Tag: pubmed

Plant Biol (Stuttg). 2026 Aug 3. doi: 10.1111/plb.70272. Online ahead of print.

ABSTRACT

Sugarcane (Saccharum spp.) is an important crop for food and energy security. Identifying SNPs and genes associated with sugarcane yield and related traits is crucial for developing high – yielding sugarcane cultivars through molecular breeding. Here, we measured nine phenotypic traits across 160 sugarcane genotypes and employed multiple statistical models (namely MLM, CMLM, MLMM, FarmCPU and SUPER) in GWAS to identify stable and pleiotropic loci. A total of 200 SNPs corresponding to 137 QTLs were detected to be significantly associated with nine traits using multiple statistical models, among which 18 QTLs were consistently identified by two or more models. Notably, the SNP S9A_47793177 on chromosome 9A showed the strongest association with phenotypic variation in aboveground biomass, with a phenotypic explanation rate of 70.54%. Additionally, several QTLs significantly associated with tillering – related traits were identified, suggesting that these QTLs may play crucial roles in the regulation of tillering. The QTLs and SNPs identified in this study provide a significant foundation for molecular marker – assisted breeding in sugarcane. This advancement can significantly enhance the efficiency of genetic improvement for sugarcane yield and tillering – related traits.

PMID:42546290 | DOI:10.1111/plb.70272

Liver Transpl. 2026 Jul 30. doi: 10.1097/LVT.0000000000000972. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty adversely affects post-transplant outcomes in chronic liver disease (CLD). This study evaluated the feasibility and the impact of preoperative supervised aerobic and resistance exercises (SARE) on frailty and outcomes after living donor liver transplantation (LDLT).

METHODS: This single-centre randomized controlled trial assigned the LDLT recipients to standard medical therapy (SMT) or SARE+SMT for 4 weeks pre-LDLT. Liver Frailty Index (LFI), Short Physical Performance Battery (SPPB), pulmonary function tests (PFTs) and postoperative outcomes were compared.

RESULTS: Sixty patients, [54 (90%) males, 26 (43.33%) alcoholic liver disease, 18 (30%) NASH, median MELDNa of 22 (19-27) and CTP A 5 (8.33%), B 22 (36.67%), C 33 (55%) were randomised (30/group)]. Baseline parameters, LFI and SPPB were comparable. At enrolment, 46(76.67%) were pre-frail, 7(11.67%) frail and 53(88.33%) were sarcopenic. Seven(11.66%) patients died during workup, four lost to follow-up and 49 underwent LDLT. In SARE arm, 40% patients attended ≥5 exercise sessions. No adverse events occurred; recurrent admissions were hinderance to study adherence. Adjusted analysis showed similar LFI (p=0.92), SPPB (p=0.71) and PFT between groups. A borderline improvement in NIV discontinuation (p=0.05) and earlier chair and bipedal ambulation (p=0.10 and p=0.09, respectively) was observed with SARE. Significant correlations were observed for POD30 LFI [MV duration- r=0.56 (p=0.00), NIV duration- r=0.509 (p=0.00), hospital stay- r=0.547 (p=0.00) and ICU stay- r=0.563 (p=0.00)], with similar statistically significant correlations for POD14 and POD30 LFI, SPPB and PFTs.

CONCLUSIONS: Preoperative SARE is safe and feasible in high MELD/ Child patients. LFI, SPPB, PFT, and postoperative outcomes were comparable between groups. SARE showed borderline improvement in ambulation and NIV discontinuation. Better LFI, SPPB, PFTs predicted improved clinical outcomes.

PMID:42546288 | DOI:10.1097/LVT.0000000000000972

J Chem Phys. 2026 Aug 7;165(5):050901. doi: 10.1063/5.0341335.

ABSTRACT

Single-molecule surface-enhanced Raman scattering (SM-SERS) should no longer be judged mainly by whether it can detect Raman signals from individual molecules but by what conclusions those signals can support under heterogeneous local conditions. In the single-molecule regime, the recorded spectrum is the product of a coupled molecule-interface-nanocavity-excitation-detection system, shaped by local geometry, molecule-metal coupling, cavity evolution, and readout conditions. The central challenge, therefore, shifts from achieving extreme enhancement to defining measurement conditions well enough for reliable interpretation. Here, we propose different evidential standards for four classes of SM-SERS claims-occupancy, assignment, local state, and mechanism-and argue that multimodal and correlative validation should increase with the strength of the claim. We assess how major platform classes reduce different sources of uncertainty and identify the field’s most tractable priorities: transparent reporting of observables, assumptions, and data-processing pipelines; quantitative statistics and reproducibility metrics for the events on which conclusions rest; and hypothesis-driven controls matched to the claim being made. SM-SERS will become a trustworthy nanospectroscopic tool only when each claim is supported by evidence strong enough to address the uncertainties of the coupled local system that produced the spectrum.

PMID:42546279 | DOI:10.1063/5.0341335

J Pediatr Orthop B. 2026 Aug 3. doi: 10.1097/BPB.0000000000001392. Online ahead of print.

ABSTRACT

This study evaluates the clinical, radiographic, and caregiver-reported outcomes of two palliative hip surgery (PHS) techniques – Egermann resection and Girdlestone resection – in nonambulatory children with cerebral palsy. A retrospective cohort of 30 Gross Motor Function Classification System (GMFCS) V children (41 hips) who underwent PHS between 2014 and 2025 at two tertiary referral centers was reviewed. Proximal femoral migration (PFM) was assessed on anteroposterior pelvic radiographs obtained immediately after surgery, at 6-12 months, and at final follow-up. Clinical outcomes were evaluated using the caregiver-reported Cerebral Palsy Quality of Life Questionnaire for Children (CP QOL-Child), and pain using a visual analog scale. Postoperative complications were recorded and classified according to the Clavien-Dindo-Sink (CDS) system. Both surgical techniques were associated with satisfactory pain relief and caregiver-reported quality of life. At final follow-up, PFM did not reach a statistically significant difference between the two groups (3 ± 20 mm vs 14 ± 18 mm; P > 0.05). Technique 2 was associated with fewer painful heterotopic ossifications requiring surgical revision. The overall complication rate was 32% of hips (13/41), with CDS III complications requiring reintervention in 12% of hips (5/41). Caregiver-reported CP QOL-Child scores were comparable between groups. PHS provides effective pain relief and satisfactory caregiver-reported quality of life in GMFCS V children. Both techniques represent viable palliative options, with distinct profiles of PFM and soft tissue-related complications. Surgical decision-making should be individualized according to patient anatomy and anticipated functional needs.

PMID:42546262 | DOI:10.1097/BPB.0000000000001392

JMIR Form Res. 2026 Aug 3;10:e91887. doi: 10.2196/91887.

ABSTRACT

BACKGROUND: Chronic pain is a growing global public health challenge and the leading cause of years lived with disability. It significantly impacts various aspects of daily life, including participation in working life, resulting in increased sick leave and substantial burdens at both the personal and societal levels. Person-centered care (PCC) is a practiced ethic that recognizes the patient as a partner in care. Partnership is established through incorporating the person’s narrative, shared decision-making, and documentation of jointly agreed goals. Remotely delivered PCC interventions have been shown in other studies to improve self-efficacy and facilitate return to work among persons on sick leave. However, little is known about how self-efficacy and sick leave are affected when a PCC intervention is delivered remotely to persons with chronic pain.

OBJECTIVE: This study aimed to evaluate the efficacy of a home-based person-centered intervention consisting of telephone support and an eHealth platform among persons on sick leave due to chronic pain.

METHODS: A 2-arm, nonblinded randomized controlled trial was conducted. Participants aged 18 to 65 years on sick leave due to chronic, nonmalignant pain lasting more than 3 months were recruited from 10 primary health care centers in Gothenburg, Sweden. Participants were randomly allocated 1:1 to either the control group or the intervention group. Both groups received usual care; the intervention group additionally participated in a 6-month PCC intervention via telephone and an eHealth platform. The primary outcome was a composite score consisting of change in general self-efficacy and sick leave at the 6-month follow-up. Self-efficacy was assessed using the Swedish version of the 10-item General Self-Efficacy Scale, and sick leave was assessed based on participants’ self-reported percentage of sick leave in relation to full-time work. The primary outcome was analyzed according to the intention-to-treat principle using the Mantel-Haenszel chi-square trend test.

RESULTS: A total of 654 patients were assessed for eligibility, of whom 59 were included in the final analysis: 29 in the intervention group and 30 in the control group. More participants in the control group (11/30, 36.7%) than in the intervention group (3/29, 10.3%) showed deterioration, resulting in a significant difference in the composite score between the groups at the 6-month follow-up (P=.04), favoring the intervention. This significance also remained in the nonimputed analysis (P=.04).

CONCLUSIONS: This study suggests that PCC via telephone and an eHealth platform may influence the level of sick leave and self-efficacy among persons with chronic pain. Since the control group deteriorated while the intervention group largely remained unchanged, PCC may play a protective role in supporting persons with chronic pain in returning to work. Further studies are warranted to confirm these findings.

PMID:42546261 | DOI:10.2196/91887

Health Aff (Millwood). 2026 Aug;45(8):925-933. doi: 10.1377/hlthaff.2026.00046.

ABSTRACT

Multiple states have established benchmarks for health care spending growth. Since 2021, spending growth has exceeded most states’ benchmarks, prompting concerns about unsustainable growth. However, these benchmarks largely do not adjust when economywide inflation changes. I collected data on states’ benchmark-setting processes, targets, and reported health care spending and identified a set of six states that reported data on per capita spending growth in both 2022 and 2023. Meeting benchmark spending targets for these years would have required real (inflation-adjusted) per capita health care spending to decline by an average of 1.6 percent per year. The same nominal spending benchmark targets would have allowed real spending growth of 1.9 percent per year if inflation had stayed at its historical average. Actual real spending growth was only 0.7 percent per year. Consistent with this, health care as a share of gross domestic product for these states remained stable, at 10.9 percent in 2021 and 10.7 percent in 2023. These findings suggest that nominal spending benchmark designs can generate misleading performance signals, which can be reduced by adopting inflation-shock adjustment protocols and routinely reporting both nominal and real spending performance.

PMID:42546245 | DOI:10.1377/hlthaff.2026.00046

Health Aff (Millwood). 2026 Aug;45(8):846-854. doi: 10.1377/hlthaff.2026.00054.

ABSTRACT

Whether US pharmaceutical markets reward novel therapies more than incremental follow-on drugs remains unclear. We examined trends in prescription drug revenues across three dimensions of pharmacological novelty-molecular structure, therapeutic target, and delivery properties-using a retrospective analysis of branded small-molecule drugs approved by the Food and Drug Administration and marketed between 2000 and 2019. Novelty measures derived from ChEMBL, a comprehensive database of bioactive molecules with druglike properties, were linked to nationally representative utilization and spending data from the Medical Expenditure Panel Survey, with rebate-adjusted net revenues estimated using SSR Health data. Beginning around 2013, gross and net revenues rose disproportionately for highly novel drugs across all three dimensions of novelty, whereas revenues for medium- and low-novelty drugs remained relatively stable. From 2013 to 2019, mean gross revenue more than tripled for drugs with high molecular or target novelty and more than doubled for those with high delivery novelty. These revenue gains were associated with increased prescription volume, rather than higher prices. The timing of this divergence coincided with the expansion of pharmacy benefit managers’ formulary exclusion policies, which may have reduced the usage of drugs with close substitutes and increased market returns to pharmacological novelty.

PMID:42546243 | DOI:10.1377/hlthaff.2026.00054

Health Aff (Millwood). 2026 Aug;45(8):888-896. doi: 10.1377/hlthaff.2025.01470.

ABSTRACT

Medicare Advantage (MA) has become a major source of dental coverage for older US adults. However, little is known about enrollment in plans with dental coverage or about the scope and continued availability of coverage over time. Using Centers for Medicare and Medicaid Services Plan Benefit Package and enrollment data, we examined county-level variation in dental plan enrollment, generosity of benefits, and continuity of dental plan availability across conventional MA plans and MA Special Needs Plans (SNPs) during the period 2010-25. Enrollment in conventional MA plans with any dental benefits rose from 50.3 percent in 2010 to 97.1 percent in 2025. Enrollment in SNPs with dental benefits increased from 68.6 percent to 93.5 percent during this period. Among plans continuously available for at least five years, benefit generosity rose after 2019, but plan continuity declined after 2021 as a result of plan exits and the withdrawal of dental benefits. Net losses of insurers offering dental benefits in conventional MA plans were more likely in counties with relatively high percentages of Black and Hispanic residents, in dental Health Professional Shortage Areas, and in areas with midlevel social deprivation. These findings underscore the need for strong oversight of MA dental benefits and strategies to achieve sustained and equitable access to dental coverage.

PMID:42546242 | DOI:10.1377/hlthaff.2025.01470

Health Aff (Millwood). 2026 Aug;45(8):880-887. doi: 10.1377/hlthaff.2025.01693.

ABSTRACT

Medicare Advantage (MA) plans receive capitated payments that could lead to greater efficiency compared with traditional Medicare but may also curtail provision of beneficial services. However, MA effects are not fully understood, as most research to date is cross-sectional and could be subject to selection bias. This study investigated a natural experiment in which five states (Alabama, Arizona, Colorado, Connecticut, and New Jersey) shifted health benefits for retired state employees from supplemental plans for traditional Medicare to MA plans during the period 2017-19, leading to 87 percent of the more than 220,000 state retirees in these states shifting to MA. We found increased use of certain outpatient services (annual wellness visits and home evaluation and management visits) and observation stays, along with reduced hospital and postacute care admissions. We found no effect on days spent at home or in the community, or on mortality.

PMID:42546241 | DOI:10.1377/hlthaff.2025.01693

Health Aff (Millwood). 2026 Aug;45(8):934-942. doi: 10.1377/hlthaff.2025.01585.

ABSTRACT

During the unwinding of the continuous coverage requirements related to the COVID-19 public health emergency in 2023, as an unprecedented volume of consumers were transitioning out of Medicaid, California launched a facilitated enrollment program for people who lost Medicaid and were eligible for subsidized Marketplace coverage. We conducted a survey in 2023-24 to assess coverage outcomes among Californians who lost Medicaid coverage, were assigned to a default plan, and had thirty days to opt in to coverage under the program. Although national surveys indicate high rates of uninsurance after loss of Medicaid, we found that 85 percent of those who were eligible for an Affordable Care Act Marketplace subsidy had some form of health insurance. Among those without other available coverage, nearly two-thirds opted in to a Marketplace plan. People with a high school education or less were least likely to enroll in Covered California, as were those who rated their health status as poor. Even after we accounted for premium amounts, income, education, health status, and language preference, take-up was higher among Asian/Asian American (84 percent) and White (79 percent) people than among Hispanic/Latino (53 percent) and Black/African American (54 percent) people. Our findings indicate that facilitated enrollment interventions should be strengthened to overcome administrative and other burdens that persist among subpopulations.

PMID:42546240 | DOI:10.1377/hlthaff.2025.01585