Tag: pubmed

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-43362-6. Online ahead of print.

ABSTRACT

This study presents the optimization of nickel oxide nanoparticles (NiO NPs) synthesized through an environmentally benign route using Sida acuta (SA) leaf extract as a reducing and capping agent. Taguchi-Grey Relational Analysis (TGRA) was employed to optimize the hydrodynamic diameter (HDD) and polydispersity index (PDI) of the synthesized NiO NPs. Key synthesis parameters (extract concentration, reaction temperature, and reaction time) were varied within an L9 orthogonal array. Using Grey Relational Analysis (GRA), a regression-based model was developed to predict the grey relational grade (GRG) for multi-response optimization. The optimal synthesis conditions (60 mg/mL extract concentration, 70 °C reaction temperature, and 120 min reaction time) produced NiO NPs with an HDD of 62.72 nm and a PDI of 0.232. ANOVA identified temperature as the dominant factor governing the size and distribution of the NPs. UV-Vis spectroscopy showed a characteristic absorption peak at 284 nm, and XRD confirmed a face-centered cubic crystalline structure with an average crystallite size of 5.99 nm. SEM, EDS, and TEM analyses indicated well-dispersed polycrystalline NPs with 80% purity. The synthesized NiO NPs possess physicochemical characteristics that position them as promising candidates for catalytic, sensing, and energy-storage applications. This work demonstrates a statistical-experimental framework for tuning nanoparticle properties through sustainable synthesis routes, highlighting a scalable strategy for precision nanomaterial design.

PMID:41865066 | DOI:10.1038/s41598-026-43362-6

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-42552-6. Online ahead of print.

ABSTRACT

Cholemic nephropathy(CN) is an unrecognized cause of kidney dysfunction in patients with acute on chronic liver failure (ACLF). We aimed to evaluate whether urine microscopy(UM) could identify CN in ACLF patients and differentiate from hepatorenal syndrome (HRS) and acute tubular necrosis (ATN). Forty-five patients with ACLF with AKI stratified based on UM as HRS(bland sediment; n = 15), CN(bilirubin crystals; n = 15) and ATN (coarse granular casts; n = 15) were compared to no AKI (n = 15). ACLF patients with mean age of 44 ± 10 years, 93% males were enrolled. Patients with HRS and CN showed significantly elevated biomarkers of renal repair (EGF, Osteopontin, calbindin) and lower levels of renal injury (renin, lipocalin-2, cystatin c, alpha-1 macroglobulin, albumin, TIMP-1, IP-10 and KIM-1) compared to ATN. CN patients had significantly elevated bile acids, proinflammatory cytokines (20 out of 29) compared to other groups. Metabolomic analysis of plasma and renal tubule epithelial cells (RTEC)identified 190 (151 up- and 39 downregulated) and 196 (61 up and 135-down) differentially expressed metabolites in biopsy-proven CN compared to ATN(FC > 1.5, P < 0.05). Preservation of mitochondrial function was seen in the RTEC of CN compared to ATN. The top 5 biomarkers which predicted CN included GST-alpha, IL-15, bile acids, IL-3, and osteopontin. Clinical models including GST-alpha, IL-15, bilirubin (> 22 mg/dl) or AARC score identified CN with more than 95% accuracy. Taken together, our study shows higher bile acids, preserved renal repair and lesser tubular injury despite intense systemic inflammation with preserved metabolic adaptation of the host differentiated CN from ATN.

PMID:41865060 | DOI:10.1038/s41598-026-42552-6

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-41744-4. Online ahead of print.

ABSTRACT

In orthodontics, the increasing use of AI-generated smile images in patient communication raises ethical and practical concerns about user perception and misinterpretation of these visuals. This cross-sectional, non-probabilistic sample study evaluated the ability of dentists, dental students, and laypeople to distinguish between real and AI-generated orthodontic smile images, and their perceived attractiveness. The final sample consisted of 288 participants, (63.4% female; mean age = 32.4 years) including 76 dentists, 63 dental students, and 149 laypeople. Each participant was presented with three clinical scenarios, mild dental misalignment, midline diastema, and moderate anterior crowding, and viewed randomized sets of images depicting pre-treatment, real post-treatment, and AI-generated smiles. For each image, participants indicated whether they believed it was AI-generated or real and rated its aesthetic appeal using a visual analog scale ranging from 0 to 100. Data were analyzed using descriptive statistics and diagnostic performance metrics (accuracy, sensitivity, specificity, PPV, and NPV), with attractiveness ratings compared between AI-generated and real images. Sensitivity for identifying AI-generated images was low across all groups (< 50%), while specificity for recognizing real images was high (> 87%). Dental students achieved the highest overall accuracy (72.7%), followed by laypeople (66.3%) and dentists (62.6%). AI-generated smiles were consistently rated as significantly more attractive than real outcomes by all groups (mean VAS: 78.8 vs. 37.9; p < 0.001). AI-generated smile images were less accurately identified and more aesthetically pleasing than real clinical outcomes compared to real post-treatment outcomes, which were more consistently recognized across all participant groups, regardless of treatment type.

PMID:41865052 | DOI:10.1038/s41598-026-41744-4

J Orthop Surg Res. 2026 Mar 21. doi: 10.1186/s13018-026-06769-5. Online ahead of print.

ABSTRACT

INTRODUCTION: This study compared the clinical outcomes of the all-inside endoscopic and the minimally invasive modified Bunnell suture configurations for the management of acute midsubstance Achilles tendon ruptures (AMATR).

METHODS: A retrospective analysis was conducted on 63 AMATR patients (54 men and 9 women, with a mean age of 39.84 ± 10.40 years (range, 21-62 years). All patients underwent Achilles tendon repair using the modified Bunnell suture configuration using the all-inside endoscopic repair (n = 31) or a minimally invasive repair (n = 32). The primary endpoint was postoperative functional outcome, assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Achilles Tendon Total Rupture Score (ATRS) at 6, 12, and 24 months. Secondary endpoints included perioperative and short-term recovery parameters, including operative time, incision length, postoperative pain assessed by the Visual Analog Scale (VAS) on postoperative days 1 and 3, wound complications, and time to return to work and sports activities.

RESULTS: There were no intraoperative complications, and all patients in the endoscopic group achieved primary wound healing. At the 6-, 12-, and 24-month follow-up, both groups demonstrated significant improvement in AOFAS and ATRS scores over time, with no significant differences between groups. Regarding secondary endpoints, the all-inside endoscopic group had a significantly longer operative time but a significantly shorter incision length compared with the minimally invasive group (p < 0.05). VAS pain scores on postoperative days 1 and 3 were significantly lower in the endoscopic group (p < 0.05). No wound infections occurred in the endoscopic group, whereas three superficial infections were observed in the minimally invasive group; however, the difference was not statistically significant. Patients in the endoscopic group returned to work one week earlier (p < 0.05), while the time to return to sports was comparable between groups.

CONCLUSION: Both the all-inside endoscopic and the minimally invasive modified Bunnell suture configurations provide reliable repair for AMATR and support a successful return to occupational and athletic activity. While the all-inside endoscopic procedure was associated with a longer operative time, it offered advantages in terms of reduced early postoperative pain, smaller incisions, and earlier return to work, without compromising functional recovery at the 2-year follow-up.

PMID:41865018 | DOI:10.1186/s13018-026-06769-5

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-39638-6. Online ahead of print.

NO ABSTRACT

PMID:41865014 | DOI:10.1038/s41598-026-39638-6

Sci Rep. 2026 Mar 21. doi: 10.1038/s41598-026-38952-3. Online ahead of print.

ABSTRACT

Environmentally benign and straightforward spectrophotometric methods were developed and validated for the simultaneous determination of saxagliptin (SAX), metformin (MET), and the pharmacopeial impurity of MET, melamine (MEL), in bulk powder and pharmaceutical formulations. These proposed approaches provide reliable, low-cost, and accessible alternatives to conventional chromatographic techniques, which often require complex instrumentation, extended analysis times, and significant solvent consumption. Two complementary spectrophotometric methods were established. Method A, the ratio-difference approach, utilized MEL as a divisor for the quantification of SAX, while SAX served as a divisor for determining MET and MEL. Method B, based on the first derivative of ratio spectra, applied MEL as a divisor under optimized conditions (scaling factor = 10, Δλ = 4 nm). However, MEL could not be quantified by Method B because its derivative ratio signals in the selected spectral region were too weak and overlapped extensively with those of SAX and MET, preventing the establishment of a reliable linear calibration curve for this impurity. The methods exhibited linearity over the ranges of 5-90 µg/mL for SAX, 1-40 µg/mL for MET, and 0.5-10 µg/mL for MEL. Validation in accordance with ICH Q2(R1) guidelines confirmed their accuracy, precision, selectivity, and specificity. The results obtained by the proposed methods were statistically compared with those of a reported RP‑HPLC method, confirming the reliability of the proposed procedures. The environmental impact was assessed using the principles of green analytical chemistry (GAC), which incorporates sustainability by promoting methods that limit hazardous reagents, reduce energy consumption, and minimize waste while maintaining suitable analytical performance. Holistic evaluation tools such as the analytical greenness metric (AGREE), the green analytical procedure index (GAPI), the national environmental methods index (NEMI), the blue applicability grade index (BAGI), and the RGB 12 model enable simultaneous assessment of analytical quality, environmental impact, and practical applicability. These tools foster the development of “white” analytical chemistry and complement emerging indices like the environmental and practical performance index (EPPI).Overall, these spectrophotometric approaches represent sustainable, efficient, and accessible analytical alternatives for the routine quality control of Saxagliptin and Metformin in combined pharmaceutical formulations.

PMID:41865005 | DOI:10.1038/s41598-026-38952-3

JACC Adv. 2026 Mar 19;5(4):102678. doi: 10.1016/j.jacadv.2026.102678. Online ahead of print.

ABSTRACT

BACKGROUND: Limited evidence exists on the relationship between socioeconomic disparities and cardiovascular disease in resource-limited settings, particularly in Latin America.

OBJECTIVES: The objective of the study was to assess the association between educational attainment, socioeconomic status (SES), and cardiovascular risk among Peruvian adults.

METHODS: We performed a cross-sectional analysis using data from 24,048 adults included in the 2023 Peruvian Demographic and Family Health Survey. Educational attainment was categorized as none, primary, secondary, or superior education, and SES was divided into 5 quintiles. Ten-year cardiovascular risk was estimated using the 2019 World Health Organization risk charts and dichotomized as high (≥10%) or nonhigh (<10%). Logistic regression models were used to estimate ORs and 95% CIs for cardiovascular risk.

RESULTS: Overall, 4.7% of adults were found to have a high cardiovascular risk, with substantial variation across education levels and socioeconomic status. In adjusted analyses, secondary and higher educational attainment were associated with substantially lower odds of high cardiovascular risk compared with no education (secondary: OR: 0.42; 95% CI: 0.25-0.71; superior: OR: 0.47; 95% CI: 0.30-0.73). These inverse associations were more pronounced among men, whereas among women the estimates were directionally similar but not statistically significant. In contrast, SES quintiles showed no independent association with high cardiovascular risk after adjustment for covariates.

CONCLUSIONS: Higher educational attainment was independently associated with lower 10-year cardiovascular risk, whereas SES quintiles showed no association.

PMID:41863208 | DOI:10.1016/j.jacadv.2026.102678

JACC Adv. 2026 Mar 19;5(4):102688. doi: 10.1016/j.jacadv.2026.102688. Online ahead of print.

ABSTRACT

BACKGROUND: Type 2 myocardial infarction (MI) (T2MI) is common and associated with adverse outcomes.

OBJECTIVES: The objective of the study was to evaluate the prevalence of coronary artery disease (CAD) in patients with T2MI and myocardial injury and its impact on outcomes.

METHODS: Observational U.S. cohort study of emergency department patients undergoing high-sensitivity cardiac troponin T measurement. Cases with >1 high-sensitivity cardiac troponin T increase >99th percentile were adjudicated following the Fourth Universal Definition of MI. CAD was defined as a prior CAD, MI, or coronary revascularization or newly diagnosed CAD during index hospitalization. Two-year major adverse cardiovascular outcomes including all-cause, cardiovascular, and noncardiovascular death, acute MI, heart failure hospitalization, and coronary revascularization were compared between patients with T2MI or myocardial injury and CAD vs type 1 MI (T1MI).

RESULTS: Among 858 patients, 64 (7.5%) had T1MI, 91 (11%) had T2MI, and 703 (82%) had myocardial injury. Patients with T2MI and CAD (n = 31; 34% of T2MI) had higher major adverse cardiovascular outcomes than T1MI (65% vs 39%; adjusted HR [aHR]: 1.95; 95% CI: 1.2-3.6), driven by higher all-cause death (52% vs 20%; aHR: 2.2; 95% CI: 1.0-4.5), noncardiovascular death (26% vs 5%; aHR: 5.04; 95% CI: 1.3-19.3), acute MI (13% vs 2%; aHR: 9.2; 95% CI: 1.01-84.2), and heart failure hospitalization (32% vs 8%; aHR: 4.6; 95% CI: 1.6-13.7). Patients with myocardial injury and CAD (n = 245) demonstrated similar trends, although differences were not statistically significant after adjustment.

CONCLUSIONS: CAD is common among patients with T2MI and myocardial injury and is associated with poor long-term outcomes. Its presence may facilitate risk-stratification and represent a potential therapeutic target.

PMID:41863201 | DOI:10.1016/j.jacadv.2026.102688

Knee. 2026 Mar 19;61:104426. doi: 10.1016/j.knee.2026.104426. Online ahead of print.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is a prevalent orthopaedic procedure often accompanied by significant postoperative pain. Central sensitization, marked by increased nervous system reactivity, may influence opioid consumption variability after TKA. Investigating central sensitization, particularly regarding sex differences, could enhance postoperative care and opioid prescribing practices for TKA patients.

METHODS: Patients scheduled for TKA were assessed preoperatively and at 2 and 6 weeks postoperatively. Data collected included demographics, PROMIS-29, Brief Pain Inventory (BPI), Pain Catastrophizing Scale, Central Sensitization Inventory (CSI), and quantitative sensory testing. Participants recorded opioid use in home diaries over 6 weeks, measured in morphine milligram equivalents (MME) and days of use. Analyses involved descriptive statistics, sex differences, correlations, and regression models.

RESULTS: Thirty-nine participants (59% females) were enrolled. CSI scores indicated sub-clinical central sensitization in a majority of patients. No sex differences were observed in patient-reported outcomes, but males consumed significantly more opioids than females (median MME: 248 vs 519, p = 0.023), with similar durations of use (median days: 18 vs 16, p = 0.50). Pain levels correlated with opioid use duration (rs = 0.50, p = 0.001), stronger in males (rs = 0.69) than females (rs = 0.33). Central sensitization correlated with opioid use duration in males (rs = 0.81, p < 0.001), unlike females (rs = -0.11, p = 0.64).

CONCLUSION: Central sensitization significantly impacts opioid use in males post-TKA, challenging existing beliefs. Males with preoperative CSI scores indicating central sensitization showed sustained opioid use above norms, suggesting CSI as a predictive tool for postoperative opioid consumption. Recognizing sex-specific differences in central sensitization could improve pain management and opioid prescribing in TKA.

PMID:41863198 | DOI:10.1016/j.knee.2026.104426

Curr Med Chem. 2026 Mar 16. doi: 10.2174/0109298673445152260120111510. Online ahead of print.

ABSTRACT

INTRODUCTION: Dual inhibitors of AROM and STS (DASIs), through their synergistic action, hold the potential to suppress estrogen biosynthesis at multiple points. It also overcomes limitations associated with single-enzyme inhibition and reduces the risk of resistance development. In order to potentially improve the clinical outcomes in hormone-dependent breast cancers, 1,2,4-triazole derivatives having similar structural characteristics to third-generation Aromatase Inhibitors (AIs), including exemestane, letrozole, and anastrozole, were subjected to ligand-based screening. This research study comparatively analyzes the drug candidates as DASIs that aim at the development of advanced therapeutic strategies for breast cancer treatment.

MATERIALS AND METHODS: In this study, a set of 172 biphenyl 1,2,4-triazole derivatives with defined biological activity against AROM and STS enzymes was subjected to 3DQSAR modelling, followed by ADMET, molecular docking, and dynamics.

RESULTS: Through 3D-QSAR, significant statistical parameters of aromatase (q2 = 0.8429, r2 = 0.8874, r2pred = 0.8252) and steroidal sulfatase (q2 = 0.8877, r2 = 0.9402, r2pred = 0.9376) indicated the accuracy and reliability, and the good prediction power of the model. The external validation set further demonstrated its predictive capability. Furthermore, molecular docking, along with molecular dynamics at a time period of 100 ns, elucidated the stability of the docked complexes and found that Compound 109 emerged as the most promising dual inhibitor, exhibiting high binding affinities of -9.94 kcal/mol for Aromatase (AROM) and -9.41 kcal/mol for Steroid Sulfatase (STS). These values reflect a strong potential for dual enzyme inhibition.

DISCUSSION: The structural features of triazole derivatives through QSAR modelling established a statistical correlation, establishing a relationship between functional groups and their biological activity. They are found to have dual inhibition efficiency in a target-based approach, accelerating for synthetic accessibility.

CONCLUSION: The study highlights the potential of triazole derivatives and provides a multi-targeted therapeutic avenue for hormone-dependent breast cancers. It shows strong reliability and predictive power through molecular docking and a dynamic approach. Compound 109 emerged as the lead candidate due to its strong binding affinities and stable dual interactions.

PMID:41863173 | DOI:10.2174/0109298673445152260120111510