Tag: pubmed

Transfusion. 2026 Jul 7. doi: 10.1111/trf.70292. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding patterns in blood availability is key to identifying appropriate interventions to increase blood access, particularly interventions intended for use in blood deserts, defined as areas in which >75% of blood needs are unmet. Blood availability patterns are particularly difficult to understand in the decentralized systems made up primarily of hospital-based blood banks, which are common in low- and middle-income countries. In Liberia, >95% of blood is collected at decentralized hospital-based blood banks.

STUDY DESIGN AND METHODS: A national cross-sectional geospatial analysis of blood bank accessibility in Liberia estimated the population residing within the cumulative travel-time thresholds of blood bank facilities and contextualized these findings using a static national estimate of blood supply. Geographic accessibility to blood banks was estimated in ArcGIS Pro 3.6 using a raster-based travel-time cost-distance approach.

RESULTS: Only 0.22% of people in Liberia live within 30 min of a blood bank; 0.87% live within 60 min.

DISCUSSION: Liberia is a blood desert, and blood-desert specific interventions (e.g., civilian walking blood banks), some of which may focus on hospital-based blood banks, should be considered. Interventions to enhance blood collection at the centralized national level, such as Club 25, are likely also appropriate. This analytic method effectively identified patters in blood availability in the absence of a countrywide blood inventory system. However, factors such as available road and population data, and specific geographic features, could lead the method to over- or underestimate blood availability and should be taken into account when choosing this approach.

PMID:42411176 | DOI:10.1111/trf.70292

J Gastric Cancer. 2026 Jul;26(3):392-407. doi: 10.5230/jgc.2026.26.e26.

ABSTRACT

PURPOSE: Although early-onset gastric cancer (EOGC; diagnosis at age <50 years) exhibits more aggressive clinicopathologic features than typical-onset gastric cancer (TOGC; diagnosis at ≥50 years), its prognostic implications remain unclear.

MATERIALS AND METHODS: Data from 44,262 patients newly diagnosed with gastric cancer between 2012 and 2019 were obtained from the Korean Cancer Public Library Database. Patients were classified as having EOGC or TOGC based on age at diagnosis. All-cause and gastric cancer-specific mortality were evaluated across Surveillance, Epidemiology, and End Results (SEER) summary stages (localized, regional, and distant) using adjusted multivariable Cox proportional hazards models. The interaction between age group and cancer stage was also examined.

RESULTS: EOGC comprised 13.9% of cases. Compared with patients with TOGC, patients with EOGC had fewer comorbidities and were more likely to present with distant-stage disease. Nonetheless, younger patients more frequently received aggressive treatment, whereas treatment rates declined with increasing age. In localized disease, EOGC was associated with significantly lower adjusted mortality (all-cause mortality: adjusted hazard ratio [aHR], 0.52; 95% confidence interval [CI], 0.42-0.66; gastric cancer-specific mortality: aHR, 0.52; 95% CI, 0.37-0.71). In contrast, in regional and distant stages, EOGC was associated with significantly higher mortality (all-cause mortality: aHR, 2.39; 95% CI, 2.20-2.60; gastric cancer-specific mortality: aHR, 1.86; 95% CI, 1.70-2.03). Age and SEER stage showed a significant interaction (P for interaction <0.0001).

CONCLUSIONS: The prognostic effect of younger age in gastric cancer is stage-dependent, conferring a survival advantage in localized disease but poorer outcomes in regional and distant stages.

PMID:42411164 | DOI:10.5230/jgc.2026.26.e26

Paediatr Anaesth. 2026 Jul 7. doi: 10.1002/pan.70257. Online ahead of print.

ABSTRACT

BACKGROUND: Genetic mitochondrial diseases (GMDs) are a large group of genetically and clinically heterogeneous disorders caused by defects in genes encoding mitochondrial components. GMDs are grouped into named syndromes based on clinical presentation, for example, Leigh syndrome (LS). Surgical interventions are often required in GMDs, necessitating the use of general anesthesia (GA). Some GMD animal models show both a marked reduction in anesthetic concentrations necessary for sedation and toxic sequelae resulting from anesthetic exposures. Hypersensitivity to sedation by anesthetic agents, most notably volatile anesthetic agents (VAs), occurs in a subset of GMD patients, and some evidence suggests toxicities are also present. Reported complications of anesthesia in GMD are varied, including minor metabolic changes, acceleration of underlying disease, and death. The potential toxicity of anesthetics in the setting of GMDs has recently been underscored by deaths among pediatric and young adult patients of Venezuelan descent putatively linked to a specific mitochondrial DNA haplotype. Interpretation of clinical findings is limited by the lack of a thorough review of case reports for anesthetic exposures in GMD patients. Here, we provide a comprehensive review of published case reports for GMD patients undergoing anesthetic exposures.

METHODS: Using search terms “anesthesia mitochondrial disease,” “anesthesia mitochondrial disease case report,” and “anesthesia Leigh syndrome” we identified case reports published up to May 2025. Non-English articles were translated and included where possible. Only reports of GMD patients undergoing GA with total intravenous anesthesia (TIVA) or VAs containing outcome information were included, totaling 148 cases from 123 reports. We examined relationships between complications and GA type, clinical diagnosis, perianesthetic drugs, procedure length and type, and general demographics. We performed a narrative review of clinical and pre-clinical literature.

RESULTS: Overall complication rate was significantly higher in VA versus TIVA cases (42% vs. 18%, Fisher’s exact p-value **p = 0.0022), as was rate of severe complications (*p = 0.01). Encephalomyelopathies, including LS, were overrepresented among cases resulting in death. Complication rate has remained relatively stable over time. Sex and age were not associated with significant differences in complication rate. Complication rate varied significantly by procedure type, and severe complications were associated with procedure length. While not statistically significant, older VAs had higher complication rates than newer VAs. Similarly, older neuromuscular blockade agents may be less safe than newer drugs. N₂O and ketamine were notably safe among drugs used in TIVA procedures.

CONCLUSIONS: Available case-report data support the notion that GMD patients are at increased risk of a variety of perianesthetic complications. Clinical symptoms and procedure length appear most strongly predictive of severe complications. Clinical and pre-clinical findings suggest more research is needed to understand the mechanisms of toxicity and more detailed reporting is needed in clinical case reports to identify potential risk factors.

PMID:42411141 | DOI:10.1002/pan.70257

Public Health Nurs. 2026 Jul 7. doi: 10.1111/phn.70149. Online ahead of print.

ABSTRACT

OBJECTIVE: The study examined the effects of a transtheoretical model based training and counseling program on the stages of change, the decisions to avoid partner violence, and the self-efficacy of the victims of intimate partner violence.

METHODS: The study was planned as a single group pre-test post-test quasi-experimental design. Data were collected from 40 women from the Investigation Bureau of Violence Against Women in a courthouse in Turkey between September 2018 and June 2019. Personal questionnaire form, a tool to determine the type of intimate violence, Abused Women’s Change Process Scales, telephone interview form, and semi-structured interview forms were used.

RESULTS: Informative training and a counseling program were offered to the women, who were then followed up for 6 months; the difference between the identified stages of change of the abused women before and after the intervention was found to be statistically significant (p < 0.05). The differences between the mean scores on the pros and cons scales and the Temptations and Confidence Scales before and after the training and counseling program for the victims of intimate partner violence were found to be significant (p < 0.01).

CONCLUSION: Nurses can use sample training and counseling models in institutions where victims of violence apply.

PMID:42411137 | DOI:10.1111/phn.70149

Pharm Stat. 2026 Jul-Aug;25(4):e70108. doi: 10.1002/pst.70108.

ABSTRACT

Oncology drug development has increasingly shifted toward determining optimal biological doses rather than maximum tolerated doses (MTDs), particularly for targeted therapies and immunotherapies that exhibit complex dose-efficacy relationships. Concurrently, basket trials have emerged as an efficient approach for evaluating investigational treatments across multiple cancer types sharing common molecular targets. We propose the BOIN-ETB design, a model-assisted dose-finding design that addresses optimal dose (OD) identification in phase I/II basket trials by incorporating both toxicity and efficacy endpoints. The proposed approach employs common toxicity boundaries across cancer types while implementing cancer-specific efficacy boundaries to account for differential efficacy responses between baskets. OD selection utilizes utility functions that quantify efficacy-toxicity trade-offs. Through comprehensive simulation studies across Fourteen realistic scenarios, the BOIN-ETB design demonstrates robust performance in identifying true ODs while maintaining acceptable safety profiles across diverse cancer populations. The design provides superior consistency compared to alternative approaches, particularly in scenarios with heterogeneous dose-efficacy relationships between cancer types, making it well-suited for contemporary oncology dose-finding basket trials.

PMID:42411136 | DOI:10.1002/pst.70108

Cytometry A. 2026 Jul 6. doi: 10.1002/cyto.a.70052. Online ahead of print.

ABSTRACT

Studies evaluating cellular phenotypes by cytometry techniques are increasingly facing analytical challenges due to the multitudes of samples and parameters that are evaluated concurrently. Spurious technical effects resulting from a lack of standardization can affect marker distributions and further complicate multi-sample analyses. User-friendly tools for exploratory data analysis to identify such technical effects in large datasets are lacking. To fill this gap, we present a novel R package, CytoScan, that evaluates inter-measurement variation in cytometry datasets and allows for detecting anomalous measurements after data acquisition. CytoScan can detect two types of anomalies: files with limited similarity to others within a dataset (outliers) and files with limited similarity to previously acquired high-quality reference data (novelties). Using simulations of skewed marker distributions and real-life technical effects, we demonstrate that CytoScan can accurately detect such anomalies. CytoScan can be applied to large cytometry datasets on consumer-grade hardware with informative visualizations, providing accessible quality control for more reliable analyses.

PMID:42411100 | DOI:10.1002/cyto.a.70052

Diagn Cytopathol. 2026 Jul 6. doi: 10.1002/dc.70178. Online ahead of print.

ABSTRACT

BACKGROUND: Intracytoplasmic lumina (ICL) are mucin-containing structures identified in histological and cytological specimens of urothelial carcinoma and are associated with high-grade tumors and poor prognosis. However, their biological significance remains unclear. This study investigated mucin expression in ICL and its association with clinical, cytopathological, and prognostic features in non-muscle-invasive urothelial carcinoma of the bladder.

METHODS: A total of 105 cases of non-muscle-invasive urothelial carcinoma of the bladder diagnosed were examined. Immunohistochemical staining for MUC1, MUC2, MUC4, MUC5AC, and MUC6 was performed in 47 cases in which ICL were identified histologically, and the staining patterns of ICL and tumor cells were evaluated. The presence of ICL in urine cytology specimens was assessed, and its associations with tumor-specific survival and recurrence were analyzed statistically.

RESULTS: ICL were identified in 47 cases histologically and in 33 cases cytologically. ICL-positive tumors were more frequently observed in high-grade histology and were more often diagnosed as malignant or suspicious for malignancy in urine cytology. Immunohistochemically, MUC1 was the most frequently expressed mucin, with localization along the microvilli of the ICL lumen and within luminal mucin. Increased expression of MUC4 and MUC5AC showed a trend toward decreased survival.

CONCLUSION: ICL in non-muscle-invasive urothelial carcinoma is more frequently observed in high-grade tumors and shows characteristic mucin expression patterns, particularly MUC1 localization within ICL structures. Increased expression of MUC4 and MUC5AC may be associated with unfavorable clinical outcomes. These findings suggest that combined evaluation of ICL and mucin expression may provide additional prognostic information in urothelial carcinoma.

PMID:42411043 | DOI:10.1002/dc.70178

Global Spine J. 2026 Jul 6:21925682261466191. doi: 10.1177/21925682261466191. Online ahead of print.

ABSTRACT

Study DesignRetrospective cross-sectional study.ObjectiveTo evaluate national trends in utilization and inflation-adjusted charges for single-level posterior cervical decompression and fusion (PCDF) performed in hospital-owned ambulatory surgery centers (ASCs).MethodsThe National Ambulatory Surgery Sample was queried from 2016 to 2022 for adult ASC encounters with CPT 22600, corresponding to single-level posterior cervical fusion. Survey-weighted methods estimated national volumes and modeled adjusted charges using generalized linear models. Statistical significance was set at P< 0.05.ResultsA weighted total of 8,609 single-level PCDF procedures were performed in hospital-owned ASCs from 2016 to 2022 (unweighted n = 6,505). Annual volume increased from 577 cases in 2016 to 3,307 cases in 2021 before declining to 1,586 cases in 2022. Median inflation-adjusted charges rose from $41,697 in 2016 to $69,255 in 2022 (P < 0.001). Adjusted mean charges varied significantly by payer and region, with higher charges for private insurance versus Medicaid ($62,621 vs $50,095, P < 0.001) and for the West versus the Northeast ($93,278 vs $19,847, P < 0.001), based on adequate regional sample sizes (unweighted n = 653 and n = 1,557, respectively). Medicare demonstrated the fastest annual charge growth, higher than Medicaid (+10.35%/year, P = 0.004), private (+12.31%/year, P < 0.001), and Other (+11.87%/year, P < 0.001).ConclusionsOutpatient PCDF adoption in ASCs rose sharply from 2016 to 2021 with persistent, pronounced regional and payer-associated charge variation. These findings suggest that geographic pricing ecosystems and payer dynamics are key drivers of outpatient PCDF economics.

PMID:42411038 | DOI:10.1177/21925682261466191

Mol Genet Genomic Med. 2026 Jul;14(7):e70262. doi: 10.1002/mgg3.70262.

ABSTRACT

BACKGROUND: Genome-wide association studies continue to recruit larger samples, increase resolution, and improve their statistical foundations. These investigations often remain restricted by design to large, outbred populations. This can exclude genetically distinct populations, to whom the genetic insights gained may not apply, and forgoes the benefits that isolated populations can offer to biomedical research. Metabolic Syndrome (MetS) is a collection of highly correlated risk factors that predisposes individuals to type 2 diabetes, cardiovascular disease, and chronic kidney disease. The environmental factors that lead to MetS are well understood, but each person’s response to these influences is modulated by their genetics.

METHODS: In this mini-review, we discuss the features of population isolates for mapping disease genes, briefly consider some of the clinical aspects of MetS, and compare the recent contributions to understanding the genetic causes of MetS by population isolates and by large open-population approaches.

RESULTS: Studies in isolated populations have revealed novel genetic associations, including determining causal variants. Isolated populations have also validated and refined associated loci discovered in large, open populations.

CONCLUSION: Much progress has been made uncovering the genetic basis of MetS and related conditions. However, while the field progresses, the definition of the syndrome remains contested, and a comprehensive understanding of MetS genetics remains elusive.

PMID:42411037 | DOI:10.1002/mgg3.70262

J Phys Chem B. 2026 Jul 6. doi: 10.1021/acs.jpcb.6c02780. Online ahead of print.

ABSTRACT

In microphase-forming systems, the loss of long-range order at the order-disorder transition does not necessarily imply the total disappearance of short-range structural organization. Instead, transient clusters locally resembling the ordered mesophase may persist within the isotropic phase. While the existence of such clusters is known, their statistical properties and their relationship to the thermodynamic signatures of the system have not been fully characterized. In this work, we address these questions for a binary mixture with isotropic Stillinger-Weber interactions that stabilizes a hexagonal mesophase by combining molecular dynamics simulations with thermodynamic modeling. A geometry-based algorithm is introduced to identify worm-like aggregates from particle configurations using a temperature-dependent B-B connectivity criterion. The resulting size distributions are monotonically decreasing and broaden markedly on approaching the order-disorder transition from above, showing that the disordered phase is not locally homogeneous but retains a population of finite worm-like fragments with persistent local compositional order. To rationalize these observations, we develop a minimal thermodynamic model based on a Flory-Huggins-type free energy, in which cluster formation is controlled by a single effective interaction parameter. The model reproduces the simulated size distributions over the explored temperature range using a single temperature-independent energetic parameter for a physically meaningful connectivity definition. Using this same parameter, fitted only to the structural distributions, the predicted disordering enthalpy closely matches that obtained directly from the simulations, providing an independent thermodynamic validation. Together, these results identify worm formation as the dominant energetic contribution in the isotropic phase and provide a direct link between microscopic cluster statistics and macroscopic thermodynamic behavior above the order-disorder transition.

PMID:42411003 | DOI:10.1021/acs.jpcb.6c02780