Tag: pubmed

Pediatr Allergy Immunol. 2026 May;37(5):e70350. doi: 10.1111/pai.70350.

ABSTRACT

BACKGROUND: Access to patient-centered medical homes (PCMH)-defined as having a primary care provider who provides comprehensive, family-centered care-is critical for children with asthma, which affects nearly 5 million children in the US. Management can be complex, and uncontrolled disease increases morbidity among children. Therefore, we examined rates and associations of PCMH status, asthma severity, and sociodemographic factors.

METHODS: This cross-sectional study used the 2022 National Survey of Children’s Health, a nationally representative dataset, to assess PCMH status among children with asthma and conducted design-based X² tests to measure differences between groups based on asthma severity, parental factors, and other social determinants of health.

RESULTS: Among a sample of 3636 children with asthma, 41.5% met criteria for a PCMH. Significant associations were observed between PCMH access, asthma severity, and several sociodemographic variables (p < .001), except the child’s age. Only 19.0% of children with severe asthma ratings met PCMH criteria. In contrast, 45.1% of children with mild asthma met PCMH criteria. Parental education and PCMH access were positively correlated, and the highest rates of PCMH access were among children with two biological parents.

CONCLUSION: Our results showed that having access to a PCMH was associated with a decreased likelihood of severe asthma symptoms. Additionally, there are sociodemographic factors that significantly impact the likelihood of children with asthma meeting criteria for a PCMH. Given the scale of children with asthma not having comprehensive medical care, national and state policies are needed to enhance access to services.

PMID:42159992 | DOI:10.1111/pai.70350

Insights Imaging. 2026 May 20;17(1):135. doi: 10.1186/s13244-026-02309-1.

ABSTRACT

OBJECTIVES: To investigate the role of super-resolution contrast-enhanced ultrasound (SR-CEUS) in evaluating inflammatory activity in Crohn’s disease (CD).

MATERIALS AND METHODS: In this prospective study, we consecutively enrolled CD patients confirmed by clinical and ileocolonoscopic findings. All patients underwent B-mode ultrasound (BMUS), color Doppler flow imaging (CDFI), CEUS, and SR-CEUS within 1 week of ileocolonoscopy. SR-CEUS quantitative parameters were recorded, with simple endoscopic score for Crohn’s disease (SES-CD) as the reference standard. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS: 52 consecutive CD patients were categorized into active (SES-CD ≥ 3, n = 30) and inactive (SES-CD < 3, n = 22) groups. SR-CEUS clearly visualized the intramural microvascular architecture of the bowel wall. SR-CEUS yielded an AUC of 0.903 with 86.4% sensitivity (95% CI: 66.7-95.3%), and 86.7% specificity (95% CI: 70.3-94.5%) for assessing inflammatory activity, significantly outperforming both CDFI (p = 0.014) and CEUS (p = 0.045), while showing no statistically significant difference in comparison with BMUS (p = 0.988). Furthermore, the combination of BMUS and SR-CEUS achieved an AUC of 0.967 for diagnosing active CD, with 100% sensitivity (95% CI: 85.1-100%) and 86.7% specificity (95% CI: 70.3-94.7%), which was significantly superior to BMUS alone (p = 0.038).

CONCLUSIONS: SR-CEUS provides quantitative microvascular perfusion maps that display vascular density, flow velocity, and direction, offering a non-invasive tool for evaluating inflammatory activity in CD.

CRITICAL RELEVANCE STATEMENT: This study demonstrates that super-resolution contrast-enhanced ultrasound (SR-CEUS) provides a novel, non-invasive approach for quantitative evaluation of inflammatory activity in Crohn’s disease (CD), which serves as a valuable supplement or alternative to endoscopy in routine monitoring.

KEY POINTS: An unmet need remains for accurate, non-invasive tools to assess CD activity. SR-CEUS outperforms conventional CDFI and CEUS in distinguishing active from inactive CD. Combining SR-CEUS with standard BMUS yields excellent diagnostic accuracy, establishing this combined approach as a promising non-invasive alternative for monitoring inflammatory activity in CD patients.

PMID:42159961 | DOI:10.1186/s13244-026-02309-1

Pediatr Allergy Immunol. 2026 May;37(5):e70371. doi: 10.1111/pai.70371.

ABSTRACT

BACKGROUND: Respiratory tract infections (RTIs) are a leading cause of morbidity in preschool children, particularly in those with recurrent wheezing. Natural compounds such as resveratrol and carboxymethyl-β-glucan have shown immunomodulatory, antiviral, and anti-inflammatory activity, supporting their potential role in preventing pediatric airway infections.

OBJECTIVE: To evaluate the efficacy, safety, and tolerability of Linfovir®, a nasal spray containing resveratrol and carboxymethyl-β-glucan, in reducing respiratory infectious symptoms in preschool children with recurrent respiratory infections and wheezing.

METHODS: This multicenter, randomized, double-blind, placebo-controlled trial enrolled children aged 2-6 years with a history of recurrent respiratory infections. Participants were randomized 1:1 to receive Linfovir® or placebo once daily for 12 weeks, with follow-up at 16 weeks. Primary and secondary outcomes including days with respiratory symptoms, number of infections, antibiotic courses, and medical visits were recorded via the VIRAPP® electronic diary.

RESULTS: Eighty-two children were included in the Full Analysis Set. The primary endpoint was not statistically significant. However, a numerical reduction in days with respiratory symptoms was observed in the resveratrol/β-glucan nasal spray group compared with placebo (15.0 vs. 20.4 days in the FAS population), corresponding to an approximate 26% relative difference. Similar non-significant patterns favoring the intervention were observed for infectious episodes, antibiotic courses, and medical visits. Treatment adherence was high in both groups, and no serious adverse events occurred.

CONCLUSIONS: In this pilot randomized controlled trial, the resveratrol/β-glucan nasal spray was safe and well tolerated. Although the study did not show a statistically significant effect on the primary endpoint, the observed numerical differences consistently favored the intervention. These findings should be interpreted as exploratory and hypothesis-generating and require confirmation in larger adequately powered studies.

PMID:42159960 | DOI:10.1111/pai.70371

Adv Ther. 2026 May 20. doi: 10.1007/s12325-026-03635-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Lack of head-to-head comparative safety and efficacy data for abobotulinumtoxinA (aboBoNT-A) and onabotulinumtoxinA (onaBoNT-A) represented an important gap for informed spasticity management. This study compared the safety and efficacy of aboBoNT-A and onaBoNT-A for upper limb spasticity (ULS).

METHODS: DIRECTION (NCT04936542), a phase IV, randomized, double-blind, crossover study, involved 72 sites. Patients stratified by botulinum toxin A status (naïve/non-naïve) were randomized (1:1) to aboBoNT-A 900U followed by onaBoNT-A 360U (one cycle each), or vice versa. Muscles (wrist/finger flexors, biceps brachii) were injected with a fixed volume, using instrument-guided injection techniques. Participants fulfilling retreatment criteria received a second cycle at Week 12; otherwise, they were reassessed every 4 weeks (to Week 24) until requiring retreatment. Primary analyses tested non-inferiority based on treatment-emergent adverse events (TEAEs) from injection to Week 12 using a 5% non-inferiority margin [non-inferiority demonstrated if upper bound of the 80% confidence interval (CI) of the adjusted difference in TEAE rates was < 5%]. Secondary analyses compared duration of response based on time to symptom re-emergence.

RESULTS: Overall, 464 patients [mean (standard deviation) age 56.8 (13.1) years, 34.1% female] were randomized (aboBoNT-A → onaBoNT-A [n = 231]; onaBoNT-A → aboBoNT-A [n = 233)]. Baseline characteristics were similar in both sequence arms. Adjusted rate of TEAEs for aboBoNT-A (20.3%) was non-inferior to onaBoNT-A (23.0%); adjusted difference (aboBoNT-A – onaBoNT-A) was – 2.7% (80%CI – 6.2%, 0.9%). Adjusted mean duration of response was 99.3 days for aboBoNT-A and 96.3 days for onaBoNT-A; adjusted difference of 3.0 (80%CI 0.2, 5.9) days favoring aboBoNT-A (p = 0.17; statistically significant under the pre-specified α = 0.20 framework). Longer duration of response with aboBoNT-A versus onaBoNT-A was seen across most subgroups over a fixed-interval follow-up.

CONCLUSION: In this first head-to-head study of aboBoNT-A and onaBoNT-A in ULS, the aboBoNT-A TEAE rate was non-inferior to onaBoNT-A. At 90% of the maximum unit dose for adult ULS in the approved label for each formulation, duration of response was 3 days longer with aboBoNT-A than onaBoNT-A. These findings may support informed therapeutic decision-making.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT04936542; EudraCT: 2023-509196-16-00.

PMID:42159955 | DOI:10.1007/s12325-026-03635-y

Trop Anim Health Prod. 2026 May 20;58(5):273. doi: 10.1007/s11250-026-05033-6.

ABSTRACT

This study investigates the prevalence and determinants of repeat breeding and infertility among small dairy farms in a district with intensive crossbred and traditional dairy farming systems in India. Data were collected from 2,254 animals and 579 farmers representing diverse herd compositions and management systems. Results revealed that repeat breeding affected 20.4% of animals, while infertility was observed in 44.7%, exceeding national averages. Species, breed type, age, milk yield, and farmer type were significant factors influencing reproductive outcomes. Crossbred cows (based on Holstein-Friesian, Jersey, and indigenous breeds) exhibited higher reproductive disorders than indigenous cattle breeds, while buffaloes recorded the highest infertility rates (62.5%). The consequences of reproductive inefficiencies include involuntary extended calving intervals, reduced lifetime milk yield, and hence an increased carbon footprint through increased methane emission intensity. Poor reproductive efficiency therefore impacts both farm profitability and environmental sustainability. The study emphasizes evidence-based reproductive management, digital herd monitoring, and farmer training as essential strategies for improving fertility and advancing climate-smart dairy practices in Tamil Nadu.

PMID:42159948 | DOI:10.1007/s11250-026-05033-6

Breast Cancer. 2026 May 20. doi: 10.1007/s12282-026-01858-z. Online ahead of print.

ABSTRACT

BACKGROUND: Large language models (LLMs), a form of generative artificial intelligence (AI), are increasingly explored for clinical applications due to their ability to synthesize medical information. In breast cancer care, where therapeutic decision-making is complex because of expanding treatment options, AI-based decision support tools may improve efficiency and consistency. However, their clinical validity and safety remain insufficiently evaluated in real-world settings. The present study aimed to compare the characteristics of treatment recommendations generated by a large language model with those proposed by breast cancer specialists using identical clinical information.

METHODS: This retrospective observational study included 100 patients with advanced or recurrent breast cancer. Clinical information was provided to ChatGPT using a standardized prompt to generate treatment recommendations. Six board-certified breast cancer specialists independently proposed treatment strategies for the same cases. Recommendations were evaluated using five predefined criteria: 1. Comprehensiveness and appropriateness of literature selection, 2. Accuracy of interpretation of key evidence, 3. Clinical appropriateness and diversity of treatment options, 4. Accuracy of adverse event information, 5. Time required to generate recommendations. Group comparisons were performed using linear mixed-effects models with case and evaluator as random effects.

RESULTS: ChatGPT achieved higher scores than specialists across all five evaluation criteria, with the largest difference observed for accuracy of key evidence interpretation. The mean total score was 93.7 for ChatGPT and 44.1 for specialists, and linear mixed-effects model analysis confirmed a significantly higher total score for ChatGPT (p < 0.001). These findings suggest that AI-generated responses tended to provide more comprehensive and structured summaries of available evidence within the predefined evaluation framework.

CONCLUSIONS: LLMs were able to generate comprehensive and structured treatment recommendations based on the provided clinical information. However, these findings primarily reflect differences in information synthesis under predefined evaluation criteria rather than superiority in real-world clinical decision-making. Given the potential risk of hallucinations, AI should be positioned as an assistive tool to support specialist-led decision-making in breast cancer care.

PMID:42159946 | DOI:10.1007/s12282-026-01858-z

Clin Exp Nephrol. 2026 May 20. doi: 10.1007/s10157-026-02886-x. Online ahead of print.

ABSTRACT

BACKGROUND: Platelet indices, including platelet distribution width (PDW) and mean platelet volume (MPV), reflect platelet activation and have been associated with kidney disease progression in various populations. However, whether these indices are associated with incident chronic kidney disease (CKD) in high-risk individuals remains unclear.

METHODS: We retrospectively examined the associations of PDW and MPV with incident CKD using longitudinal data from 1,281 individuals without CKD but with one or more established CKD risk factors (hypertension, diabetes mellitus, dyslipidemia, or a history of cardiovascular disease) in the Fukushima Cohort Study. Participants were categorized into quartiles according to baseline PDW or MPV. The primary outcome was incident CKD.

RESULTS: During a median follow-up of 5.2 years, 384 participants developed incident CKD. Higher quartiles of PDW and MPV were associated with increased cumulative incidence of CKD in Kaplan-Meier analyses. Compared with the second PDW quartile, the highest quartile was associated with a significantly higher risk of incident CKD (adjusted hazard ratio 1.51, 95% confidence interval 1.11-2.06). A similar association was observed for MPV. However, when PDW and MPV were simultaneously included in the multivariable model, only PDW remained significantly associated with incident CKD, whereas the association of MPV was no longer statistically significant. In addition, analyses treating these indices as continuous variables did not show statistically significant associations.

CONCLUSION: PDW and MPV showed associations with incident CKD in high-risk individuals; however, these findings were not consistent across all analyses. Therefore, the results should be interpreted as hypothesis-generating and require further confirmation.

PMID:42159944 | DOI:10.1007/s10157-026-02886-x

Discov Ment Health. 2026 May 20;6(1):90. doi: 10.1007/s44192-026-00475-8.

ABSTRACT

BACKGROUND: About 3-6% of individuals infected with SARS-CoV-2 develop post-COVID-19 condition (post-COVID), also known as multisystem disease, which comprises somatic and psychological symptoms. Nevertheless, there is an absence of research findings that differentiate patients with post-COVID from those with psychosomatic problems, for instance with regard to the presence of mental disorders. In addition, a comprehensive understanding of the factors that influence the manifestation of psychological symptoms in these patients is crucial for the development of multimodal interventions and lead to a destigmatization of post-COVID.

METHODS: A cross-sectional study was conducted at a Clinic for Psychotherapy and Psychosomatics (Dresden University Hospital) to compare the self-reported sociodemographic, clinical, and psychopathological characteristics of post-COVID patients (n = 357), attending a psychosomatic post-COVID outpatient clinic, with those of a group of patients with different psychosomatic disorders, attending a general psychosomatic outpatient clinic (n = 991). Clinical diagnoses were assessed by clinical experts according to the International Classification of Diseases (ICD-10), somatic symptom severity, depressive symptoms and anxiety, using the Patient Health Questionnaire (PHQ-D) (primary outcomes). In addition, in the post-COVID group, the influence of sociodemographic, clinical, and psychopathological variables on primary outcomes and incapacity to work were analyzed. The statistical methods encompassed linear and logistic regression analyses, generalized linear models, Mann-Whitney U-tests and chi-squared tests.

RESULTS: Post-COVID patients demonstrated a greater degree of PHQ-15 somatic symptom severity (B = 1.37, p < .001) and higher levels of somatic and psychological multimorbidity (OR = 1.14, p = .005). At the level of specific disorders, post-COVID patients demonstrated an elevated risk of somatoform disorders (OR = 3.25, p < .001), while the risk of anxiety disorders (OR = .40, p < .001), affective disorders (OR = .52, p < .001) and personality disorders (OR = .11, p < .001) was reduced. In post-COVID, female gender (p = .003), somatic and psychological multimorbidity (p ≤ .025), experience of psychotherapy (p ≤ .031), and stress (p < .001) were associated with increased psychological symptom burden.

CONCLUSIONS: Post-COVID patients can be regarded as a specific group, distinguishable from psychosomatic patients and presumably with prevailing somatoform processing mechanisms. In accordance with the recommendations of the German post-COVID guideline, mental disorders should be accorded serious consideration in the treatment of post-COVID, with the objective of averting the risk of chronicity through early intervention.

TRIAL REGISTRATION: The present study does not report results of a health care intervention on human participants. Therefore no registration was necessary.

PMID:42159938 | DOI:10.1007/s44192-026-00475-8

Discov Nano. 2026 May 20;21(1):206. doi: 10.1186/s11671-026-04625-3.

ABSTRACT

The present study examines the magnetohydrodynamics (MHD) flow of a ternary hybrid nanofluid, comprised of titanium oxide, zinc oxide, and gold nanoparticles dispersed in a water-based fluid, over a curvilinear catalytic surface within a porous medium. The model integrates volumetric and surface nonthermal plasma heating with species generation. The Joseph slip conditions are implemented to characterize the tangential partial slip behavior. The governing partial differential equations are reduced to a system of nonlinear, coupled ordinary differential equations for analysis. Subsequently, the Galerkin weighted residual method is employed to solve the resulting system of equations. The friction coefficients compared to the existing literature demonstrate an agreement. The skin friction coefficient, Nusselt number, and Sherwood number converge to 0.202419, -1.48261, and -1.00, respectively, for different trial numbers. Volumetric and surface nonthermal plasma heating have been observed to enhance the Nusselt number, whereas the species generation parameter correspondingly increases the Sherwood number. The magnetic parameter diminishes fluid velocity and enhances energy and species concentrations, while the isotherm contours exhibit a pronounced elliptic configuration, thereby illustrating the fluid’s thermal maximum. These findings indicate that the magnetic parameter can be employed to guide the fluid, thereby facilitating the localization and subsequent removal of charged impurities within the system. Furthermore, the nonthermal plasma parameters not only elevate the fluid’s temperature but also exhibit a propensity to enhance heat and mass transfer between the fluid and the curved catalytic surface.

PMID:42159935 | DOI:10.1186/s11671-026-04625-3

CVIR Endovasc. 2026 May 20;9(1):58. doi: 10.1186/s42155-026-00699-3.

ABSTRACT

OBJECTIVE: Determine the outcome of patients treated with catheter-directed interventions as per published recommendations for management escalation by the Pulmonary Embolism Response Team (PERT) Consortium.

DESIGN: Retrospective, observational cohort study.

MATERIALS AND METHODS: Retrospective review of patient records managed with catheter-directed intervention between April 2012 and March 2022. Risk stratification was performed as per European Society of Cardiology (ESC) guidelines. Patient demographics, clinical status, and imaging on presentation, procedural details, and outcomes with a minimum follow-up period of 1 year were analysed.

RESULTS: Seventy-nine cases were performed in 76 patients (n = 76; mean age 52 years, range 7-86; male:female = 37:39). Fifty-four patients were high-risk, 16 intermediate-high and 7 intermediate-low risk (n = 77 cases). 39% of high-risk and 22% of intermediate-risk cases had an absolute or relative contraindication to thrombolytic therapy. Seventeen percent of high-risk and 4% of intermediate-risk cases had a failed trial of systemic thrombolysis. 54% of high-risk and 78% of intermediate-risk cases had a failed trial of anticoagulation. There was a statistically significant reduction in the RV:LV ratio (p = 0.05) and clot burden (p < 0.0001) following catheter intervention. Available echocardiographic data demonstrated a trend towards improving right heart strain. Bleeding events occurred in 18% of cases, with 79% being high-risk. There was a significant improvement in functional outcomes as per WHO functional status (p < 0.001).

CONCLUSION: Catheter-directed thrombolysis under the guidance of a PERT is a safe and effective therapy and provides a valuable management option for patients who have a contraindication to systemic thrombolysis or have failed a trial of systemic therapy.

PMID:42159923 | DOI:10.1186/s42155-026-00699-3