120 min). Infants in HICs were more likely to receive delivery room continuous positive airway pressure and earlier surfactant. Survival post-SRT was highest in HICs (88.1%) and lowest in public MIC centers (69.5%) with sepsis being a particular problem in MICs. Disparities in the proportion of infants receiving SRT, the timing of doses, and neonatal outcomes such as mortality and sepsis rates persist between HICs and MICs, and between public and private sectors in MICs.

PMID:42160703 | DOI:10.1093/tropej/fmag031

JCO Glob Oncol. 2026 May;12(5):e2500317. doi: 10.1200/GO-25-00317. Epub 2026 May 20.

ABSTRACT

PURPOSE: The combination of venetoclax (VEN) and a hypomethylating agent (HMA) is a standard of care for patients with AML and higher-risk myelodysplastic syndromes (MDS). However, real-world outcomes data from low- and middle-income countries are scarce, where constraints in advanced diagnostics, financial resources, and supportive care infrastructure present unique challenges. This study evaluates the efficacy and safety of this regimen in a resource-limited setting.

MATERIALS AND METHODS: We conducted a retrospective analysis of 96 patients (AML, n = 54; MDS, n = 42) treated with HMA + VEN at a single center between January 2020 and December 2024. Key outcomes included overall survival (OS), disease-free survival (DFS), and response rates, assessed per standard criteria.

RESULTS: The median age was 52 years for patients with AML and 51 years for patients with MDS. In the AML cohort, OS was 77.4% and DFS was 52.8% at 2 years. The overall response rate (ORR) reached 66.6% at end of treatment (EOT), with 55.5% achieving complete remission. In the MDS cohort, 2-year OS was 59.5% and DFS was 44.4%. The most common major toxicity was febrile neutropenia (AML: 66.7%; MDS: 54.8%), although no related mortality occurred. A minority of patients underwent consolidative transplant (AML: 12.9%; MDS: 21.4%). Statistical analysis identified EOT ORR and VEN maintenance as significant for AML OS, while relapse was a critical factor for MDS OS.

CONCLUSION: The HMA-VEN combination is a highly effective and feasible treatment for AML and MDS, even within a resource-limited setting. The findings underscore the critical need for improved supportive care measures, expanded access to molecular diagnostics for risk stratification, and the development of individualized treatment strategies to optimize patient outcomes.

PMID:42160693 | DOI:10.1200/GO-25-00317

J Chem Inf Model. 2026 May 20. doi: 10.1021/acs.jcim.6c00885. Online ahead of print.

ABSTRACT

Genotoxicity assessment is crucial for drug development and chemical safety evaluation. However, traditional experimental approaches are time-consuming, resource-intensive, and raise ethical concerns related to animal testing. Although computational models offer efficient alternatives, most existing approaches treat all data points equally, disregarding the heterogeneous quality of public database records and rarely addressing predictive uncertainty. We present a reliability-aware framework for genotoxicity prediction using a curated data set of 8,389 compounds annotated with experimental reliability tiers reflecting protocol quality, reproducibility, and review status. A two-step hierarchical learning strategy is employed. First, a message-passing neural network trained on high- and medium-reliability data is used to evaluate low-reliability samples and assign adaptive weights. These weights are then incorporated into conventional machine learning models, including random forest, support vector machine (SVM), and logistic regression, using molecular fingerprints. To address predictive uncertainty, we integrate conformal prediction, which provides distribution-free, finite-sample coverage guarantees for individual predictions. Random forest and RBF-kernel SVM achieved AUC values of 0.8613 and 0.8582, respectively, with Brier scores of 0.1523 and 0.1530. Conformal prediction attained 90.7% empirical coverage at α = 0.1 and identified 35.8% of test compounds as ambiguous. By incorporating data reliability and uncertainty quantification, the proposed framework provides a more transparent and uncertainty-aware approach.

PMID:42160670 | DOI:10.1021/acs.jcim.6c00885

ACS Nano. 2026 May 20. doi: 10.1021/acsnano.6c05258. Online ahead of print.

ABSTRACT

The chiral-induced spin selectivity (CISS) effect presents a promising avenue for enhancing electrocatalytic processes through spin-polarized electron transfers. However, a comprehensive understanding of how nanoscale chirality influences catalytic activity has remained elusive. In this study, we employ scanning electrochemical cell microscopy (SECCM) to directly investigate the oxygen evolution reaction (OER) at individual chiral Au nanocrystals featuring precisely tunable helicoidal morphologies. Such a single-chiral-particle measurement allows the decoupling of the CISS effect from other influencing factors on the intrinsic OER activity. Our finding reveals that chiral D- and L-Au nanocrystals exhibit a 70% increase in OER activity compared to their achiral counterparts. Furthermore, the increasing OER activities of chiral nanocrystals with different helicities were statistically significant (p < 0.001, ANOVA), leading to a positive correlation between spin polarization and chiral-enhanced activity. This single-chiral nanoparticle electrochemical measurement not only provides mechanistic insight into CISS-mediated electrocatalysis but also establishes a design principle for the development of highly efficient spin-selective catalytic nanomaterials.

PMID:42160667 | DOI:10.1021/acsnano.6c05258

J Urol. 2026 May 20:101097JU0000000000005127. doi: 10.1097/JU.0000000000005127. Online ahead of print.

ABSTRACT

PURPOSE: MRI membranous urethral length is associated with post-prostatectomy continence. Nevertheless, it is not routinely used for patient counseling because predictive models haven’t been externally validated. The objective of this study was to assess the performance of membranous urethral length continence model on an external cohort.

METHODS: A continence prediction model was applied to a prospective cohort of patients with a pre-prostatectomy MRI and validated assessment of post-operative continence between 2015-2023. Patients from multiple surgeons underwent open or robotic prostatectomy. Membranous urethral length was retrospectively measured by two reviewers. The model included: age, nerve spare plan, prostate volume, surgical approach, and membranous urethral length. Continence definitions were: 0 pads/24hours and 0-1 pad/24 hours. Model performance was assessed using c-statistics, calibration curves, and decision curve analyses.

RESULTS: Among 500 patients, median membranous urethral length was 11 mm (IQR 8.1, 14). One-year post-prostatectomy continence (defined as 0 pads/24h) occurred in 312 (62%) patients. The c-statistic was 0.64 (95% CI 0.59, 0.69). The calibration was poor. The decision curve analysis showed no net-benefit of using the model. Continence defined as 0-1 pad/24h was achieved in 450 (90%) patients. The c-statistic was 0.69 (95%CI 0.61, 0.76) and the calibration was moderate. Decision curves showed a net-benefit of using the model over a range of clinically relevant continence risk thresholds.

CONCLUSION: This recalibrated prediction model incorporating MRI derived membranous urethral length provides net-benefit for predicting continence defined as 0-1 pad/24h. However, the model was not useful for predicting 0 pad use.

PMID:42160664 | DOI:10.1097/JU.0000000000005127

Lab Med. 2026 Apr 3;57(3):lmag025. doi: 10.1093/labmed/lmag025.

ABSTRACT

INTRODUCTION: ATP2B1 and STK39 loci influence blood pressure in genome-wide association studies. We tested whether ATP2B1 rs2681472 and STK39 rs35929607 are associated with essential hypertension and blood pressure.

METHODS: We studied 194 untreated hypertensive adults and 191 normotensive control individuals. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. Logistic regression evaluated hypertension risk, and linear regression assessed systolic and diastolic blood pressure (BP) under genotypic, dominant, and additive models, with adjustment for clinical covariates; the false discovery rate was controlled.

RESULTS: The STK39 rs35929607 G allele was associated with hypertension (adjusted odds ratio [OR], 1.97 [95% CI, 1.21-3.21]; P = .007) and higher systolic BP (+8.02 mm Hg per G allele, 95% CI, 2.18-13.87; P = .007). Effects on diastolic BP were weaker (additive P = .10; dominant P = .06). ATP2B1 rs2681472 showed no statistically significant associations (hypertension per T allele OR, 1.18 [95% CI, 0.74-1.87]; P = .49). In sex-stratified analyses, STK39 associations were evident in men (hypertension OR, 3.22 [95% CI, 1.42-7.31]; P = .005; systolic BP, +15.88 mm Hg [95% CI, 5.95-25.80]; P = .002) but not in women.

DISCUSSION: In our study cohort, STK39 rs35929607 is associated with essential hypertension and higher systolic BP, with possible sex-specific effects. ATP2B1 rs2681472 is not associated with hypertension or BP traits.

PMID:42160625 | DOI:10.1093/labmed/lmag025

J Pak Med Assoc. 2026 Apr;76(4):567-570. doi: 10.47391/JPMA.20901.

ABSTRACT

OBJECTIVE: To evaluate adherence to the guidelines for the management of gallstones in a tertiary care setting.

METHODS: The clinical audit was conducted at the General Surgical Unit VI, Civil Hospital, Karachi, and comprised data of laparoscopic cholecystectomy from October 1 to November 1, 2023. Management practices were assessed using the guidelines published by the National Institute of Health and Care Excellence. The audit conformed to the Standards for Quality Improvement Reporting Excellence 2.0 guidelines for quality improvement projects. Data was analysed using SPSS 20.

RESULTS: Of the 62 patients, 49(79%) were females, 12(21%) were males, 18(29%) were aged 40-50 years and 17(27.4%) were aged 30-49 years. All the 62(100%) patients underwent liver function tests and an ultrasound of the abdomen. There were 26(41.9%) patients with acute cholecystitis, and 6(23%) underwent surgery within a week of diagnosis as recommended. There were 48(77.4%) symptomatic patients, and the recommended day-care admission was employed for 15(31,3%).

CONCLUSION: The delay in surgical intervention for acute cholecystitis warranted attention. Balancing this with resource limitations underscored the need for effective adaptive strategies to optimise patient care.

PMID:42160558 | DOI:10.47391/JPMA.20901