Tag: pubmed

Respir Res. 2026 Jul 15. doi: 10.1186/s12931-026-03809-w. Online ahead of print.

ABSTRACT

BACKGROUND: In a phase 2 trial (NCT04308681), treatment with admilparant (BMS-986278), an oral lysophosphatidic acid receptor 1 (LPA₁) antagonist, reduced lung function decline in patients with idiopathic pulmonary fibrosis (IPF) or progressive pulmonary fibrosis (PPF). In this exploratory analysis, we evaluated post-treatment changes in circulating biomarkers of lung fibrosis to elucidate mechanisms of admilparant action.

METHODS: Patients with IPF or PPF were randomized 1:1:1 to receive twice-daily admilparant (30 or 60 mg) or placebo for 26 weeks; background antifibrotics were allowed. The IPF and PPF cohorts were analyzed separately. Changes from baseline (CfB) in serum proteins associated with epithelial injury, inflammation, and fibrosis were measured by quantitative immunoassays at 4, 12, and 26 weeks, and compared between patients who received admilparant versus placebo. Pharmacodynamic biomarker changes were evaluated by clinical response status at week 26. Plasma samples from patients with IPF were assessed post hoc by SomaScan v4.1 proteomics assay. Statistical evaluations used linear mixed-effects models.

RESULTS: In the IPF cohort (n=276), nine serum proteins showed significant CfB (p<0.05) at week 26 in patients treated with 60-mg admilparant versus placebo, including increased adiponectin, MMIF, CD163, CEA, and ENRAGE, and decreased markers of epithelial injury and fibrosis (CA-125/MUC16, MMP-7, TN-C, PRO-FIB). In the PPF cohort (n=116), significant differences at week 26 (p<0.05) were observed for 11 serum proteins, including increased CEA and decreased periostin, IL6Rβ, CD163, KIM-1, multiple inflammatory markers (YKL-40, VCAM-1, PECAM-1, ferritin), and collagen degradation markers (C3M and C4M). Two serum proteins, CA-125 and TN-C, showed significantly greater CfB (p<0.05) in responders compared with non-responders in the IPF cohort. Plasma proteomic analysis identified differential expression (adjusted p<0.1) of adiponectin, CKMT1A, ANGPTL3, PDCD1LG2, and IGFBP6 at week 26 in patients with IPF treated with 60-mg admilparant versus placebo.

CONCLUSIONS: Treatment with 60-mg admilparant improved circulating biomarkers associated with epithelial injury and fibrosis in IPF, and with inflammation, fibrosis, and collagen degradation in PPF. Proteomic analysis identified additional biomarkers associated with mitochondrial and metabolic pathways in IPF. These findings expand our understanding of potential mechanisms of LPA₁ antagonism with admilparant and identify biomarkers that may help evaluate treatment response and disease activity.

PMID:42458495 | DOI:10.1186/s12931-026-03809-w

Harm Reduct J. 2026 Jul 15. doi: 10.1186/s12954-026-01425-x. Online ahead of print.

ABSTRACT

BACKGROUND: Attendance in substance-use-disorder group-treatment is challenging with only 32% of patients attending at least one session (Substance Abuse and Mental Health Services Administration and Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2023 admissions to and discharges from substance use treatment services reported by single state agencies, Bethesda, 2025). The present study tested a set of strategies to increase group session attendance in Community Wise, an innovative evidence-based group-intervention delivered in harm-reduction-community-based agencies and designed to reduce alcohol and substance use among people with substance-use-disorders living in predominantly Black and disinvested communities. We examined: (1) if strategies to increase attendance stratified by surveillance status (participation in mandatory programs that use urine screens regularly) would result in a clinically and statistically significant increase in intervention session attendance, with a goal of at least 50% of participants attending at least half of sessions; (2) the effects of group session attendance and strategies to increase attendance on alcohol and substance use frequency in the past 30 days at three-months-follow-up.

METHODS: We conducted a 2² stratified full factorial experiment with 164 adults with substance-use-disorder in East St. Louis, IL. Participants were randomized to combinations of two strategies to increase attendance: Financial incentives (receiving $20 to attend group sessions) and group type (open versus closed groups). Surveillance status was treated as a fixed factor in the analytical model. Logistic and multiple regression models, using effect coding, tested main and interaction effects on number of sessions attended and alcohol and substance use. Analyses followed an intent-to-treat approach, adjusting for demographic covariates, using SAS 9.4.

RESULTS: Of 164 participants, 29% attended ≥ 50% of Community Wise sessions. Paying participants increased odds of attending at least 50% of sessions (OR = 1.97, p = 0.004), while being under surveillance reduced odds by 39% (OR = 0.61, p = 0.036). No main effects were found for group type. Yet, a significant interaction showed financial incentives were more effective in closed versus open groups (OR = 0.58, p = 0.021). Higher attendance predicted reduced percent alcohol and substance use at follow-up (p = 0.011).

CONCLUSIONS: Financial incentives effectively improved intervention attendance, while being under surveillance reduced participation. Higher attendance was associated with decreased alcohol and substance use. The Community Wise intervention should be further tested for effectiveness in harm reduction community-based-organizations among people who are disengaged from treatment and experiencing vulnerabilities such as poverty and houselessness.

TRIAL REGISTRATION: Clinical Trials: NCT05934591.

PMID:42458493 | DOI:10.1186/s12954-026-01425-x

Diagn Pathol. 2026 Jul 16. doi: 10.1186/s13000-026-01804-9. Online ahead of print.

ABSTRACT

BACKGROUND: Prostate cancer is a common malignancy. Intraductal carcinoma of the prostate (IDCP) is associated with poor prognosis, but is underreported in certain geographic regions. The presence of IDCP is recently recognized as an independent prognosticatior of poor prognosis. We aim to identify factors associated with IDCP on radical prostatectomy specimens to aid in more accurate diagnosis of IDCP.

METHODS: A retrospective study was conducted on specimens from Showa Medical University Hospital (Japan) and Queen’s Medical Center (Hawaii) from April 2020 to March 2024. Clinical data included age, PSA, and race; pathological data included GS, GG, and factors indicated the extent of cancer (EPE, RM, LVI, PNI, SVI). IDCP was diagnosed morphologically; equivocal lesions underwent basal cell IHC. Statistical analyses identified factors associated with IDCP.

RESULTS: Among 279 cases, IDCP was found in 70 (25.1%). The IDCP-positive group had higher PSA levels (14.2 vs. 10.7 ng/ml, p = 0.048). Univariate and Multivariate analyses identified GS (OR: 16.41, p < 0.001), EPE (OR: 2.36, p = 0.02), and PNI(OR: 2.57, p = 0.02) remained independently associated.

CONCLUSION: High grade (GS ≥ 8), EPE, and PNI serve as practical pathological triggers to scrutinize ducts and apply basal-cell IHC, which may reduce under-recognition of IDCP in RP specimens.

PMID:42458491 | DOI:10.1186/s13000-026-01804-9

Radiat Oncol. 2026 Jul 15. doi: 10.1186/s13014-026-02886-x. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: The optimal postoperative adjuvant treatment for pathological T3N0M0 (pT3N0M0) thoracic esophageal squamous cell carcinoma (TESCC) remains unclear. This study evaluated whether adding radiotherapy to postoperative chemotherapy provides an additional survival benefit in these patients.

METHODS: We retrospectively reviewed 1,090 TESCC patients treated at Sichuan Cancer Hospital (2009-2020). After applying inclusion and exclusion criteria, 356 patients who received adjuvant therapy were analyzed: 274 underwent surgery plus postoperative chemotherapy (S+POCT) and 82 received surgery plus postoperative chemoradiotherapy (S+POCRT). Propensity score matching balanced baseline characteristics between groups. Overall survival (OS) and disease-free survival (DFS) were compared, and survival predictors were assessed using a Cox proportional hazards model.

RESULTS: Before matching, the S+POCRT group had more female patients, and patients with vascular or perineural invasion were more likely to receive chemoradiotherapy. After matching (82 patients per group), baseline characteristics were balanced. The 5-year OS was 70.9% for the entire cohort. In the matched cohort, 5-year OS rates were 65.3% (S+POCT) versus 71.4% (S+POCRT), and 5-year DFS rates were 63.3% versus 70.9%, respectively. No statistically significant differences in OS or DFS were observed between the two groups. Multivariate analysis indicated that neither postoperative chemotherapy nor chemoradiotherapy independently improved OS. In the subgroup analysis, patients with tumors located in the lower third of the esophagus were more likely to derive a significant DFS benefit from S+POCRT but no subgroup showed a statistically significant OS benefit from S+POCRT compared with S+POCT.

CONCLUSIONS: For pT3N0M0 TESCC patients undergoing R0 resection without neoadjuvant therapy, postoperative chemotherapy alone provides comparable survival to chemoradiotherapy in the overall retrospective cohort. These findings suggest that the routine addition of postoperative radiotherapy to chemotherapy may not provide a clear survival advantage in the overall pT3N0M0 TESCC population. Further prospective studies are needed to identify patients who may benefit from postoperative radiotherapy.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42458490 | DOI:10.1186/s13014-026-02886-x

J Orthop Surg Res. 2026 Jul 15. doi: 10.1186/s13018-026-07094-7. Online ahead of print.

ABSTRACT

OBJECTIVE: Previous meta-analyses often lacked explicit time and included heterogeneous case types and surgical strategies. This led to substantial heterogeneity and limited the clinical applicability of these meta-analyses. This study focuses on evidence from the past 15 years, systematically comparing percutaneous pedicle screw fixation (PPSF) with open pedicle screw fixation (OPSF) for unstable traumatic thoracolumbar fractures (TTF). We aim to evaluate perioperative outcomes and radiographic correction based on contemporary practice.

METHODS: Randomized controlled trials (RCTs) published in English between January 2011 and January 2026 were retrieved from PubMed, Embase, the Cochrane Library, and the Web of Science Core Collection. Studies were screened using predefined inclusion and exclusion criteria. Six RCTs involving 305 patients were included, with 151 patients in the experimental group and 154 in the control group. Meta-analysis was performed using Review Manager 5.4. Mean difference (MD) was used as the effect size. Heterogeneity was assessed with the I² statistic. Sensitivity analysis was used to identify the main source of heterogeneity. Publication bias was evaluated using Egger’s test.

RESULTS: The random-effects meta-analysis showed that the experimental group had significantly less intraoperative blood loss (MD = – 32.51 mL, 95% CI – 57.52 to – 7.51, P = 0.01), shorter postoperative hospital stay (MD = – 2.09 d, 95% CI – 3.89 to – 0.29, P = 0.02), and smaller postoperative Cobb angle (MD = – 1.06°, 95% CI – 1.67 to – 0.46, P < 0.001). There was no significant difference in operative time (MD = – 10.15 min, 95% CI – 28.75 to 8.46, P = 0.29) or postoperative vertebral wedging angle (MD = 0.25°, 95% CI – 1.73 to 2.24, P = 0.80) between groups. Sensitivity analyses identified the study by Yang et al. as the main source of heterogeneity for operative time. After excluding this study, the fixed-effects model showed a shorter operative time in the experimental group (MD = – 8.85 min, 95% CI – 12.74 to – 4.95, P < 0.001). Perioperative outcomes showed high heterogeneity, whereas radiographic outcomes showed low to moderate heterogeneity. Egger’s test indicated no significant publication bias. Risk-of-bias assessment classified four RCTs as having a low risk of bias and two as having some concerns; no study was judged to have a high risk of bias.

CONCLUSION: PPSF may offer perioperative advantages over OPSF in selected unstable traumatic thoracolumbar fractures, mainly by reducing visible intraoperative blood loss and shortening postoperative hospital stay. PPSF was also associated with a modestly smaller postoperative segmental Cobb angle, although its clinical relevance and long-term durability remain uncertain. The operative-time finding should be interpreted cautiously because it became significant only in exploratory sensitivity analysis.

PMID:42458487 | DOI:10.1186/s13018-026-07094-7

BMC Med Educ. 2026 Jul 15. doi: 10.1186/s12909-026-09946-6. Online ahead of print.

ABSTRACT

BACKGROUND: The social model of disability acknowledges that the difficulties faced by persons who stutter (PWS) stem not only from speech dysfluency but also from societal barriers, misconceptions, and stigmatizing attitudes that limit participation and inclusion. As future healthcare professionals, health sciences students play an important role in promoting early detection, proper referral, and supportive care. However, there is limited research about their knowledge, beliefs, and attitudes around stuttering, particularly in Palestine and underserved areas.

METHODS: A cross-sectional study was carried out on 603 students enrolled in 14 health-related fields at An-Najah National University in Palestine. Participants completed an online questionnaire that assessed their knowledge and attitudes toward stuttering. SPSS version 25 was used to conduct descriptive statistics and chi-square tests to investigate the relationships between responses and gender, residence, and academic discipline.

RESULTS: Significant misconceptions persisted even though the majority of participants acknowledged the significance of early identification (87.9%) and disputed the idea that stutterers are less intelligent (83.3%). Less than half (38.1%) were aware of nearby treatment facilities, and only 22.9% recognized stuttering as a genetic problem. Many participants thought stutterers were quiet or shy (69.5%), more susceptible to mental health issues (73.6%), and socially ignored (46.1%). Gender, place of residence, and academic discipline all showed significant disparities. While students from a number of other disciplines showed more doubt and misconceptions, students in audiology and speech consistently showed the highest levels of knowledge and more evidence-informed attitudes.

CONCLUSION: This study reveals considerable knowledge gaps and persistent stigmatizing attitudes toward people who stutter among health sciences students, with marked disparities across disciplines. Targeted curricular interventions are warranted to address misconceptions about people who stutter.

PMID:42458485 | DOI:10.1186/s12909-026-09946-6

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08654-5. Online ahead of print.

ABSTRACT

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in children, young people (CYP) lacks validated diagnostic biomarkers. Post-exertional malaise (PEM) is central to case definitions and is usually assessed by patient report. We evaluated the feasibility and clinical value of handgrip strength (HGS) testing in PEM-reporting CYP referred for suspected ME/CFS.

METHODS: In this prospective observational study at the Munich Chronic Fatigue Center for Young People (November 2022-November 2024), 147 patients (10-25 years) referred for the assessment of ME/CFS with positive DSQ-PEM screening and 83 healthy controls (HC) completed two HGS sessions (10 maximal grips/session; 3-s contraction/5-s rest; 60-minute inter-session break) using a digital dynamometer. We derived maximal force (Fmax), mean force (Fmean), fatigue ratio (FR = Fmax/Fmean), and recovery ratio (RR = Fmean session 2 / session 1). Analyses used repeated-measures ANCOVA, linear regression, partial Spearman correlations (adjusted for sex, age, and BMI), and proportional odds models for group membership (HC, noME/CFS, ME/CFS), reporting accuracy, and the C-statistic. Sensitivity analyses compared noME/CFS with confirmed CCC-ME/CFS.

RESULTS: After clinical work-up, 84/147 (57%) patients were classified as ME/CFS (confirmed or probable) and 63/147 (43%) as noME/CFS. HGS test completion rate was high (session 1: 146/147, 99.3%; session 2: 142/147, 96.6%). Compared with HC, patients had substantially lower HGS (mean difference -9.93 kg, 95% CI: -12.00 to -7.85), and HGS indices correlated modestly with physical functioning (SF-12 PCS), but not with PEM duration. Both noME/CFS and ME/CFS groups differed from HC in absolute strength indices (Fmean, Fmax) and FR. RR differed between ME/CFS and HC, whereas no HGS index significantly separated noME/CFS from ME/CFS. In proportional odds models, each HGS index improved fit (all p < 0.001), but discrimination across HC, noME/CFS, and ME/CFS patients was moderate (accuracy 49.2-57.3% vs no-information rate 36.5%, with best performance for Fmean in session 2). In the CCC-restricted sensitivity analysis, discrimination between confirmed CCC-ME/CFS and noME/CFS was moderate (accuracy 62.8-70.7%; C-statistic 0.63-0.73), with best performance for absolute strength indices and RR.

CONCLUSIONS: Standardized two-session repeated HGS testing is feasible in CYP with chronic fatigue and self-reported PEM and provides an objective marker of functional impairment that aligns with physical health status but not with PEM duration. However, HGS alone shows limited ability to discriminate ME/CFS from other fatiguing noME/CFS conditions. HGS may be useful for quantitative phenotyping, patient stratification, and longitudinal outcome assessment rather than as a standalone diagnostic biomarker.

TRIAL REGISTRATION: Not applicable.

PMID:42458481 | DOI:10.1186/s12967-026-08654-5

J Transl Med. 2026 Jul 15. doi: 10.1186/s12967-026-08625-w. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic lung diseases impose a massive global burden, yet translating genetic findings into biologically interpretable target hypotheses remains challenging. We aimed to prioritize genetically supported candidate gene-cell type-disease associations and characterize pharmacological annotations for asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and bronchiectasis (BE).

METHODS: We integrated immune-cell-specific single-cell cis-eQTL data (14 immune cell subsets) with two-sample cis-Mendelian randomization and Bayesian colocalization. Using FinnGen R12 and UK Biobank as independent outcome cohorts, we developed a cross-cohort tiered framework to rank candidate gene-cell type-disease associations based on MR evidence, colocalization support, and cross-cohort consistency.

RESULTS: Asthma yielded the most robust signals, highlighting 6 “Tier 1” candidates (e.g., CD247, FADS1) with replicated colocalization support across both cohorts. We mapped 17 prioritized druggable genes to existing drug-, compound-, or metabolite-related annotations via DrugBank, DGIdb, and HMDB. These annotations nominate CD247, FADS1, and other loci for mechanistic and pharmacological follow-up, but they should not be interpreted as direct evidence of clinical repurposing readiness. The limited peripheral immune signals observed in IPF and BE suggest that local tissue niches, together with limited power and phenotype heterogeneity, may influence signal detection.

CONCLUSIONS: By bridging single-cell genomics with pharmacological databases, our tiered prioritization framework provides a statistically grounded map of genetically supported candidate genes for chronic respiratory diseases. The results refine broad genetic loci into cell-contextualized candidate genes and pharmacological annotations that require independent, functional, and pharmacological validation before therapeutic inference. These findings should be interpreted as hypothesis-generating prioritization evidence rather than proof of therapeutic efficacy, clinical utility, or drug-repurposing readiness.

PMID:42458479 | DOI:10.1186/s12967-026-08625-w

BMC Oral Health. 2026 Jul 15;26(1):1271. doi: 10.1186/s12903-026-09231-4.

ABSTRACT

OBJECTIVE: To investigate, using micro-computed tomography (micro-CT), the apical anatomy of mandibular second primary molar roots in Egyptian children, with emphasis on the spatial relationship between the apical foramen and the anatomic apex, and the morphology and dimensions of the root canal at the apical foramen level.

MATERIALS AND METHODS: Fifty extracted human mandibular second primary molars (150 canals: 50 distal, 50 mesiobuccal, 50 mesiolingual) with complete root length and minimal resorption were scanned using high-resolution micro-CT (15.24 μm voxel size). The distance between the apical foramen and the apex, canal major diameter, and roundness at the foramen level were measured using CTAn software. Descriptive statistics were calculated, and exploratory canal-type comparisons were performed using one-way ANOVA followed by Tukey post-hoc tests. (α = 0.05).

RESULTS: The apical foramen did not coincide with the anatomic apex in any canal. The mean apex-to-foramen distance was 0.57 ± 0.44 mm. Mean apical canal diameter was 0.63 ± 0.24 mm and mean roundness was 0.48 ± 0.17, indicating predominantly oval canal shapes. The overall comparison suggested variation in apex-to-foramen distance among canal types (p = 0.040), but post-hoc comparisons did not confirm statistically significant pairwise differences between individual canal types. Distal canals exhibited significantly larger diameters than both mesial canals (p < 0.05), whereas the difference between mesiobuccal and mesiolingual canals was not significant. Roundness did not differ significantly among canal types (p = 0.079).

CONCLUSIONS: In Egyptian children, the apical foramen of mandibular second primary molar is consistently offset from the anatomic apex. The distal canals demonstrated the largest major canal diameter at the apical foramen level.

CLINICAL RELEVANCE: Because the apical foramen rarely coincides with the apex and complete mechanical enlargement to the true apical diameter is often clinically unrealistic, pediatric endodontic treatment should prioritize accurate working-length determination (e.g., electronic apex locators) and combine conservative shaping with effective chemical disinfection to optimize apical cleaning while preserving root integrity.

PMID:42458474 | DOI:10.1186/s12903-026-09231-4

BMC Nurs. 2026 Jul 15. doi: 10.1186/s12912-026-05046-4. Online ahead of print.

ABSTRACT

BACKGROUND: Major Depressive Disorder (MDD) is a debilitating psychiatric condition that severely impairs patients’ self-care capabilities, self-esteem, and resilience. Dorothea Orem’s Self-Care Deficit Theory offers a systematic nursing framework to transition patients from passive care recipients to active self-managers. This study aimed to evaluate the effects of a nursing intervention based on Orem’s self-care model on self-esteem and resilience among hospitalized patients with MDD.

METHODS: This randomized controlled trial was conducted from February to May 2026 among 60 patients diagnosed with MDD who were hospitalized in the psychiatric ward of Shahid Madani Hospital in Khoy, Iran. Patients were selected via convenience sampling and randomly assigned to either the intervention group (n = 30) or the control group (n = 30) using block randomization. The intervention group received 5 sessions of a tailored self-care program based on Orem’s supportive-educative system, alongside routine clinical care. The control group received only standard hospital care. Data were collected at baseline (pre-test), immediately post-intervention (post-test), and at a one-month follow-up using the Rosenberg Self-Esteem Scale (RSES) and the Connor-Davidson Resilience Scale (CD-RISC). Data were analyzed using SPSS software via descriptive statistics and Repeated Measures ANOVA.

RESULTS: Baseline demographic and clinical characteristics were homogeneous between the two groups (P > 0.05). Mauchly’s test confirmed sphericity for both self-esteem (W = 0.992, P = 0.788) and resilience (W = 0.953, P = 0.252) variables. The Repeated Measures ANOVA demonstrated a significant time-group interaction effect for both self-esteem (F = 10.11, P < 0.001, Partial Eta Squared = 0.15) and resilience (F = 6.59, P = 0.002, Partial Eta Squared = 0.10). At post-test, the intervention group exhibited significantly higher self-esteem (Mean = 18.33, 95% CI: [17.08, 19.58]) and resilience (Mean = 55.70, 95% CI: [52.00, 59.40]) compared to the control group (Self-esteem Mean = 12.03, 95% CI: [10.78, 13.28]; Resilience Mean = 42.07, 95% CI: [38.37, 45.77]) (P < 0.001), which remained stable at the one-month follow-up.

CONCLUSION: Psychiatric nurses can integrate this structured, low-cost, and empowering model into routine clinical practice to foster autonomy and reinforce essential psychological capacities-specifically self-esteem and resilience-in hospitalized psychiatric patients.

TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20250723066609N3. Registered on February 6, 2026.

PMID:42458470 | DOI:10.1186/s12912-026-05046-4