Tag: pubmed

Sante Publique. 2026;38(HS1):201-211. doi: 10.3917/spub.hs1.2026.0201.

ABSTRACT

INTRODUCTION: Supported Employment, based on the Individual Placement and Support (IPS) model, is increasingly implemented in France to promote the professional inclusion of people with mental health disabilities. This study examines its effects on employment outcomes and certain dimensions of mental health, as well as its implementation modalities.

METHODS: The study is based on a mixed-methods approach combining quantitative and qualitative analyses at three levels: organizations (N = 27), employment specialists (N = 71), and service users (N = 1,027, including N = 67 followed longitudinally over one year). Qualitative data were collected through 27 group interviews and telephone interviews conducted as part of the longitudinal follow-up.

RESULTS: An employment rate of 51% and a 6-month job retention rate of 62% were observed. Mental well-being increased among individuals who gained employment, while some dimensions of recovery progressed independently of employment status. Organizations showed a high level of fidelity to the IPS model, and employment specialists reported high levels of competency associated with employment outcomes.

DISCUSSION: These findings suggest that Supported Employment is not limited to facilitating access to employment but may also contribute to broader recovery processes. They highlight the role of employment specialists and the importance of cooperation between mental health, social, and employment sectors.

CONCLUSION: Supported Employment promotes professional inclusion and supports recovery trajectories in mental health. It constitutes a lever for improving public mental health.

PMID:42674991 | DOI:10.3917/spub.hs1.2026.0201

J Inherit Metab Dis. 2026 Sep;49(5):e70241. doi: 10.1002/jimd.70241.

ABSTRACT

Glycogen storage disease type Ia (GSDIa) is a rare, life-threatening inherited carbohydrate metabolism disorder caused by biallelic pathogenic G6PC gene variants resulting in deficiency of glucose-6-phosphatase. DTX401 is an investigational AAV8 vector containing the human G6PC gene. DTX401-CL301 is a pivotal, phase 3, double-blind, randomized, placebo-controlled trial of DTX401 in patients ≥ 8 years with GSDIa. The primary endpoint was percent change from Baseline to Week 48 in daily cornstarch intake for the DTX401 versus placebo group. Participants were randomly assigned (1:1) to blinded DTX401 or placebo. After the 48-week Primary Efficacy Analysis Period (PEAP), participants crossed over in a blinded manner for an additional 48-week blinded Crossover Period. Following randomization: 21 participants received DTX401; 25 received placebo. At Week 48, DTX401 treatment resulted in a statistically significant least squares (LS) mean (SE) daily cornstarch intake reduction of 41% (4.6) versus 10% (4.1) for Placebo (p < 0.0001). Clinical meaningfulness was evidenced by a mean desired percent reduction in daily cornstarch intake among those reporting in Baseline interviews (n = 33) of 45% (median = 41%). Greater and faster reductions in cornstarch were observed at Week 96 for the Crossover DTX401 group compared with the DTX401 group in the PEAP. The DTX401 safety profile was acceptable, and expected hepatic reactions consisting of transaminase elevations were managed with prophylactic corticosteroids. Treatment with DTX401 resulted in both a statistically significant and clinically meaningful reduction in cornstarch intake in the 48-week PEAP versus placebo, with greater cornstarch reductions in both groups at Week 96.

PMID:42674977 | DOI:10.1002/jimd.70241

AJNR Am J Neuroradiol. 2026 Aug 31:ajnr.A9615. doi: 10.3174/ajnr.A9615. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Recent advances in spontaneous intracerebral hemorrhage (ICH) management increasingly expand the role of neuroimaging beyond diagnosis to potentially guide time-sensitive therapies and targeted clinical trial enrollment. We surveyed neuroradiologists to characterize current ICH imaging and reporting practices and identify opportunities for quality improvement.

MATERIALS AND METHODS: An anonymous 52-item electronic survey was distributed through the American Journal of Neuroradiology Survey Corner and REDCap between April and May 2026. Survey domains included imaging acquisition, reporting practices, hematoma volume quantification, assessment of hematoma expansion predictors, ICH localization, etiologic assessment, and follow-up imaging. Responses were summarized using descriptive statistics.

RESULTS: A total of 267 neuroradiologists completed the survey. Nearly all respondents (97.3%) reported 24/7 emergency head CT interpretation coverage. However, 41.5% did not routinely quantify hematoma volume, only 45% reported routine CTA acquisition for patients with ICH, and 30% rarely or only occasionally recommended CTA when it was not performed. While 91.3% routinely reported a positive CTA spot-sign, only 43.0% almost always assessed non-contrast CT predictors of hematoma expansion. Confidence in hemorrhage localization when crossing anatomical boundaries and etiologic classification was modest, and 45.8% routinely used the Boston Criteria version 2.0 for MRI-based assessment of cerebral amyloid angiopathy.

CONCLUSIONS: Contemporary neuroradiology practice demonstrates several readily addressable gaps in ICH imaging and reporting, including hematoma volume quantification, routine vascular imaging, standardized assessment of hematoma expansion imaging markers, and etiologic assessment. Standardizing these practices can improved image guided risk-stratification and facilitate implementation of emerging time-sensitive ICH therapies.

PMID:42674966 | DOI:10.3174/ajnr.A9615

AJNR Am J Neuroradiol. 2026 Aug 31:ajnr.A9613. doi: 10.3174/ajnr.A9613. Online ahead of print.

ABSTRACT

BACKGROUND: Fibrocartilaginous embolism (FCE) is a rare but serious cause of spinal cord infarction. Vertical disc herniation (e.g., Schmorl’s nodes) may enable FCE in the thoracolumbar spine but is unlikely in the pediatric cervical spine. We hypothesized that radial disc herniation (annular fissuring), rather than vertical herniation, may contribute to cervical spinal cord infarction in children via an FCE mechanism.

METHODS: In this retrospective case-control study, the frequency of annular fissures and nuclear degeneration was assessed in patients with possible FCE from January 2004 to December 2023. The presumed diagnosis of FCE was based on clinical evaluation characteristic imaging findings of cord infarction, and exclusion of other diagnoses in electronic medical records. The two control groups included children without myelopathy (Control 1), selected during a 6-month consecutive sampling period from March to July 2014, and children with non-compressive cervical myelopathy (Control 2), selected through consecutive sampling from April 2004 to February 2014. Data analysis was performed using SPSS (IBM, version 29.0). The significance level was p<0.05.

RESULTS: A total of 156 children were included, 18 with possible FCE (Case) and 138 without (Control 1 and Control 2 with 39 and 99 patients, respectively). The median ages (IQR) were 12.6 (9.0-16.5), 9.6 (5.0-15.6), and 10.3 (5.0-14.6) years for Case, Control 1, and Control 2 groups respectively and 48.1% (75/156) were female. Annular fissures were observed in 28.8% (45/156) across ≥1 disc levels, and all patients showed nuclear degeneration at one or more disc levels. Among FCE patients, 88.9% (16/18) had at least one annular fissure. The odds ratio of having an annular fissure in FCE patients compared with the total control group was 30.06 (CI [6.53-138.30]). The odds ratio compared with Control 1 was 31.60 (CI [6.70-148.83]) and compared with Control 2 was 26.66 (CI [5.13-138.56]).

CONCLUSION: This study demonstrated a statistically significant association between annular fissures and cervical spinal cord infarction. This finding is consistent with the theory that disc material may embolize through a radial annular tear into the cervical spinal cord microcirculation.

PMID:42674965 | DOI:10.3174/ajnr.A9613

Acad Radiol. 2026 Sep 1:S1076-6332(26)00595-7. doi: 10.1016/j.acra.2026.08.008. Online ahead of print.

NO ABSTRACT

PMID:42674936 | DOI:10.1016/j.acra.2026.08.008

Eur Urol Oncol. 2026 Aug 31:S2588-9311(26)00190-2. doi: 10.1016/j.euo.2026.07.001. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The Food and Drug Administration and the European Medicine Agency approved erdafitinib for patients with FGFR3-altered metastatic urothelial carcinoma (mUC), highlighting the central role of tumor molecular profiling for patients with mUC. Although different studies described the molecular landscape of muscle-invasive bladder cancer (MIBC) using publicly-available data, a dedicated evaluation of real-world actionable alterations, with evidence-based therapeutic recommendations according to current Molecular Tumor Board (MTB) guidelines, is still lacking.

DESIGN, SETTING, AND PARTICIPANTS: We characterized actionable genetic alterations in a retrospective cohort of 233 patients with MIBC/mUC (Muscle-Invasive Erlangen [MIER] cohort) using targeted sequencing.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Clinically relevant variants were assessed through a custom bioinformatics workflow and expert medical review. To validate their clinical relevance in a real-world setting, we examined actionable alterations and associated therapy recommendations in a cohort of 40 patients with MIBC/mUC undergoing routine diagnostics (MTB cohort).

RESULTS AND LIMITATIONS: In the MIER cohort, 95% of patients (n = 226/233; 95% confidence interval [CI], 94-99) harbored at least one pathogenic/likely pathogenic variant. Therapeutically relevant FGFR3 alterations were identified in 11% of patients (n = 26/233; 95% CI, 7.4-16). Additionally, 40% of patients (95% CI, 34-47) showed alterations in 24 biomarkers for FDA-approved therapies. In the MTB cohort, 55% of patients received either on-label (5.0%) or off-label (50%) therapy recommendations. Notably, the recommendation was implemented in only one patient, who achieved stable disease for 4 mo with off-label alpelisib. Retrospectively, similar on-label and off-label indications could have applied to 10% and 70% of patients in the MIER cohort, respectively.

CONCLUSIONS: Overall, evidence-based indications for on-label and off-label therapies were observed for the majority of patients with MIBC/mUC. However, our results also revealed a significant gap between the high prevalence of actionable findings and the actual implementation of MTB-guided treatments in clinical practice, suggesting a need for enhanced therapy access and physician adherence to MTB recommendations.

PMID:42674932 | DOI:10.1016/j.euo.2026.07.001

Clin Ther. 2026 Aug 31:S0149-2918(26)00284-5. doi: 10.1016/j.clinthera.2026.08.003. Online ahead of print.

ABSTRACT

PURPOSE: Plantar fasciopathy is the most common cause of heel pain in adults and is estimated to affect about 10% of people over their lifetime. The National Institute for Health and Care Excellence notes that extracorporeal shockwave therapy (ESWT) for refractory plantar fasciitis raises no major safety concerns but has inconsistent efficacy evidence and should be used with special governance/audit arrangements; further research with validated outcomes and ≥1‑year follow-up is encouraged.

METHODS: This prospective, single-arm clinical series followed consecutive patients treated for refractory plantar fasciopathy in a publicly funded UK musculoskeletal service. Participants received a standardized program of 3 weekly radial ESWT (rESWT) sessions (2500 impulses; 10 Hz; 2-4 bar according to tolerance; no local anesthetic). The primary outcome was participant-level Foot Function Index (FFI) total score at baseline, 6 and 12 months.

FINDINGS: Of 50 patients (71 heels) with plantar fasciopathy underwent the treatment protocol. Mean (SD) FFI improved from 60.3 (20.9) at baseline to 37.3 (23.0) at 6 months and remained improved at 39.5 (24.6) at 12 months. Improvements from baseline to 6 months (mean difference 23.0, P < 0.001) and baseline to 12 months (mean difference 20.8, P < 0.001) were statistically significant. There was no significant change between 6 and 12 months (P = 0.451).

IMPLICATIONS: In this real-world NHS cohort with refractory plantar fasciopathy, rESWT was associated with substantial improvement in FFI by 6 months, sustained through to 12 months. As the study had no comparator, causality cannot be confirmed in this the single-arm study. However, these findings support further controlled trials and provide useful data to confirm their design and sample size.

PMID:42674927 | DOI:10.1016/j.clinthera.2026.08.003

Ultrasound Med Biol. 2026 Aug 31:S0301-5629(26)00303-0. doi: 10.1016/j.ultrasmedbio.2026.07.029. Online ahead of print.

ABSTRACT

OBJECTIVE: Breast ultrasound imaging is widely used for the early detection of malignant breast lesions. Although deep learning models have shown strong performance, most approaches rely solely on raw image features and overlook clinically significant characteristics essential for reliable diagnosis. This study aims to develop a graph-based neural network model that integrates medically meaningful features to improve malignancy detection in breast ultrasound images.

METHODS: The Breast Ultrasound (BUS) and Breast Ultrasound 2 (BUS2) datasets were pre-processed for region extraction using a bit-wise AND operation. Clinically relevant tumor features, such as shape, texture and statistical attributes, were extracted using Histogram of Oriented Gradients, gray-level co-occurrence matrix (GLCM) and histogram descriptors from the BUS, BUS2 and Mendeley Breast Ultrasound datasets. Each image was represented as a graph node with feature attributes, with the edges constructed using k-nearest neighbors based on feature similarity. A GraphSAGE-based graph neural network classifier with mean, max and long short-term memory (LSTM) aggregators was trained and evaluated.

RESULTS: On the BUS dataset, the proposed approach achieved accuracies of 92.89% (mean), 93.20% (max) and 94.13% (LSTM). On the Mendeley Breast Ultrasound dataset, accuracies reached 99.80% (mean), 99.60% (max) and 99.99% (LSTM). For the BUS2 dataset, accuracies were 71.96% (mean), 73.15% (max) and 73.19% (LSTM). On the combined BUS-BUS2 dataset, the model achieved 86.69% (mean), 86.58% (max) and 87.62% (LSTM).

CONCLUSION: The proposed GraphSAGE-based graph neural network effectively incorporates clinically significant features for breast ultrasound malignancy detection and demonstrates strong generalization across multiple datasets. By modeling feature-based relationships among ultrasound images through a graph structure, the proposed framework captures similarities between lesions and enhances classification performance. These findings highlight the potential of graph-based representations for improving computer-aided breast cancer diagnosis using medically meaningful descriptors.

PMID:42674880 | DOI:10.1016/j.ultrasmedbio.2026.07.029

Influenza Other Respir Viruses. 2026 Sep;20(9):e70314. doi: 10.1111/irv.70314.

ABSTRACT

BACKGROUND: In Kenya, influenza and other respiratory viruses circulate year-round. The Ministry of Health monitors severe acute respiratory infections (SARI), including influenza-associated hospitalizations, through a sentinel surveillance network. We developed intensity thresholds (ITs) to assess seasonal severity based on respiratory illness- and influenza-associated hospitalizations.

METHODS: Nine surveillance sites contributed data from January 2019 through December 2025 (with rolling start dates). Weekly all-cause admissions, respiratory illnesses, and influenza testing in pediatric (0-13 years) and adult (≥ 14 years) medical wards were collected using retrospective record review (prior to June 2023) and SARI surveillance platform reporting (June 2023 onwards). Four sites had sufficient historical data to calculate ITs for the 2024 assessment; eight sites were included for 2025. We used the moving epidemic method to calculate annual and biannual ITs for moderate (50th percentile; IT₅₀), high (IT₉₀), and very high (IT₉₈) severity for the percentage of hospitalizations for respiratory illness and influenza, overall and by age group.

RESULTS: During 2024 and 2025, respiratory illness-associated hospitalizations remained below the IT₅₀ for most of the year across age groups, with 1-2 weeks above the IT₅₀. Influenza-associated hospitalizations also remained below the annual IT₅₀ in both years but exceeded the biannual IT₅₀ for several weeks at each wave’s peak.

CONCLUSIONS: In 2024 and 2025, respiratory illness-associated and influenza-associated hospitalization severity was low to moderate. This approach can guide public health activities in Kenya, contribute to global influenza surveillance, and provide a framework to assess influenza severity in countries without clear Northern or Southern Hemisphere seasonality.

PMID:42674866 | DOI:10.1111/irv.70314

J Fish Dis. 2026 Aug 31:e70268. doi: 10.1111/jfd.70268. Online ahead of print.

ABSTRACT

Poikilothermic organisms like fish are key economic drivers in aquaculture and the ornamental fish trade. Climate change impacts the health of fish because poikilothermic hosts experience the same temperature as their environment, making temperature a critical determinant of parasite infection dynamics. Pseudocapillaria tomentosa, a capillarid nematode infecting approximately 20% of zebrafish research facilities, provides an excellent model for investigating temperature effects on nematode development because zebrafish can tolerate a wide temperature range. We examined how water temperature influences egg development and worm maturation across the zebrafish’s tolerable thermal range (13°C-35°C). Eggs held at 4°C or 13°C failed to larvate but resumed development when returned to 28°C. Larvation increased at 35°C, though infectivity was reduced in larval zebrafish. In adult zebrafish, cold water (13°C) slowed worm development for up to 3 months; only immature larvae were observed even at 102 days post-exposure. Returning these fish to 28°C triggered rapid maturation, with gravid females appearing within 1 month. Conversely, fish held at 35°C had reduced worm burdens and arrested maturation compared to 28°C controls, with development resuming after temperature reduction. These findings align with field observations of seasonal P. tomentosa dynamics in temperate climates.

PMID:42674860 | DOI:10.1111/jfd.70268