Tag: pubmed

Ultrasound Med Biol. 2026 Aug 8:S0301-5629(26)00287-5. doi: 10.1016/j.ultrasmedbio.2026.07.013. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the value of Microvascular Flow (MV-Flow) vascular pattern and quantitative parameter vascular index (VI) in differentiating benign from malignant lymph nodes.

METHODS: A total of ninety-five patients who underwent ultrasound-guided lymph node aspiration biopsy at the First Hospital of Sun Yat-sen University between February 2023 and September 2023 were prospectively enrolled. Conventional ultrasound and MV-Flow examinations were performed, and the diagnostic efficacy was analyzed. The influencing factors of the VI were investigated.

RESULTS: Among grayscale features, lymph node hilum, shape, liquefaction, and calcification differed significantly between benign and malignant nodes (p < 0.05). In the vascular pattern of Color Doppler Flow Imaging (CDFI) and MV-Flow, benign nodes mainly showed hilar flow, while malignant nodes mainly showed mixed flow (p < 0.05 for both). MV-Flow and CDFI demonstrated comparable overall diagnostic performance (AUC: 0.682 vs. 0.646), with no statistically significant difference (p > 0.05). MV-Flow vascular pattern classification showed good interobserver agreement (κ = 0.801), and the vascular index (VI) demonstrated high reliability (ICC = 0.811). A moderate negative correlation was observed between lymph node depth and VI across all four sections.

CONCLUSIONS: MV-Flow provided superior qualitative visualization of microvascular flow compared to CDFI, but this did not translate into a statistically significant improvement in quantitative diagnostic performance for differentiating benign from malignant lymph nodes. Therefore, it should serve as a secondary diagnostic adjunct for lymph nodes with indeterminate CDFI findings, particularly to microvascular architecture that traditional Doppler fails to detect.

PMID:42570926 | DOI:10.1016/j.ultrasmedbio.2026.07.013

Acad Radiol. 2026 Aug 8:S1076-6332(26)00557-X. doi: 10.1016/j.acra.2026.07.049. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: To compare an integrated “Plaque-Vessel” high-resolution vessel wall imaging (HR-VWI) radiomics model against a “Plaque-only” model for predicting 1-year adverse clinical events in symptomatic intracranial atherosclerotic stenosis (ICAS).

MATERIALS AND METHODS: This retrospective study enrolled 272 symptomatic ICAS patients. A temporal split was applied: patients from 2022 (n = 133) constituted the training and validation cohorts, while those from 2023 (n = 139) served as an independent temporal test cohort. Radiomic features were extracted from T1-weighted and contrast-enhanced T1-weighted HR-VWI. Two signatures were constructed: a “Plaque” model (plaque ROI only) and a “Plaque-Vessel” model (incorporating plaque, vessel wall, and lumen). The primary endpoint was a composite of 1-year adverse clinical events. Performance was assessed using the area under the curve (AUC) and decision curve analysis (DCA), comparing against a qualitative imaging model (comprising intraplaque hemorrhage, plaque enhancement, and positive remodeling), the Essen Stroke Risk Score (ESRS), and NIHSS.

RESULTS: The Plaque-Vessel model yielded the highest predictive performance, achieving an AUC of 0.800 (95% CI: 0.724-0.863) in the temporal test set. This performance showed a trend toward improvement compared to the Plaque-only model (AUC = 0.721, P = .27) and significantly outperformed the qualitative plaque features model (AUC = 0.631, P = .03), ESRS (AUC = 0.554, P < .01), and NIHSS (AUC = 0.543, P < .01). Calibration curves showed good agreement. DCA demonstrated that the Plaque-Vessel signature provided greater net clinical benefit than the Plaque-only model or clinical scores across the majority of threshold probabilities.

CONCLUSION: The integrated Plaque-Vessel radiomics model significantly outperforms conventional clinical scores and routine visual plaque assessment for predicting 1-year adverse events. However, given the inconclusive statistical difference between the integrated and plaque-only models, these findings remain exploratory. The model requires further large-scale validation before it can be considered ready to guide routine clinical decisions.

PMID:42570909 | DOI:10.1016/j.acra.2026.07.049

Acad Radiol. 2026 Aug 8:S1076-6332(26)00572-6. doi: 10.1016/j.acra.2026.07.067. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Crohn’s disease (CD) is often associated with sleep disturbances through poorly understood mechanisms. The glymphatic-related perivascular clearance system may provide a potential link via the gut-brain axis. This study investigated noninvasive diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) in patients with CD and its correlations with intestinal inflammation and sleep quality. MATERIALS AND METHODS: This study enrolled 90 patients with CD (45 active, 45 in remission) and 50 healthy controls (HC). All subjects underwent comprehensive clinical screening, sleep evaluation using the Pittsburgh Sleep Quality Index, and 3T magnetic resonance imaging with DTI for ALPS index quantification. Patients with CD additionally provided stool samples for fecal calprotectin to assess levels of intestinal inflammation.

RESULTS: Patients with CD demonstrated significantly reduced ALPS index compared to HC (P < 0.001), particularly in the active disease state. The ALPS index exhibited moderate diagnostic utility in distinguishing active from remitted CD (area under the curve = 0.785, 95% confidence interval: 0.688-0.883). Partial correlation analysis revealed a significantly negative correlation between the ALPS index and both inflammatory markers and poor sleep quality. Mediation analysis revealed that reduced ALPS statistically accounted for 25.22% of the association between intestinal inflammation and sleep disturbances.

CONCLUSION: Reduced periventricular diffusivity assessed by DTI-ALPS is associated with both intestinal inflammation and sleep disturbances in CD, statistically accounting for a modest proportion of their association. These cross-sectional findings suggest a potential gut-brain perivascular pathway connection that requires prospective validation.

PMID:42570907 | DOI:10.1016/j.acra.2026.07.067

J Prosthet Dent. 2026 Aug 8:S0022-3913(26)00518-4. doi: 10.1016/j.prosdent.2026.07.015. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Three-dimensional (3D) facial scanning has been increasingly integrated into digital dental workflows. Smartphone-based 3D facial scanning applications offer an accessible alternative to professional extraoral scanners; however, their metric validity for clinically relevant facial measurements remains unclear.

PURPOSE: The purpose of this retrospective clinical study was to determine whether linear facial measurements obtained from smartphone-based 3D facial scanning applications were statistically equivalent to those obtained from professional extraoral facial scanners.

MATERIAL AND METHODS: Facial scans from 23 participants, obtained via repeated scanning with smartphone-based scanners (Qlone, Magiscan, 3D App Scanner, on iPhone 13 Pro; Apple Inc) and professional scanners (Artec Spider; Artec, EinStar; Shining 3D), were retrospectively analyzed. Four facial distances (trichion-nasion, nasion-pronasion, pronasion-pogonion, and right zygomatic-left zygomatic) were measured on all scans. The equivalence of these distances between smartphone-based scanners and each professional scanner was assessed using the two 1-sided t tests (TOST) procedure with a predefined equivalence margin of ±1 mm and Bonferroni-adjusted significance levels.

RESULTS: Across all distances, smartphone-based and professional scanners were statistically equivalent, with absolute mean differences below 0.12 mm (90% confidence interval: -0.03 to 0.26; P<.001 for all comparisons).

CONCLUSIONS: Smartphone-based 3D facial scanning applications provided linear facial measurements that were statistically equivalent to those obtained from professional extraoral scanners for selected distances. These applications may be considered valid for targeted clinical applications in dentistry and as complementary tools within digital workflows.

PMID:42570899 | DOI:10.1016/j.prosdent.2026.07.015

Eur Urol Oncol. 2026 Aug 8:S2588-9311(26)00215-4. doi: 10.1016/j.euo.2026.07.015. Online ahead of print.

ABSTRACT

BACKGROUND: Erectile dysfunction remains a major morbidity after radical prostatectomy. The SAFE technique uses real-time, micro-ultrasound-guided low-pressure hydrodissection to enable atraumatic nerve sparing.

OBJECTIVE: We compared functional and oncologic outcomes of SAFE versus standard robotic-assisted radical prostatectomy (RARP).

DESIGN, SETTING, AND PARTICIPANTS: In this randomized trial, patients were assigned 1:1 to micro-ultrasound-guided SAFE-RARP or standard RARP. Surgeons were unblinded; patients and outcome assessors were blinded.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoint was erectile function recovery at 6 mo (SHIM ≥17), with secondary functional and oncologic outcomes. The primary endpoint was assessed at the prespecified interim analysis using a one-sided pooled z-test within a group-sequential O’Brien-Fleming α-spending framework (interim efficacy boundary, one-sided p < 0.002).

RESULTS AND LIMITATIONS: A total of 107 patients were analyzed (SAFE, n = 54; control, n = 53). At 6 mo, erectile function recovery was higher with SAFE than with standard RARP (52% vs 43%; absolute difference 8.5%, 95% CI -10% to 27%; one-sided p = 0.22), without crossing the prespecified interim efficacy boundary. At 6 weeks, early recovery rates were higher with SAFE (37% vs 21%; one-sided p = 0.032), with a smaller difference at 3 mo. Linear mixed-effects modeling showed earlier improvement in SHIM with SAFE, with convergence by 6 mo. Continence, oncologic outcomes, and complication rates were similar between groups. Limitations include the prespecified interim nature of the analysis, the relatively small sample size, and the need for longer follow-up to determine the durability and clinical significance of functional differences.

CONCLUSIONS: In this prespecified interim analysis, the primary endpoint of 6-mo recovery was not met. Exploratory analyses suggested earlier postoperative recovery with SAFE, without evidence of compromised safety or oncologic outcomes; these findings are hypothesis-generating.

PMID:42570880 | DOI:10.1016/j.euo.2026.07.015

Am J Clin Nutr. 2026 Aug 8:101462. doi: 10.1016/j.ajcnut.2026.101462. Online ahead of print.

ABSTRACT

BACKGROUND: The potential cardiac toxicity of glutamate is debated and has been suggested by some epidemiological and experimental studies. To our knowledge, none investigated the links between both naturally occurring and food additive glutamate and cardiovascular disease (CVD) risk.

OBJECTIVE: Our objective was to assess the associations between intakes of total, food additive and naturally occurring glutamate, and the risk of CVD, including cerebrovascular (CVA) and coronary heart (CHD) diseases, in a large population-based study.

METHODS: Participants (n= 108,932, NutriNet-Santé prospective cohort, 2009-2023, France, mean age=42.4y (SD=14.5), 79.3% females) completed repeated 24h-dietary records (mean = 21 (SD=18), up to 84), including brands of industrial food consumed. Exposure to food additive glutamate was evaluated through multiple composition databases and ad-hoc laboratory assays in food matrices. Associations between time-dependent continuous exposures to total, naturally occurring and food additive glutamate and risk of CVD, CVA, and CHD were investigated using multivariable Cox models.

RESULTS: During follow-up (median=7.92y), 2397 CVD, 1113 CVA, and 1284 CHD cases were diagnosed. Higher intakes of food additive glutamate (Hazard Ratio_{per 200mg/d}=1.05, 95%Confidence Interval (1.01, 1.09), p-value=0.02), naturally occurring glutamic acid (HR_3000mg/d=1.13(1.03, 1.25), p-value=0.009), and total glutamate (HR_3000mg/d=1.15(1.05, 1.26), p-value=0.004) were associated with higher risks of CHD. For CVD, corresponding HRs were 1.03(1.00, 1.06; p-value=0.07), 1.09(1.01, 1.18; p-value=0.02) and 1.10(1.02, 1.18; p-value=0.01). No association was detected for CVA (all p-values≥0.5). Residual confounding cannot be entirely ruled out, and causality cannot be established based on this single observational study.

CONCLUSIONS: This large prospective study showed positive linear associations between higher glutamate intakes and increased risks of CVD. In particular, food additive glutamate, naturally occurring glutamic acid, and total glutamate intakes were all associated with higher CHD risk. This adds to previous experimental data showing a role of glutamate in regulating heart functioning at physiological doses, while also suggesting heart rate dysfunction at higher exposures.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03335644.

PMID:42570865 | DOI:10.1016/j.ajcnut.2026.101462

Orthop Traumatol Surg Res. 2026 Aug 8:104856. doi: 10.1016/j.otsr.2026.104856. Online ahead of print.

ABSTRACT

BACKGROUND: Transtibial pull-out repair is widely used for the treatment of medial meniscus posterior root tears (MMRTs). However, the optimal suture material remains unclear despite differences in biomechanical and biological properties between absorbable and non-absorbable sutures. This study aimed to evaluate whether suture material influences clinical and radiological outcomes after transtibial pull-out repair for MMRTs through a systematic review and meta-analysis.

METHODS: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Eligible studies reporting clinical or radiological outcomes after transtibial pull-out repair for MMRTs were included. Extracted data included patient-reported outcomes, magnetic resonance imaging (MRI)-based meniscal healing, meniscal extrusion, Kellgren-Lawrence (KL) grade progression, and conversion to total knee arthroplasty (TKA). Random-effects meta-analyses and subgroup analyses were performed according to suture absorbability, and meta-regression was used to explore potential sources of heterogeneity.

RESULTS: Sixteen studies encompassing 647 patients were included; these comprised one Level II study, seven Level III studies, and eight Level IV studies. No significant subgroup differences according to suture absorbability were identified for changes in International Knee Documentation Committee score (P = 0.07), Lysholm score (P = 0.43), meniscal extrusion (P = 0.19), MRI-based meniscal healing (P = 0.77), KL grade progression (P = 0.75), or conversion to TKA (P = 0.06). The pooled healing proportions were 0.60 (95% CI, 0.33-0.82) for non-absorbable sutures and 0.68 (95% CI, 0.00-1.00) for absorbable sutures. The corresponding pooled proportions of conversion to TKA were 0.05 (95% CI, 0.00-1.00) and 0.22 (95% CI, 0.10-0.38), respectively.

CONCLUSION: The available evidence did not identify statistically significant differences in clinical or radiological outcomes between absorbable and non-absorbable sutures after transtibial pull-out repair for MMRTs. However, because these findings were derived primarily from indirect comparisons across heterogeneous studies, they should not be interpreted as evidence of equivalence, and the current evidence remains insufficient to determine whether suture absorbability independently influences postoperative outcomes.

LEVEL OF EVIDENCE: IV; systematic review and meta-analysis of Level II-IV studies.

PMID:42570862 | DOI:10.1016/j.otsr.2026.104856

RSC Adv. 2026 Aug 7. doi: 10.1039/d6ra03455a. Online ahead of print.

ABSTRACT

Welfare assessment of housed dairy cattle currently relies on subjective, snapshot-like observations that fail to capture the physiological impacts of the inhabited environment. Metabolomic profiling offers potential for objective welfare assessment, but its application to behavioural interventions remains unexplored. Here, we show that provision of outdoor access to housed dairy cows produces detectable changes in milk metabolite levels and associated pathway signatures, with effects impacted by exposure duration. Using untargeted metabolomics via direct infusion mass spectrometry on 371 samples across five timepoints, we applied univariate analysis and pathway analysis for the identification of fundamental physiological changes. Further analyses comprised stability explorations of machine learning methods alongside Cox-Battey selection, to aid the triangulation of high specificity detection of mass ions. Univariate analysis of the 14 day intervention period (S2-S4) identified 10 statistically significant mass ions (9 decreased, 1 increased; adjusted p < 0.05, FC > 2.0), while no significant ions emerged at early (S2-S3) or post-intervention (S4-S5) timepoints. Functional pathway analysis revealed impacted steroid hormone biosynthesis, pyruvate metabolism, and riboflavin metabolism during intervention, with glycerophospholipid metabolism and branched-chain amino acid pathways altered post-intervention. Machine learning identified discriminant features at all timepoints, with only m/z 621.2404 achieving both univariate significance and machine learning selection. These findings suggest that metabolomic profiling can detect welfare-relevant physiological adaptations to the environment provided to housed dairy cows, with convergent multi-method signals providing the most robust discriminant features for advancing dairy welfare assessment beyond subjective observation.

PMID:42569159 | PMC:PMC13448961 | DOI:10.1039/d6ra03455a

Front Sleep. 2026 Jul 24;5:1876293. doi: 10.3389/frsle.2026.1876293. eCollection 2026.

ABSTRACT

INTRODUCTION: Young Black children experience poorer sleep health than children from other racial/ethnic groups. Tailored family-centered interventions are needed to improve sleep health among young Black children. Tailoring requires information about parent perceptions, practices and context. The purpose of this study was to (1) understand the contextual definition of sleep health for Black families; (2) bedtime routines and sleep practices among Black families; and (3) parent preferences that may inform intervention design.

METHODS: We engaged 30 Black parents of 3-8-year-old children with mild sleep problems (e.g., child takes >30 min to fall asleep at bedtime) in this study. Parents completed three ratings scales about sleep health practices and child bedtime behavior and a semi-structured interview. Statistical analysis included descriptive statistics and correlations. We used an implementation science rapid qualitative analysis approach to analyze qualitative data from the interviews.

RESULTS: The final sample identified as 52% African-American, 14% Jamaican, 10% Haitian, and 26% mixed multi-ethnic groups. Parent mean age was 41 years and child mean age were 5 years old. About 80% of responders were women. About one-third of the sample held a doctoral degree, and half the sample had a bachelor’s or Master’s degree. Parents answered 56% of sleep knowledge questions accurately (ranging from 32 to 100%) and reported an average of two sleep problems. Parents described healthy sleep as involving flexibility in sleep timing and bedtime routines. More than half of parents reported co-sleeping practices, with reasons ranging from a strategy to address night wakings, to a way to preserve bonding. Later child bedtime (after 9 pm) was associated with bedtime resistance, permissive parenting, and parent stress. Many parents reported that they had poor sleep quality and duration.

DISCUSSION: Findings elucidate a range of factors to consider in tailoring sleep health interventions for Black families of young children. These include the common practice of co-sleeping, parents’ value for flexibility related to bedtime and bedtime routines, and parents’ own challenges with getting enough and good quality sleep. Tailored family-centered interventions will benefit from considering these factors.

PMID:42569147 | PMC:PMC13449300 | DOI:10.3389/frsle.2026.1876293

Pol J Radiol. 2026 Jun 30;91:e308-e319. doi: 10.5114/pjr/217693. eCollection 2026.

ABSTRACT

PURPOSE: This study aimed to investigate whether body composition and thoracic morphology parameters could serve as predictors of pneumothorax risk in patients undergoing computed tomography (CT)-guided lung biopsies.

MATERIAL AND METHODS: We retrospectively analyzed 147 percutaneous CT-guided lung biopsies performed between January 2019 and December 2023, categorizing patients into groups with and without pneumothorax. Indirect assessment methods for body composition, including body mass index (BMI) and thoracic morphology parameters, were evaluated alongside confounding factors such as access route (AR) through dependent lung areas (DA), patient demographics, lesion characteristics, and procedural details. Statistical analyses included chi-square, Fisher’s exact, and Mann-Whitney U tests, while univariate and binomial logistic regression models were used to examine the impact of these factors on pneumothorax occurrence.

RESULTS: BMI ≥ 27.5 (p < 0.01), pectus excavatum at the level of the target lesion (PEL) (p = 0.028), transverse asymmetry at the anatomical reference level, defined as the level of the inferior pulmonary vein (TAA) (p < 0.01), and AR through DA (p < 0.01) were significantly associated with a reduced incidence of peri-interventional pneumothorax. Binary logistic regression confirmed BMI ≥ 27.5, AR through DA, TAA, and PEL as significant protective factors (R² = 0.497, p < 0.001).

CONCLUSIONS: Constitutional factors such as higher BMI or the identification of subclinical chest deformities on pre-procedural imaging may facilitate stratification into lower-risk categories, facilitating more precise and confident procedural planning. Especially in the absence of these protective factors, ensuring that the AR traverses the DA becomes particularly important for minimizing the risk of pneumothorax during CT-guided lung biopsies.

PMID:42569144 | PMC:PMC13449063 | DOI:10.5114/pjr/217693