Tag: pubmed

Int J Cardiovasc Imaging. 2026 Feb 4. doi: 10.1007/s10554-026-03626-8. Online ahead of print.

ABSTRACT

Accurate assessment of coronary lesion complexity is essential for guiding revascularization strategies in patients with coronary artery disease. The SYNTAX score, originally derived from invasive coronary angiography (ICA), plays a key role in clinical decision-making. With advancements in cardiac computed tomography angiography (CCTA), its potential as a non-invasive tool for SYNTAX scoring has gained interest, but discrepancies between modalities remain uncertain. To systematically compare SYNTAX scores obtained by CCTA versus ICA and evaluate their concordance, with implications for clinical decision-making. We conducted a systematic review and meta-analysis of studies published between 2013 and 2024 comparing SYNTAX scores derived from CCTA and ICA in the same adult populations. Databases including PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched through January 2025. The primary outcome was the pooled standardized mean difference (Hedges’ g) in SYNTAX scores between modalities. Risk of bias was assessed using QUADAS-2, and meta-regression explored potential sources of heterogeneity. Thirteen studies with a total of over 1,800 patients met inclusion criteria. The pooled analysis demonstrated a statistically significant underestimation of SYNTAX scores by CCTA compared to ICA (Hedges’ g = – 0.121; 95% CI: -0.185 to – 0.056; p < 0.01). Heterogeneity was moderate (I² = 30.7%) after exclusion of one outlier. Meta-regression revealed no significant impact of publication year, scanner generation, or sample size on effect size. Several studies highlighted meaningful discrepancies in SYNTAX classification near critical decision thresholds (22 and 32). Funnel plot symmetry and Q-Q plot normality suggested minimal publication bias. CCTA systematically underestimates SYNTAX scores compared to ICA, which may impact treatment decisions in patients with complex coronary artery disease. While CCTA offers a promising non-invasive alternative, clinicians should interpret CCTA-derived SYNTAX scores with caution-particularly in borderline cases where therapeutic strategies may differ. Further standardization of scoring protocols and incorporation of functional imaging tools such as CT-FFR are warranted.

PMID:41636974 | DOI:10.1007/s10554-026-03626-8

Ann Biomed Eng. 2026 Feb 4. doi: 10.1007/s10439-026-03980-7. Online ahead of print.

ABSTRACT

PURPOSE: This study presents a novel algorithm for the automatic detection of motor unit (MU) fractions within the motor unit potential (MUP) scans derived from multiscanning EMG recordings. MU fractions are spatially distinct regions identified in the MUP scans that reflect the distribution of muscle fibres within each MU. Multiscanning EMG allows recording multiple MUPs simultaneously in a single recording, improving efficiency and reducing patient discomfort.

METHODS: The algorithm combines amplitude thresholding, morphological operations, and connected component analysis to identify MU fractions. Algorithm performance was evaluated using MUP scans from tibialis anterior muscles of five healthy individuals. The analysis was performed in two ways: the first included all the fractions detected automatically, and the second included only those fractions detected in both the automatic and the ground truth. Additionally, the association between muscle depth, number of MU fractions, and signal-to-noise ratio (SNR) of the recorded signals was analysed.

RESULTS: T-tests showed no statistically significant difference between the algorithm and ground truth for both start and end markers. ANOVA indicated that muscle depth did not affect the signal-to-noise ratio (f = 1.06, p = 0.35). Overall, the algorithm reliably identified MU fractions.

CONCLUSION: The proposed automatic method accurately detects MU fractions, providing a valuable tool for analysing motor unit activity in clinical and research settings.

PMID:41636959 | DOI:10.1007/s10439-026-03980-7

J Mol Neurosci. 2026 Feb 4;76(1):24. doi: 10.1007/s12031-026-02474-4.

NO ABSTRACT

PMID:41636955 | DOI:10.1007/s12031-026-02474-4

Breast Cancer Res Treat. 2026 Feb 4;215(3):71. doi: 10.1007/s10549-026-07908-6.

ABSTRACT

BACKGROUND: In patients with ipsilateral breast tumor recurrence (IBTR) previously treated with breast-conserving surgery (BCS) followed by radiotherapy, salvage mastectomy (SM) is still considered standard of care. Currently, there is little evidence available about complication rates of repeat BCS or salvage mastectomy in patients with IBTR and possible differences.

AIM: The primary aim was to report postoperative complication rates after IBTR treatment with salvage mastectomy or repeat BCS after previous BCS (± radiotherapy). Secondary, risk factors associated with complications were examined.

METHODS: Complication rates were reported using descriptive statistics. Complications were classified between short-term (less than 3 months after surgery) and long-term (more than 3 months after surgery). Logistic regression was used to evaluate possible risk factors after salvage mastectomy to report an odds ratio (OR) with a 95% confidence interval (CI).

RESULTS: A total of 549 cases with IBTR after primary BCS were included. Short-term complications occurred in 200 (45.2%) of 442 patients treated with salvage mastectomy and in 9 (16.4%) of 55 patients treated with repeat BCS. Seroma and surgical site infection (SSI) were most common in salvage mastectomy (31.7% and 10.9%, respectively). Long-term complications were reported in 16.7% treated with salvage mastectomy and in 14.5% with repeat BCS. The risk of short-term postoperative complications after salvage mastectomy increased significantly with higher BMI. The regression analysis showed that adjuvant radiotherapy after IBTR surgery was associated with long-term postoperative complications.

CONCLUSIONS: Salvage mastectomy in case of IBTR after primary BCS is associated with high short-term complication rates, especially seroma. The risk of short-term complications after salvage mastectomy increased with increasing BMI, while adjuvant radiotherapy after salvage mastectomy is associated with long-term complications.

PMID:41636939 | DOI:10.1007/s10549-026-07908-6

Hernia. 2026 Feb 4;30(1):84. doi: 10.1007/s10029-026-03593-y.

ABSTRACT

PURPOSE: Ruptured umbilical hernia (UH) is a life-threatening condition in cirrhotic patients with a morbidity and mortality rate of 30%. Despite its high risk, the best surgical treatment strategy for this condition remains controversial. This study aimed to evaluate the feasibility and safety of mesh repair of ruptured UH.

METHODS: 149 patients who underwent surgical management for ruptured UH between January 2018 and December 2022 were included in this retrospective study. The patients were divided into two groups: anatomical repair (group 1, n = 92) and mesh repair (group 2, n = 57). Hernia recurrence, wound infection, and other perioperative morbidity and mortality were evaluated.

RESULTS: The recurrence of hernia was significantly lower after mesh repair (5.3% vs. 17.4%, P = 0.03). Other postoperative complications were not significantly different between the two groups. However, the incidence of wound infection after mesh repair was higher than that after anatomical repair, but this was statistically non-significant (12.3% vs. 8.7%, p = 0.48). Two patients in the mesh repair group required mesh removal due to infection.

CONCLUSIONS: Mesh repair of ruptured UH in cirrhotic patients is a feasible and safe surgical option that results in a significantly lower hernia recurrence rate with acceptable morbidity and mortality, provided that careful patient optimization is carried out.

PMID:41636907 | DOI:10.1007/s10029-026-03593-y

Laryngoscope. 2026 Feb 4. doi: 10.1002/lary.70405. Online ahead of print.

ABSTRACT

OBJECTIVE: There is no consensus on blood thinner management in the perioperative period for head and neck free flap reconstructions. This study evaluated head and neck free flap outcomes in patients on baseline blood thinners, aspirin flap prophylaxis, and deep venous thrombosis (DVT) prophylaxis regimens.

METHODS: Patients undergoing head and neck free flap reconstruction at a single tertiary, academic institution were included. Patients were grouped according to baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis regimens. The primary outcome was overall complication rate, while secondary outcomes included flap compromise, flap failure, bleeding, venous thrombotic events, and arterial thrombotic events. Statistical analysis was performed with Fisher’s exact test and risk ratio (RR) regression analysis, using propensity score-adjusted models.

RESULTS: Of 470 patients, 16.6% experienced postoperative complications. Longer preoperative holds (odds ratio [OR] = 1.81, p = 0.04) and delayed resumption of baseline blood thinners (OR = 1.56, p = 0.04) were associated with increased complication risk, particularly flap compromise. Unfractionated heparin was associated with higher complication rates compared to sequential compression devices (RR = 3.10, p = 0.018) and low molecular weight heparin (RR = 2.79, p < 0.001) for DVT prophylaxis. No other perioperative blood thinner regimens were significantly associated with postoperative complications.

CONCLUSIONS: Most regimens, including baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis, can be managed safely in the perioperative period. However, unfractionated heparin was associated with higher complication rates than other DVT prophylaxis regimens. While baseline blood thinners did not increase most complications, prolonged preoperative holding and delayed resumption may jeopardize flap viability-highlighting a modifiable point of intervention.

PMID:41636139 | DOI:10.1002/lary.70405

Lakartidningen. 2026 Feb 4;123:25052.

ABSTRACT

A high coverage rate of cervical cancer screening is necessary to prevent cervical cancer. Women who have not been tested in the last 10 years are considered as long-term non-attenders from the screening program. A recent report from the Regional Cancer Centers in Sweden addressed geographic disparities in the 10-year coverage rate among 33-62-year-old women residing in Sweden in 2023, and compared the results with those in a previous report from 2020. The analytic method employed is referred to as geomapping, based on geo-coded data to 5984 neighborhoods (Statistics Sweden’s Demographic Statistics Areas [DeSO]). Individual data on HPV/Pap testing in the previous 10-year period, age, and residential address (used for the geo-coding) were retrieved from the National Cervical Screening Registry. Neighborhood-level data on economic standard, proportion of non-Western immigrants, and geographic location (urban/semi-urban/rural) were assessed, based on data from Statistics Sweden, for estimation of neighborhood-level associations. The overall 10-year coverage rate decreased from 91.9% in 2020 to 91.1% in 2023. We identified 147 out of the 5984 neighborhoods as showing statistical evidence for a pronouncedly lower 10-year coverage rate than the overall average of 91.1 %. Furthermore, we found a decreasing 10-year coverage rate with lower economic standard, as well as with increasing proportion of non-Western immigrants. After adjustments for these two neighborhood-level covariates, we found that rural geographical location was associated with lower 10-year coverage rate. The results demonstrate that geomapping can provide a rational basis for targeting population-level interventions to improve screening. Specifically, it is rational to allocate extra resources, if available, towards the 147 identified neighborhoods with a pronouncedly lower 10-year coverage rate.

PMID:41636138

Hum Vaccin Immunother. 2026 Dec;22(1):2609345. doi: 10.1080/21645515.2025.2609345. Epub 2026 Feb 4.

ABSTRACT

Human papillomavirus (HPV) is a major global health concern due to its link to cervical and other cancers. Although HPV vaccination is highly effective, acceptance and willingness to pay (WTP) differ widely across populations. This review summarizes global evidence from 2015-2025. A systematic search of PubMed, Scopus, CENTRAL, Web of Science, and Google Scholar was conducted in 2025 following PRISMA guidelines. Studies reporting data on knowledge, acceptance, attitudes, and WTP across any population were included. Quality assessment used ISPOR checklists, and data were synthesized in Excel 2019. Thirty-five studies met inclusion criteria, with China and Nigeria contributing most. WTP ranged from 52.68% in lower-middle-income countries to 65.38% in low-income countries. Mean WTP was highest in upper-middle-income settings. Knowledge, positive attitudes, socioeconomic status, and trust increased WTP, while cost remained the primary barrier. Improving affordability, awareness, and policy support is essential to enhance global HPV.

PMID:41636135 | DOI:10.1080/21645515.2025.2609345

JBI Evid Synth. 2026 Feb 4. doi: 10.11124/JBIES-25-00177. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review will examine the association between pesticide use and cancer incidence among farm workers.

INTRODUCTION: Farmers are the most essential part of many countries’ agriculture-based economies. Several studies have identified acute and chronic hazards associated with pesticide use, including lymphoma, leukemia, brain tumors and other cancers. However, no systematic reviews have comprehensively assessed the association between pesticide use and cancer incidence among farmers.

ELIGIBILITY CRITERIA: Primary observational studies (case-control, cohort, and cross-sectional) that include participants who are farm workers (farmers, their spouses, and seasonal workers) in any geographic location and that document exposure to pesticides associated with cancer incidence will be eligible for inclusion.

METHODS: Academic databases (PubMed, Web of Science Core Collection, Ovid Embase, Cochrane CENTRAL, and ProQuest Health and Medical Collection), non-academic databases (Google Scholar up to 20 pages), and other gray literature (OAIster, Shodhganga, and medRxiv) will be searched. Two reviewers will independently screen titles/abstracts and full texts, with adjudication by a third reviewer. Critical appraisal of the included studies will be performed using JBI checklists. Quantitative outcomes on the association of pesticide exposure and cancer incidence will be pooled in statistical meta-analysis, where possible. Heterogeneity between studies will be assessed statistically using standard χ2 and I2 tests. Where statistical pooling is not possible, the findings will be presented narratively. Certainty of the evidence regarding the carcinogenicity of pesticides will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

REVIEW REGISTRATION: PROSPERO CRD420251019979.

PMID:41636132 | DOI:10.11124/JBIES-25-00177

J Basic Microbiol. 2026 Feb;66(2):e70148. doi: 10.1002/jobm.70148.

ABSTRACT

Cordycepin, a nucleoside analog derived from Cordyceps militaris, is a bioactive compound with potent pharmacological properties and growing relevance in functional food and pharmaceutical industries. However, its production is highly variable depending on cultivation conditions, making real-time and scalable prediction essential for efficient process control. This study aimed to develop a machine learning-based predictive model to estimate cordycepin content based on measurable cultivation parameters. Three machine learning algorithms-XGBoost, Random Forest, and Support Vector Machine-were trained using experimental data encompassing environmental and nutritional factors. Model validation was conducted using Tropsha’s statistical criteria, and model explainability was achieved through SHAP analysis. A user-friendly GUI was also developed for real-time prediction and application. Among the models, XGBoost demonstrated the highest performance with a cross-validated Q² of 0.9087 and an R² of 0.9544, satisfying all statistical requirements for reliability. SHAP analysis identified light wavelength and carbon/nitrogen ratio as the most influential factors in cordycepin biosynthesis. The developed GUI enables end-users to input cultivation conditions and receive immediate predictions, facilitating data-driven decision-making. This approach offers a scalable and interpretable framework for optimizing bioactive compound production in edible fungi, with potential application in smart bioprocessing and precision fermentation.

PMID:41636097 | DOI:10.1002/jobm.70148