Tag: pubmed

J Gastrointestin Liver Dis. 2026 Jul 20. doi: 10.15403/jgld-7495. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) requires reliable non-invasive biomarkers to monitor mucosal healing, systemic inflammation, and gut-liver axis involvement. This study evaluated the diagnostic potential of accessible clinical parameters, including fecal calprotectin (FC), hemogram-derived ratios, and composite albumin-integrating and liver fibrosis scores, alongside standardized endoscopic severity findings.

METHODS: This retrospective observational study included 36 adult IBD patients [21 with Crohn’s disease (CD), 15 with ulcerative colitis (UC) receiving biological therapy. Systemic inflammatory indices [e.g., neutrophil-lymphocyte ratio (NLR)], nutritional scores [e.g. prognostic nutritional index (PNI)], and hepatic fibrosis scores [e.g. aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 (FIB-4), platelet-albumin-bilirubin (PALBI)] were assessed. Receiver operating characteristic (ROC) curve analysis evaluated the diagnostic performance, reported as area under the curve (AUC), of these biomarkers.

RESULTS: Routine laboratory parameters and non-invasive liver fibrosis indices showed no statistically significant differences between CD and UC patients. Biologic treatment initiation differed significantly between the groups (p<0.001). Endoscopically, CD presented marked phenotypic heterogeneity with predominantly ileocolonic involvement, whereas active UC was characterized mainly by pancolitis. Fecal calprotectin concentrations were notably higher in UC (median 1000 μg/g) compared to CD (310 μg/g). Diagnostically, FC demonstrated the highest predictive capacity for differentiating the conditions (AUC=0.74). Furthermore, albumin-integrating scores, specifically the PALBI score (AUC = 0.686) and PNI (AUC = 0.657), alongside NLR (AUC=0.632), outperformed traditional hepatic indices in capturing the systemic inflammatory toll. Complex composite inflammatory formulas unexpectedly underperformed.

CONCLUSIONS: FC remains the most robust non-invasive marker for localized mucosal inflammation. Albumin-integrating scores and simple hemogram-derived ratios better reflect the systemic inflammatory burden than pure hepatic fibrosis indices, but their moderate diagnostic accuracies preclude independent clinical application. Effective IBD management requires integrating these non-invasive adjunctive tools with standard endoscopic assessments within a personalized, multiparametric framework.

PMID:42550963 | DOI:10.15403/jgld-7495

JMIR AI. 2026 Aug 4;5:e78485. doi: 10.2196/78485.

ABSTRACT

BACKGROUND: Patient-reported outcome measures (PROMs) are central to multinational clinical research, but high-quality translation and linguistic validation remain resource-intensive. AI-powered translation may accelerate this process, but its performance relative to validated human PROM translations requires systematic evaluation.

OBJECTIVE: This benchmarking study evaluated the quality and comparability of 4 AI-powered translation services for the EuroQol 5-dimension 5-level (EQ-5D-5L) across 5 target languages, using official, linguistically validated human translations as the reference standard (gold standard).

METHODS: The 43 text segments of the EQ-5D-5L were translated from English into Danish, Dutch, French, German, and Spanish using Google Translate, GPT-4.1, Amazon Translate, and DeepL. GPT-4.1 was evaluated with a structured medical-translator prompt, whereas Google Translate, Amazon Translate, and DeepL were evaluated using standard unprompted application programming interfaces without domain-specific glossary constraints. Outputs were benchmarked against official, validated human translations using 4 automated metrics: BLEU (bilingual evaluation understudy), METEOR (metric for evaluation of translation with explicit ordering), COMET (cross-lingual optimized metric for evaluation of translation), and BLEURT (bilingual evaluation understudy with representations from transformers). Friedman tests were used to assess overall between-service differences within each metric-language combination. When the Friedman test was significant, paired Wilcoxon signed-rank post hoc tests with Holm-Bonferroni correction were conducted. Descriptive summaries, score distributions, and sentence-level hotspot analyses were used to evaluate semantic similarity patterns and identify localized low-scoring deviations.

RESULTS: Friedman tests assessed whether the AI services differed in performance, whereas descriptive summaries and visualizations were used to determine whether scores clustered in ranges consistent with strong semantic similarity to the gold standard. Friedman tests identified statistically significant between-service differences in 11 of the 20 (55%; P<.05) metric-language combinations. Subsequent paired Wilcoxon signed-rank post hoc tests with Holm-Bonferroni correction identified 11 significant pairwise differences, with adjusted P values ranging from <.001 to .049. Most of these differences were detected by surface-overlap metrics (10/11 for BLEU or METEOR), whereas only 1 of 11 was detected by a semantic metric (BLEURT), suggesting that many between-service differences were stylistic rather than meaning-altering. Descriptive and visual analyses further showed that semantic similarity was generally high across services, while low-scoring deviations clustered in specific linguistic hotspots, particularly domain headers, abstract health concepts, and short, context-dependent interface strings.

CONCLUSIONS: Among the evaluated high-resource European languages, AI translation services showed high semantic similarity to the validated human translations, although localized conceptual deviations persisted. These findings suggest that AI can support the generation of translations for PROM workflows in these languages; however, expert human review may still be required to confirm conceptual equivalence. The practical relevance of isolated header differences could not be assessed in the present study, whereas abstract health concepts and other clinically sensitive phrasing should be evaluated in further research.

PMID:42550950 | DOI:10.2196/78485

Am J Speech Lang Pathol. 2026 Aug 4:1-24. doi: 10.1044/2026_AJSLP-25-00321. Online ahead of print.

ABSTRACT

PURPOSE: This study examined whether systemic and experiential factors predict overall job satisfaction among speech-language pathology assistants (SLPAs) and supervising speech-language pathologists (SLPs). Specifically, the study explored the influence of state regulation category, years of experience, and supervision practices on satisfaction in both roles.

METHOD: Participants included 68 professionals (38 SLPAs, 30 SLPs) recruited through professional networks and social media. Ordinal logistic regression was used to identify predictors of satisfaction. SLPA satisfaction was analyzed in relation to years of experience, state regulation category, and monthly hours of direct supervision. SLP satisfaction was examined in relation to state regulation category and perceptions of SLPA impact on workload and caseload.

RESULTS: Among SLPAs, years of experience significantly predicted overall job satisfaction, with greater experience associated with higher odds of satisfaction. Hours of direct supervision per month did not significantly predict overall satisfaction but were positively associated with satisfaction regarding the quantity of supervision received. Supervisory practices varied in frequency, with limited opportunities reported for observation and feedback on therapy material selection. Among SLPs, no statistically significant predictors of job satisfaction were identified. Perceptions of SLPA impact on workload and caseload were divided.

CONCLUSIONS: Findings highlight the role of experience and supervision in shaping SLPA satisfaction, particularly during early career stages. Although supervision time was not linked to overall satisfaction, it was associated with perceptions of supervisory adequacy. For supervising SLPs, satisfaction may be influenced by factors beyond those examined in this study. Implications for training, supervision practices, and systemic support are discussed. Given the modest effect sizes and small sample, these findings should be interpreted as preliminary and exploratory.

PMID:42550947 | DOI:10.1044/2026_AJSLP-25-00321

South Med J. 2026 Aug 3;119(8):500-503. doi: 10.14423/SMJ.0000000000001996.

ABSTRACT

OBJECTIVES: Using the most recent US population projections data, we sought to update the estimated number of women who will undergo surgery for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in the United States from 2025 through 2060. We hypothesize that the number of pelvic floor surgeries will increase in the upcoming decades.

METHODS: We used the 2017 National Population Projections from the US Census Bureau, which provides age-specific estimates on the number of women in the US from 2025 to 2060. We used previously published age-specific rates of surgery for women undergoing SUI-only surgery, POP-only surgery, and either SUI or POP surgery. These rates were applied to the population estimates of women aged 18 to 89 years to determine the projected surgeries from 2025 to 2060 in 5-year increments.

RESULTS: From 2025 to 2060, the population of women in the United Sates ages 18 to 89 years is projected to increase 17%, from 136.0 million to 158.5 million. Correspondingly, the total number of either SUI or POP surgeries will increase from 469,460 in 2025 to 553,858 in 2060.

CONCLUSIONS: From 2025 to 2060, there will be an 18% increase in the projected number of surgeries for SUI or POP, from 469,460 to 553,858. Our field should be proactive in ensuring that enough specialists and fellowship-trained subspecialists are available to meet the future surgical demands of women with pelvic floor disorders.

PMID:42550940 | DOI:10.14423/SMJ.0000000000001996

J Magn Reson Imaging. 2026 Aug 4. doi: 10.1002/jmri.70476. Online ahead of print.

ABSTRACT

BACKGROUND: Photodynamic microenvironment-modulating therapy (PMMT) represents a promising strategy for nasopharyngeal carcinoma (NPC). However, early assessment of therapeutic response remains challenging.

PURPOSE: To evaluate whether intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and blood oxygen level-dependent functional MRI (BOLD-fMRI) can noninvasively detect early responses to PMMT in an NPC xenograft model.

STUDY TYPE: Experimental, animal model.

ANIMAL MODEL: Subcutaneous 5-8F NPC xenograft model (110 female BALB/c nude mice).

FIELD STRENGTH/SEQUENCE: 3.0 T, T2WI FSE sequence, IVIM-DWI single-shot echo-planar imaging sequence, and BOLD-fMRI SPGR sequence.

ASSESSMENT: Following tumor establishment, mice were randomly assigned to five treatment groups: PBS, NH₂-MIL-101(Fe), PPa@NH₂-MIL-101(Fe) + near-infrared (P@MIL+NIR), Doxy@NH₂-MIL-101(Fe) (D@MIL), and PPa + Doxy@NH₂-MIL-101(Fe) + NIR (PD@MIL+NIR). IVIM-DWI (D and f) and BOLD-fMRI (R²*) were acquired before and after treatment to assess changes in tumor microstructure, perfusion, and oxygenation. The proliferation, apoptosis, angiogenesis, and hypoxia of NPC tumor were evaluated by Ki-67 immunofluorescence staining, TUNEL immunofluorescence staining, VEGF immunohistochemical staining, and HIF-1α immunohistochemical staining.

STATISTICAL TESTS: One-way ANOVA, the intraclass correlation coefficient (ICC), Pearson’s correlation analysis, and the Least Significant Difference (LSD) test for post hoc pairwise comparisons, p value < 0.05 was considered significant.

RESULTS: Good and excellent agreements between two evaluators can be seen (The range of ICCs was from 0.864 to 0.985). In P@MIL+NIR, D@MIL, and PD@MIL+NIR groups, D and f values initially decreased and then increased, while R²* values peaked at 0.5 h (63.20 ± 2.57, 61.62 ± 0.98, and 67.38 ± 1.37) and gradually declined. D, f, and R²* values were significantly correlated with the histological staining results.

DATA CONCLUSION: The combination of IVIM-DWI and BOLD-fMRI could be used in monitoring the early therapeutic responses to PD@MIL-based PMMT in NPC.

EVIDENCE LEVEL: 1.

TECHNICAL EFFICACY: Stage 1.

PMID:42550581 | DOI:10.1002/jmri.70476

Intern Med J. 2026 Aug 4. doi: 10.1111/imj.70583. Online ahead of print.

ABSTRACT

BACKGROUND: Systemic anticancer therapy (SACT) near the end of life can contribute to significant patient morbidity and mortality in an already vulnerable population. There are variable rates of SACT use within 30 days of death in Australia, including immunotherapy (IO).

AIMS: To assess the characteristics of medical oncology patients who died within 30 days of SACT and 30 or 90 days of IO and identify factors associated with treatment-related mortality (TRM).

METHODS: Retrospective study of 2948 medical oncology patients at a tertiary metropolitan hospital, between 1 January 2019 and 31 December 2023, who received intravenous or subcutaneous SACT within 30 days of death, and a subgroup who received IO within 90 days of death. Demographic, oncological and mortality-related data were collected. Descriptive statistics and univariable logistic regression analyses were used.

RESULTS: Overall, 170 (5.8%) patients died within 30 days of receiving SACT. Thirty-seven (22%) deaths were attributed to treatment-related complications. Pre-treatment Eastern Co-operative Group Score 0-1 (odds ratio (OR) = 2.43, P = 0.03, 95% confidence interval (CI) 1.08-5.49) or chemotherapy administration (OR = 20.3, P < 0.001, 95% CI 4.58-89.97) were associated with TRM within 30 days of SACT. A total of 855 patients received IO containing regimens, of which 61 (7.1%) died within 30 days and 139 (16.3%) died within 90 days.

CONCLUSION: The proportion of patients who died within 30 days of SACT was comparable to that of previous Australian studies. TRM was associated with good pre-treatment performance status or chemotherapy administration. Prospective research should examine IO use at the end of life and evaluate optimal patient selection for SACT in larger Australian cohorts.

PMID:42550571 | DOI:10.1111/imj.70583

J Magn Reson Imaging. 2026 Aug 4. doi: 10.1002/jmri.70398. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with multivessel disease (MVD) after acute myocardial infarction (AMI) have worse outcomes than those with single-vessel disease (SVD), but whether MVD is associated with diffuse myocardial injury beyond the infarct zone (IZ) remains unclear.

PURPOSE: To characterize infarct-related and remote myocardial tissue properties using cardiac MRI in patients with MVD compared with SVD after AMI, and to explore differences according to revascularization completeness.

STUDY TYPE: Retrospective.

POPULATION: Two hundred and twenty-four patients with AMI who underwent MRI within 31-90 days after percutaneous coronary intervention (90 SVD, 42 MVD with complete revascularization [CR], and 92 MVD with incomplete revascularization [IR]).

FIELD STRENGTH/SEQUENCES: 3.0 T; balanced steady-state free precession cine, phase-sensitive inversion recovery late gadolinium enhancement (LGE), modified Look-Locker (pre- and post-contrast T1-mapping), and gradient and spin echo (T2-mapping) sequences.

ASSESSMENT: Left ventricular volumes and function (cine), infarct size (LGE), and myocardial tissue parameters (native T1 and extracellular volume [ECV], and T2) were quantified in IZ, peri-infarct zone (PIZ), and remote zone (RZ) using standardized methods.

STATISTICAL TESTS: Group comparisons used Student’s t-test or Mann-Whitney U test for continuous variables and χ² or Fisher exact test for categorical variables. Adjusted comparisons of myocardial tissue parameters between coronary disease groups were performed using multivariable logistic regression models including relevant clinical covariates and infarct size. A p value < 0.05 was considered significant.

RESULTS: Compared with SVD, MVD showed larger infarct size (p < 0.001), and higher native T1, ECV, and T2 values in PIZ (p = 0.034, 0.004, 0.005) and RZ (p = 0.041, < 0.001, < 0.001). After adjustment for clinical covariates (age, diabetes, hyperlipidemia, BMI) and infarct size, these differences in RZ remained significant. Among patients with MVD, infarct size and ventricular function did not differ between CR and IR groups (p = 0.661, 0.494, 0.857). However, MVD-IR was associated with significantly higher ECV-PIZ (p = 0.023), ECV-RZ (p = 0.025) and T2-RZ (p = 0.003).

DATA CONCLUSIONS: In AMI, MVD was associated with diffuse myocardial injury extending beyond the IZ. Differences related to revascularization completeness predominantly involved non-infarct myocardium.

TECHNICAL EFFICACY: Stage 2.

PMID:42550547 | DOI:10.1002/jmri.70398

Pain Physician. 2026 Jul;29(5):E443.

NO ABSTRACT

PMID:42550540

Pain Physician. 2026 Jul;29(5):E407-E416.

ABSTRACT

BACKGROUND: Fibromyalgia (FM) has been increasingly studied in the context of gut-brain-immune interactions, and several reports have suggested an association between FM and alterations in gut or oral microbial communities. However, prior studies have often suffered from heterogeneous comorbidities, inconsistent sampling procedures, and limited control for environmental factors, making it unclear whether FM is associated with a reproducible, site-independent microbial signature.

OBJECTIVES: To determine whether women with FM exhibit consistent alterations in gut or oral microbiota when evaluated under strictly standardized physiological, clinical, and environmental conditions.

STUDY DESIGN: A prospective, observational, case-control study.

SETTING: The Department of Pain Medicine and Department of Medical Microbiology at Gazi University, Türkiye.

METHODS: The patient selection comprised 31 women (16 with FM; 15 healthy controls) who met rigorous inclusion and exclusion criteria, minimizing confounding from diet, metabolic disease, medications, hormonal status, and recent infections. No therapeutic intervention was performed; all patients provided paired oral mucosal and fecal samples during the follicular phase of the menstrual cycle. Sequencing of 16S rRNA V3-V4was performed on DNA extracted from all samples. Alpha and beta diversity metrics, taxonomic profiles, and differential abundance analyses (including LEfSe with FDR correction) were compared between groups. The clinical severity of FM was assessed using scores on the visual analog scale (VAS), Widespread Pain Index (WPI), and Symptom Severity Scale (SSS).

RESULTS: No statistically significant differences were observed between FM patients and controls in fecal or oral alpha diversity (Shannon, Simpson, Chao1, Observed OTU indices, all P > 0.05). Beta diversity analyses (Bray-Curtis PERMANOVA) revealed no between-group separation in either compartment (fecal R² = 0.032, P = 0.529; oral R² = 0.032, P = 0.464). Both groups displayed preserved core microbial communities in the gut, dominated by Firmicutes and Bacteroidota and, in the oral cavity, Streptococcus-enriched profiles. Minor genus-level variations were detected, but none remained significant after FDR correction. Cross-site analyses confirmed the expected ecological divergence between oral and fecal habitats but identified no FM-specific microbial pattern. Post hoc sensitivity analysis indicated that the study was powered to detect only moderate effect sizes (R² ≥ 0.11), suggesting that subtle differences might have remained undetected.

LIMITATIONS: A modest sample size, a lack of quantitative dietary assessment, and reliance on 16S rRNA sequencing limited the detection of subtle or functional microbial alterations. Additionally, the cross-sectional design precludes causal inference.

CONCLUSIONS: Under highly controlled sampling and exclusion conditions, FM was not associated with detectable alterations in the diversity or composition of gut or oral microbes. These findings suggest that previously reported dysbiosis may reflect comorbidity-driven or phenotype-specific variation rather than a universal microbial hallmark. Larger, multi-omic and phenotype-stratified studies are needed to clarify functional host-microbiome interactions in FM.

PMID:42550534

Pain Physician. 2026 Jul;29(5):335-343.

ABSTRACT

BACKGROUND: Fibromyalgia (FM) is a chronic condition characterized by widespread pain and a range of somatic and psychological symptoms that impose a substantial burden on patients. While pregabalin is an approved and effective monotherapy for many individuals with FM, the efficacy of this medication is often incomplete, particularly for symptoms like fatigue and anxiety. Combination therapy incorporating selective serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine, has shown promise for enhancing therapeutic outcomes. Venlafaxine, an SNRI with demonstrated efficacy as an FM treatment, has a distinct pharmacological mechanism from pregabalin. However, the synergistic potential of pregabalin and venlafaxine in combination has not been formally evaluated.

OBJECTIVES: This study protocol describes a trial designed to test the hypothesis that the combination of pregabalin and venlafaxine is superior to pregabalin monotherapy in providing pain relief to patients with FM.

STUDY DESIGN: This is a multicenter, prospective, randomized, open-label, blinded-endpoint study.

SETTING: This study will be conducted at 7 different hospitals.

METHODS: We will recruit 750 adults with a diagnosis of FM and moderate-to-severe pain. Patients will be randomly assigned in a one-to-one ratio to receive either pregabalin monotherapy or combination therapy consisting of pregabalin and venlafaxine for 12 weeks. Both groups will follow a flexible, forced-titration schedule to achieve the maximum tolerated dose. While the patients and treating physicians will be aware of the treatment allocation, the outcome assessors will remain blinded.

RESULTS: The primary outcome is the mean daily pain intensity at week 4, measured on an 11-point numeric rating scale. Secondary outcomes will be evaluated at baseline and at weeks one, 2, 4, 8, and 12 after the treatment initiation. Secondary outcomes include the worst pain intensity, the responder rates (≥ 30% and ≥ 50% pain reduction), the dose of pregabalin and/or venlafaxine, the Revised FM Impact Questionnaire, the Brief Pain Inventory severity and interference subscales, the 36-Item Short Form Survey (SF-36), the Medical Outcomes Study Sleep Scale, the Beck Depression Inventory-II, and adverse events (AEs) occuring throughout the study. Statistical analyses will be performed on the modified intention-to-treat population.

LIMITATIONS: An open-label design will be employed, with patient follow-up limited to 12 weeks.

CONCLUSION: If the combination of pregabalin and venlafaxine proves to be more effective and better tolerated than pregabalin monotherapy, the combination therapy could establish a new standard of care for FM patients who struggle to achieve sufficient pain relief through nonpharmacological therapies.

PMID:42550524