Tag: pubmed

Proc Natl Acad Sci U S A. 2026 Jul 7;123(27):e2601775123. doi: 10.1073/pnas.2601775123. Epub 2026 Jun 29.

ABSTRACT

RNA polymerase III (Pol III) is specialized for the high-throughput synthesis of short RNAs, a capability linked to its unique TFIIE- and TFIIF-like subcomplexes that are stably associated through different stages of transcription. To date, the role of a winged helix domain (WH2) of Rpc34 subunit in the TFIIE-like subcomplex during elongation has remained a conundrum because its density is consistently absent in cryo-EM structures of Pol III elongation complexes (ECs), suggesting its high conformational mobility. In this study, we employed single-molecule Förster resonance energy transfer (smFRET) and nano-positioning triangulation to characterize the dynamics and determine the position of the Rpc34-WH2 domain within transcription-competent but nontranslocating Pol III ECs. To achieve the required site-specific labeling, we developed a chemical biology framework that utilizes azido-carrying unnatural amino acid incorporation and a thiol-capping strategy to eliminate off-target alkyne-thiol cross-reactivity. With the acceptor at Rpc34-WH2 and the donor at a defined position on the DNA template as the reference point, our smFRET results reveal that Rpc34-WH2 dynamically transitions among three discrete states, corresponding to preferred positional sites in downstream, middle, and upstream regions across the DNA-binding cleft. One of these sites coincides with Rpc34-WH2’s position in the preinitiation complex, indicating positional similarity across transcriptional states. Together with prior Pol I and Pol II studies, these findings establish Rpc34-WH2 as a mobile regulatory element that engages the Pol III EC through transient, weak interactions. Additionally, the bio-orthogonal labeling strategy presented here provides a robust, generalizable route for smFRET studies of large, multisubunit protein assemblies.

PMID:42372135 | DOI:10.1073/pnas.2601775123

Proc Natl Acad Sci U S A. 2026 Jul 7;123(27):e2524283123. doi: 10.1073/pnas.2524283123. Epub 2026 Jun 29.

ABSTRACT

Estimating the number of insect species on Earth is a daunting challenge. The current consensus estimate-about six million species-is likely far too low, as we will show. Our estimate of the global number of insect species rests on a sample of more than 1,600,000 DNA-barcoded insect specimens representing 53,945 species from 15 “core” Malaise traps deployed in dry forest, cloud forest, and rainforest ecosystems of the Área de Conservación Guanacaste (ACG) in Costa Rica. Even this massive sample fails to reveal the full extent of ACG insect species richness. To estimate total ACG insect richness, we adjust the observed count of insect species by an “undersampling ratio,” computed for a hyperdiverse subfamily of parasitoid wasps (Braconidae: Microgastrinae). The ratio compares microgastrine richness from the core Malaise traps to a lower-bound estimate of true microgastrine richness-including undetected species-based on 21,669 specimens from three sources: the 15 core Malaise traps, 15 “peripheral” Malaise traps spanning all three ecosystems, and 11,373 DNA-barcoded specimens reared from some 1,500 species of microgastrine-parasitized caterpillars (Lepidoptera). To estimate global insect richness, we apply Earth/ACG ratios for tree species and several animal taxa to upscale our estimate of ACG insect richness (nearly 333,000 species). Adopting conservative assumptions, we reach an estimate of 14 to 20 million insect species on Earth, depending on the upscaling group-two to three times the current consensus estimates. Upscaling instead from a point estimate of ACG richness with a wide CI, global estimates reach nearly 30 million species.

PMID:42372133 | DOI:10.1073/pnas.2524283123

Adv Neonatal Care. 2026 Jun 29. doi: 10.1097/ANC.0000000000001369. Online ahead of print.

ABSTRACT

BACKGROUND: Developmentally supportive care (DSC) for preterm infants is essential for promoting optimal growth and neurodevelopment in neonatal intensive care units (NICUs). However, successful implementation of DSC depends not only on institutional systems but also on individual nurse attributes.

PURPOSE: This study aimed to examine the influence of self-leadership, emotional intelligence (EI), and nursing professionalism on DSC competency among NICU nurses.

METHODS: A descriptive cross-sectional survey was conducted with 130 NICU nurses from 8 hospitals in South Korea. Data were collected using validated instruments measuring self-leadership, EI, nursing professionalism, and DSC competency. Statistical analyses included descriptive statistics, independent t-tests, ANOVA, Pearson correlations, and multiple linear regression.

RESULTS: The mean DSC competency score was 2.83 of 4, with “professional development” scoring the lowest among its subdomains. DSC competency levels were higher among nurses who were married, had children, had longer clinical experience, were assigned more than 4 patients, and reported higher monthly income. EI (β = 0.41, P < .001), nursing professionalism (β = 0.28, P < .001), more than 10 years of total clinical experience (β = 0.27, P = .011), and self-leadership (β = 0.25, P = .003) were identified as significant predictors of DSC competency, explaining 69% of the variance.

IMPLICATIONS FOR PRACTICE AND RESEARCH: Findings suggest that psychosocial attributes-particularly EI-are critical enablers of developmental care. Interventions aimed at fostering EI, nursing professionalism, and self-leadership may provide a useful framework for future research examining strategies to support DSC competency in NICU settings.

PMID:42372121 | DOI:10.1097/ANC.0000000000001369

Am Surg. 2026 Jun 29:31348261465403. doi: 10.1177/00031348261465403. Online ahead of print.

ABSTRACT

BackgroundIt is difficult to predict which patients will have longer postoperative hospital stays after rectal cancer surgery. We aimed to determine the predictors of a long hospital stay following abdominoperineal resection (APR) for rectal cancer.MethodsRetrospective cohort analysis of patients diagnosed with rectal adenocarcinoma in the National Cancer Database between 2015 and 2019 with clinical stage I-IV cancers who underwent APR. Multiple linear regression analysis was conducted to determine the predictors of a long hospital stay. A statistical calculator was created to predict the in-hospital length of stay.Results7470 patients (63.2% males; mean age: 62.3 years) were included. Median hospital stay was 6 (IQR: 4-8) days. Black patients stayed nearly two days longer compared to other patients (1.9; 95% CI: 1.33-2.49, P < 0.001). Patients with a Charlson Deyo Score of 3 also had a longer length of stay (1.96, 95% CI: 1.02-2.91, P < .001). Robotic surgery was associated with shorter hospital stays (-0.7 days, 95% CI – 1.1, -0.4, P < .001), while conversion from minimally invasive to open surgery was associated with a longer hospital stay (1.1 days, 95% CI: 0.55-1.68, P < .001).ConclusionOlder age, black race, male sex, and severe comorbidities were associated with longer hospital stays, while minimally invasive surgery was associated with decreased length of stay.

PMID:42372118 | DOI:10.1177/00031348261465403

Cranio. 2026 Jun 29:1-14. doi: 10.1080/08869634.2026.2693138. Online ahead of print.

ABSTRACT

BACKGROUND: Predoctoral dental education in temporomandibular disorders (TMD) remains inconsistent and highly variable despite CODA’s mandate. This study examined how different TMD educational models (based on orofacial pain [OFP] postgraduate program affiliation, presence of OFP faculty offering TMD patient exposure, or absence of OFP faculty and clinical exposure) influence student confidence and perceived challenges.

METHODS: An anonymous survey was distributed to third- and fourth-year students at U.S. CODA-accredited dental schools through the Hispanic Student Dental Association and American Student Dental Association. Students rated confidence in TMD-related skills (1-5 scale, 5=”most confident”) and identified educational challenges. Data were analyzed using ANOVA, chi-square tests, and correlation analyses across four educational models.

RESULTS: Among 136 respondents, overall confidence was low-to-moderate (2.4 ± 0.8), with only 26.3% reaching a sufficient threshold (≥3). Confidence was highest for screening and lowest for advanced procedures. Educational model type showed no significant effect on overall confidence (p = .099), whereas prior TMD patient exposure was associated with higher confidence (2.7 ± 0.7 vs. 2.1 ± 0.7, p < .001; r = .384, p < .001). Common challenges included limited patient availability (61.8%), insufficient faculty expertise (42.3%), and poor interdisciplinary integration (46.3%). Students without OFP faculty and clinical exposure reported significantly greater clinical challenges (p < .001).

CONCLUSION: Lack of clinical exposure to TMD patients is strongly associated with low student confidence. Faculty calibration and integration of TMD screening and management into routine care are critical to improving competence and confidence in dental training.

PMID:42372117 | DOI:10.1080/08869634.2026.2693138

J Int Med Res. 2026 Jun;54(6):3000605261461956. doi: 10.1177/03000605261461956. Epub 2026 Jun 29.

ABSTRACT

ObjectiveThis study aimed to evaluate the feasibility of intraperitoneal injection as an alternative to the technically challenging intravenous route for contrast agent administration in murine brain magnetic resonance imaging by comparing their enhancement effects. Specifically, it sought to determine the optimal injection dose and imaging time window for administration of gadobutrol, a macrocyclic gadolinium-based contrast agent, in orthotopic glioblastoma models.MethodsThis study used an orthotopic glioblastoma model established in BALB/c nude mice (n = 24) by intracranial implantation of LN229 cells. Mice were randomized to receive gadobutrol at doses of 1 or 2 mmol/kg via both intravenous and intraperitoneal routes on separate days. Contrast-enhanced magnetic resonance imaging was performed at multiple post-injection time points. The resulting images were evaluated qualitatively by blinded neuroradiologists and quantitatively by measuring signal-to-noise ratio and contrast-to-noise ratio, with statistical comparisons made between injection methods and dosage groups.ResultsImage quality assessments revealed no significant differences in signal-to-noise ratio, contrast-to-noise ratio, or enhancement metrics between the intravenous and intraperitoneal routes. Peak enhancement occurred at 7 min following intravenous injection and 30 min following intraperitoneal injection.ConclusionsIntraperitoneal injection is a viable alternative, with scanning at 30 min recommended for optimal contrast enhancement.

PMID:42372112 | DOI:10.1177/03000605261461956

Physiother Theory Pract. 2026 Jun 29:1-11. doi: 10.1080/09593985.2026.2695769. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the reliability and measurement error of digital algometer-based pressure pain threshold (PPT) assessment inpatients with end-stage knee osteoarthritis (KOA).

METHODS: This prospective observational reliability study included 60 patients with end-stage KOA scheduled for total knee arthroplasty. Pressure pain threshold was assessed by two raters with different levels of experience at baseline and 7 days later at the medial aspect of the affected knee (local site) and the dorsal aspect of the contralateral forearm (remote site), following standardized training and measurement procedures. Three repeated measurements were obtained at each site per session and averaged. Relative reliability was assessed using intraclass correlation coefficients (ICC), with the ICC2,k model used for intra-session reliability based on the mean of three repeated measurements and the ICC2, 1 model used for inter-session and inter-rater reliability. Absolute measurement error was quantified using the standard error of measurement (SEM), relative SEM (SEM%), and the minimal detectable change at the 95% confidence level (MDC₉₅). Inter-rater agreement was examined using Bland – Altman analysis.

RESULTS: Pressure pain threshold measurements demonstrated excellent reliability across all conditions. Intra-session, inter-session, and inter-rater ICC values all exceeded 0.87. Intra-session ICC2, k values ranged from 0.874 to 0.965, inter-session ICC2, 1 values from 0.870 to 0.984, and inter-rater ICC2, 1 values from 0.921 to 0.953. Relative SEM values remained below 7%, and inter-session MDC₉₅ ranged from 0.33 to 0.72 kg/cm², representing measurement-error thresholds for detecting change beyond random variability. Bland-Altman analysis showed that most differences lay within the 95% limits of agreement, with no apparent proportional bias. Mean inter-rater differences ranged from 0.09 to 0.19 kg/cm².

CONCLUSIONS: Under standardized conditions, digital algometer-based PPT assessment showed high reliability with low measurement error in patients with end-stage KOA. Clinical utility requires further validation.

PMID:42371695 | DOI:10.1080/09593985.2026.2695769

J Clin Psychol. 2026 Jun 29. doi: 10.1002/jclp.70172. Online ahead of print.

ABSTRACT

OBJECTIVE: The mass evacuation of Israeli residents from conflict zones after the events of October 7, 2023, coupled with ongoing security threats, has taken a substantial psychological toll, with many individuals exhibiting symptoms of post-traumatic stress disorder (PTSD), anxiety, and sleep problems. This pilot study examined the feasibility and preliminary within-group changes associated with participation in transcendental meditation (TM), a non-pharmacological program, in relation to PTSD symptoms, depression, anxiety, and sleep problems among 39 Israeli civilians evacuated after October 7.

METHOD: In an 8-week intervention, we examined changes in psychological well-being using the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder scale (GAD-7), and Insomnia Severity Index (ISI). Changes in PTSD symptoms, depression symptoms, anxiety, and sleep problems were analyzed using dependent t-tests. Additional analyses of baseline, 4-week, and 8-week post-test data used repeated-measures analysis of variance.

RESULTS: Participants showed statistically significant within-group decreases from baseline to post-test in PTSD symptoms, depression, anxiety, and sleep problems.

CONCLUSION: Findings provide preliminary support for the feasibility and acceptability of TM in trauma-exposed civilians and suggest that participation in the program was associated with improvements in psychological symptoms over time. Given the uncontrolled pilot design, these results should be interpreted cautiously and require confirmation in randomized controlled trials.

PMID:42371680 | DOI:10.1002/jclp.70172

Echocardiography. 2026 Jul;43(7):e70495. doi: 10.1111/echo.70495.

ABSTRACT

BACKGROUND: Residual congestion at discharge in acute heart failure (AHF) is a primary driver of readmission and mortality. Inferior vena cava (IVC) ultrasound provides a noninvasive bedside assessment of volume status, yet its clinical impact on guiding therapy remains underdefined. This systematic review evaluated the efficacy of IVC ultrasound-guided therapy compared to standard clinical assessment in AHF decongestion.

METHODS: Following PRISMA guidelines (PROSPERO: CRD420251171323), a systematic search was conducted across PubMed, EMBASE, and other major databases through October 2025. We included randomized controlled trials (RCTs) and nonrandomized studies focusing on IVC-guided management in adults with AHF. Outcomes included congestion markers, NT-proBNP levels, hospitalization duration, and mortality.

RESULTS: Four studies involving 629 patients met the inclusion criteria. Most studies showed improved decongestion with IVC ultrasound guidance, evidenced by lower residual congestion and improved IVC metrics (diameter/collapsibility). While NT-proBNP levels decreased in all cohorts, between-group differences were not statistically significant. Clinical outcomes improved in 50% of studies, showing shorter hospital stays and reduced mortality. Notably, one trial reported a significant mortality benefit (3.3% vs. 33.3%; p = 0.003). Adverse events were either similar or significantly fewer (p < 0.05) in the ultrasound-guided groups.

CONCLUSION: IVC ultrasound is an effective bedside tool for individualized volume management in AHF, potentially enhancing treatment precision and clinical outcomes. While current evidence is promising, larger multicenter trials are necessary to standardize its implementation in routine heart failure care.

PMID:42371669 | DOI:10.1111/echo.70495

JAMA Intern Med. 2026 Jun 29. doi: 10.1001/jamainternmed.2026.1517. Online ahead of print.

ABSTRACT

IMPORTANCE: Screening for unhealthy alcohol use is recommended in primary care; however, completion and quality are inconsistent especially during telemedicine visits. Little is known about optimal workflows incorporating electronic screening (e-screening).

OBJECTIVE: To evaluate whether use of previsit asynchronous e-screening is associated with improved completion and detection of unhealthy alcohol use via the Alcohol Use Disorders Identification Test (AUDIT-C) questionnaire compared with usual staff-administered screening during telemedicine primary care visits.

DESIGN, SETTING, AND PARTICIPANTS: Pragmatic cluster randomized quality improvement trial conducted at 2 primary care clinics in the Veterans Health Administration (VHA) from June 24 to August 1, 2024. Primary care clinicians (PCCs) were randomized 1:1, stratified by site, to intervention or control.

INTERVENTION: For PCCs in the control arm, patients received usual care including staff-administered AUDIT-C at telemedicine visits. For PCCs in the intervention arm, 24 to 48 hours before visits patients additionally received an invitation to asynchronous self-administered e-screening. Veterans who did not complete e-screening were still eligible for staff completion of screening during their clinic visits.

MAIN OUTCOMES AND MEASURES: The primary outcome was completion of AUDIT-C; secondary outcome was positive screen result (AUDIT-C ≥5). The exploratory outcome was brief intervention after positive screen result. All statistical models were clustered by PCC and adjusted for patient age, sex, race and ethnicity, comorbidity, prior primary care use, and site.

RESULTS: Among 848 veterans in the primary analysis (mean [SD] age, 55.4 [16.1] years; 729 [86.0%] male), use of e-screening was associated with increased telemedicine visit screening completion rates by 30.5 percentage points (74.4% [95% CI, 68.5%-80.3%] for e-screening vs 43.9% [95% CI, 26.6%-61.2%] for usual care; P < .001) and with increased likelihood of a positive screen result (10.6% [95% CI, 8.0%-13.2%] for e-screening vs 2.7% [95% CI, 0.7%-4.7%] for usual care; P < .001). Exploratory analysis identified the proportion of veterans receiving a brief intervention after a positive screen result (2.3% [10 of 442] for usual care vs 5.9% [24 of 406] for e-screening; P = .01).

CONCLUSIONS AND RELEVANCE: In this study, use of asynchronous e-screening was associated with improved completion and screen-positive results for unhealthy alcohol use in primary care, with the greatest gains for telemedicine encounters. Overall, this approach may close the implementation gap for population-based screening, improve disclosure, and reduce staff burden, particularly in hybrid care models.

TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN16316660.

PMID:42371662 | DOI:10.1001/jamainternmed.2026.1517