Tag: pubmed

ESC Heart Fail. 2026 Apr 16:xvag108. doi: 10.1093/eschf/xvag108. Online ahead of print.

ABSTRACT

BACKGROUND: Transcatheter therapies offer new treatment options for patients with both mitral regurgitation (MR) and tricuspid regurgitation (TR). However, the optimal treatment pathway in patients with combined MR and TR is not completely understood.

AIMS: This analysis evaluated the natural TR progression after mitral transcatheter edge-to-edge repair (MTEER) with the MitraClip System in patients with MR and TR from the EXPANDed studies.

METHODS: EXPANDed is a pooled cohort from the EXPAND and EXPAND G4 studies. This study includes patients who had severe TR, achieved procedural success with MTEER, and received no direct TR intervention. Echocardiographic assessments were performed independently by echo core lab. Baseline characteristics, 1-year outcomes, and associations with TR improvement were reported based on 30-day TR severity following MTEER.

RESULTS: Of those with evaluable TR data at 30 days (N=160), 73% (N=116) improved to ≤moderate TR, while 28% (N=44) had ≥severe TR. The ≤moderate TR group had a lower prevalence of atrial fibrillation (68% vs 89%, p=0.009), numerically lower LV ejection fraction (49% vs 56%, p=0.07), and larger LV dimensions (LVEDV: 137.5±73.4 vs 107.9±44.8 ml, p=0.01). TR reduction was sustained in 86% of ≤moderate TR patients, while 45% of ≥severe TR patients improved to ≤moderate at 1 year. In the ≤moderate TR group, significant and larger improvements in NYHA functional class (p<0.0001) and KCCQ-OS score (Δ = +30.6±25.7, p<0.0001) were observed through 1 year. One-year mortality was numerically lower in the ≤moderate TR group (12.4% vs 22.3%) though not statistically significant (HR=1.92 [0.77, 4.79], p=0.16). Lower LVEF and larger baseline LV size were associated with TR improvement post-MTEER.

CONCLUSIONS: Early TR improvement to ≤moderate was observed in almost 3/4 of the population and was associated with significant symptomatic relief. Patients with both severe MR and TR, particularly those with LV dilation, may experience TR improvement following MTEER.

PMID:41989098 | DOI:10.1093/eschf/xvag108

Disabil Rehabil. 2026 Apr 16:1-16. doi: 10.1080/09638288.2026.2647439. Online ahead of print.

ABSTRACT

PURPOSE: Although rehabilitation is vital for cerebral palsy (CP), in Indonesia, where the prevalence is high, practices are understudied. This study aimed to describe rehabilitation practice, explore perceptions of service delivery, and examine how dosage correlated with perceptions to inform strategies.

METHODS: A total of 233 Indonesian therapists (83% physiotherapists; 17% occupational therapists) completed an anonymous online survey between February and April 2025. Survey developed from existing literature and validated through expert review. The survey captured dosage and perceptions of service-related factors (Likert scale). Data were analyzed using descriptive statistics and correlations.

RESULTS: Therapists reported using both recommended evidence-based practices (e.g., mobility training) and non‑recommended practices (e.g., neurodevelopmental therapy). Rehabilitation typically lasted 30-45 min, 1-2 times/week, with limited agreement on strong evidence-based practice (EBP) exposure, adequate workforce, and families’ financial readiness. Therapy time correlated with positive perceptions of EBP exposure (p < 0.001, r = 0.305), skill set (p = 0.001, r = 0.244), infrastructure (p = 0.001, r = 0.239), and workforce (p = 0.002, r = 0.231). Moreover, institutional support for training showed the strongest association with greater EBP exposure (p < 0.001, r = 0.700).

CONCLUSION: In Indonesia, rehabilitation practice stays below recommended dosages, mirroring trends elsewhere. Barriers include families’ financial constraints, limited workforce, and insufficient exposure to EBP. Institutional support for training is vital for improving therapy and EBP adoption. Increasing the therapist workforce through new programs could enhance the delivery of CP services.

PMID:41989062 | DOI:10.1080/09638288.2026.2647439

Anal Chem. 2026 Apr 16. doi: 10.1021/acs.analchem.5c06848. Online ahead of print.

ABSTRACT

In their recently published article (DOI: 10.1021/acs.analchem.5c03117), Xu et al. argue that the detection of differentially abundant proteins in proteomic experiments should go beyond traditional statistical methods and should leverage unsupervised machine learning for anomaly detection. Shedding light on this category of methods is insightful, and the reported performances are promising. However, we believe the benchmarking angle of this article is restrictive. First, the reported performance increments are associated with overstated theoretical differences. Second, an excessive focus on the performances could lead proteomic investigators to undermine their usual elicitation of the biological question. As both reasons pertain to the researchers’ empowerment of machine learning tools and of computational workflows, we believe it is important to formulate complementary guidelines.

PMID:41989059 | DOI:10.1021/acs.analchem.5c06848

Perfusion. 2026 Apr 16:2676591261429813. doi: 10.1177/02676591261429813. Online ahead of print.

ABSTRACT

BackgroundOpen pulmonary endarterectomy (PEA) carries a high risk of neurological complications due to cerebral hypoperfusion and ischemia-reperfusion injury. Systemic cooling during extracorporeal circulation may not sufficiently reduce brain temperature. Combining systemic and targeted head-neck cooling may enhance neuroprotection.MethodsIn this single-center retrospective study, 22 PEA patients were analyzed. All underwent deep systemic hypothermia (22-24°C). Eleven received adjunctive external head cooling using the Aurora head-neck device, and eleven used ice packs (Control). Cerebral oxygenation was monitored with near-infrared spectroscopy (NIRS), and neuron-specific enolase (NSE) levels were measured preoperatively and postoperatively.ResultsCerebral desaturation events (rSO₂ < 40%) occurred in 22.2% of Aurora patients versus 77.8% of Controls (p = 0.030). Postoperative NSE levels were lower in the Aurora group; however, the difference did not reach statistical significance (p = 0.087).ConclusionDual-modality cooling combining extracorporeal hypothermia and targeted head-neck cooling improved intraoperative cerebral oxygenation and were associated with lower postoperative NSE levels; however, due to the limited sample size, no definitive conclusions regarding neuronal injury can be drawn.

PMID:41989018 | DOI:10.1177/02676591261429813

Med Vet Entomol. 2026 Apr 16. doi: 10.1111/mve.70073. Online ahead of print.

ABSTRACT

Blow flies represent one of the most forensically significant insects in legal investigations. Their habitat-specific abundance and temperature-dependent development rates can help estimate a post-mortem interval (PMI), cause of death and post-mortem movement of a deceased body. As the role of forensic entomology expands in human and wildlife criminal investigations, there is a need for updated regional surveys for blow fly species. All recent and previous blow fly surveys in Arizona have been limited to the southern and central ecoregions. The objective of this study was to identify blow fly species between two contrasting habitats in northwestern Arizona-the Black Mountains (Mojave Desert) and the Hualapai Mountains (Arizona/New Mexico Mountains). This research aimed to assess the impacts of food source (game meat (javelina; Tayassu tajacu) compared to chicken (Gallus domesticus) liver), seasonality and elevation on blow fly biodiversity. Each habitat had three site locations at different elevational gradients (low, middle, high) with four bait traps deployed at each site (two of each bait type). This study found a significant difference in the biodiversity of blow flies between and within each habitat seasonally, as well as elevational variation within each habitat. Bait-preference also was statistically significant for overall abundance, and two indicator species for each bait type were identified. Additionally, this research presents the northernmost recorded presence of Chrysomya rufifacies in Arizona, as well as the first records of Cynomya cadaverina and Calliphora alaskensis in the state. The data collected establishes an important baseline for these understudied regions of Arizona and facilitates a wider use of blow flies in forensic investigations for rural areas of Mohave County, AZ.

PMID:41989004 | DOI:10.1111/mve.70073

Glob Health Action. 2026 Dec;19(1):2627679. doi: 10.1080/16549716.2026.2627679. Epub 2026 Apr 16.

ABSTRACT

BACKGROUND: Community health workers (CHWs) play a vital role in spreading health-related information in low-and middle-income countries. Assessing their knowledge is crucial to combat health misinformation.

OBJECTIVE: To identify locally relevant COVID-19 and mental health-related information commonly held by CHWs and the misconceptions most prevalent in their communities in Haiti, Malawi, and Rwanda.

METHODS: A card-sorting activity was conducted with 39 CHWs from rural communities in Haiti (n = 13), Malawi (n = 12), and Rwanda (n = 14), between February and April 2023. The activity involved free sorting, true/false sorting, and card ranking to assess CHWs’ knowledge, beliefs, and misconceptions surrounding COVID-19 and mental health.

RESULTS: CHWs primarily categorized cards based on perceived truths, reflecting knowledge from trainings, media, and community beliefs. Overall, CHWs correctly identified 59% of true COVID-19 statements and 73% of false statements, with no statistical differences in COVID-19 knowledge rates among countries [correctly sorted as true: p = 0.421; correctly sorted as false: p = 0.128]. However, specific COVID-19 misconceptions varied across countries, such as beliefs about vaccine effectiveness and side effects. Mental health knowledge varied substantially across countries, with Haitian CHWs demonstrating the highest expertise in correctly identifying false mental health information [Haiti: median 86.0%; Malawi: median 21.0%; Rwanda: median 79.0%; p < 0.001)]. Significant misunderstandings about mental health causes and treatments were influenced by religious and spiritual beliefs.

CONCLUSION: CHWs have substantial gaps in information about COVID-19 and mental health. Knowledge of areas of misinformation can differ between countries. Constructing country-specific educational messages to address these areas can better inform CHWs and improve health literacy.

PMID:41988959 | DOI:10.1080/16549716.2026.2627679

Cancer. 2026 Apr 15;132(8):e70409. doi: 10.1002/cncr.70409.

ABSTRACT

BACKGROUND: There is limited information about care experiences and health outcomes among transgender, gender-nonconforming, and nonbinary (TGNCNB) individuals with cancer. This study quantifies experienced health care discrimination among TGNCNB individuals living with cancer and its impact on their health.

METHODS: This cross-sectional analysis used data from the All of Us Research Program on individuals with cancer. The authors performed propensity score matching (1:5) to balance TGNCNB and cisgender individuals by sociodemographic factors and cancer site. Health care discrimination and health were assessed using the Discrimination in Medical Settings Scale and the Overall Health survey. They used multivariable logistic regression models to adjust for sociodemographic characteristics.

RESULTS: The cohort included 1476 participants, of which 246 (17%) identified as TGNCNB. TGNCNB participants had greater odds of reporting feeling unheard by providers (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.79-3.17), treated with less respect (OR, 2.61; 95% CI, 1.91-3.57), receiving poorer service (OR, 2.39; 95% CI, 1.73-3.31), and providers acting afraid (OR, 2.32; 95% CI, 1.37-3.93) compared to their cisgender counterparts. In adjusted models, TGNCNB identity was associated with increased odds of experiencing any health care discrimination (OR, 2.42; 95% CI, 1.81-3.25), and discrimination was associated with self-reported poor health (OR, 3.24; 95% CI, 2.58-4.07).

DISCUSSION: The findings of this study suggest that in the TGNCNB population, increased rates of health care discrimination are associated with poorer health outcomes, which may perpetuate medical mistrust and decrease patient-centric quality of care overall. Future research and policy efforts should identify actionable interventions to advance equitable cancer care for TGNCNB individuals.

PMID:41988958 | DOI:10.1002/cncr.70409

Health Econ. 2026 Apr 16. doi: 10.1002/hec.70107. Online ahead of print.

ABSTRACT

Governments frequently adopt austerity policies when facing economic crises, yet their long-term consequences for population health remain incompletely understood. This paper examines the impact of large-scale fiscal austerity on infant mortality by exploiting the Troika-led economic adjustment program implemented in Greece beginning in 2010 as a quasi-experimental shock. Using the synthetic control method, we construct a counterfactual for Greece based on OECD and Union for the Mediterranean countries that did not experience austerity of comparable depth or duration. Relative to this counterfactual, Greece experienced a sharp and persistent increase in infant mortality following the onset of austerity. The divergence emerges immediately after 2010, remains statistically significant throughout the post-intervention period, and shows little evidence of full reversion prior to the COVID-19 pandemic. The estimated effect corresponds to an average 43 percent increase in the infant mortality rate. Mortality effects are larger for boys than for girls and are concentrated in the neonatal period. Accounting explicitly for the fertility decline, we estimate approximately 854 excess infant deaths cumulatively from 2010 to 2020. Extensive robustness checks support the findings. The results identify the total effect of austerity and highlight the importance of protecting early-life health during fiscal consolidation.

PMID:41988926 | DOI:10.1002/hec.70107

J Mol Endocrinol. 2026 Apr 15:JME-25-0224. doi: 10.1530/JME-25-0224. Online ahead of print.

ABSTRACT

The gonadotrophin-releasing hormone (GnRH) pulse generator is a critical neural oscillator that governs reproductive function through the pulsatile release of luteinising hormone (LH) and follicle stimulating hormone (FSH). Early electrophysiological studies, notably by Ernst Knobil, identified multiunit activity (MUA) volleys in the mediobasal hypothalamus that aligned with LH pulses, suggesting a neural basis for GnRH pulsatility. Although GnRH neurons exhibit some intrinsic secretory rhythmicity in vitro, their isolated electrophysiological signatures have proven inconsistent. Recent advances, including GCaMP fibre photometry in freely behaving mice, have revealed a precise correlation between episodic GnRH distal processes and LH pulses. However, it is now well established that a neural oscillator comprising hypothalamic kisspeptin neurones co-expressing neurokinin B and dynorphin, collectively termed the KNDy network, represents the core construct of the GnRH pulse generator. Understanding the dynamics of this network and its modulation by external inputs such as stress, metabolic cues, and circadian rhythms is essential. Computational modelling provides a systematic framework for integrating experimental data with mechanistic and predictive analyses to decode the GnRH pulse generator dynamics.

PMID:41988873 | DOI:10.1530/JME-25-0224

Water Environ Res. 2026 Apr;98(4):e70386. doi: 10.1002/wer.70386.

ABSTRACT

BACKGROUND: Harmful algal blooms (HABs) pose a significant threat to aquatic ecosystems worldwide, with freshwater environments being particularly vulnerable. Among the primary contributors to these blooms is Microcystis aeruginosa, a cyanobacterium known for producing toxins that are harmful to both human health and aquatic life. Given its toxic nature and ecological impact, understanding the factors that influence its growth is crucial. Since M. aeruginosa naturally inhabits sunlit surface waters, it is especially vulnerable to ultraviolet (UV) radiation stress, making this an ecologically and practically relevant area of study. Investigating the effects of UV radiation on M. aeruginosa growth can provide valuable insights into bloom dynamics, ecological consequences, and potential strategies for bloom management and control.

OBJECTIVES: This study aims to examine the effects of UV radiation on the growth dynamics of both toxic and nontoxic strains of M. aeruginosa, specifically PCC 7806 and PCC 7005.

METHODS: M. aeruginosa cultures PCC 7806 and PCC 7005 were exposed to varying levels of UV radiation (80, 60, and 20 mW/cm²). Key parameters such as growth rates, cell concentrations, and the relative UV effects were monitored. Cell counts were determined microscopically and subsequently used to calculate the growth rate.

RESULTS: UV radiation was found to exert a significant influence on the proliferation of both strains of M. aeruginosa, inducing discernible alterations in growth patterns and physiological mechanisms as compared to the control group. A one-way analysis of variance (ANOVA) indicated a significant effect of treatment intensity, with an F statistic of 13.71, p < 0.0001, and an R² value of 0.5950. Pairwise comparisons revealed that the mean difference for the 80 mW/cm² treatment was -4.458 (95% CI: -8.937 to -0.02000, p = 0.0514). Overall, the findings indicate that UV treatment intensity significantly influences growth, with the most pronounced effects observed at 80 mW/cm².

CONCLUSIONS: Our data suggest that the growth of both M. aeruginosa strains, PCC 7806 and PCC 7005, is reduced under high UV radiation during algal blooms. A reduction in dense Microcystis blooms as a result of increased UV exposure could enhance light penetration in water bodies. These findings provide valuable insights for water resource management teams, enabling them to develop strategies to mitigate the public health risks associated with HABs.

PMID:41988826 | DOI:10.1002/wer.70386