Tag: pubmed

Eur J Orthop Surg Traumatol. 2026 Jul 1;36(1):267. doi: 10.1007/s00590-026-04832-9.

ABSTRACT

PURPOSE: To evaluate surgical outcomes in cervical spondylotic myelopathy (CSM) with intramedullary signal changes (IMSCs) and assess the impact of preoperative severity on recovery.

METHODS: This retrospective study included 312 patients undergoing cervical decompression. Neurological status was assessed using the mJOA score preoperatively and at 6-12 months. A subset of 43 patients was analyzed separately for inferential statistics using chi-square testing.

RESULTS: Severe CSM was present in 54.2% and moderate in 45.8%. Overall improvement occurred in 53.2%, with a mean mJOA increase of 2.9 points. In the subset, mean mJOA improved from 10.25 (SD 1.80) to 13.16 (SD 2.43). A significant association was found between preoperative severity and outcome (p < 0.05).

CONCLUSION: Surgical decompression leads to meaningful neurological improvement, with outcomes influenced by preoperative severity.

PMID:42384242 | DOI:10.1007/s00590-026-04832-9

Arch Toxicol. 2026 Jul 1. doi: 10.1007/s00204-026-04419-7. Online ahead of print.

ABSTRACT

Ethylene oxide (EtO) is a widely used industrial compound with known carcinogenic potential in humans. Due to its high reactivity and short biological half-life, occupational exposure assessments (> 1 ppm) rely on the detection of stable biomarkers, such as N-(2-hydroxyethyl)-L-valine (HE-V), formed as hemoglobin adducts in blood. Existing analytical methods for HE-V detection often require large volumes of blood and purified hemoglobin due to limited sensitivity, restricting their application in characterizing the dose-response relationship between EtO exposure and HE-V accumulation-particularly at low environmental exposure levels relevant to assessing potential general population health risks. In this study, we aimed to characterize the molecular dosimetry of HE-V formation in B6C3F1 mice exposed by whole body inhalation to a broad range of concentrations of EtO: 0, 0.05, 0.1, 0.5, 1, 50, 100, and 200 ppm, 7 days/week for 4 weeks. To achieve this, we developed a sensitive LC-MS-based workflow for HE-V quantification, incorporating hemoglobin purification, HE-V release plus enrichment, and targeted mass spectrometric detection from as little as 10 μL of blood and 50 μg of extracted hemoglobin. A clear, dose-dependent increase in HE-V levels was observed following EtO exposure, with statistically significant elevations detected even at 0.05 ppm compared to endogenous background levels. At lower concentrations (0.5 to 1 ppm), HE-V levels increased linearly with dose, while higher concentrations (50 to 200 ppm) exhibited an upward-bending (increasing slope) dose response. No sex-specific differences were observed. Taken together, these findings indicate EtO exhibits linear systemic toxicokinetics at lower exposures that transition to nonlinear toxicokinetics in the range of higher exposures (likely due to saturation of glutathione-mediated detoxification), thus providing new quantitative insights to support improved risk assessments and toxicological evaluations of EtO exposure.

PMID:42384196 | DOI:10.1007/s00204-026-04419-7

Eur J Orthop Surg Traumatol. 2026 Jul 1;36(1):268. doi: 10.1007/s00590-026-04811-0.

ABSTRACT

INTRODUCTION: Bicruciate-retaining (BCR) total knee arthroplasty (TKA) was developed to better replicate native knee biomechanics by preserving both cruciate ligaments. First-generation BCR implants were notorious for technical challenges and suboptimal survivorship. However, advancements in implant design and surgical techniques have renewed interest in second-generation BCR TKA systems. This study aimed to evaluate the overall survivorship of contemporary (second-generation) BCR primary TKA implants.

METHODS: A systematic review of PubMed, Scopus, Embase, Web of Science, and Cochrane databases was conducted from inception to January 3, 2025. Inclusion criteria were studies that reported the number of revisions following second-generation BCR TKA. We excluded case reports, review articles, and studies that evaluated first-generation BCR TKA. A total of 1046 articles were retrieved; ultimately, 13 were included. Events per person-years pooled analysis was performed to estimate the incidence of all-cause revision, adjusting for duration of follow-up. Heterogeneity was measured using I² test. A p-value < 0.05 was considered statistically significant.

RESULTS: A total of 1,087 BCR TKA implants among 13 studies were analyzed. The mean follow-up was 2.6 years. A total of 62 (5.7%) knees were revised. The overall pooled rate of all-cause revision was 1.6 per 100 person-years (95% confidence interval [CI] 0.009-0.023) Heterogeneity among the analyzed studies was significant (I² = 75.5%, p < 0.001).

CONCLUSION: Contemporary BCR TKA implants showed improved survivorship compared to historical reports, with a low pooled all-cause revision rate of 1.6 per 100 person-years, corresponding to a 1.6% chance of revision per year of follow-up. Despite the associated heterogeneity, these findings suggest that modern BCR designs offer durable outcomes and support their continued use. Further long-term comparative data are needed to better define their role relative to modern knee implants.

PMID:42384182 | DOI:10.1007/s00590-026-04811-0

J Egypt Natl Canc Inst. 2026 Jul 1;38(1):40. doi: 10.1186/s43046-026-00374-7.

ABSTRACT

BACKGROUND: Cervical cancer continues to pose a considerable challenge to global health, necessitating innovative approaches for improved diagnostics and personalized treatment strategies. Prior investigations have suggested that plasma proteins may play a role in the pathogenesis of cervical cancer; however, these studies do not confirm a causal relationship. To address this gap, conducted a large-scale Mendelian randomization (MR) study of the plasma proteome.

METHODS: We performed a two-sample bidirectional Mendelian randomization analysis involving 4,907 plasma proteins, utilizing publicly accessible genome-wide association study (GWAS) summary statistics, to examine the causal association between the plasma proteome and the risk of cervical cancer. Analytical methods included inverse variance weighting (IVW), weighted median, MR-Egger regression, and simple and weighted models. Additionally, we performed sensitivity analyses to evaluate heterogeneity and horizontal pleiotropy through Cochran’s Q test, MR-Egger intercept, MR-PRESSO test, and leave-one-out analysis. We also applied false discovery rate (FDR) correction to the results of all IVW methods to identify the plasma proteins most strongly associated with cervical cancer. Finally, we enriched the most relevant plasma protein genes using the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses and GeneMANIA to identify disease-related pathways.

RESULTS: According to the IVW method, seven plasma proteins are significantly associated with cervical cancer risk (P < 0.05). Specifically, six proteins demonstrated protective factors: DEFB135 (OR = 0.201, 95% CI = 0.082-0.492, P < 0.001), FGL2 (OR = 0.104, 95% CI = 0.032-0.338, P < 0.001), FTMT (OR = 0.612, 95% CI = 0.465-0.804, P < 0.001), PDIA4 (OR = 0.088, 95% CI = 0.026-0.295, P < 0.001), SPHK2 (OR = 0.102, 95% CI = 0.030-0.350, P < 0.001), and TMED2 (OR = 0.045, 95% CI = 0.008-0.246, P < 0.001). In contrast, RACGAP1 (OR = 1.755, 95% CI = 1.286-2.395, P < 0.001) was identified as a risk factor. Reverse MR analysis revealed no significant evidence of reverse causation (P > 0.05) between cervical cancer and these plasma proteins. Functional enrichment analysis identified several biologically relevant pathways potentially involved in cervical cancer pathogenesis, including the establishment of organelle localization, regulation of oxidoreductase activity, Ferroptosis, and Porphyrin metabolism.

CONCLUSION: These findings suggest that DEFB135, FGL2, FTMT, PDIA4, SPHK2, and TMED2 may protect against cervical cancer, while RACGAP1 may represent a potential risk factor. The identified tumor markers provide mechanistic insights into the molecular basis of cervical cancer and warrant further investigation in functional studies.

PMID:42384160 | DOI:10.1186/s43046-026-00374-7

J Behav Med. 2026 Jul 1. doi: 10.1007/s10865-026-00694-y. Online ahead of print.

ABSTRACT

Adverse childhood experiences (ACEs) increase the risk of developing chronic pain in adulthood. However, the impact of ACEs and specific ACEs subdomains on treatment response to cognitive behavioral interventions, which are among the frontline interventions for chronic pain, remains unexplored. This exploratory secondary analysis of a psychotherapy trial for chronic pain examined the associations among total ACEs and ACEs subdomains (household dysfunction and maltreatment) with pre-intervention level and treatment-related change in pain severity and interference. Trial participants (116 Veterans, M_age = 51.40; SD = 13.20) received one of two cognitive behavioral therapies for chronic pain that performed similarly in terms of pain outcomes. Participants completed self-report measures of ACEs at pre-treatment and measures of pain severity and interference at pre-treatment, weekly during treatment, post-treatment, and 3-month follow-up. There was a null association between ACEs (total and subdomains) and pain outcomes at pre-intervention. Higher total ACEs scores predicted significantly greater improvements in pain interference from pre-intervention to follow-up (p = .025). ACEs subdomains patterned differently with pain outcomes: higher maltreatment predicted significantly greater improvement in pain interference from pre-to-post-intervention (p = .049) and greater improvement from pre-intervention to follow-up, though above the threshold for statistical significance (p = .079). Further, higher household dysfunction predicted greater improvement in pain severity from pre-intervention to follow-up, though similarly above the threshold for statistical significance (p = .080). The present study yielded surprising and clinically informative results: cognitive behavioral interventions may be especially helpful for reducing pain interference in adults with higher ACEs. Furthermore, household dysfunction and maltreatment may be differentially associated with pain severity and interference. Future research is required to replicate the findings of this exploratory study.

PMID:42384155 | DOI:10.1007/s10865-026-00694-y

Ir J Med Sci. 2026 Jul 1. doi: 10.1007/s11845-026-04514-9. Online ahead of print.

ABSTRACT

AIM: This study aims to evaluate midwifery students’ achievements and feedback regarding the use of mannequin models in acquiring gynecological examination skills.

METHOD: The study was carried out using a parallel-group, randomized controlled design. A total of 68 students were included in the education and control groups. The education group received hands-on training with a gynecological examination mannequin in a laboratory setting, whereas the control group watched a gynecological examination instructional video together with the education group. Evaluations were conducted using the Learner’s Guide (LG), the Self-Confidence Scale (SCS), and the Student Satisfaction and Self-Confidence in Learning Scale (SSSCLS). The statistical significance level was set at p < 0.05.

RESULTS: A significant difference was found between the SCS and the SSSCLS scores of students in the education group, whereas there were no significant differences in the control group’s mean scores. Of the 17 procedural steps outlined in the Learner’s Guide, 13 were determined to be significantly better performed by the education group compared to the control. However, there were no significant differences between the groups in terms of ensuring the availability of all necessary materials before the procedure, maintaining patient privacy, and inspecting and palpating the external genital organs.

CONCLUSION: The use of mannequin models is an effective method for enhancing both self-confidence and student satisfaction in acquiring gynecological examination skills. It is very important to encourage the integration of simulation models in midwifery education and to emphasize the critical procedural steps outlined in the Learner’s Guide.

TRIAL REGISTRATION: Clinicaltrials.gov NCT06536192.

PMID:42384149 | DOI:10.1007/s11845-026-04514-9

J Thromb Thrombolysis. 2026 Jul 1. doi: 10.1007/s11239-026-03347-8. Online ahead of print.

ABSTRACT

Atrial fibrillation is a common cardiac arrhythmia associated with serious complications such as stroke, heart failure, and mortality. Catheter ablation is frequently used for drug-resistant cases but requires femoral venous access and anticoagulation, increasing the risk of vascular complications. Manual compression is the standard method for post-ablation hemostasis, though it can be time-consuming and uncomfortable, whereas figure-of-eight sutures have emerged as a potential alternative. To compare safety and procedural outcomes of figure-of-eight sutures versus manual compression for venous hemostasis after ablation. A systematic literature search was conducted across Cochrane Library, PubMed/MEDLINE, Scopus, and Embase up to February 2026 to identify studies comparing figure-of-eight (Fo8) sutures with manual compression for post-ablation femoral venous hemostasis. Randomized controlled trials and observational cohort studies were included. Data extraction and quality assessment were performed independently by two reviewers, with discrepancies resolved by a third reviewer. Statistical analyses and meta-analyses were performed using RevMan software version 5.4. Nine studies with a total of 2,125 patients were analyzed. Figure-of-Eight (Fo8) suturing demonstrated no significant difference compared with manual compression for total, major, or minor vascular access site complications, bleeding, or hematoma. However, FO8 suturing was associated with significantly shorter time to hemostasis, earlier ambulation, and reduced time to discharge. Figure-of-eight suturing is as safe as manual compression for post-ablation femoral venous hemostasis, showing no increase in vascular access-site complications, bleeding, or hematoma. It provides the added benefit of faster hemostasis, earlier ambulation, and reduced discharge time.

PMID:42384139 | DOI:10.1007/s11239-026-03347-8

Eur J Anaesthesiol. 2026 Aug 1;43(8):692-702. doi: 10.1097/EJA.0000000000002370. Epub 2026 Feb 25.

ABSTRACT

BACKGROUND: Day of surgery cancellation (DOSC) for elective surgery occurs in 18% of elective surgeries worldwide with resultant impacts on patients and healthcare systems. Accurate prediction of such cancellations could yield significant benefit.

OBJECTIVE: This systematic review synthesises evidence to inform future efforts at gold-standard statistical modelling.

DESIGN: Systematic review and qualitative synthesis using the ‘Synthesis Without Meta-Analysis’ (SWiM) framework.

DATA SOURCES: MEDLINE, Embase, Scopus and Web of Science, 2013-2024.

ELIGIBILITY CRITERIA: Studies were considered eligible if they presented the development, validation or update of a model to predict DOSC. Risk of bias for included studies was assessed using the prediction model risk of bias assessment tool (PROBAST). Data was collected on included variables, method of prediction, whether prediction was made at the level of the patient or the system, and training and assessment processes.

RESULTS: Literature searching identified 7154 unique studies, 6 of which were included in the final synthesis. These studies encompassed total of 759 337 elective surgical procedures, of which 47 609 were cancellations, across a variety of adult and paediatric surgery. Methods of prediction included logistic regression models, machine learning, and spatial regression models. These used demographic, socioeconomic, comorbidity, surgical, appointment and other factors as predictors. The best discrimination achieved by models in each study, quantified by area under the receiver operator curve, ranged from 0.75 to 0.92 in development and 0.70 to 0.74 in validation datasets. One study demonstrated better calibration at the census tract level of spatial regression models when incorporating local survey data compared with individual-prediction-aggregation models.

CONCLUSIONS: Models to predict DOSC identified in this review demonstrated moderate discrimination ability but there was significant heterogeneity between studies and reports of calibration were limited. This review serves as a valuable synthesis of current models to predict DOSC and should serve as a core reference for emerging studies in this field.

PMID:42383309 | DOI:10.1097/EJA.0000000000002370

Int Forum Allergy Rhinol. 2026 Jul 1. doi: 10.1002/alr.70215. Online ahead of print.

ABSTRACT

BACKGROUND: Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor that has demonstrated a propensity to recur. Multiple anatomic and surgical factors have been proposed to influence recurrence; dysplasia has recently emerged as a predictor, yet its prognostic significance remains unclear. Clarifying its role may improve postoperative risk stratification.

METHODS: A systematic review and meta-analysis were performed following PRISMA guidelines and registered with PROSPERO (CRD420251140223). PubMed, Embase, Scopus, and Web of Science were queried for studies reporting recurrence outcomes stratified by dysplasia status. Studies with extractable recurrence data for dysplasia and non-dysplasia SNIP were included. Fixed-effects meta-analysis was performed using the inverse variance method to calculate pooled odds ratios (OR) with 95% confidence intervals (CIs). Heterogeneity was assessed using I² and Cochran’s Q statistics.

RESULTS: Thirteen studies comprising 1893 patients were included. Based on reported data, mean age ranged from 48.3 to 58.0 years. The cohort was predominantly male (1172/1720; 68.1%). Of 283 patients with dysplasia, 104 experienced recurrence (36.7%), compared with 302 of 1346 patients without dysplasia (22.4%). Dysplasia was significantly associated with increased recurrence risk (pooled OR 3.42; 95% CI, 2.45-4.78; p < 0.001) with low-moderate heterogeneity (I² = 20.33%). Mean follow-up was 39.8 months. Findings were robust on leave-one-out sensitivity analysis and trim-and-fill adjustment (adjusted OR 3.05; 95% CI 2.21-4.22).

CONCLUSION: Dysplasia is a significant independent predictor of recurrence in SNIP, conferring 3.4 times increased odds of recurrence. Standardized dysplasia reporting and risk stratification protocols are needed to optimize surveillance strategies in SNIP patients.

PMID:42383302 | DOI:10.1002/alr.70215

J Esthet Restor Dent. 2026 Jul 1. doi: 10.1111/jerd.70216. Online ahead of print.

ABSTRACT

OBJECTIVE: Contemporary dental adhesives demonstrate strong durable adhesion to enamel while long-term bonding stability to dentin remains uncertain. This in vitro study aimed to compare conventional dentin conditioning protocols supplemented with protease inhibition and chelate-based conditioning protocols.

MATERIALS AND METHODS: Four groups of extracted teeth were subjected to four different protocols. Groups A and B were conditioned as conventional etching techniques: in group A orthophosphoric acid 37%, chlorhexidine 0.20%, and adhesive, group B self-etch two-step adhesive and chlorhexidine 0.20%, followed by a composite layer. Groups C and D were treated using extrafibrillar demineralization techniques: Group C ethylenediaminetetraacetic acid (EDTA) (17%) and a self-etch two-step adhesive process, and Group D polyacrylic acid salt solution (225 kDa) and adhesive, followed by a composite layer. Shear bond strength tests, scanning electron microscopy evaluations, and zymography were conducted to evaluate the adhesion forces, stability and proteolytic activity of the hybrid layer before and after accelerated aging. Data were analyzed with two-way ANOVA and Tukey tests for SBS analysis. Non-parametric Mann-Whitney test and an Aligned Rank Transformation model were performed for the zymography analysis. The Weibull distribution test assessed each type of failure.

RESULTS: No statistically significant differences in bond strength were observed immediately after adhesion among groups (p ≥ 0.05). After aging, significant differences appeared (p < 0.05). Groups A and D showed stability in bond strength. Proteolytic activity differed significantly between conventional and extrafibrillar groups both immediately and after aging (p < 0.05). Group D showed no significant changes pre- or post-aging (p > 0.05). Group C had higher stability than groups A and B.

CONCLUSIONS: Compared with conventional conditioning protocols combined with protease inhibition, the evaluated chelate-and-rinse protocols showed improved maintenance of bond strength and reduced proteolytic activity over time under the conditions of this in vitro study.

CLINICAL SIGNIFICANCE: The application of a novel extrafibrillar demineralization method represents a significant improvement in dentin bonding protocols, as it preserves collagen structural integrity and reduces proteolytic activity. This results in a more stable adhesive interface over time, with no loss of bond strength after aging, potentially increasing the longevity of restorations. Clinically, this strategy may enhance the predictability and durability of adhesive procedures. In the context of esthetic dentistry, improved bond stability contributes to better marginal integrity, reduced risk of discoloration and microleakage, and longer-lasting esthetic outcomes, ultimately leading to more reliable and visually stable restorations over time and patient comfort.

PMID:42383299 | DOI:10.1111/jerd.70216