Tag: pubmed

Ann Surg Oncol. 2026 Apr 2. doi: 10.1245/s10434-026-19458-8. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare the perioperative and oncologic outcomes between robotic and open retroperitoneal lymph node dissection in patients with testicular cancer.

METHODS: The study was conducted in accordance with the PRISMA guidelines, and quality assessment was performed following the AMSTAR criteria. A systematic search was performed in Embase, PubMed, and Web of Science databases, with the search period up to July 2025. Statistical analysis was performed using Stata 17 software.

RESULTS: The current results showed that compared with open retroperitoneal lymph node dissection (O-RLND), robotic retroperitoneal lymph node dissection (R-RPLND) had a shorter hospital length of stay (effect, – 3.68; 95 % confidence interval [CI], – 4.16 to – 3.21; P < 0.05), less estimated blood loss (effect, – 296.09; 95 % CI, – 416.62 to – 175.55; P < 0.05), and a lower overall complication rate (relative risk, 0.66; 95 % CI, 0.49-0.89; P < 0.05). Lymph node production and recurrence rate did not differ significantly between the two.

CONCLUSION: Robotic retroperitoneal lymph node dissection appears to be safer than O-RLND and has a faster postoperative recovery. Oncologic outcomes did not differ significantly, but more research is needed to explore further.

PMID:41927958 | DOI:10.1245/s10434-026-19458-8

AAPS J. 2026 Apr 3;28(3):85. doi: 10.1208/s12248-026-01213-2.

ABSTRACT

This study presents a workflow for virtual bioequivalence (VBE) assessment of 3-month paliperidone palmitate (PP) long-acting injectable (LAI) suspensions using a novel physiologically-based pharmacokinetic (PBPK) model. The mechanistic absorption and PBPK model was implemented in the Simcyp® Simulator and calibrated against individual concentration-time profiles derived from a published and validated population pharmacokinetic model. The model was able to accurately simulate drug concentration profiles after PP administration. Across 1000 subjects, four model-predicted bioequivalence (BE) metrics, including C_max,ss and AUC_tau,ss, differed by at most 10% from validation data. The initial mean drug particle radius was assessed as the critical formulation attribute in the VBE analysis. We conducted extensive VBE simulations to evaluate the required sample size of parallel trial designs for a given statistical power. The statistical power of two-one-sided t tests (TOST) to declare BE was estimated from the passing rate of Monte Carlo simulated VBE trials. Power calculations using the validated model indicated that a VBE trial with a minimum of 160 subjects per arm is required to achieve at least 80% power for declaring BE when the formulations are identical in terms of mean particle size. If the mean drug particle radius between test and reference formulations differs by 20%, the required sample size for BE demonstration approximately doubles to maintain the same power. This suggests that particle size affects formulation variability. The power calculations demonstrated that BE assessments were very sensitive to formulation differences in drug particle radius and to the parametrization of the model. These findings emphasize the critical need for rigorous model validation to ensure reliable VBE assessments.

PMID:41927954 | DOI:10.1208/s12248-026-01213-2

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-46698-1. Online ahead of print.

ABSTRACT

Necrotising enterocolitis (NEC) is a devastating gastrointestinal disease of premature infants, in which hypoxia-induced apoptosis plays a critical role in intestinal epithelial injury. The balance between pro-apoptotic and anti-apoptotic proteins, particularly Bax and Bcl-2, as well as the hypoxia-responsive transcription factor HIF-1α, are key determinant of epithelial survival. Sildenafil citrate, a phosphodiesterase-5 inhibitor, has been shown to improve microcirculation and exert anti-apoptotic effects through nitric oxide-cGMP signalling, but its role in NEC-related intestinal injury remains poorly understood. This study aimed to evaluate the protective effects of sildenafil on apoptosis in a hypoxia-ischemia-induced NEC-like intestinal injury model. A total of 75 Wistar rat pups were randomly assigned to six groups: control, NEC, vehicle (saline+DMSO), and sildenafil-treated groups (1, 5, and 10 mg/kg/day). Sildenafil was administered intraperitoneally for 4 days before NEC induction. NEC was induced by hypoxia (100% nitrogen for 60 s, twice daily for 48 h) and followed by cold stress (10 min at 4 °C). Intestinal tissues were collected for histopathological scoring, caspase-3 immunohistochemistry, and quantitative RT-PCR analysis of HIF-1α, Bax, and Bcl-2 expression. Data were analysed using ANOVA and Kruskal-Wallis tests, with p ≤ 0.05 considered statistically significant. Pups subjected to hypoxia-induced intestinal ischemia exhibited severe villous damage, elevated histological injury scores, and marked upregulation of HIF-1α and Bax, along with downregulation of Bcl-2. Caspase-3 immunoreactivity strongly correlated with histological injury (Spearman’s ρ = 0.795, p < 0.001). Sildenafil pretreatment reduced histological damage and apoptosis in a dose-dependent manner. The Sil_10 group showed the lowest injury score (1.06 ± 0.4, p < 0.0001 vs. NEC), significantly reduced Caspase-3 labelling, suppressed Bax and HIF-1α expression, and increased Bcl-2 levels, resulting in a markedly reduced Bax/Bcl-2 ratio compared with NEC (p < 0.0001). Sildenafil attenuates hypoxia-induced, ischemia-dominant NEC-like intestinal injury by modulating apoptotic and hypoxia-related pathways, lowering HIF-1α expression, reducing Bax/Bcl-2 ratio, and preserving epithelial integrity. These findings provide novel histological and molecular evidence for the anti-apoptotic effects of sildenafil in experimental NEC, highlighting HIF-1α modulation as a potential therapeutic strategy.

PMID:41927903 | DOI:10.1038/s41598-026-46698-1

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-47139-9. Online ahead of print.

NO ABSTRACT

PMID:41927879 | DOI:10.1038/s41598-026-47139-9

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-46957-1. Online ahead of print.

ABSTRACT

Since its nationwide implementation in 2014, China’s standardized residency training system has aimed for homogeneous clinical competency outcomes. In obstetrics and gynecology, where minimally invasive techniques now dominate, this goal faces significant challenges. The high volume of laparoscopic procedures necessitates efficient training, yet traditional apprenticeship models within real-world clinical settings are often inconsistent, time-intensive, and carry inherent patient safety concerns. These factors can hinder the systematic and equitable skill acquisition required for reliable, standardized proficiency across all trainees. This study aimed to evaluate the efficacy of a structured laparoscopic simulator curriculum in improving basic surgical skills and promoting skill-level convergence among obstetrics and gynecology residents at different training stages. A prospective educational intervention was conducted at a national residency training base. Thirty residents (PGY-1, n = 10; PGY-2, n = 10; PGY-3, n = 10) undertook a standardized four-week curriculum on a box-trainer, covering four core skill modules. Performance was assessed weekly by task completion time and analyzed using repeated-measures ANOVA. Significant improvements in task efficiency were observed among PGY-1 and PGY-2 residents over the training period (p < 0.05), whereas PGY-3 residents maintained stable, proficient performance. By the end of the curriculum, no statistically significant differences in performance were observed among the three groups at Week 4. A structured simulator-based curriculum can effectively enhance basic laparoscopic skills among residents and may help achieve comparable skill outcomes across different training levels, indicating its potential as a useful adjunct to traditional clinical training.

PMID:41927862 | DOI:10.1038/s41598-026-46957-1

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-45702-y. Online ahead of print.

ABSTRACT

This study aimed to assess male barbers’ knowledge, attitudes, and practices (KAP) in Herat City, Afghanistan, regarding HBV/HCV transmission and prevention. A cross-sectional survey using a structured, localized KAP questionnaire based on validated tools was conducted from April to June 2025, involving 283 practicing male barbers in Herat. Descriptive statistics summarized binary scores, while associations between KAP and sociodemographic factors were analyzed using chi-square or Fisher’s exact tests, and logistic regression has also been applied (p < 0.05). Among 283 male barbers, good knowledge was higher among those aged 31-50 years (73.7%) compared with those aged 21-30 years (58.5%) and 18-20 years (48.5%) (p = 0.008), and among those with > 8 years of work experience (70.5%) compared with those with ≤ 8 years (45.8%) (p < 0.001). Good preventive practice was higher among barbers who had formal training (68.8%) compared with those without training (48.0%) (p < 0.001). In multivariable analysis, barbers with > 8 years of work experience had higher odds of good knowledge than those with ≤ 8 years (AOR = 2.74; 95% CI 1.40-5.35) (p = 0.003). For attitude, barbers with fair economic status had lower odds of a positive attitude compared with those with good economic status (AOR = 0.25; 95% CI 0.06-0.97) (p = 0.046), while those working > 12 h per day had higher odds of a positive attitude than those working ≤ 12 h (AOR = 1.98; 95% CI 1.11-3.51) (p = 0.020). For practice, barbers aged 21-30 years had lower odds of good practice than those aged 18-20 years (AOR = 0.32; 95% CI 0.16-0.66) (p = 0.002), barbers serving > 5 customers/day had lower odds of good practice than those serving ≤ 5 customers/day (AOR = 0.50; 95% CI 0.29-0.88) (p = 0.016), and barbers without formal training had lower odds of good practice than those with training (AOR = 0.50; 95% CI 0.29-0.89) (p = 0.017). Male barbers in Herat City demonstrate commendable hygiene practices but exhibit significant gaps in their knowledge and attitudes regarding HBV/HCV. These findings highlight the need for targeted education and vaccination programs, integrated into barber training, to improve preventive attitudes and reduce the risk of viral transmission. Public health interventions that incorporate barbers into hepatitis control strategies are essential for mitigating the spread of HBV/HCV in the community.

PMID:41927830 | DOI:10.1038/s41598-026-45702-y

J Imaging Inform Med. 2026 Apr 2. doi: 10.1007/s10278-026-01934-y. Online ahead of print.

ABSTRACT

This study proposes a Residual Conditional Variational Autoencoder model (ResCVAE-Harmonizer) that integrates batch information and clinical covariates for multi-center feature harmonization and systematically and comprehensively evaluates its harmonization performance. This study collected 806 cases from 9 different centers. After preprocessing, three types of features were extracted from PET and CT images: low-dimensional radiomic features, high-dimensional radiomic features, and deep learning features based on 3D-DenseNet-121. Each feature type was harmonized using ComBat, CovBat, and the proposed ResCVAE-Harmonizer. Both harmonized and original features were included in a comprehensive evaluation framework comprising variance homogeneity analysis, multi-center classification test, and downstream task effectiveness evaluation. The ResCVAE-Harmonizer significantly improved cross-center feature consistency. Levene’s test results showed a general reduction in – log₁₀(p) values after harmonization, with more pronounced improvements observed in low- and high-dimensional radiomic features. In center classification tasks, ResCVAE-harmonized features demonstrated greater stability across four classifiers and outperformed the original features. For the downstream survival prediction task, PET deep learning features processed by ResCVAE achieved the highest C-index (0.8920, 95% CI 0.8514-0.9325), surpassing those of the original features (0.8765), ComBat (0.8909), and CovBat (0.8455). Similarly, the C-index for CT deep features improved to 0.8296 (95% CI 0.7715-0.8877). Kaplan-Meier survival stratification based on ResCVAE features showed clearer separation between high- and low-risk groups, with statistically significant log-rank test results. While slightly inferior to ComBat in linear variance consistency, ResCVAE-Harmonizer effectively eliminated both linear and nonlinear batch effects and significantly enhanced survival prediction performance, demonstrating strong research potential.

PMID:41927822 | DOI:10.1007/s10278-026-01934-y

Sci Rep. 2026 Apr 2. doi: 10.1038/s41598-026-47272-5. Online ahead of print.

ABSTRACT

Although radiation hazards are prevalent in the operating room, making radiation protection critical for occupational safety, the current status of radiation-related knowledge and compliance with radiation safety practices remains suboptimal in many operating rooms. This study aimed to evaluate the current status and identify the influencing factors of radiation protection knowledge, safety practices, and compliance among operating room personnel. A cross-sectional survey was conducted among operating room personnel in hospitals at various levels in Hunan Province, China, using the Healthcare Professional Knowledge of Radiation Protection (HPKRP) scale was employed to assess radiation-related knowledge and a self-designed questionnaire to evaluate participants’ radiation protection compliance. Collected data were analyzed using SPSS 27.0, with statistical significance set at p < 0.05. A total of 381 participants were surveyed, including 349 operating room nurses (91.6%), 13 anesthesiologists (3.41%), and 19 surgeons (4.99%). Among these participants, 206 (54.07%) participants had received radiation-related training and only 27.8% routinely used at least one type of personal protective equipment (PPE) during potential radiation exposure. Multivariate regression analysis indicated tertiary hospitals, departments with standardized radiation protection management, and radiation-related training were independent factors associated with both superior radiation-related knowledge and better radiation protection compliance. Higher knowledge scores (OR = 2.366, p < 0.001) and physicians (OR = 4.845, p = 0.001) were independently associated with better radiation protection compliance. This study demonstrated that radiation relative knowledge and protection compliance need to be strengthened among physicians and operating room nurses. Standardized training and radiation protection management should be adopted according to specific needs of different hospitals and staff. These results offer meaningful evidences for the optimization of occupational radiation protection management and policy-making.

PMID:41927799 | DOI:10.1038/s41598-026-47272-5

Environ Monit Assess. 2026 Apr 3;198(4):402. doi: 10.1007/s10661-026-15194-4.

ABSTRACT

Urban expansion presents escalating challenges to ecological connectivity, while comprehensive research on long-term corridor conservation remains limited. This study integrates Omniscape with land-use scenario simulation to assess urbanization impacts on ecological networks in China’s Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and Pearl River Delta (PRD) regions. Key findings indicate: (1) By 2035, 41, 29, and 24 critical disruption points are projected for PRD, BTH, and YRD, respectively, requiring prioritized protection; (2) the expansion-loss ratio (corridor loss per urban growth unit) exhibits significant regional variation, with PRD (1.75) demonstrating ratios approximately 15% and 9% of those in YRD (11.56) and BTH (6.88); and (3) regionally tailored conservation strategies are essential due to distinct vulnerability patterns.

PMID:41927789 | DOI:10.1007/s10661-026-15194-4

AAPS J. 2026 Apr 3;28(3):86. doi: 10.1208/s12248-026-01215-0.

ABSTRACT

We present an analysis of statistical type I error and safe space calculations in virtual bioequivalence (VBE) assessments using a previously published physiologically-based pharmacokinetic (PBPK) model for 3-month long-acting paliperidone palmitate (PP) injectable suspensions. The type I error for the two-one-sided t test (TOST) applied to virtual parallel design bioequivalence (BE) trials was estimated through approximation of ‘simulated BE boundaries’. This was defined as the range of formulation critical quality attribute values (CQA, which in this paper pertains to mean drug particle radius), corresponding to simulated population-level geometric mean ratios (GMRs) for key pharmacokinetic (PK) metrics of between 0.8 to 1.25. Monte Carlo simulations were then used to combine these limits with power calculations to display estimates of the safe space for BE extending from a predefined particle radius. Type I error for detecting formulation difference in the model was controlled at 5% for PK endpoints. The simulated BE boundaries for 3-month PP LAI suspension mean particle radius extended over 5 µm, but acceptable statistical power (≥ 80%) was obtained only when the mean particle radius was within 1 µm of the reference formulation. For PBPK models, type I error calculations are notably more complex than power calculations because the simulated BE boundaries for CQAs need to be determined before the error assessment. This study appears to be the first to discuss the intersection of type I error control and safe space estimation in PBPK modeling for a BE assessment. Our case study shows the conditions that allow for a controlled type I error in a VBE assessment. Safe space is shown to depend on both formulation characteristics and the statistical power afforded by BE studies, offering valuable insights for formulation design considerations.

PMID:41927781 | DOI:10.1208/s12248-026-01215-0