Tag: pubmed

Forensic Sci Med Pathol. 2026 Aug 11. doi: 10.1007/s12024-026-01320-8. Online ahead of print.

ABSTRACT

Hymenal examination plays an important role in the forensic examination of suspected child sexual abuse. However, interpretation of hymenal findings remains challenging because of anatomical variation and subtle genital injuries, creating the potential for misinterpretation in medico-legal assessments. This study aimed to characterize hymenal morphology, hymenal injuries, and related forensic findings among female child sexual abuse victims in Vietnam and to examine patterns associated with repeated abuse. A retrospective analysis was conducted using forensic examination records of female children under 16 years of age referred for suspected sexual abuse at a specialized medico-legal center. Sociodemographic characteristics, assault-related information, hymenal morphology, and genital and extra-genital injuries were extracted from standardized forensic reports. Cases with diagnostic uncertainty or complex forensic findings were reviewed through expert consultation, and final conclusions were established by consensus within the forensic assessment team. A total of 443 children were included, with a mean age of 13.3 ± 2.6 years. The median interval between the alleged assault and forensic examination was 19 days (IQR: 4-89 days). Repeated sexual abuse accounted for 68.4% of cases. In multivariable analysis, older age (aOR = 1.25, 95% CI: 1.14-1.37), parental divorce (aOR = 1.95, 95% CI: 1.15-3.30), and abuse occurring in private or semi-private settings were independently associated with repeated sexual abuse. The annular hymen was the most frequently observed morphology (60.3%). Overall, 69.3% of cases showed combined hymenal dilatation and tear, followed by tear only (19.6%) and dilatation only (6.3%), while 4.7% had no hymenal injury. Most tears were old (81.7%) and located in the anterior region (65.2%). Additional genital and extra-genital injuries were uncommon. Repeated sexual abuse was common among examined victims. The annular hymen was the most frequently observed morphology, and combined hymenal dilatation and tear was the predominant injury pattern, while other genital and extra-genital injuries were uncommon. While these findings provide additional forensic reference data, no single hymenal morphology or injury pattern should be interpreted as diagnostic of sexual abuse in isolation and findings should be considered within the broader clinical and investigative context.

PMID:42579240 | DOI:10.1007/s12024-026-01320-8

J Mol Neurosci. 2026 Aug 11;76(3):128. doi: 10.1007/s12031-026-02586-x.

ABSTRACT

Major depressive disorder (MDD) constitutes a substantial global health burden; however, the causal genes and cell-type-specific mechanisms underlying its pathogenesis remain incompletely understood. We conducted an integrative transcriptomic and proteomic Mendelian randomization (MR) study incorporating expression quantitative trait loci (eQTL) and protein quantitative trait loci (pQTL) datasets to prioritize genes associated with MDD. Candidate genes were further evaluated using neuron-specific single-cell eQTL analyses across multiple brain cell types, and brain imaging-derived phenotypes were assessed as exploratory structural mediators through two-step MR mediation analysis. Integrative eQTL-MR and pQTL-MR analyses identified 20 genes associated with MDD at both transcriptomic and proteomic levels. Notably, CKAP2 showed directionally discordant associations across molecular layers: genetically predicted CNS-related CKAP2 expression was inversely associated with MDD risk, whereas genetically predicted plasma CKAP2 protein levels showed an association in the opposite direction. Rather than establishing a unified causal mechanism across transcriptomic and proteomic layers, this discordance suggests that CKAP2-related genetic signals may differ across tissues, molecular layers, or instrument constructions. Single-cell eQTL analyses provided supportive evidence for a protective-direction association of CKAP2 expression in excitatory neurons (OR = 0.986, p = 0.007), inhibitory neurons (OR = 0.990, p = 0.007), and oligodendrocyte precursor cells (OR = 0.987, p = 0.009). Mediation analysis suggested that right thalamic ventral anterior nucleus volume may represent an exploratory imaging phenotype related to the CKAP2-MDD association, accounting for 17.0% of the total effect, although this finding requires independent replication. Sensitivity analyses provided no evidence of heterogeneity or horizontal pleiotropy, and reverse MR analyses showed no evidence of reverse causation, although these analyses were limited in statistical power. Collectively, these findings prioritize CKAP2 as a candidate gene with convergent but non-confirmatory genetic evidence for involvement in MDD, warranting further validation in independent causal and experimental frameworks.

PMID:42579238 | DOI:10.1007/s12031-026-02586-x

J Robot Surg. 2026 Aug 11;20(1):813. doi: 10.1007/s11701-026-03790-y.

ABSTRACT

To compare perioperative, oncologic, and learning curve outcomes between open radical prostatectomy (ORP) and Versius^®-assisted robot-assisted radical prostatectomy (RARP) in Jordan. This prospective observational case series included 133 patients (58 ORP, 75 RARP) treated at King Hussein Cancer Center (open cohort, June 2015-February 2024; robotic cohort, February 2022-December 2025). Baseline characteristics, perioperative parameters, pathologic outcomes, and complications were compared using Wilcoxon rank-sum, Chi-square, and Fisher’s exact tests. Multivariable regression adjusted for confounders. The learning-curve analysis used total operative time as the primary endpoint (console time co-primary), with data-driven breakpoint identification and CUSUM analysis. The primary surgeon had prior experience with open and da Vinci-assisted radical prostatectomies before Versius® implementation. RARP was associated with significantly longer operative time (median 360 vs. 255 min; p < 0.001) but lower estimated blood loss (200 vs. 700 mL; p < 0.001). Median hospital stay was 3 days in both groups, but open patients were more likely to stay ≥ 4 days (40.4% vs. 14.0%; p = 0.003). Positive surgical margin rates were similar (53.3% vs. 51.1%; p = 0.813). Lymph node yield was lower in the robotic cohort (median 9 vs. 19; p < 0.001). Operative and console time improved systematically with case number (ρ = -0.65 and – 0.70; both p < 0.001), with a data-driven efficiency transition around case 30 corroborated by CUSUM analysis; the blood-loss advantage was present from the earliest cases whereas the lymph-node-yield deficit persisted beyond the learning curve. Pathologic Gleason score, not surgical approach, independently predicted biochemical recurrence (OR 2.41; p = 0.008). Versius®-assisted RARP achieves lower blood loss and comparable short-term oncologic outcomes to ORP, with operative efficiency improving beyond case 30. Lymph node yield during early adoption requires prospective monitoring. These findings provide an evidence-based framework for centers adopting this emerging platform.

PMID:42579233 | DOI:10.1007/s11701-026-03790-y

Metab Brain Dis. 2026 Aug 11;41(1):181. doi: 10.1007/s11011-026-01949-y.

ABSTRACT

Dysregulated lipid metabolism and neuroinflammation are increasingly recognized as interacting contributors to Alzheimer’s disease (AD), but the cell-type-specific genetic links between fatty acid metabolism and AD remain incompletely defined. This study aimed to identify fatty acid metabolism-related genes associated with AD risk and to characterize their relevance to perivascular macrophage (PVM) states. Single-cell RNA-sequencing data from GSE160936 and bulk transcriptomic data from GSE270454 were integrated to evaluate cell-type-specific fatty acid metabolism activity in AD and control samples.The primary data sources, fatty acid metabolism gene set, AUCell scoring strategy, CellChat workflow, GSEA resources, and MR software settings were specified to improve reproducibility. PVMs were further analyzed for differential expression, ligand-receptor communication, pathway enrichment, transcription factor regulation, and pseudotime-associated transcriptional changes. Cis-eQTL-based two-sample Mendelian randomization was performed using eQTLGen exposure data and AD GWAS summary statistics, followed by sensitivity analyses, reverse MR, and Bayesian colocalization.The analyses were interpreted across three distinct evidence levels: cell-type-resolved transcriptional association, systemic genetic expression prioritization, and tissue-level protein expression. Nominal MR findings were interpreted alongside multiple-testing considerations and colocalization support.Candidate protein expression was examined in hippocampal tissue from APP/PS1 and wild-type mice by Western blotting. Single-cell analysis identified eight major cell populations and showed increased fatty acid metabolism activity in PVMs from AD samples. Mendelian randomization prioritized ten fatty acid metabolism-related genes associated with AD risk, among which ACSL1, EPM2AIP1, MALT1, and RASGRP3 showed strong colocalization support (PP.H4 > 0.9). Pathway analyses linked these genes to lipid metabolic regulation, inflammatory signaling, phagocytosis, and mitochondrial/peroxisomal fatty acid metabolism. Co-expression analysis suggested associations between MALT1 and fatty acid oxidation-related genes, including ACADM and ACOX1. Western blotting in whole hippocampal lysates from APP/PS1 mice provided exploratory tissue-level protein evidence, showing increased ACSL1 and MALT1 and decreased RASGRP3 expression; these findings should not be interpreted as confirmatory PVM-specific validation. This integrative analysis prioritizes ACSL1, EPM2AIP1, MALT1, and RASGRP3 as candidate genes connecting fatty acid metabolic dysregulation with AD-associated neuroinflammatory processes. Because the genetic instruments were blood-derived and the protein assays used whole hippocampal lysates, the findings should be interpreted as candidate-gene prioritization and hypothesis generation rather than proof of direct PVM-specific causality.Accordingly, the study supports a prioritized candidate framework for future functional testing, not validated therapeutic targets or direct causal proof.

PMID:42579211 | DOI:10.1007/s11011-026-01949-y

Cancer Causes Control. 2026 Aug 11;37(9):145. doi: 10.1007/s10552-026-02228-y.

ABSTRACT

BACKGROUND: The impact of cancer extends beyond clinical outcomes, often disrupting interpersonal relationships and living situations. Although these social factors are important for survivorship, little is known about how marital status, residential urbanicity, and income change over time for cancer patients.

METHODS: Using SEER 17, we obtained data from 457,058 adults diagnosed with multiple primary cancers from 2000 to 2021 and evaluated changes in marital status, urbanicity, and household income between the first and last recorded diagnoses. Analyses were stratified by follow-up interval (short: 2-5, long: > 5 years). Marital status change was evaluated among patients who were married at the first cancer diagnosis (n = 255,939), and changes in urbanicity and household income were evaluated as secondary analyses among patients who remained married from first to last diagnosis (n = 214,956). Logistic regressions adjusted for demographic and clinical factors were used to estimate odds ratios and 95% confidence intervals.

RESULTS: Among patients married at the first diagnosis, 5% became not married (divorced/separated/single) and 11% were widowed; rates were higher in women (6% not married; 16% widowed) than men (4; 7%). Among patients who remained married from the first to the last diagnosis, 5% changed urbanicity (1.5% more rural; 3.4% more urban) and 26% changed income (15% increase; 10% decrease). NHB patients had > twofold higher odds of being unmarried (not married or widowed) and income decrease compared to non-Hispanic Whites. Hispanic patients also had elevated odds of unmarried, while Non-Hispanic Asian/Pacific Islander patients had lower odds of income decrease.

CONCLUSIONS: Cancer diagnoses are associated with notable social and economic disruptions, disproportionately affecting women and vulnerable racial/ethnic populations. This study provides the first large-scale analysis of how marital status, residence, and income evolve, highlighting the need to address social determinants of health in survivorship care.

PMID:42579198 | DOI:10.1007/s10552-026-02228-y

Int J Biometeorol. 2026 Aug 11;70(8):229. doi: 10.1007/s00484-026-03275-5.

ABSTRACT

To investigate whether short-term changes in meteorological parameters are associated with hemorrhage subtype in patients presenting to the emergency department (ED) with spontaneous intracranial hemorrhage, with a particular focus on intraparenchymal hemorrhage (IPH) and subarachnoid hemorrhage (SAH). This single-center retrospective observational study included adults presenting to the ED between 2013 and 2022 with spontaneous intracranial hemorrhage confirmed on initial non-contrast computed tomography. Of 901 screened patients, 238 with IPH or SAH were included in the final comparative analysis. Clinical variables and meteorological data, including atmospheric pressure (AP), air temperature, and relative humidity, were recorded. Group comparisons were followed by univariable and multivariable logistic regression analyses. Because AP-related variables showed substantial collinearity, full, backward, and forward models were compared, and the final model was selected based on performance and parsimony. AP showed the most consistent association with hemorrhage subtype, whereas air temperature and relative humidity were not consistently related to either group. Event-hour mean AP was independently associated with SAH, whereas 3-day pre-event mean AP was independently associated with IPH. In the final forward multivariable models, headache remained positively associated with SAH, while lateralized neurological findings, systolic blood pressure, family history of hypertension, and 3-day pre-event mean AP were positively associated with IPH. Model discrimination was acceptable, with an area under the receiver operating characteristic curves of 0.789 for SAH and 0.823 for IPH. Short-term AP changes, rather than air temperature or relative humidity, were associated with hemorrhage subtype in this ED cohort. Further multicenter studies are needed to validate these findings and clarify underlying mechanisms.

PMID:42579194 | DOI:10.1007/s00484-026-03275-5

Int J Biometeorol. 2026 Aug 11;70(8):230. doi: 10.1007/s00484-026-03292-4.

ABSTRACT

The present study intended to analyze the comprehensive niche overlapping among four invasive whitefly species viz., Aleurodicus rugioperculatus (rugose spiraling whitefly), Paraleyrodes bondari (Bondar’s nesting whitefly), Paraleyrodes minei (nesting whitefly), and Aleurotrachelus atratus (palm infesting whitefly), which invaded successively into the coconut ecosystem during 2016-2019. Analyzing ecological niche overlap among these whiteflies helps understand their invasion dynamics and manage ecological impacts on the coconut. The study is grounded in niche conservatism theory and tests whether co-invasive whiteflies retain their fundamental climatic niches in India, and whether niche overlap reflects non-random climatic convergence consistent with shared ecological filtering. Further, niche equivalency and similarity tests provide a statistical basis for determining whether observed overlaps are greater than expected by chance. Spatial thinning (10 km) and target-group background correction were applied to occurrence records to minimize sampling bias. Study revealed that all four niche models substantially outperform random prediction, with Paraleyrodes bondari exhibiting the highest discriminatory power (AUC = 0.914). Additional model evaluation using True Skill Statistic (TSS) and partial ROC further confirmed robust predictive performance across all species. Across all species, temperature-related variables were more influential than precipitation-related variables. Notably, isothermality (bio03) consistently emerged as the most important predictor for A. rugioperculatus, A. atratus, and P. bondari, whereas P. minei showed a stronger influence of the maximum temperature of the warmest month (bio05). Habitat suitability mapping predicted that southern India has high to moderate suitability for A. rugioperculatus, A. atratus, and P. bondari, and southern and central India for P. minei. Pairwise ecological niche overlap was greatest between A. rugioperculatus and P. minei, and lowest between A. rugioperculatus and P. bondari. Native versus invaded niche comparisons revealed significant niche conservatism in A. rugioperculatus and A. atratus, while P. minei showed the greatest niche shift, expanding into climatic space not occupied in its Neotropical native range. The present study is useful for the spatial ecology of invasive whiteflies, interspecific competition, hotspots for co-infestation, pest risk assessments, and early-warning systems for multi-species management in coconut production systems.

PMID:42579177 | DOI:10.1007/s00484-026-03292-4

Front Nephrol. 2026 Jul 27;6:1818921. doi: 10.3389/fneph.2026.1818921. eCollection 2026.

ABSTRACT

BACKGROUND: Infection is the second leading cause of death and hospitalization in hemodialysis (HD) patients. The occurrence of infections in HIV/AIDS patients with End-Stage Renal Disease (ESRD) undergoing maintenance hemodialysis is influenced by patient characteristics and related treatment regimens. Currently, there is limited data both domestically and internationally on the risk factor analysis for adverse outcome following infections in HIV/AIDS patients with ESRD receiving maintenance hemodialysis. This study aims to identify the risk factors associated with adverse outcomes following infections during hemodialysis in patients with HIV/AIDS and ESRD.

METHODS: In this retrospective cohort study, we evaluated the 9-month treatment outcomes of 70 HIV/AIDS patients with ESRD and concurrent infections undergoing maintenance hemodialysis at a hospital in Guangxi between January 2019 and December 2024. The patients were divided into adverse outcome group(defined as mortality or severe complications leading to prolonged hospitalization) and survival group. Data analysis was performed using IBM SPSS Statistics version 26.0, with statistical significance set at P ≤ 0.05, to identify adverse outcome risk factors for concurrent infections in HIV/AIDS patients with ESRD.

RESULTS: Among the 70 enrolled patients, the age ranged from 11 to 86 years. Adverse outcomes occurred in 48 cases (68.57%), while 22 patients (31.43%) survived without severe events. Multivariate analysis identified low-level hemoglobin(HB)(OR 0.952(95%CI 0.908,0.998),P = 0.042) and platelet (PLT)(OR 0.987(95%CI 0.975,1.000),P = 0.046).

CONCLUSION: Adverse outcomes are common among HIV/AIDS patients with ESRD who develop infections during maintenance hemodialysis. Low hemoglobin and low platelet levels are significant risk factors for poor prognosis in this patient population. Early identification and management of these hematologic abnormalities may help improve clinical outcomes.

PMID:42577440 | PMC:PMC13454224 | DOI:10.3389/fneph.2026.1818921

Front Immunol. 2026 Jul 27;17:1870438. doi: 10.3389/fimmu.2026.1870438. eCollection 2026.

ABSTRACT

BACKGROUND: Latent autoimmune diabetes in adults (LADA) is characterized by progressive β-cell impairment and severe glycemic lability, predisposing patients to in-hospital hypoglycemia. Few tailored risk-stratification models exist for this population. This study aimed to develop and validate an interpretable machine learning model using routine clinical data to predict in-hospital hypoglycemia in LADA inpatients.

METHODS: This multicenter retrospective study recruited participants from five Chinese tertiary hospitals between January 2019 and September 2025. Data from four centers formed the derivation cohort, and the remaining center served as the independent external validation cohort. The primary endpoint was in-hospital hypoglycemia (blood glucose < 3.9 mmol/L). Three machine learning models, including logistic regression, random forest, and XGBoost, were developed using routine clinical data and assessed for discrimination, calibration, and clinical utility. SHAP analysis was applied to improve model interpretability. Exploratory subgroup analyses in the internal validation cohort examined model performance across clinical subgroups.

RESULTS: A total of 752 LADA inpatients were enrolled. The incidence of in-hospital hypoglycemia was 44.8% in the derivation cohort and 54.4% in the external validation cohort. Six core predictive factors were identified: largest amplitude of glycemic excursion, fasting C-peptide, glycated hemoglobin, sex, insulin pump use, and previous hypoglycemia. The three models yielded numerically variable discriminative performance across cohorts. Pairwise DeLong tests indicated no statistically significant differences in the AUROC among the three algorithms during external validation. All models showed comparable calibration and threshold-dependent predictive performance in the external cohort. XGBoost was selected as the final model after comprehensive evaluation. Fasting C-peptide was identified as the most influential predictor. Exploratory subgroup analyses demonstrated generally stable model performance across clinical strata. These findings are limited by small subgroup sample sizes and wide confidence intervals, and thus cannot be generalized to external populations. Sensitivity analysis suggested that model performance was not predominantly dependent on the retained glucose-derived predictor.

CONCLUSIONS: The interpretable XGBoost model showed acceptable discrimination, calibration, and potential clinical utility for in-hospital hypoglycemia risk stratification in patients with LADA. This pragmatic predictive tool has the potential to support individualized inpatient glycemic management and facilitate targeted clinical intervention for LADA populations.

PMID:42577431 | PMC:PMC13454309 | DOI:10.3389/fimmu.2026.1870438

Health Sci Rep. 2026 Aug 9;9(8):e73029. doi: 10.1002/hsr2.73029. eCollection 2026 Aug.

ABSTRACT

BACKGROUND AND AIMS: Armed conflict in Sudan has severely disrupted traditional medical education, prompting a shift toward online learning as an alternative. While digital platforms enable educational continuity, they are associated with increased screen exposure and a rising incidence of digital eye strain (DES) among medical students. This study aimed to investigate the prevalence, symptoms, and associated factors of DES in this conflict-driven educational environment. To assess the prevalence, risk factors, and awareness of DES symptoms among Sudanese medical students engaged in online learning during the armed conflict.

METHODS: A descriptive cross-sectional study was conducted from April to June 2025 among undergraduate Sudanese medical students who transitioned to online learning during the conflict. A total of 1028 participants were recruited using convenience sampling. Data were collected using an online self-administered questionnaire adapted from a validated instrument used in a previously published study. Responses were analyzed using SPSS version 27. Descriptive statistics were used to summarize findings, binomial logistic regression was performed to identify predictors of DES symptoms, and the Wilcoxon signed-rank test assessed changes in screen time before and during the conflict.

RESULTS: About 80.6% of students reported that prolonged screen use negatively impacted their eye health and lifestyle. Eye-related symptoms were reported by 86.6% of participants, and 61.5% experienced physical discomfort. The average screen time increased significantly during the conflict. Awareness of the 20-20-20 rule was limited (24.2%), with only 13.5% reporting regular practice. However, 70.9% were willing to reduce screen time to help prevent DES.

CONCLUSION: Digital eye strain was highly prevalent among medical students and was associated with extended screen use, poor posture, and limited awareness. Its association with physical discomfort and academic stress highlights the need for targeted interventions. Medical institutions should integrate DES awareness and prevention strategies into curricula to promote student well-being and academic success.

PMID:42577426 | PMC:PMC13454369 | DOI:10.1002/hsr2.73029