Tag: pubmed

Infect Dis Ther. 2026 Mar 5. doi: 10.1007/s40121-026-01310-x. Online ahead of print.

ABSTRACT

INTRODUCTION: The incidence of herpes zoster (HZ) is increasing globally. Despite the availability of a highly effective recombinant zoster vaccine (RZV), vaccination rates are still low in the United States, especially among racially and ethnically minoritized (REM) and socially vulnerable groups. There is an urgent need to identify obstacles to vaccination in these communities and develop effective strategies to increase confidence in the RZV.

METHODS: From August 2024 to December 2024, we conducted a community-based educational intervention in San Bernardino County, California, partnering with five churches in neighborhoods with high Centers for Disease Control and Prevention (CDC) Social Vulnerability Index scores. The intervention included a 45-min presentation on HZ, its complications, and RZV recommendations. Participants aged 18 + completed pre- and post-surveys to assess attitudes, knowledge, and behaviors. Descriptive statistics summarized outcomes, while a two-proportion Z-test and Fisher’s exact test evaluated changes in vaccine literacy.

RESULTS: A total of 156 individuals completed the pre-intervention survey, and 134 completed the post-intervention survey. All identified as REM, with 99% in vulnerable neighborhoods. Sixty-three percent had at least one co-morbid illness, and 46% had received info about HZ or RZV before the session. At baseline, 57% believed they were at risk of HZ, but 75% found the education session “extremely effective” in reassessing their risk. Significant improvements in vaccine literacy, especially regarding disease and age-based recommendations, were observed, with correct responses increasing post-intervention (p < 0.05). Following the intervention, 82% reported a high likelihood of receiving RZV, and 90% a high likelihood of recommending it.

CONCLUSIONS: This study demonstrates the feasibility and acceptability of a faith-based, community-led educational intervention to address barriers to RZV uptake among vulnerable REM populations. Using trusted community infrastructure can support equitable expansion of adult immunization programs to reduce preventable HZ disparities.

PMID:41784913 | DOI:10.1007/s40121-026-01310-x

Infection. 2026 Mar 5. doi: 10.1007/s15010-026-02757-3. Online ahead of print.

ABSTRACT

BACKGROUND: Candida endocarditis (CE) is a rare but highly lethal complication of candidemia, comprising 1-2% of infective endocarditis cases, yet associated with disproportionately high mortality. Large-scale contemporary data on predictors of in-hospital death remain limited.

METHODS: We conducted a retrospective cohort study using the National Inpatient Sample (2016-2022) to identify adult CE hospitalizations. Weighted descriptive statistics described the cohort, and multivariable logistic regression identified predictors of in-hospital mortality. Secondary outcomes included length of stay (LOS) and hospitalization costs.

RESULTS: Among 1280 CE hospitalizations, in-hospital mortality was 18.8%. Predictors of higher mortality included age 45-64 years (aOR 2.61; 95% CI 1.57-4.41) and ≥ 75 years (aOR 2.11; 95% CI 1.06-4.19), hematologic malignancy (aOR 33.5; 95% CI 12.3-101), surgical ventricular assist devices (aOR 45.7; 95% CI 8.25-284), femoral (aOR 12.9; 95% CI 4.78-36.0) or subclavian (aOR 22.4; 95% CI 5.65-82.7) central venous catheters, septic shock (aOR 9.47; 95% CI 6.21-14.8), embolic stroke (aOR 10.5; 95% CI 4.72-23.9), cardiogenic shock (aOR 3.69; 95% CI 1.61-8.51), and acute kidney injury (aOR 1.64; 95% CI 1.04-2.60). Valve intervention significantly reduced mortality (aOR 0.04; 95% CI 0.01-0.09). Non-survivors had longer hospital stays (median 24 vs. 19 days) and nearly double the hospitalization costs ($117,808 vs. $61,178).

CONCLUSIONS: In this nationally representative cohort, CE remained highly lethal, with age, malignancy, invasive devices, and critical complications driving mortality. Valve intervention conferred substantial survival benefit, underscoring the importance of early recognition, multidisciplinary care, and timely surgical evaluation.

PMID:41784858 | DOI:10.1007/s15010-026-02757-3

Clin Exp Med. 2026 Mar 5. doi: 10.1007/s10238-026-02096-5. Online ahead of print.

ABSTRACT

Knee osteoarthritis (KOA) is a leading cause of chronic pain and disability. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a systemic metabolic disorder that influences extra-hepatic conditions. Although cross-sectional studies link MAFLD to KOA, prospective evidence remains limited. This study aimed to investigate the longitudinal association between MAFLD, and KOA and assess the mediating role of inflammation. This study included 303,604 participants from the UK Biobank without baseline osteoarthritis. MAFLD was defined using the fatty liver index alongside metabolic criteria, fibrosis severity was assessed using the Fibrosis-4 score, and MAFLD subtypes were categorized. Incident KOA was identified through linked health records. Cox proportional hazard regression model was used to estimate hazard ratios (HR) and 95% confidence interval (CI) for the association. Mediation analysis evaluated the potential role of high-sensitivity C-reactive protein (hs-CRP). Over a median follow-up of 13.67 years, 17,137 KOA cases occurred. MAFLD was associated with an 18% higher risk of KOA (HR 1.18, 95% CI 1.13-1.24), with risk increasing by fibrosis severity (P for trend < 0.001). Among subtypes, MAFLD-overweight/obesity showed a significant association with KOA (HR 1.19, 95% CI 1.14-1.25), while MAFLD-diabetes (HR 1.05, 95% CI 0.96-1.16) and MAFLD-lean (HR 1.23, 95% CI 0.93-1.62) did not reach statistical significance. Additionally, hs-CRP explained 8.94% of the association between MAFLD and KOA. MAFLD was independently associated with higher KOA risk; inflammation partially mediates this association. These findings suggest MAFLD as a systemic metabolic condition affecting musculoskeletal health, supporting integrated management strategies.

PMID:41784857 | DOI:10.1007/s10238-026-02096-5

J Robot Surg. 2026 Mar 5;20(1):318. doi: 10.1007/s11701-026-03243-6.

NO ABSTRACT

PMID:41784855 | DOI:10.1007/s11701-026-03243-6

Int J Colorectal Dis. 2026 Mar 5;41(1):76. doi: 10.1007/s00384-026-05110-0.

ABSTRACT

PURPOSE: Magnetoelectric biofeedback therapy (MEBFT) is an emerging intervention for moderate rectocele-associated obstructed defecation syndrome (ODS); however, its efficacy and mechanisms remain unclear. This study compared MEBFT with conventional biofeedback therapy (BFT) and developed a 3D high-resolution anorectal manometry (HR-ARM)-based predictive model for clinical decision-making.

METHODS: In this prospective, single-blind, randomized controlled trial, 68 female patients with defecography-confirmed moderate rectocele-associated ODS were treated in the outpatient department of Tianjin Union Medical Center from January 2019 to June 2024). Patients were randomly assigned in a 1:1 ratio to either the MEBFT or BFT group. Primary outcomes included 3D HR-ARM parameters, Glazer surface electromyography, and patient-reported outcomes (Cleveland Clinic Constipation and Patient Assessment of Constipation Quality of Life scores) at baseline and 3 months. The secondary outcomes included predictive indicators derived from the Hosmer-Rothman model and treatment response stratification.

RESULTS: MEBFT significantly improved fast-twitch fiber recruitment, anorectal function, and quality of life compared to BFT (all P < 0.01). The Hosmer-Rothman model identified a negative MRP-MTV interaction (synergy index = 0.20), with the R₁₁ phenotype (MRP < 80 mmHg-MTV < 135 cc) predicting an 82.35% response to MEBFT after 3 months of treatment (area under the curve [AUC] = 0.72). Phenotypic stratification-guided management: R₁₁ for MEBFT, R₀₀ (elevated MRP-MTV) for surgical evaluation, and R₁₀/R₀₁ for extended MEBFT with surgical backup.

CONCLUSIONS: MEBFT demonstrated superior clinical effectiveness, anorectal functional recovery, and quality of life compared with BFT after 3 months of treatment. The exploratory Hosmer-Rothman model may provided a moderate-accuracy phenotype-based approach using 3D HR-ARM parameters to stratify treatment response and optimize the individualized management of moderate rectocele-associated ODS.

TRIAL REGISTRATION: 1. Date of registration (needs to be before the Date of the First Patient): December 26, 2023. 2. Date of initial participant enrollment: January 9, 2019. 3. Clinical trial identification number: ChiCTR2300079173. 4. URL of the registration site: http://www.chictr.org.cn/.

PMID:41784838 | DOI:10.1007/s00384-026-05110-0

Amino Acids. 2026 Mar 5. doi: 10.1007/s00726-026-03507-3. Online ahead of print.

ABSTRACT

Amino acid metabolic (AAM) reprogramming is a key characteristic of gastric cancer (GC) cells metabolic remodeling, which regulates cell growth, survival, immune cell activation and function to affect tumor immune escape. This study aims to systematically investigate AAM reprogramming in gastric cancer (GC) and construct prognostic model, and validate gene signatures for predictive value and clinical decision-making. This study leveraged data from TCGA and GEO to construct a prognostic model related to AAM and assess its clinical relevance in GC. We identified differentially expressed genes and conducted GO, GSEA, and GSVA enrichment analyses, along with constructing PPI networks and interaction networks of mRNA-miRNA, mRNA-TF, and mRNA-RBP. Additionally, immune infiltration analysis was performed and the relationships between eight hub-type amino acid metabolism-related genes (AAMRGs) and immune cells was investigated using scRNA-seq datasets. Lastly, we validated the elevated expression of these eight genes in GC cells through PCR. The study constructed a prognostic model for GC based on AAMRGs, identifying 16 key genes: ACLY, ADH4, COL1A1, F2, GADL1, GAMT, HBB, KYNU, MRI1, MTHFR, NR1D1, PDK4, SLC1A7, SLC25A15, SLC52A3, and SYCE2. Statistical analysis showed that 14 of these genes showed significant differential expression between tumor and normal tissues. Furthermore, the model demonstrated strong correlations with OS outcomes. Immune infiltration analysis indicated that various immune cell types were significantly associated with the expression of 8 hub genes, highlighting their potential role in the tumor microenvironment and immune response modulation. Furthermore, elevated expression of these genes in GC cells was validated through PCR, highlighting their relevance as potential biomarkers and therapeutic targets. Our AAMRGs prognostic model reveals AAMRGs as independent prognostic factors for GC, highlighting their association with prognosis and immune cell infiltration. These findings provide important insights for improving survival outcomes and advancing immunotherapy strategies in GC.

PMID:41784817 | DOI:10.1007/s00726-026-03507-3

Wien Klin Wochenschr. 2026 Mar 5. doi: 10.1007/s00508-026-02722-y. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency physician-staffed emergency medical services (EMS) in Austria frequently attend low priority calls, raising concerns about over-triage and future workforce sustainability.

OBJECTIVE: To quantify the proportion of emergency physician-attended calls that could have been managed by advanced emergency medical technicians (AEMT), with or without telemedical physician support, and evaluate current AEMT practice and training needs.

METHODS: This prospective, nationwide audit collected data from public physician-staffed EMS in Austria over a 24‑h period. Emergency physicians documented call characteristics, NACA (National Advisory Committee for Aeronautics) severity scores, AEMT presence, actual and potential EMT or AEMT interventions, accuracy of severity assessment and their judgement regarding the necessity of on-scene physician involvement.

RESULTS: Out of 149 physician-staffed EMS, 88 (59.1%) participated recording 313 calls and 273 emergency calls, 25 interhospital transfers and 15 telemedical emergency physician consultations were included. Emergency physicians assessed that 53.4% (95% confidence interval, CI 46.8-60.0%) of emergency calls and 48.0% (95% CI 28.4-67.6%) of interhospital transfers could have been managed by AEMTs. Approximately one third of these would have required telemedical physician support. The AEMTs arrived on the scene before emergency physicians in 75.1% of emergency calls and correctly assessed disease severity in 88.4% of cases and one or more additional interventions could have been set by AEMTs before emergency physician arrival in 48.0% of emergency calls. Most physicians supported expanding AEMT competencies and telemedical physician services.

CONCLUSION: The results of this nationwide audit suggest that more than half of emergency calls and interhospital transfers attended by emergency physicians in Austria could have been managed by AEMTs with or without telemedical emergency physician support.

PMID:41784793 | DOI:10.1007/s00508-026-02722-y

Eur Radiol. 2026 Mar 5. doi: 10.1007/s00330-026-12425-7. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify a quantitative surrogate parameter for the embolic endpoint in genicular artery embolization (GAE).

MATERIALS AND METHODS: Digital subtraction angiography (DSA) images were fused and converted into color maps. Using segmentation software, blush size was measured before and after embolization, and blush reduction ratio (BRR) was calculated. Osteoarthritis severity was graded on radiographs, and clinical outcome was evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 6 weeks, 3 months, and 6 months. Embolized vessels and embolic volume were recorded. Blush size and BRR were compared between osteoarthritis grades and across embolized vessels.

RESULTS: GAE using 100-300 µm permanent microspheres was performed in 90 patients with mild to severe osteoarthritis and 23 patients with pain after total knee replacement (post-TKR) (404 vessels). The median number of vessels embolized per session was 4 (range: 1-6) with a median total embolic volume of 3.5 mL (1.1-8.0 mL). Pre-embolization blush size (+ 1116 mm²/osteoarthritis grade; p < 0.0001) and embolic volume (+ 1.1 mL/OA grade; p < 0.0001) increased with higher osteoarthritis grade and post-TKR. Blush size significantly decreased after embolization (p < 0.0001) with a median BRR of 0.81 (0.62-0.94). No significant differences in BRR were observed between osteoarthritis grades and different vessels. All KOOS subscales improved significantly at each follow-up (p < 0.0001).

CONCLUSION: Segmentation of blush size enables quantitative assessment of embolic endpoints across all genicular arteries and osteoarthritis grades, including post-TKR cases. “Pruning” corresponds to a blush size reduction of 80%. Higher osteoarthritis grades are associated with larger blush areas, requiring higher embolic volumes to achieve comparable embolic endpoints.

KEY POINTS: Question Standardized, quantitative assessment of embolic endpoints in GAE is lacking, as the angiographic endpoint “pruning” has so far been defined only subjectively. Findings Segmentation of angiographic blush using color-coded maps enables objective quantification of embolic endpoints. With increasing osteoarthritis grade, baseline blush size and embolic volume increase, while an 80% blush reduction defines the endpoint “pruning.” Clinical relevance Objective blush quantification improves the reproducibility of embolic endpoint assessment in GAE and supports individualized embolization strategies across disease severity and vascular territories.

PMID:41784792 | DOI:10.1007/s00330-026-12425-7

Analyst. 2026 Mar 5. doi: 10.1039/d5an01340b. Online ahead of print.

ABSTRACT

Small extracellular vesicles (sEVs) hold immense potential for liquid biopsy given the wealth of biological information they carry. Currently, the clinical application of these methods is limited due to their low abundance and the complexities associated with traditional isolation techniques. To address this, we developed a strategy integrating cholesterol-mediated capture with a Self-Protected DNAzyme Walker for the rapid and simultaneous specific isolation and quantification of small extracellular vesicles (sEVs). Upon specific binding to CD63, the blocker strand is released, which activates the DNAzyme catalytic core, leading to substrate cleavage, which triggers the specific release of sEVs from magnetic beads and the generation of a fluorescent signal. Importantly, the circular DNA Shield design provides remarkable stability to the system by safeguarding the DNAzyme core from nuclease degradation. Furthermore, the cyclic cleavage mechanism allows for highly sensitive detection, achieving a limit of detection (LOD) as low as 361 particles per μL. In addition, by leveraging the lipid bilayer structure for sEV enrichment, this strategy effectively eliminates interference from free proteins. Furthermore, the clinical feasibility of this assay was validated by successfully distinguishing Stage I breast cancer patients from healthy individuals with high statistical significance (p < 0.001), highlighting its promise for early cancer diagnosis. This work presents a robust paradigm for sEV analysis and lays a solid foundation for their downstream biomedical applications.

PMID:41784788 | DOI:10.1039/d5an01340b

Med Biol Eng Comput. 2026 Mar 5. doi: 10.1007/s11517-026-03542-y. Online ahead of print.

NO ABSTRACT

PMID:41784751 | DOI:10.1007/s11517-026-03542-y