Tag: pubmed

Lung. 2026 Apr 27;204(1):23. doi: 10.1007/s00408-026-00889-9.

ABSTRACT

PURPOSE: Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare lung disorder characterized by autoantibodies against Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF). Whole-lung lavage is the conventional treatment, but it does not address the underlying pathophysiology. This systematic review and meta-analysis aims to further evaluate the effects of inhaled GM-CSF on gas exchange, oxygenation, and lung volume.

METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. A literature search was performed across PubMed, Embase, and the Cochrane Library from inception to October 2025. Randomized Controlled Trials (RCTs) comparing inhaled GM-CSF to a control in adult patients with aPAP were included. The primary outcomes assessed pulmonary gas exchange, oxygenation, and lung volume, while exercise capacity and dyspnea levels were secondary outcomes. Statistical analyses were performed using Review Manager (RevMan) version 5.4.1 and R version 4.5.2, with heterogeneity assessed using I² statistics.

RESULTS: Four phase III RCTs comprising 402 patients (224 inhaled GM-CSF, 178 control) with ≥ 25 weeks of follow-up were included. Inhaled GM-CSF significantly enhanced DLCO% predicted (MD 5.09; 95% CI 2.05 to 8.13; p = 0.001; I² = 0%) and reduced PA-aO₂ (MD – 4.25; 95% CI – 6.62 to – 1.88; p = 0.0004; I² = 0%), with corresponding increases in PaO₂. Dyspnea scores significantly improved (SMD – 0.49; 95% CI – 0.70 to – 0.29; I² = 9%). No significant improvements were observed in lung volume or exercise capacity. Continuous and intermittent regimens demonstrated comparable efficacy and side effects across subgroups.

CONCLUSION: Inhaled GM-CSF improves gas exchange, oxygenation, and dyspnea in aPAP while maintaining a favorable safety profile, indicating its potential as a noninvasive, targeted therapy.

PMID:42045620 | DOI:10.1007/s00408-026-00889-9

Sci Rep. 2026 Apr 27. doi: 10.1038/s41598-026-50567-2. Online ahead of print.

ABSTRACT

This study aimed to compare the efficacy of oral azithromycin with oral doxycycline in moderate acne vulgaris and to assess the corresponding changes in patient-reported quality-of-life. In this open label, randomised controlled trial conducted at a university student clinic, Muscat, Oman, 163 patients with moderate and severe acne vulgaris were assigned equally to receive either oral azithromycin or oral doxycycline. Treatments were administered over a three-month period with monthly clinical assessments. Acne severity was quantified using a validated acne severity scale, and quality of life was measured at baseline and at study end via a standardised questionnaire. Analyses were performed using univariate statistics. The cohort comprised 163 participants (mean age 20.2 ± 1.7 years; 67.3% female). Both groups experienced significant and comparable reductions in acne severity after three months. Parallel, statistically significant improvements were observed in quality-of-life scores across domains related to symptoms, emotional well-being, and social functioning. Oral azithromycin and doxycycline demonstrate equivalent efficacy in reducing moderate acne vulgaris and both confer substantial enhancements in patients’ quality of life. These findings support either antibiotic as an appropriate option for addressing both the dermatological and psychosocial burdens of moderate acne. The trial was registered with the Australia New Zealand Clinical Trial Registry (ACTRN12619000073101; Date: 18^th of January 2019).

PMID:42045615 | DOI:10.1038/s41598-026-50567-2

Sci Rep. 2026 Apr 27. doi: 10.1038/s41598-026-50540-z. Online ahead of print.

ABSTRACT

Neuroimaging hyperscanning-the monitoring of brain activity of two or more persons simultaneously-has emerged as a popular tool to uncover the neural mechanisms of social interactions. The use of functional near-infrared spectroscopy (fNIRS)-a non-invasive, child-friendly technique tolerant of motion artifacts-has significantly advanced the research of social interactions. Despite its popularity, the field has yet to agree on best practices for quantifying inter-brain connections (IBC) during social interactions, including the frequency band of interest (FOI) for signal analysis. Various choices of FOIs, along with subject-level physiological differences or experimental design, may have contributed to inconsistent findings across prior studies. In this study, we reviewed various methods used and their corresponding FOI results in previous fNIRS hyperscanning research focused on the topics of cooperation. Additionally, we propose a new methodology to quantify FOI that aims to point to the origin of synchronization between brains. We tested the proposed method on three independent fNIRS hyperscanning datasets. The three datasets involved three different populations and three types of social interactions commonly studied in the literature. We examined the effect of sample sizes and data exclusion rates on the calculation of FOIs and statistical results. We offer a method for testing and adoption within the fNIRS community, aimed at eliminating arbitrary FOI selections and potentially enhancing the reproducibility of results in future fNIRS hyperscanning research.

PMID:42045603 | DOI:10.1038/s41598-026-50540-z

Sci Rep. 2026 Apr 27. doi: 10.1038/s41598-026-50824-4. Online ahead of print.

ABSTRACT

Hastelloy C276 is extensively used in aerospace, chemical, and high-temperature engineering systems, yet its poor machinability leads to rapid tool degradation and reduced productivity. This study develops a comprehensive machine-learning (ML) framework to model and predict flank-wear progression during the turning of Hastelloy C276 under Dry, Minimum Quantity Lubrication (MQL), and nanoparticle-assisted MQL environments. A series of controlled machining experiments were performed by varying cutting speed, feed, depth of cut, and machining length, generating more than 700 labeled wear samples measured using optical microscopy. Four ML models-Ridge Regression, Decision Tree, Random Forest, and Support Vector Regression- were trained using five-fold cross-validation for hyperparameter optimization, and their final performance was evaluated on an independent test dataset. Among them, Random Forest exhibited the highest predictive accuracy (R² = 0.982, MAE = 0.004 mm, RMSE = 0.006 mm), effectively capturing nonlinear wear behavior associated with thermal-mechanical interactions. Experimental results confirmed the strong influence of lubrication environment on tool life, with nano-MQL reducing average flank wear by 28-35% compared to Dry machining due to enhanced cooling and tribo-film formation by hBN nanoparticles. Feature-importance analysis further identified lubrication condition, machining length, and feed rate as the dominant predictors governing wear evolution. The study demonstrates that reliable tool-wear prediction can be achieved using machining parameters alone-without additional sensors-highlighting the potential of ML-driven frameworks for future intelligent tool-condition monitoring and sustainable machining of difficult-to-cut superalloys.

PMID:42045593 | DOI:10.1038/s41598-026-50824-4

Sci Rep. 2026 Apr 27. doi: 10.1038/s41598-026-50838-y. Online ahead of print.

ABSTRACT

We explore the critical dynamics of driven interfaces propagating through a two-dimensional disordered medium with long-range spatial correlations, modeled using fractional Brownian motion (FBM). Departing from conventional models with uncorrelated disorder, we introduce quenched noise fields characterized by a tunable Hurst exponent [Formula: see text], allowing systematic control over the spatial structure of the background medium. The interface evolution is governed by a quenched Kardar-Parisi-Zhang (QKPZ) equation modified to account for correlated disorder, namely QKPZ[Formula: see text]. Through analytical scaling analysis, we uncover how the presence of long-range correlations reshapes the depinning transition, alters the critical force [Formula: see text], and gives rise to a family of critical exponents that depend continuously on [Formula: see text]. Our findings reveal a rich interplay between disorder correlations and the non-linearity term in QKPZ[Formula: see text], leading to a breakdown of conventional universality and the emergence of nontrivial scaling behaviors. The exponents are found to change by H in the anticorrelation regime ([Formula: see text]), while they are nearly constant in the correlation regime ([Formula: see text]), suggesting a robust-universal behavior for the latter. By a comparison with the quenched Edwards-Wilkinson model, we study the effect of the non-linearity term in the QKPZ[Formula: see text] model.

PMID:42045590 | DOI:10.1038/s41598-026-50838-y

Sex Reprod Healthc. 2026 Apr 18;48:101219. doi: 10.1016/j.srhc.2026.101219. Online ahead of print.

ABSTRACT

OBJECTIVE: Early pregnancy loss (EPL) affects over 15% of clinically confirmed pregnancies. Despite typically uncomplicated medical courses, EPL is associated with significant psychological burden. While international studies have documented gaps in EPL care, comparable data from Germany are largely absent. This study examined healthcare experiences of women following EPL in Germany.

METHODS: An online cross-sectional survey was conducted between February and April 2025. Recruitment took place via social media and peer support organizations. Women aged 18 and older who had experienced EPL within the past five years in Germany were eligible. Quantitative data were analyzed using descriptive statistics, binary logistic regression, and linear regression. Free-text responses were analyzed using structuring qualitative content analysis following Kuckartz.

RESULTS: Of 720 participants, 633 were included in the analysis. Only 24.2% reported being offered all three management options (expectant, medical, surgical), 20% did not receive their preferred option. More than half of participants received no emotional or psychological support. Midwifery care was significantly associated with higher rates of expectant management and higher perceived emotional support.

CONCLUSION: The results reveal discrepancies between guideline recommendations and the actual care experienced by women following EPL in Germany. The sample was predominantly highly educated and recruited via digital platforms, introducing likely self-selection bias; findings should therefore be interpreted with caution and may not be representative of all affected women. Woman-centered counseling, systematic emotional support, greater integration of midwives, and the development of digital support tools warrant further consideration to improve care quality.

PMID:42044584 | DOI:10.1016/j.srhc.2026.101219

Water Res. 2026 Apr 17;300:125962. doi: 10.1016/j.watres.2026.125962. Online ahead of print.

ABSTRACT

This study evaluated wastewater-based epidemiology (WBE) for monitoring dengue virus (DENGV) and chikungunya virus (CKV) during Brazil’s most severe arbovirus epidemic, focusing on the city of Belo Horizonte, Minas Gerais. From March 2022 to August 2024, 24-hour composite raw sewage samples were collected weekly from two major wastewater treatment plants, encompassing over 80% of the city’s population. Viral RNA was quantified via RT-qPCR and positive samples underwent genome sequencing for genotype characterization. DENGV and CKV RNA were detected in over 90% of samples across both wastewater treatment plants (WWTPs), demonstrating sustained and widespread viral circulation throughout epidemic and inter-epidemic periods. Although CHIKV concentrations varied significantly across years, DENGV concentrations remained statistically stable, and no significant correlations were observed between wastewater viral loads and reported clinical cases. A considerable proportion of samples presented concentrations below the limit of quantification, indicating that while WBE is highly sensitive for qualitative detection of arboviruses, quantitative interpretation remains methodologically constrained. Sequencing confirmed the presence of DENGV-1 sorotype I and CKV genotype V, clustering with contemporaneous Brazilian strains and reflecting regional transmission dynamics. Wastewater-based modelling further suggested that reported clinical cases may substantially underestimate true infection burden, although quantitative estimates were highly sensitive to assumptions regarding viral shedding variability. These findings demonstrate that WBE provides a sensitive, non- invasive, population level approach for tracking arboviral circulation and viral diversity during large-scale outbreaks and could complement public health surveillance frameworks, especially in regions with limited diagnostic capacity or high levels of underreporting, to enhance epidemic response and control strategies.

PMID:42044571 | DOI:10.1016/j.watres.2026.125962

Medwave. 2026 Apr 27;26(3):e3122. doi: 10.5867/medwave.2026.03.3122.

ABSTRACT

INTRODUCTION: In the global context of the HIV pandemic, the biopsychosocial environment of key populations remains marked by a culture that fosters stigma and discrimination. These attitudes, based on misconceptions of what it means to live with HIV, transcend the healthcare sphere and negatively impact people’s quality of life. In Mexico, systematic documentation of this issue within hospital settings remains limited. The objective of this study was to estimate the frequency of HIV-related stigma and discrimination among healthcare personnel of a secondary-level public hospital, as well as to identify differences by job category.

METHODS: We conducted an observational, descriptive, cross-sectional study from February to March 2025 at a secondary-level public hospital in Cancún, Quintana Roo, Mexico. We applied the short version of the HIV stigma questionnaire proposed by Nyblade et al. A total of 316 healthcare workers from different areas participated. To identify differences in stigmatizing attitudes across professional groups and to explore potential associations between sociodemographic variables and HIV-related beliefs, descriptive statistical analyses were performed, along with non-parametric tests (Kruskal-Wallis, Mann-Whitney U, and Spearman correlations) and post hoc comparisons using Dunn’s test with Bonferroni correction.

RESULTS: A total of 22.5% of participants reported having witnessed refusal to work with people living with HIV, and 30.1% observed lower-quality care toward them. Additionally, 32.9% agreed that people living with HIV are irresponsible, and 30.4% believed they “do not care about spreading the infection.” Significant differences in stigma levels were found across occupational categories (p < 0.001). Medical assistants and interns showed higher levels of stigmatizing attitudes, while family physicians, nursing supervisors, and laboratory staff demonstrated greater empathy. Personally knowing someone living with HIV was significantly associated with greater acceptance of the right to become pregnant (p = 0.047).

CONCLUSIONS: Stigma toward people living with HIV remains present in hospital environments. There is an urgent need to implement institutional training and awareness programs to reduce discriminatory attitudes and promote respect, accurate information, and empathy among all healthcare staff.

PMID:42044522 | DOI:10.5867/medwave.2026.03.3122

Ultrasound Q. 2026 Apr 27;42(2):e00739. doi: 10.1097/RUQ.0000000000000739. eCollection 2026 Jun 1.

ABSTRACT

This study aims to evaluate the implementation of the uterine sliding sign in routine pelvic ultrasound examinations for improving the diagnosis of deep endometriosis. A retrospective analysis was conducted at Mayo Clinic’s Florida and Arizona campuses, including 200 premenopausal and perimenopausal women with chronic pelvic pain, infertility, or suspected endometriosis. Sonographers performed a uterine sliding maneuver during transvaginal ultrasound, and the acquisition times were recorded. Sonographer experience and the time required to perform the sliding sign were analyzed using Microsoft Excel. The median acquisition time for the uterine sliding sign was 26 seconds, with no statistically significant difference based on sonographer experience. The addition of this maneuver extended the ultrasound examination by <1 minute on average, regardless of sonographer experience level. Incorporating the uterine sliding sign into routine pelvic ultrasound protocols is a quick and efficient method that enhances the detection of deep endometriosis, potentially reducing the significant diagnostic delay associated with endometriosis. This study supports the feasibility and minimal time impact of implementing the Society of Radiologists in Ultrasound (SRU) recommendations for augmented pelvic ultrasound in clinical practice.

PMID:42044514 | DOI:10.1097/RUQ.0000000000000739

Anesth Analg. 2026 Apr 27. doi: 10.1213/ANE.0000000000008049. Online ahead of print.

ABSTRACT

BACKGROUND: Dexamethasone is used in primary total joint arthroplasty (TJA) to reduce postoperative nausea and vomiting, and there is emerging evidence that it also ameliorates adverse events more broadly. Despite a lack of supporting data, a vocal minority has continued to question the appropriateness of dexamethasone in cases where the hyperglycemic burden and/or risk of infection are increased. This study sought to assess the benefits and potential harms of dexamethasone in a cohort of patients undergoing revision TJA for periprosthetic joint infection (PJI). We hypothesize that perioperative dexamethasone exposure is associated with fewer postoperative complications, regardless of diabetes status.

METHODS: An all-payer, US hospital-based dataset was queried. Patients ≥18 years with a diagnosis of hip or knee PJI between 2015 and 2023 were identified using billing and procedural codes, and verified using hospital charges for antibiotics and spacers. The primary outcome was composite complications. Secondary outcomes (wound and infectious complications, as well as mortality) were evaluated to probe for potential safety signals.

RESULTS: In total, 61,527 patients were identified. A total of 30,644 nondiabetic patients and 14,996 diabetic patients were 1:1 matched based on dexamethasone exposure, with good balance. Dexamethasone-treated patients had fewer aggregate complications in both cohorts (nondiabetic: adjusted odds ratio [aOR], 0.934 and 95% confidence interval [CI], 0.760-0.978; diabetic: aOR, 0.814 and 95% CI, 0.746-0.889). Dexamethasone was also associated with fewer wound complications (nondiabetic: aOR, 0.891 and 95% CI, 0.823-0.964; diabetic: aOR, 0.879 and 95% CI, 0.787-0.981) and infectious complications (nondiabetic: aOR, 0.891 and 95% CI, 0.823-0.964; diabetic: aOR, 0.827 and 95% CI, 0.754-0.908) . Only diabetic patients saw a statistically significant decrease in mortality (aOR, 0.692 and 95% CI, 0.532-0.901).

CONCLUSIONS: As with any retrospective study, findings should be interpreted cautiously due to the possibility of residual confounding. Nevertheless, dexamethasone appears to be safe to use in patients undergoing first-stage revision for TJA for PJA regardless of diabetic status. Further, findings suggest that dexamethasone is associated with lower odds of aggregate complications, and contrary to conventional wisdom, these benefits may be even greater among diabetics.

PMID:42044508 | DOI:10.1213/ANE.0000000000008049