Tag: pubmed

Sci Rep. 2026 Apr 12. doi: 10.1038/s41598-026-46677-6. Online ahead of print.

ABSTRACT

It is challenging to reduce time to optimal antimicrobial therapy in patients with sepsis for microbiology laboratories in low to middle-income countries. We evaluated the diagnostic accuracy and impact of a diagnostic stewardship bundle titled “Sepsis-24” to reduce turnaround time (TAT) of provisional blood culture reports (pBCR) ≤ 24 h in patients with gram-negative bacteraemia. During the preintervention period (January-May 23), the key preanalytical and analytical parameters of automated blood culture diagnostics were optimized in a multiphasic manner. Early microbial identification and susceptibility testing were performed by direct inoculation of VITEK-2 identification cards from flagged blood culture bottles (+ BCs) and EUCAST RAST method, read at 8-hour. During the intervention period (June-December 2023), Sepsis-24 was implemented in adult ICUs to provide pBCR for four RAST reportable gram-negatives (RRGNs). The agreements of direct microbial identification and RAST for tested drug-bug combinations were 94% [95%CI: 90-98] and 93% [95%CI: 91-94], respectively during both periods. There was a statistically significant reduction in BC loading, unloading and performance of direct VITEK/RAST from + BC during intervention period [median (minutes): 32 versus 25, 12 versus 2, and 181 versus 70, p ≤ 0.001, respectively]. Of 49 pBCRs released, 48 (98%) were concordant in species-level microbial identification with a median TAT of 1473 min [IQR: 1635 – 1321], from sample receiving. Sepsis-24 facilitated early review of antimicrobial regimen in 71% (34/48) patients leading to therapy change in 64.7% (22/34) patients. Sepsis-24 was found to be diagnostically accurate and facilitated early review of antimicrobial therapy in our resource-limited setting.

PMID:41968153 | DOI:10.1038/s41598-026-46677-6

Sci Rep. 2026 Apr 12. doi: 10.1038/s41598-026-45399-z. Online ahead of print.

ABSTRACT

Heterogeneous three-dimensional (3D) wireless sensor network (WSN) deployment requires balancing sensing coverage, communication connectivity, and deployment cost under coupled K-coverage and C-connectivity constraints. This setting yields a constrained mixed discrete optimization landscape where many conventional multi-objective methods lose diversity or handle feasibility inconsistently. We formulate heterogeneous 3D WSN deployment as a constrained multi-objective problem and propose the Enhanced Multi-Objective Genghis Khan Shark Optimizer (EnMOGKSO). The core novelty is the integration of leader-pursuit dynamics with (i) dual archive-guided selection (elite and neighborhood memories), (ii) bounded external archive diversity control, and (iii) feasibility-first environmental selection for fragmented feasible regions. On the Congress on Evolutionary Computation (CEC) 2020 suite, EnMOGKSO obtains the best Friedman mean ranks in hypervolume (HV) (2.04) and inverted generational distance (IGD) (2.38), with statistically significant differences against most competitors ([Formula: see text], Wilcoxon/Friedman). In heterogeneous 3D WSN deployment, EnMOGKSO yields higher coverage/connectivity values (typically coverage means around 11-12 and connectivity around 7) than weaker baselines (often coverage 5-7 and connectivity 4-5), with higher but stable deployment cost. Overall, the results indicate a stronger convergence-diversity balance and more reliable feasibility-aware search under tight constraints, with practical applicability to 3D monitoring tasks such as industrial facilities, smart buildings, and environmental sensing.

PMID:41968147 | DOI:10.1038/s41598-026-45399-z

NPJ Parkinsons Dis. 2026 Apr 12. doi: 10.1038/s41531-026-01343-6. Online ahead of print.

ABSTRACT

Classification of fallers in Parkinson’s disease (PD) is challenging due to the heterogenous motor and non-motor symptoms. We developed a machine learning model integrating clinical and gait data to identify key clinical markers of faller status in PD. Of 468 participants, 396 with complete data were analyzed, with 298 assigned to training from one center and 98 to external validation from the other. Clinical assessments and GAITRite-derived gait metrics were obtained. Fall history classified participants as PD fallers, PD non-fallers, or healthy controls. Features were selected through statistical and importance-based approaches, and seven machine learning algorithms were trained. The Extra Trees classifier utilizing statistics-based feature selection demonstrated the highest performance (accuracy 88% internal, 89% external). Three principal domains consistently emerged: fear of falling (FoF), balance/gait measures (stride length, velocity, 360° rotation), and autonomic dysfunction. These findings support the feasibility of externally validated, multidomain machine learning-based faller classification in PD.

PMID:41968129 | DOI:10.1038/s41531-026-01343-6

Int J Dent Hyg. 2026 Apr 12. doi: 10.1111/idh.70062. Online ahead of print.

ABSTRACT

INTRODUCTION: Saliva, a complex fluid with various chemical and physical properties, significantly influences oral health. Its secretion plays a vital role in maintaining oral cavity health, and Streptococcus mutans is more prevalent in areas surrounding caries and exhibits a close relationship with the disease. Magnets are believed to be robust safeguards against illness and serve as highly beneficial preventive tools. Hence, we intended to evaluate the effects of magnetized water oral rinse on salivary pH, salivary flow rate and the Streptococcal mutant colony count in healthy individuals.

MATERIALS AND METHODS: In this randomized controlled study, fifty participants were divided into either a magnetized water group (MWG; n = 25) or a normal water group (NWG; n = 25). The MWG underwent oral rinsing using magnetized water, whereas the NWG underwent oral rinsing using normal water for 2 min a day, daily for 2 weeks. Assessments were performed before and after the intervention. Statistical analysis was performed with the appropriate statistical test using SPSS, version 16.

RESULT: Within-Groups analysis showed a significant reduction in salivary pH [MWG (p = 0.001); NWG (p = 0.003)], and Streptococcal mutants colony count (p < 0.001 in both the groups) in both groups, with a significant increase in salivary flow rate only in the MWG (p = 0.002), unlike NWG (p = 0.081). However, between-group analysis showed a significant reduction in the Streptococcal mutant colony count in the MWG compared to the NWG (p = 0.005).

CONCLUSION: Oral rinsing using magnetized water is effective in reducing Streptococcal mutant colony count and increasing salivary flow rate compared to oral rinsing using normal water. However, further studies with a larger sample size are recommended to warrant the results of the study.

PMID:41968119 | DOI:10.1111/idh.70062

Int J Dent Hyg. 2026 Apr 12. doi: 10.1111/idh.70068. Online ahead of print.

ABSTRACT

OBJECTIVES: To understand and improve toothbrushing behavior among persons with intellectual disability (ID) and who have difficulties with toothbrushing and vulnerabilities in executive function (EF), using the ‘Executive Function-related Toothbrushing Behaviour Questionnaire’ (EF-TB). This study aimed to evaluate the validity and reliability of the EF-TB in a population of adults with ID.

METHODS: In total, 92 participants with ID who utilize commuting (non-residential) welfare facilities were rated by family members or guardians using the EF-TB and by facility staff using the Dysexecutive Questionnaire (DEX). The DEX was used as an external standard to assess the concurrent validity of the EF-TB. The comparison group, comprising 70 participants without ID, completed the EF-TB. Factor structure, internal consistency reliability, discriminant validity, and concurrent validity were investigated.

RESULTS: Exploratory factor analysis yielded three factors: ‘Systematic implementation’, ‘Sustained implementation’, and ‘Start and Finish’. The Cronbach’s alpha and item-total correlation showed good levels of internal consistency reliability. All three sub-scale scores and the total score, showed statistically significant differences between the two groups, indicating a satisfactory level of discriminant validity for the EF-TB. Futhermore, a significant correlation was observed between the total scores of the two measures, suggesting an acceptable level of concurrent validity of the EF-TB.

CONCLUSIONS: The EF-TB is a valid and reliable tool for assessing EF related to toothbrushing behavior among persons with ID. The EF-TB scores offer useful information for developing effective ways of improving oral health behavior in this population.

PMID:41968117 | DOI:10.1111/idh.70068

J Matern Fetal Neonatal Med. 2026 Dec;39(1):2654342. doi: 10.1080/14767058.2026.2654342. Epub 2026 Apr 12.

ABSTRACT

BACKGROUND: In vitro fertilization (IVF) pregnancies are associated with an increased risk of maternal and perinatal complications. Advanced maternal age and multiple gestations are more common in IVF and may contribute to adverse outcomes. Evaluating the interaction between mode of conception and maternal age may help clarify risk profiles in IVF pregnancies.

METHODS: This single-center, retrospective observational study included nulliparous women who delivered from 26 weeks’ gestation onward. A total of 144 IVF and 106 spontaneously conceived pregnancies were analyzed. IVF pregnancies included cycles with fresh or frozen embryo transfer and homologous or heterologous fertilization. Maternal characteristics, pregnancy complications, fetal and neonatal outcomes were compared between groups.

RESULTS: IVF pregnancies were associated with a significantly higher incidence of hypertensive disorders (17.9% vs 7.3%), and multiple pregnancies (25.9% vs 4.6%). Fetal complications, including fetal growth restriction (20% vs 7.3%), oligohydramnios (10.6% vs 2.8%), polyhydramnios (7.3% vs 0%), preterm premature rupture of membranes (6.4% vs 3%), and non-reassuring fetal heart rate patterns (17.1% vs 8%), were more frequent in IVF pregnancies. IVF pregnancies delivered at a lower gestational age (35.98 vs 37.99 weeks, p < .001), with lower birth weight (2244 vs 3074 g, p < .001), lower Apgar scores at 1 and 5 min, higher cesarean section rate (70.7% vs 52.8%), and higher NICU admission (38.8% vs 5.1%).

CONCLUSION: IVF pregnancies were associated with increased maternal morbidity and adverse fetal and neonatal outcomes compared to spontaneous pregnancies, including hypertensive disorders, fetal growth restriction, preterm birth, cesarean delivery, and NICU admission.

PMID:41968114 | DOI:10.1080/14767058.2026.2654342

Nurs Health Sci. 2026 Jun;28(2):e70334. doi: 10.1111/nhs.70334.

ABSTRACT

This study examines the effect of multifaceted interventions based on education (1) and recognition (2) of compliance with standard precautions (SPs). A quasi-experimental research design with a one-group pre-test and post-test was used. The purposive sample included 71 nurses working in different specialty units at a large hospital in Turkey. The researchers developed multifaceted interventions informed by existing literature, data from the hospital, and insights from frontline experts, including nurses, ward managers, infection control officers, and health and safety officers. Initially, modifications were implemented in the physical environment of the clinics, and material deficiencies were addressed. In the subsequent phase, nurses engaged in an educational session focused on SPs. The nurses completed the Compliance with Standard Precaution Scale (CSPS) three times, including baseline (before the intervention, T0), third month after the intervention (T1), and sixth month after the intervention (T2). Nurses’ median compliance with SPs was significantly higher at T2 (15.8 ± 3.42) than at T0 (13.7 ± 3.16, p < 0.05). The multifaceted interventions comprising structured education and recognition enhanced the compliance with SPs of clinical nurses.

PMID:41968111 | DOI:10.1111/nhs.70334

Aquat Toxicol. 2026 Apr 3;295:107819. doi: 10.1016/j.aquatox.2026.107819. Online ahead of print.

ABSTRACT

Microplastics (MPs) and antibiotics are emerging pollutants that frequently co-occur in aquatic environments, where their interactions intensify ecotoxicological risks and may accelerate the spread of antibiotics resistance. Experimental assessment of such sorption-driven environmental behavior of mixture is costly, time-intensive, and ethically constrained, underscoring the need for predictive computational approaches. We have reported a Partial Least Squares (PLS)-based quantitative Read-Across Structure-Activity Relationship (q-RASAR) framework to evaluate the sorption-driven toxicity of antibiotics-microplastics mixtures. The distribution coefficient (log K_d) was selected as the endpoint, reflecting partitioning between aqueous and plastic phases, a key determinant of environmental persistence and bioavailability. A curated dataset of antibiotics-microplastics mixtures was used to generate mixture descriptors based on additivity, squared, and norm-based rules. Descriptors reduction and q-RASAR integration yielded a final model with five hybrid descriptors (structural + similarity-based). The model exhibited strong internal robustness (Q²_LOO = 0.761) and high external predictivity (Q²_F1 = 0.832; MAE_test = 0.152). Applicability domain and Y-randomization confirmed statistical soundness. Mechanistic analysis indicated that hydrogen-bond donors, oxygen-based polar functionalities, and terminal unsaturation enhance adsorption, while steric hindrance and charge asymmetry reduce binding affinity. To address limited experimental data, we further designed 111 hypothetical mixtures and validated predictions using the Prediction Reliability Indicator (PRI) tool. Most predictions were classified as “Good” and within the applicability domain, confirming the framework’s scalability and reliability. By combining mechanistic interpretability with strong predictive power, the framework enables high-throughput virtual screening and supports early-stage environmental risk assessment, data-gap filling, and regulatory decision-making in line with OECD guidelines.

PMID:41967171 | DOI:10.1016/j.aquatox.2026.107819

Eur J Obstet Gynecol Reprod Biol. 2026 Apr 10;322:115116. doi: 10.1016/j.ejogrb.2026.115116. Online ahead of print.

ABSTRACT

BACKGROUND: Colpocleisis remains an effective yet often underutilised surgical option for advanced pelvic organ prolapse (POP), particularly in elderly women who no longer desire vaginal intercourse. Despite its long history, concerns persist regarding postoperative complications, urinary symptoms, and patient regret. This study aimed to evaluate the perioperative, long-term, and patient-reported outcomes of colpocleisis, and to identify predictors of persistent urinary incontinence.

METHODS: A retrospective single-centre cohort study was conducted including 66 women aged ≥60 years who underwent colpocleisis between January 2015 and January 2025. Perioperative data were obtained from a prospectively maintained database. Long-term follow-up was available for 40 patients, with a mean follow-up duration of 41.36 months. Outcomes included complications, prolapse recurrence, urinary symptoms, and patient satisfaction assessed using Patient Global Impression (PGI) questionnaires. Comparisons between partial and total colpocleisis were performed using risk ratios (RR), and univariate logistic regression was used to identify predictors of persistent urinary incontinence.

RESULTS: The mean age was 78 years. Overall perioperative complication rate was 9.1% (95% CI 4.2-18.5%). At long-term follow-up, anatomical success was achieved in 92.5% (95% CI 80.1-97.4%), with no patients requiring repeat prolapse surgery (0%, 95% CI 0-4.5%). Persistent urinary incontinence occurred in 30% (95% CI 18.1-45.4%), while no cases of de novo incontinence were observed. High patient satisfaction was reported by 81.4% (95% CI 63.0-92.1%), with a low regret rate of 3.7% (95% CI 0.7-18.3%). There were no statistically significant differences in outcomes between partial and total colpocleisis. On univariate analysis, urodynamic stress incontinence (OR 7.5, 95% CI 1.57-35.7, p = 0.01) and BMI ≥ 30 (OR 5.0, 95% CI 1.13-22.2, p = 0.03) were significant predictors of persistent urinary incontinence.

CONCLUSIONS: Colpocleisis is a safe and highly effective procedure for selected patients with advanced POP especially during the current emphasis on native tissues repairs for POP, offering durable anatomical outcomes, high satisfaction, and low regret rates. Preoperative urodynamic findings and obesity are important predictors of persistent urinary symptoms and should be considered during patient counselling and surgical planning.

PMID:41967161 | DOI:10.1016/j.ejogrb.2026.115116

Eur J Obstet Gynecol Reprod Biol. 2026 Apr 9;322:115110. doi: 10.1016/j.ejogrb.2026.115110. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of our study is to investigate the percentage of ovarian cancer (OC) patients with concomitant endometriosis and its distribution across histological subtypes, and to assess whether the presence of endometriosis influences overall survival (OS) and disease-free survival (DFS) in patients with clear cell and endometrioid OC.

METHODS: We conducted a retrospective observational study using patient’s medical records of two reference hospitals in Spain, including OC patients, with and without endometriosis. We analysed the frequency of the association between cancer and endometriosis, the differences in OS and DFS survival between patients with and without endometriosis and the influence of age, tumour size, histological subtype and grade.

RESULTS: Among the 257 patients included, 39 (15.2%) had concomitant endometriosis. This correlation was particularly strong in endometrioid (EC) and clear cell carcinoma (CCC) patients; 61.0% of whom have concomitant endometriosis. Survival analysis demonstrated that, in EC and clear CCC, endometriosis-associated patients had longer OS (HR = 0.1773 [IC95% 0.03053-1.019]) and DFS (HR = 0.02 [IC95% 0.0009266-0.5100]) than OC patients without endometriosis. The difference was statistically significant for OS (p = 0.0174) but not for DFS (p = 0.0525). Univariate analysis shows that age, BMI or cyst size did not significantly affect disease outcomes.

CONCLUSIONS: Endometriosis has a clear association with EC and CCC. Its presence improves OS in Ovarian Cancer patients. Further studies are needed to confirm the improvement in outcomes and to determine the nature of the putative protection.

PMID:41967157 | DOI:10.1016/j.ejogrb.2026.115110