Tag: pubmed

Orbit. 2026 Aug 10:1-7. doi: 10.1080/01676830.2026.2714930. Online ahead of print.

ABSTRACT

PURPOSE: To characterize nuclear expression of Yes-associated protein 1 (YAP1), a key effector of the Hippo pathway, in lacrimal gland adenoid cystic carcinoma (LG ACC) and explore potential associations with clinicopathologic features and clinical outcomes.

METHODS: A retrospective, multi-institutional study of 24 LG ACC specimens was performed. Immunohistochemistry (IHC) was used to assess nuclear YAP1 expression. Staining intensity and percentage expression were combined into a composite NY-SCORE. Exploratory analyses evaluated relationships between YAP1 expression scores, clinicopathologic features, and clinical outcomes.

RESULTS: Nuclear YAP1 expression was observed in all 24 LG ACC cases: 6 tumors showed moderate staining (NY-SCORE 5-6), 18 tumors showed high staining (NY-SCORE 7-8), and none were low-scoring. Exploratory analyses did not demonstrate statistically significant associations between YAP1 expression and clinicopathologic features or clinical outcomes.

CONCLUSIONS: Nuclear YAP1 expression was consistently present in LG ACC tissue, suggesting that YAP1 nuclear localization is a common feature of this malignancy and supports future investigation of Hippo pathway activation in LG ACC. While YAP1 expression did not distinguish clinicopathologic risk or outcomes in this cohort, its uniform presence provides a foundation for future studies evaluating its biological role and potential therapeutic relevance.

PMID:42576145 | DOI:10.1080/01676830.2026.2714930

Biol Trace Elem Res. 2026 Aug 11. doi: 10.1007/s12011-026-05270-8. Online ahead of print.

ABSTRACT

Blood lead levels were associated with increased mortality in cancer patients, with mediation analyses suggesting a partial role of oxidative stress and inflammation, and heterogeneity across cancer types linked to Hallmark pathway activity. We analyzed 2,689 cancer patients from NHANES (1999-2016) using Cox regression, restricted cubic spline, and mediation analyses. Over 22,151.5 person-years, 983 deaths occurred. Compared with the lowest quartile, the highest blood lead quartile was associated with increased all-cause mortality (HR = 2.44; 95% CI: 1.79-3.34) and cancer mortality (HR = 2.34; 95% CI: 1.20-4.46). Lipid-adjusted inflammation indicators-including uric acid-to-high-density lipoprotein ratio (UHR), monocyte-to-lymphocyte ratio (MLR), and systemic inflammatory response index (SIRI)-mediated 4.51-5.72% of the association, supporting partial mediation through oxidative stress and inflammation. The effect varied by cancer type and correlated with TCGA Hallmark pathway activities, including KRAS signaling (ρ = -0.95) and xenobiotic metabolism (ρ = 0.79), suggesting that molecular context modulates lead toxicity.

PMID:42576141 | DOI:10.1007/s12011-026-05270-8

Clin Teach. 2026 Oct;23(5):e70494. doi: 10.1111/tct.70494.

ABSTRACT

BACKGROUND: Explicit teaching of clinical reasoning to medical students can be difficult to achieve, though may be facilitated through structured clinical debrief sessions supporting student discussions of case studies and placement experiences. This study aimed to understand student perceptions of the value of clinical debrief throughout their curriculum.

APPROACH: A scaffolded series of clinical debrief sessions were incorporated into Years 1, 3 and 5 of a 5-year UK undergraduate medical programme. Sessions are increasingly complex across year-levels and continuously improved across academic years according to student feedback. Each session receives student feedback through Likert-scale and open-ended questions on the session and their facilitating tutor, which were consolidated and analysed using descriptive statistics and AI-assisted conceptual content analysis.

EVALUATION: From over 8000 responses across the three year-levels and nine academic years, clinical debrief was positively viewed across all cohorts, with increasing perceived value for Year 3 students, though some decrease in perceptions for Year 5 students. Earlier year students emphasised the value for their communication and clinical reasoning skills, while later year students valued the ethical and medico-legal skill development and preparing for practice as a doctor. Tutors across all year levels were perceived highly for their contributions to an inclusive and effective learning environment and reducing professional isolation.

IMPLICATIONS: Scaffolded clinical debrief is positively viewed by undergraduate medical students across year levels, with perceived contributions to skill development influenced by year level. Development and implementation of clinical debrief require design aligning to student experiences and expectations, with effective tutor training.

PMID:42576138 | DOI:10.1111/tct.70494

Cogn Affect Behav Neurosci. 2026 Aug 10. doi: 10.3758/s13415-026-01487-1. Online ahead of print.

ABSTRACT

The present study examined how social competition modulates motor response execution and inhibition using behavioral, signal-detection, and event-related potential measures. Forty-three participants completed a Go/NoGo (GNG) task under social-competition and control conditions while EEG was recorded. Relative to control, social competition shortened Go-trial reaction times (RTs) without reducing accuracy, and greater RT speeding was associated with larger increases in the rated importance of response speed. Competition also increased NoGo commission errors, reflecting reduced Go/NoGo discriminability (lower d’) and a more liberal response criterion (C). Neurally, NoGo trials elicited larger N2 and P3 amplitudes than Go trials, whereas competition enhanced both Go-P3 and NoGo-P3 amplitudes without reliably modulating the N2. Go-P3 amplitude, maximal over centro-parietal/parietal sites, was negatively associated with Go RTs in the control condition. Competition-related increases in Go-P3 amplitude were associated with greater Go-RT speeding and statistically mediated the effect of competition on Go RTs, suggesting greater engagement of an stimulus-response (S-R) mapping process that translates task-relevant stimulus features into the appropriate Go-response representation. NoGo-P3 amplitude, maximal over frontocentral/central sites, was not significantly associated with commission errors or d’ in the control condition. However, competition-related increases in NoGo-P3 amplitude were associated with increased commission errors and reduced d’ and statistically mediated both effects. This pattern suggests that enhanced NoGo-P3 amplitude reflects increased demands for reactive control under a heightened prepotent Go tendency. Overall, social competition preferentially modulated P3-indexed, time-resolved control processes during motor response execution and inhibition, facilitating faster but still accurate motor response execution while impairing response withholding.

PMID:42576125 | DOI:10.3758/s13415-026-01487-1

J Child Psychol Psychiatry. 2026 Aug 10. doi: 10.1111/jcpp.70217. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to compare the effects of atomoxetine (ATX) and methylphenidate (MPH) on emotional dysregulation (ED) in children with attention deficit/hyperactivity disorder (ADHD), and to explore potential neural correlates underlying treatment-related changes.

METHODS: A total of 152 children with ADHD were randomly assigned to receive ATX (n = 76) or MPH (n = 76). After individualized dose titration, participants received a stable dose for 4 weeks. Emotional lability (EL) was the primary outcome, while emotion regulation strategies, ADHD symptoms, and overall illness severity were secondary outcomes. Mixed-effects linear models were applied to examine group differences across three time points (baseline, post-titration, and endpoint). Resting-state functional MRI data were acquired at baseline and endpoint and analyzed using whole-brain functional connectivity (FC) analysis with six amygdala subregions as seeds.

TRIAL REGISTRATION: ChiCTR2200062905; approved on August 23, 2022.

RESULTS: In both ATX and MPH groups, EL scores decreased significantly over time (β = -1.54, p < .001), with treatment effects in a similar range and no statistically significant between-group difference (MPH: d = -1.46; ATX: d = -0.93). After controlling for ADHD symptom improvement, treatment effects remained significant (β = -0.75, p < .001), suggesting that EL improvement was not solely accounted for by ADHD symptom reduction. Increased FC between the right basolateral amygdala and left orbital middle frontal gyrus (r = -0.46, p = .043), and between the left superficial amygdala and left middle cingulate cortex (r = -0.48, p = .031), was associated with EL changes and remained significant after controlling for ADHD symptom changes. No significant changes were found in self-reported emotion regulation strategies.

CONCLUSIONS: ATX and MPH both alleviate ED in children with ADHD, and these effects are not solely accounted for by improvements in ADHD symptoms. Increased amygdala-centered FC may be associated with medication-related ED improvements.

PMID:42576119 | DOI:10.1111/jcpp.70217

Ann Surg Oncol. 2026 Aug 10. doi: 10.1245/s10434-026-20361-5. Online ahead of print.

NO ABSTRACT

PMID:42576116 | DOI:10.1245/s10434-026-20361-5

Surg Endosc. 2026 Aug 10. doi: 10.1007/s00464-026-13270-x. Online ahead of print.

ABSTRACT

INTRODUCTION: There is an increased risk of hazardous alcohol use following metabolic and bariatric surgery (MBS). Identifying risk factors of hazardous alcohol use, particularly factors that may differentiate risk among those with regular postoperative alcohol consumption, would inform postoperative monitoring.

METHOD: Participants (N = 100) who were up to 5 years post-MBS and were consuming alcohol at least 2-3 times per month completed an assessment as part of a larger study. Measures assessed hazardous alcohol use, drinking motives, psychiatric symptoms, and disordered eating behaviors.

RESULTS: Participants were primarily female (87.0%), White (49.0%) or Black (44.0%), with a mean age of 48 years. Approximately 1 in 5 met the threshold for hazardous alcohol use. In bivariate analyses, clinically significant symptoms of depression (OR = 4.88, p = .01) and anxiety (OR = 8.21, p < .001) were associated with the presence of hazardous alcohol use. All four types of drinking motives were associated with greater likelihood of hazardous alcohol use: social (OR = 1.10, p = .03), coping (OR = 1.33, p < .001), enhancement (OR = 1.24, p < .001), and conformity (OR = 1.25, p = .01). Emotional eating scores and the presence of a food addiction were not significantly associated with hazardous alcohol use (p > .05). In a multivariable analysis, only the coping drinking motive remained statistically significant (OR = 1.26, p = .003).

CONCLUSION: Drinking to cope with negative emotions may be a factor associated with increased risk of hazardous drinking among individuals who regularly consume alcohol after MBS. Interventions aimed at improving coping strategies could mitigate risk of hazardous alcohol use.

PMID:42576078 | DOI:10.1007/s00464-026-13270-x

Eur J Nucl Med Mol Imaging. 2026 Aug 11. doi: 10.1007/s00259-026-08079-8. Online ahead of print.

ABSTRACT

PURPOSE: The DOSISPHERE-01 study demonstrated a survival benefit for patients treated with ⁹⁰Y radioembolization using personalised [^99mTc]Tc-MAA guided versus standard dosimetry guided treatment. This ancillary analysis complements DOSISPHERE-01 by reporting post-treatment dosimetry and assessing agreement between predictive ([^99mTc]Tc-MAA) and post-treatment (⁹⁰Y) absorbed doses.

MATERIALS AND METHODS: All DOSISPHERE-01 patients with both pre-treatment [^99mTc]Tc-MAA SPECT/CT and post-treatment ⁹⁰Y imaging were eligible. Multicompartment dosimetry was performed using two segmentation methods: anatomic (MRI/CT) and count-threshold based (SPECT). Mean normal liver tissue and index-lesion absorbed dose, and dose volume histogram (DVH) metrics were determined using Simplicit⁹⁰Y (Mirada Medical, Oxford UK). Agreement between [^99mTc]Tc-MAA and ⁹⁰Y absorbed doses was assessed via Bland-Altman and paired-sample analysis, with correlation assessed via linear-regression.

RESULTS: Thirty-seven patients were included: 19 from the personalised arm and 18 from the standard dosimetry arm. Pre- and post-treatment absorbed dose differences were not statistically significant for the index lesion (241 Gy vs. 229 Gy, p = 0.15; mean difference 11.9 Gy; 95% LoA – 84.3 to 108.2 Gy), Perfused Volume Normal Liver Tissue (PVNT) (91 Gy vs. 99 Gy, p = 0.14; mean difference – 8.2 Gy; 95% LoA – 71.6 to 55.1 Gy), or DVH metrics (V200, D70, D50) using anatomic segmentation. Corresponding metrics were significantly different using count-threshold segmentation (p < 0.05). For both methods, pre- and post-treatment mean index lesion and PVNT absorbed doses, and V200, D70, D50 were strongly correlated (Pearsons Correlation Coefficient > 0.65, p < 0.05).

CONCLUSION: ⁹⁰Y absorbed dose outcomes in the DOSISPHERE-01 study corresponded closely with [^99mTc]Tc-MAA predictive dosimetry, confirming the validity of [^99mTc]Tc-MAA for dosimetry-based treatment planning in this clinical scenario. Agreement was maximised using anatomic segmentation.

PMID:42576071 | DOI:10.1007/s00259-026-08079-8

Aesthetic Plast Surg. 2026 Aug 10. doi: 10.1007/s00266-026-06211-5. Online ahead of print.

ABSTRACT

OBJECTIVE: This article aims to evaluate the application value of augmented reality (AR)-assisted surgical navigation in perpendicular plate of ethmoid bone (PPE) resection teaching, assessing the extent to which AR improves medical trainees’ mastery of PPE anatomical localization and surgical navigation, and providing a standardized training method.

METHODS: PPE osteotomy lines were designed and integrated into an AR navigation system that superimposes virtual guidance onto the surgical field using HoloLens 2 AR glasses. Ten participants (five clinical medical students and five non-clinical students) were instructed to localize five anatomical points on the PPE of eight cranial models, both manually and with AR guidance. Teaching effect was evaluated via statistical analysis of localization accuracy and operation time.

RESULTS: AR-assisted navigation significantly improved the accuracy of the safety harvesting area points of PPE localization in both groups. Clinical group trainees demonstrated higher accuracy than non-clinical group trainees, both when using AR and not using AR. However, AR guidance prolonged annotation time due to participants reassessing anatomical landmarks. Point E consistently exhibited the greatest deviation, suggesting that it is a critical anatomical landmark during PPE harvest.

CONCLUSION: Integrating AR technology into simulated PPE resection training may enhance trainees’ spatial positioning accuracy and reduce experience-related variability. While current limitations exist in projection alignment and system fidelity, AR serves as a feasible auxiliary educational tool for PPE resection. As a preliminary simulation study, it provides a technical foundation for trainees to master complex landmarks prior to clinical practice.

LEVEL OF EVIDENCE V: Experimental simulation study: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

PMID:42576063 | DOI:10.1007/s00266-026-06211-5

Aesthetic Plast Surg. 2026 Aug 10. doi: 10.1007/s00266-026-06199-y. Online ahead of print.

ABSTRACT

BACKGROUND: Hairline lowering (HALO) surgery is commonly performed using either a single anterior incision (AI) placed along the hairline or an anterior incision combined with bilateral extensions (BE) oriented anteroposteriorly along the superior temporal lines. The biomechanical implications of these incision designs remain insufficiently defined.

METHODS: Cadaveric dissections were performed on five heads. After placement of an AI and subgaleal release, maximal scalp advancement was measured in the midline and along both mid-pupillary lines. Subsequently, bilateral extensions were added, together with additional posterior subgaleal dissection and one additional galeotomy, and measurements were repeated. Statistical analysis compared advancement achieved with each incision design.

RESULTS: The BE design demonstrated greater scalp advancement at all measurement points compared with the AI design. Midline advancement increased by 21% (P = 0.043), right mid-pupillary advancement by 24.29% (P = 0.048), and left mid-pupillary advancement by 28.15% (P = 0.048). The most pronounced qualitative difference was observed at the lateral endpoints of the hairline, where BE allowed substantially greater advancement than AI; however, this observation was not quantitatively measured.

CONCLUSIONS: This cadaveric study provides preliminary anatomical evidence suggesting that the BE incision design may allow greater scalp advancement than the AI technique, particularly at the lateral hairline endpoints. These findings should be interpreted with caution given the small sample size and the presence of additional release maneuvers in the BE group. Further clinical studies are warranted to validate these anatomical observations.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:42576061 | DOI:10.1007/s00266-026-06199-y