Tag: pubmed

J Exp Orthop. 2026 Jul 30;13(3):e70861. doi: 10.1002/jeo2.70861. eCollection 2026 Jul.

ABSTRACT

PURPOSE: Whether medially congruent (MC) total knee arthroplasty (TKA) provides clinically meaningful advantages over posterior-stabilized (PS) designs remains controversial. In this randomized trial, early recovery profiles and 2-year outcomes were compared between Persona® MC and PS TKA.

METHODS: In this triple-blinded randomized controlled trial, 82 patients undergoing primary TKA for Kellgren-Lawrence Grade IV osteoarthritis were allocated to receive a Persona® MC or PS system. The primary endpoint was Knee injury and Osteoarthritis Outcome Score-Activities of Daily Living (KOOS-ADL). Secondary outcomes included range of motion, visual analogue scale (VAS) pain, Forgotten Joint Score-12 (FJS-12), satisfaction and complications. Follow-up was 2 years. Group, time and group × time interaction were assessed using repeated-measures models.

RESULTS: Both groups improved over time. Significant group × time interactions were observed for ROM, VAS pain, KOOS-ADL and FJS-12, indicating different recovery profiles. MC knees had greater flexion at 2 weeks (95.3° vs. 83.9°, p < 0.001), and flexion contracture at 2 weeks was observed only in the PS group (0/41 vs. 4/41). Conversely, PS patients reported lower pain scores at 2 weeks (4.75 vs. 6.17, p < 0.001) and 6 weeks (1.92 vs. 2.97, p < 0.001). Later flexion favoured PS, including at 2 years (118.8° vs. 113.9°, p < 0.001). MC patients reported statistically higher KOOS-ADL and FJS-12 scores at 1 and 2 years; however, between-group differences did not exceed established minimum clinically important difference thresholds. Satisfaction was high in both groups and complications were infrequent.

CONCLUSION: Persona® MC and PS TKA showed different recovery profiles rather than clear superiority of either design. MC-TKA was associated with better early flexion and fewer observed early flexion contractures, whereas PS TKA was associated with lower early postoperative pain and greater flexion at later follow-up. MC showed statistically higher KOOS-ADL and FJS-12 scores, but these differences remained below minimum clinically important difference thresholds. Both designs provided substantial 2-year improvement without clinically meaningful between-group differences in patient-reported outcomes.

LEVEL OF EVIDENCE: Level I.

PMID:42534647 | PMC:PMC13420843 | DOI:10.1002/jeo2.70861

Cureus. 2026 Jun 30;18(6):e111801. doi: 10.7759/cureus.111801. eCollection 2026 Jun.

ABSTRACT

Periprosthetic distal femur fractures (PDFFs) are challenging injuries that commonly affect elderly patients following total knee arthroplasty (TKA). The commonly used surgical interventions are distal femoral replacement (DFR) and open reduction and internal fixation (ORIF), although the best approach remains debatable. This study aimed to evaluate the different ORIF subtypes and compare DFR versus ORIF for the management of PDFFs. This study was conducted in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with International Prospective Register of Systematic Reviews (PROSPERO). A comprehensive search was conducted across various databases up to October 2025. This study included only cohort studies comparing various surgical management approaches. Primary outcomes included functional scores (Knee Society Score (KSS)/Knee Society Function Score (KSFS)/Oxford Knee Score (OKS)), reoperation, and range of motion (ROM). Risk of bias and methodological quality were assessed using the Methodological Index for Non-Randomized Studies (MINORS) tool. Fifteen retrospective comparative studies involving 1,417 patients were included. Pooled analysis demonstrated a statistically significant reduction in reoperation rates favoring DFR (OR = 0.64; 95% CI: 0.42-0.97). One-year mortality showed a non-significant trend favoring DFR (OR = 0.70; 95% CI: 0.45-1.09). Infection rates were slightly higher in the DFR group without statistical significance (OR = 1.39; 95% CI: 0.61-3.18). No significant differences were observed in perioperative and functional outcomes between the two interventions. DFR allowed earlier full weight-bearing and mobilization, whereas ORIF required protected weight-bearing protocols. Compared with ORIF in PDFFs, DFR was associated with a reduced risk of reoperation and earlier postoperative mobilization. Mortality and functional outcomes remained comparable between the two interventions. Treatment selection should be individualized, with ORIF appropriate for reconstructible fractures with stable implants and DFR reserved for patients in whom fixation is unlikely to succeed or protected weight-bearing is unrealistic; all findings should be interpreted cautiously given the retrospective evidence base.

PMID:42534630 | PMC:PMC13420835 | DOI:10.7759/cureus.111801

Front Endocrinol (Lausanne). 2026 Jul 16;17:1893897. doi: 10.3389/fendo.2026.1893897. eCollection 2026.

ABSTRACT

INTRODUCTION: The influence of physical activity on outcomes of assisted reproductive technology (ART) remains incompletely understood, with conflicting evidence regarding the impact of exercise intensity and frequency. This study aimed to evaluate the association between self-reported physical activity and reproductive outcomes in patients undergoing ART.

METHODS: This retrospective single-center cohort study included 2,576 patients undergoing 6,850 ART cycles with embryo transfer between 2000 and 2021. Patients were categorized according to self-reported weekly physical activity as no regular exercise (Group A), exercise 1-2 times per week (Group B), and exercise ≥3 times per week, including competitive athletes (Group C). The primary outcome was cumulative live birth rate per oocyte pick-up (OPU), including fresh and frozen embryo transfers within one year following OPU. Secondary outcomes included cumulative pregnancy rate, pregnancy rate per embryo transfer, live birth rate per transfer, miscarriage rate, and number of oocytes retrieved.

RESULTS: Patients exercising 1-2 times weekly demonstrated the most favorable reproductive outcomes. Pregnancy rate per embryo transfer was highest in Group B (34.8%) compared with Group A (32.5%) and Group C (29.7%, p<0.005). Similarly, live birth rate per transfer was higher in Group B (25.6%) than in Groups A (23.0%) and C (22.4%, p<0.05). Cumulative pregnancy rate per OPU was highest in Group B (58.7%) compared with Group A (52.5%) and Group C (49.5%, p<0.001). Cumulative live birth rate per OPU was also higher in Group B (43.1%) compared with Group A (37.2%) and Group C (37.1%, p<0.01).

DISCUSSION: Moderate physical activity was associated with more favorable ART outcomes, including higher cumulative pregnancy and live birth rates, compared with both no regular exercise and high levels of physical activity. These findings suggest that moderate exercise may represent a beneficial lifestyle factor for patients undergoing ART and may support individualized patient counseling.

PMID:42534628 | PMC:PMC13421417 | DOI:10.3389/fendo.2026.1893897

Qatar Med J. 2026 Jun 10;2026(2):29. doi: 10.5339/qmj.2026.29. eCollection 2026.

ABSTRACT

BACKGROUND: Abdominoplasty, although classified as a clean elective procedure, carries a meaningful risk of surgical site infection (SSI), with reported SSI rates varying depending on patient factors and procedural complexity.

OBJECTIVE: To describe SSI incidence and associated risk factors after abdominoplasty at a Qatari tertiary facility, and to assess compliance with prophylaxis practices, antibiotic consumption, and costs.

METHODS: Retrospective cohort of all abdominoplasties at The Cuban Hospital, from January 1, 2022, to July 31, 2025 (N = 323). Data included demographics, comorbidities, perioperative glucose monitoring, procedure characteristics, and antibiotic use (prophylactic and therapeutic). The cohort comprised both simple abdominoplasties and combined procedures performed with additional interventions such as liposuction or hernia repair. SSI rates were analyzed using relative risk, 95% confidence intervals, and statistical tests with significance at P < 0.05.

RESULTS: A total of 323 patients underwent abdominoplasty with a mean age of 40.5 years (SD, 9.8; range, 19-63 years). The majority were female (276 patients, 85.4%), and 13.9% (45 patients) had a history of diabetes mellitus. Overall SSI incidence was 5.3% (17/323), highest in 2025 (8/112; 7.1%). Combined abdominoplasty had a higher SSI rate than simple procedures (10.4% [5/48] vs. 4.4% [12/275]; RR, 2.36 [95% CI, 0.88-6.35]). SSI was more frequent with diabetes (11.1% [5/45] vs. 4.3% [12/278]), overweight/obesity (7.3% [12/151]/4.3% [5/112] vs. 0% [0/42]), and higher postoperative glucose (mean: 7.97, standard deviation: 1.99; P = 0.04). Adherence to antibiotic prophylaxis was high for timing/selection/dose, but discontinuation beyond 24 hours and 7-day discharge prescriptions were common. Antibiotic consumption and costs were higher in SSI cases (355.9 vs. 280.5 DDD/100; 2807.6 vs. 2180 QR/100; P = 0.45; P = 0.72).

CONCLUSION: SSI incidence after abdominoplasty was modest but increased with combined procedures and poorer postoperative glycemic control. Strengthening perioperative glucose protocols and enforcing 24-hour prophylaxis limits may reduce SSI and unnecessary antimicrobial use and costs.

PMID:42534619 | PMC:PMC13421423 | DOI:10.5339/qmj.2026.29

Front Sociol. 2026 Jul 16;11:1842865. doi: 10.3389/fsoc.2026.1842865. eCollection 2026.

ABSTRACT

PURPOSE: Youth unemployment remains one of the most pressing socioeconomic challenges in fragile and conflict-affected contexts such as Somalia, where prolonged instability, weak institutions, and limited labor market opportunities continue to constrain young adults’ access to sustainable employment. In response to these challenges, innovation hubs have emerged as important platforms for skills development, entrepreneurship support, and freelancing opportunities. However, empirical evidence on the relationship between innovation hub initiatives and employment outcomes remains limited. This study examines the association between innovation hub services, specifically skills development and training, entrepreneurship support, and freelancing programs, and young adults’ employment outcomes in Mogadishu, Somalia.

METHODOLOGY: A quantitative cross-sectional research design was employed using primary data collected through a structured online questionnaire. The study focused on young adults who had participated in innovation hub programs, with a sample of 360 respondents selected through purposive sampling. Data were analyzed using SPSS through descriptive statistics, reliability analysis, Pearson correlation, and multiple linear regression to examine the relationships among the study variables.

FINDINGS: The findings reveal that all three innovation hub services are positively and significantly associated with young adults’ employment outcomes. Skills development and training emerged as the strongest predictor, followed by freelancing programs and entrepreneurship support. The results further suggest that participants reported improved employment experiences after engaging in innovation hub programs. The regression model demonstrated a moderate level of explanatory power, indicating that the three predictors jointly account for a meaningful proportion of variation in employment outcomes.

IMPLICATIONS: The study provides important insights for policymakers, educators, and practitioners by highlighting the potential role of innovation hubs in addressing youth unemployment in fragile and conflict-affected settings. Strengthening practical skills training, expanding freelancing opportunities, and supporting entrepreneurship development may enhance employment opportunities for young adults. The findings further support the integration of innovation hubs into broader employment and workforce development strategies in Somalia.

PMID:42534614 | PMC:PMC13422156 | DOI:10.3389/fsoc.2026.1842865

Front Nutr. 2026 Jul 16;13:1831634. doi: 10.3389/fnut.2026.1831634. eCollection 2026.

ABSTRACT

INTRODUCTION: The role of sarcopenia in cancer treatment remains to be fully documented. This umbrella meta-analysis aimed to investigate the impact of sarcopenia on therapeutic outcomes across common malignancies with high incidence or mortality.

METHODS: We conducted an umbrella review of existing meta-analyses based on cohort studies. PubMed, Web of Science, and Embase were systematically searched from inception to October 2025. The primary endpoints were survival outcomes after surgical or first-line treatments. Supplementary meta-analyses were performed for outcomes with insufficient existing evidence. The systematic review protocol was registered in PROSPERO (CRD42022383726).

RESULTS: A total of 59 meta-analyses were included, comprising 49 from the literature search and 10 newly conducted in this study, covering 12 cancer types. In patients undergoing surgery, sarcopenia was significantly associated with shorter overall survival (HR = 1.59, 95% CI: 1.37-1.88) and disease-free survival (HR = 1.64, 95% CI: 1.39-1.93), as well as increased risks of any postoperative complications (OR = 1.48, 95% CI: 1.21-1.81) and major complications (OR = 1.51, 95% CI: 1.30-1.76). In patients receiving first-line non-surgical therapy, sarcopenia remained an independent risk factor for poorer overall survival (HR = 1.49, 95% CI: 1.39-1.61) and progression-free survival (HR = 1.39, 95% CI: 1.17-1.66). The methodological quality of included meta-analyses was generally high, while the GRADE certainty of evidence for most outcomes was rated as low or very low. Sarcopenia was also associated with inferior survival after cancer immunotherapy.

DISCUSSION: Sarcopenia is consistently associated with adverse therapeutic outcomes across multiple cancers and treatment modalities. It warrants attention in clinical management and represents a promising target for improving cancer therapeutic outcomes.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42022383726.

PMID:42534612 | PMC:PMC13421404 | DOI:10.3389/fnut.2026.1831634

J Clin Lab Anal. 2026 Jul 30:e70324. doi: 10.1002/jcla.70324. Online ahead of print.

ABSTRACT

BACKGROUND: In Hiroshima, thyroid cancer tissue samples from A-bomb survivors have been preserved since 1958. However, the feasibility of using these old formalin-fixed paraffin-embedded (FFPE) specimens for genetic analysis has not been fully evaluated. Here, we aimed to assess the quality of DNA extracted from long-term stored FFPE specimens obtained from patients with papillary thyroid carcinoma (PTC) in Hiroshima and to evaluate their applicability to whole exome sequencing (WES).

METHODS: We extracted DNA from tumor and adjacent normal regions of FFPE thyroid tumor specimens from 57 cases stored for up to 55 years at three hospitals in Hiroshima and confirmed the quality of the extracted DNA. From this cohort, tumor and paired normal samples from 24 patients with PTC were selected for WES, and sequencing metrics were evaluated.

RESULTS: Both DNA yield and DNA integrity number were negatively correlated with storage duration. WES analysis showed that storage duration was also negatively correlated with mean insert size and normalized read depth. In contrast, the uniformity score, which reflects the evenness of sequence coverage across targeted regions, did not show a significant correlation with storage duration. Among the 22 BRAF V600E-positive cases identified by droplet digital PCR, 18 cases (82%) had at least one sequencing read supporting the mutation.

CONCLUSIONS: These findings suggest that FFPE samples preserved for up to 55 years may be amenable to sequencing with increased read depth. However, the progressive decline in DNA quality with longer storage periods indicates that careful interpretation of sequencing results is warranted.

PMID:42533294 | DOI:10.1002/jcla.70324

Diabetes Obes Metab. 2026 Jul 30. doi: 10.1111/dom.71170. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence on psychological, cognitive and functional outcomes of advanced diabetes technologies in older adults with long-standing type 1 diabetes (T1D) remains limited. We evaluated whether initiation of advanced hybrid closed-loop (AHCL) therapy was associated with changes in fear of hypoglycaemia, diabetes distress, psychological well-being, cognition, frailty-related measures and mobility-related function in adults aged ≥ 65 years with T1D.

METHODS: This prespecified, exploratory secondary analysis was conducted within a single-centre, open-label, randomised, controlled, parallel-group trial including adults aged ≥ 65 years with long-standing T1D. Participants were randomly assigned (1:1) to initiate AHCL therapy using the MiniMed 780G system or to continue standard diabetes treatment. The secondary outcomes included WHO-5, the 17-item Diabetes Distress Scale (DDS), Hypoglycemia Fear Survey-II (HFS-II), Montreal Cognitive Assessment, Digit Symbol Substitution Test, Fried frailty phenotype and performance-based functional measures. No formal sample-size calculation was performed for these secondary outcomes.

RESULTS: Thirty-one participants were randomised and 29 completed 12 months of follow-up and were included in the treatment-effect analyses. In the baseline-adjusted primary analysis, AHCL therapy was associated with a lower HFS-II score than standard treatment (adjusted mean difference -18.9; 95% CI: -32.4 to -5.4; nominal p = 0.008), although this finding did not remain statistically significant after Holm correction (adjusted p = 0.104) or in an exploratory model additionally adjusted for sex (difference -13.6; 95% CI: -32.2 to 5.0; p = 0.145). Diabetes distress, psychological well-being, global cognition and processing speed did not differ between groups. In sex-adjusted sensitivity analyses, the between-group differences remained statistically significant for 6-min walk distance (92.6 m; 95% CI: 36.8 to 148.3; p = 0.002) and Timed Up and Go performance (-2.27 s; 95% CI: -4.28 to -0.27; p = 0.028), but not for gait speed (0.27 m/s; 95% CI: -0.05 to 0.59; p = 0.099). At 12 months, 12 of 14 AHCL participants were robust and 2 were pre-frail; in the control group, 11 of 15 were robust and 4 were pre-frail. No participant was classified as frail at follow-up.

CONCLUSIONS: In this small, selected cohort, AHCL therapy was associated with a nominally lower fear-of-hypoglycaemia score and better performance on selected mobility-related tests over 12 months. The fear-of-hypoglycaemia finding did not remain statistically significant after correction for multiple comparisons or additional adjustment for sex. Six-minute walk distance and Timed Up and Go remained statistically significant in the exploratory sex-adjusted sensitivity analyses, whereas the gait-speed difference did not. No measurable between-group deterioration in global cognition or processing speed was observed. These exploratory findings require confirmation in larger studies with balanced representation by sex and direct measurement of physical activity. These findings also support a person-centred clinical message: older age alone should not be regarded as a barrier to AHCL when treatment is introduced with individualised education and appropriate ongoing support.

PMID:42533279 | DOI:10.1111/dom.71170

Diabetes Obes Metab. 2026 Jul 30. doi: 10.1111/dom.71103. Online ahead of print.

ABSTRACT

AIM: To estimate the societal costs of Type 1 diabetes (T1D) in France, including direct and indirect costs.

MATERIALS AND METHODS: We conducted a descriptive retrospective cross-sectional study on all adult patients (aged 18 and over) with T1D identified in the SFDT1 cohort and compared them to a matched cohort of patients without diabetes considering age, gender, deprivation status and geographical area. An Insurance claim data analysis was conducted for the year 2023 individually and then extrapolated to all of France. Costs were broken down by expense categories and insulin delivery devices.

RESULTS: The average individual societal cost of T1D in France in 2023 compared with the absence of diabetes was estimated at €9940 (€9340 when considering direct costs only). Nearly half of the identified costs were attributable to the use of medical devices. An analysis stratifying patients by treatment modality (closed-loop, pump or multiple daily injections) highlighted the significant costs associated with the use of the most advanced technologies for delivering insulin (average costs were respectively €13 557, €11 062, and €7004, respectively). The total cost of T1D in France was estimated at between €1.59 and €1.79 billion in 2023 excluding undiagnosed cases and premature mortality associated with the disease.

CONCLUSIONS: Our results suggest that the most advanced insulin delivery devices have a significant short-term economic impact. Although this paper does not cover the research, model-based studies do suggest that there are some advantages to using such devices, including potential future savings due to lower complication rates.

PMID:42533268 | DOI:10.1111/dom.71103

Ann Surg Oncol. 2026 Jul 30. doi: 10.1245/s10434-026-20315-x. Online ahead of print.

ABSTRACT

PURPOSE: Incidence of appendiceal cancer is increasing, with one-third of patients diagnosed before age 50 years. Fertility preservation (FP) is important for patients who have not completed childbearing; however, the safety of oocyte and embryo banking remains unclear due to concerns for ovarian metastases. This study evaluates incidence of ovarian metastases at cytoreductive surgery (CRS) and describes FP practices and outcomes among reproductive-aged women with appendiceal cancer.

METHODS: A retrospective review was conducted of female patients aged 18-45 years treated for appendiceal cancer at MD Anderson Cancer Center from January 2020 to January 2025. Clinical, surgical, pathologic, and fertility-related variables were collected. Descriptive statistics assessed rates and laterality of ovarian metastases, FP practices, and reproductive outcomes.

RESULTS: A total of 100 reproductive-aged women (median age 35.9 years, range 19-44 years) with histology-confirmed appendiceal cancer were identified, of whom 47 underwent CRS. Ovarian metastases were documented in 89.4% (42/47), with bilateral involvement in 71.4% (30/42) and unilateral involvement in 28.6% (12/42). Fertility-sparing surgery included retention of one ovary in 25.5% (12/47) and uterine preservation in 19.1% (9/47). Among patients retaining an ovary, 60% developed amenorrhea after adjuvant therapy. Desire for FP was documented in 23.4% (11/47), all were referred for oncofertility consultation. Five patients underwent oocyte or embryo cryopreservation before CRS, including three with confirmed ovarian involvement.

CONCLUSION: Reproductive-aged women with appendiceal cancer have a high and often bilateral incidence of ovarian metastases, with important implications for FP safety. Individualized fertility counseling prior to CRS is essential to optimize reproductive outcomes while maintaining oncologic safety.

PMID:42533253 | DOI:10.1245/s10434-026-20315-x