Tag: pubmed

J Am Acad Orthop Surg. 2026 May 1;34(9):e1228-e1236. doi: 10.5435/JAAOS-D-25-00483. Epub 2025 Oct 17.

ABSTRACT

INTRODUCTION: Existing literature supports weight-bearing and activity restriction following hip arthroscopy, as well as early participation in physical therapy. However, there is a knowledge gap surrounding how failure to adhere to these instructions affects long-term outcomes. This study aims to evaluate how noncompliance with postoperative protocol after hip arthroscopy affects patient-reported outcomes at 2 years after surgery.

METHODS: Seventy-nine patients who underwent hip arthroscopy for femoroacetabular impingement between January and December 2022 were identified, with 52 in the compliant group and 27 in the noncompliant group. Patient noncompliance was defined as loss to follow-up (n = 4), delayed or lack of physical therapy (n = 12), and nonadherence to weight-bearing and activity restrictions (n = 17) within 3 months following surgery. Symptom and functional status were assessed at 2 years with the international Hip Outcomes Tool (iHOT-12), the Physical Function Short Form of the Hip Disability and Osteoarthritis Outcome Score (HOOS-PS), and the single-item patient-acceptable symptom state.

RESULTS: The average iHOT and HOOS-PS scores were lower for noncompliant patients (iHOT, 50.67; SD, 28.9; HOOS-PS, 60.9; SD, 23.8) compared with compliant patients (iHOT, 71.95; SD, 26.8; P = 0.002; HOOS-PS, 79.0; SD, 23.0; P = 0.002). Noncompliant patients had lower rates of reaching Patient Acceptable Symptom State at 2 years (compliant: 69%, noncompliant: 37%; OR = 3.86; 95% CI [1.42, 10.0] 0.006). Multivariate analysis revealed independent predictors of lower iHOT scores were history of a mental health disorder (-12.0 points SD, 2.9; P = 0.001) and noncompliance (-8.6 points SD, 3.0; P = 0.01). No baseline demographic differences were identified between compliant and noncompliant patients.

CONCLUSION: Noncompliance with functional restrictions and postoperative physical therapy is a strong independent risk factor for poor patient-reported outcomes at 2 years after hip arthroscopy.

PMID:41995396 | DOI:10.5435/JAAOS-D-25-00483

Am J Epidemiol. 2026 Apr 17:kwag078. doi: 10.1093/aje/kwag078. Online ahead of print.

ABSTRACT

We examined the role of nSEP on 1-year and 5-year survival among children with critical congenital heart defects (CCHDs). Children with CCHDs in the National Birth Defects Prevention Study (1999-2011) were grouped into univentricular and biventricular defects and linked to vital records for 1-year and 5-year mortality. The Neighborhood Deprivation Index (NDI) classified census-tract nSEP (low [referent], moderate, high deprivation) using maternal periconceptional address. Kaplan-Meier survival curves and log-rank tests evaluated survival differences. Cox proportional hazards regression models estimated crude and adjusted hazard ratios (HRs) and 95% confidence intervals, adjusting for birth years, maternal sociodemographic factors, and residential mobility. Among 2459 children with CCHDs, 1-year survival curves differed by neighborhood deprivation. Survival was lowest among children of mothers living in high vs. low deprivation neighborhoods. In crude analyses, high deprivation was associated with higher 1-year mortality (all CCHDs: 1.58 [1.17, 2.13]; univentricular CCHDs: 1.50 [0.99, 2.26]; biventricular CCHDs: 1.64 [1.02, 2.64]). After adjustment, estimates were generally attenuated and less precise. Five-year survival showed similar trends. Further research could inform strategies to address the structural, environmental, and/or physiological factors associated with a potential reduced survival among children with CCHDs born to mothers in socioeconomically deprived areas.

PMID:41995389 | DOI:10.1093/aje/kwag078

Appl Environ Microbiol. 2026 Apr 17:e0234225. doi: 10.1128/aem.02342-25. Online ahead of print.

ABSTRACT

Fusarium graminearum is a major pathogen of wheat and barley, causing fusarium head blight (FHB) and contaminating grain with harmful mycotoxins. Azole fungicides (demethylation inhibitors) are among the key tools available for managing F. graminearum infections. In an attempt to characterize how resistance to azole fungicides arises, we performed an experimental evolution study that imposed selection by exposing F. graminearum to increasing concentrations of prothioconazole (PTZ), tebuconazole (TBF), a combination of both fungicides (CMB), or a no-drug control. All evolved lineages exceeded the ancestral minimum inhibitory concentration before strain extinction, retained normal in vitro colony growth in the absence of drugs, and were able to successfully infect a fusarium head blight-susceptible wheat cultivar. However, most lineages lost their apparent resistance improvements after being revived from preservation at -80°C. One lineage (TBF1), however, showed stable enhanced resistance to tebuconazole, which was accompanied by a phenotype of precocious germination of macroconidia. Genomic analyses indicated no change in the cyp51 genes in any lineage but identified a single base insertion resulting in a premature stop codon in the aos1 gene (involved in SUMOylation) in the TBF1 genome. We created aos1 gene deletion strains, which phenocopied TBF1 for both tebuconazole resistance and altered macroconidial germination. This work suggests that adjustments to spore germination processes may influence sensitivity toward fungicides and also highlights the role of SUMOylation in spore dormancy.IMPORTANCEFusarium graminearum is a major crop pathogen that can acquire mutations over time to common fungicides. Historically, studies have focused their attention on a single gene, cyp51, as the primary cause of resistance. However, there may be other pathways to enhanced resistance. For example, changes in macroconidium germination rates and transitions between cell types offer a route to fungicide resistance that has not been adequately appreciated to date. This study highlights a novel pathway to azole resistance, providing new insights into how F. graminearum may circumvent chemical controls. Through laboratory evolution, a single base insertion arose within the aos1 gene, which caused phenotypes of altered macroconidium dormancy and reduced fungicide sensitivity. This research highlights the importance of experimental approaches that remain open to surprising evolutionary innovations and unexpected resistance mechanisms.

PMID:41995307 | DOI:10.1128/aem.02342-25

Womens Health (Lond). 2026 Jan-Dec;22:17455057261442095. doi: 10.1177/17455057261442095. Epub 2026 Apr 17.

ABSTRACT

BACKGROUND: In the United States, Black women face racial stressors that significantly undermine their well-being and contribute to poor mental health outcomes.

OBJECTIVES: The current study examines how racial stressors (i.e., racial violence exposure through social media, vicarious racism, and interpersonal racism) are associated with racial trauma and dysphoria (i.e., depression, anxiety, and hostility) and the moderating role of emotion-focused coping self-efficacy (e.g., suppression of unpleasant thoughts and emotions) among Black women (M_age = 35, N = 283).

DESIGN: The study employed a quantitative, cross-sectional, analytical design.

METHODS: A cross-sectional online survey was administered to Black women aged 18 and over in the Northeast US between March and July 2024. Participants from diverse socioeconomic backgrounds were recruited. Data were collected via Qualtrics and analyzed using IBM SPSS version 29.0. A hierarchical regression analysis assessed the association between racial stressors (social media violence, interpersonal racism, and vicarious racism), racial trauma, and dysphoria, with emotion-focused coping self-efficacy as a moderator.

RESULTS: Greater exposure to racial stressors and the suppression of unpleasant thoughts and emotions were associated with higher dysphoria. Interpersonal racism was positively linked to racial trauma, while social media exposure to racial violence was associated with lower trauma. Interaction effects showed that Black women who reported high social media violence exposure and suppressed unpleasant thoughts experienced less trauma. Similarly, those who reported higher vicarious racism and felt confident in suppressing unpleasant thoughts also experienced less trauma. Conversely, those who felt less efficacious in suppressing unpleasant thoughts were more likely to endorse racial trauma symptoms.

CONCLUSION: Black women’s racial stressors, dysphoria, and racial trauma are linked. However, the psychological effects of racial violence exposure through social media depend on available coping resources. Suppressing unpleasant thoughts and emotions is a conditional coping strategy that may mitigate racial trauma when accompanied by high coping self-efficacy, especially in situations involving vicarious racism and social media-based racial violence exposure. Conversely, low confidence in suppressing distress is associated with heightened racial trauma, highlighting the importance of emotion-focused coping self-efficacy in shaping psychological vulnerability.

PMID:41995294 | DOI:10.1177/17455057261442095

J Acoust Soc Am. 2026 Apr 1;159(4):3406-3417. doi: 10.1121/10.0043324.

ABSTRACT

Underwater sound recordings from Helgoland, Germany, were analyzed to detect passages of crew transfer vessels (CTVs). From these opportunistic observations, the source levels of 13 individual vessels were derived using the smoothed semi-coherent image method, including frequency-dependent absorption. Statistical analysis, using both generalized additive models and random forest models, showed that vessel-specific differences are the primary source of variability in source levels. While speed, length, and propulsion type all influence source levels, their effects vary across vessels and frequency bands, with no single factor dominating overall. The results indicate that, despite their relatively small size, CTVs have radiated noise levels similar to larger cargo vessels. The low variability in source levels across vessels suggests that a single source level spectrum for transiting CTVs could be a viable input for future noise modelling efforts.

PMID:41995288 | DOI:10.1121/10.0043324

J Adhes Dent. 2026 Apr 17;28:39-47. doi: 10.3290/j.jad.c_2654.

ABSTRACT

PURPOSE: Self-adhesive flowable giomer (SAG) has been used in dental practice recently to simplify clinical procedures and shorten chair times. However, there are only few studies evaluating its bond strength to enamel and dentin, resulting in a lack of evidence. The purpose of this study was to compare the micro-shear bond strength with and without adhesive in enamel and dentin to evaluate the self-adhesive ability of SAG.

METHODS AND MATERIALS: Sound bovine teeth were used as the tooth substrates. For μ-SBS tests, enamel and dentin specimens were prepared for SAG (Beautifil Kids SA – BK), a self-adhesive flowable composite (Vertise Flow – VF), and a nanohybrid flowable giomer (Beautifil Flow Plus F03 – BF). Two adhesive modes were tested for BK and VF (with self-etching adhesive and no adhesive), and one for BF (with self-etching adhesive). The μ-SBS test was conducted after 24 h and after thermocycling for 10,000 cycles using a universal testing machine.

RESULTS: For all materials, when self-etching adhesive was used, the μ-SBS was significantly higher than that of the no-adhesive group (P 0.05). No statistically significant difference was found between the restorative materials under any condition. Thermocycling had no significant effect on the μ-SBS of BK. In the self-etching adhesive group, mixed failure was predominant for all materials. However, in no-adhesive group, adhesive failure and mixed failure were observed at similar levels for all materials.

CONCLUSION: The self-adhesive resin without adhesive showed lower bonding strength in both enamel and dentin compared to the one with adhesive.

CLINICAL RELEVANCE: Although there were no significant differences in bond strength stability between materials, SAG still offers a simplified bonding process without compromising bond strength, making it a viable option for clinical use.

PMID:41995273 | DOI:10.3290/j.jad.c_2654

J Gynecol Oncol. 2026 Mar 31. doi: 10.3802/jgo.2026.37.e97. Online ahead of print.

ABSTRACT

OBJECTIVE: Poly (ADP-ribose) polymerase inhibitors (PARPis) have emerged as a novel targeted therapy, necessitating the development of PARPi sensitivity tests for clinical application. However, the requirement for matched normal tissue complicates clinical testing procedures and increases the burden on patients. In this study, we optimized a bioinformatics algorithm utilizing the Panel of Normals to accommodate tumor-only scenarios.

METHODS: Paired samples from both clinical (Chinese population) and International Cancer Genome Consortium (ICGC) databases (Caucasian population) were employed to establish training cohorts. The tumor-only algorithm was developed based on these cohorts. The performance of the tumor-only algorithm was evaluated through linear regression against the paired sample algorithm. The validity of both algorithms was tested using progression-free survival data from patients treated with PARPis. Additionally, clinical samples from an independent institution were utilized to further validate the tumor-only algorithm.

RESULTS: In the training sets, we observed high correlations between the tumor-only and paired sample algorithms regarding tumoral purity and homologous recombination deficiency (HRD) scores, with most R² values exceeding 0.9. In the validation set, a slight decrease in correlation was noted, although the majority of R² values remained close to 0.9. Both algorithms effectively distinguished PARPi-sensitive patients. No statistically significant differences were identified between the training and validation cohorts concerning clinical characteristics. Cross-racial validation yielded similar results.

CONCLUSION: The tumor-only algorithm demonstrated an equivalent capacity to the paired sample algorithm for classifying HRD status in ovarian cancer. This algorithm also showed cross-racial applicability, highlighting its potential for clinical use.

PMID:41995271 | DOI:10.3802/jgo.2026.37.e97

JMIR Form Res. 2026 Apr 16. doi: 10.2196/89306. Online ahead of print.

ABSTRACT

BACKGROUND: There are a large number of pediatric emergency patients. Due to the fact that the children cannot describe their own conditions, there is a shortage of nursing staff, it is extremely important to identify the early warning signs of the children’s conditions as early as possible. The current targeted care needs to be improved.

OBJECTIVE: This study aimed to investigate the application of an artificial intelligence-based pediatric early warning score (PEWS) in the pediatric emergency observation unit, analyze the relationship between PEWS and disease severity , and assess its impact on length of hospital stay and hospitalization costs after admission, so as to provide references for targeted nursing care.

METHODS: We performed a retrospective study. A total of 1,233 pediatric patients admitted via the pediatric emergency department of a tertiary specialty hospital in Guangzhou from September 2023 to March 2024 were included. The patients were divided according to the status of the activation of the early-warning group (PEWS score ≥ 1) vs. not triggered [score 0]) during emergency observation. Length of stay and hospitalization costs were compared between the early warning group and the non-early warning group.The differences between groups were performed with the Mann-Whitney U test. We did the multivariable logistic regression to discuss the association of resource utilization metrics and the status of AI-PEWS, adjusted by age, sex and disease category (respiratory, neurological, hematologic).

RESULTS: In 1,233 patients, 597 (48.4%) triggered the AI-PEWS (mean score 2.44 ± 1.41), and 636 (51.6%) did not. In the early warning group, 68 children were transferred to the intensive care unit, with a mean PEWS of 3.32 ± 1.73. Compared with the non-early warning group, the early warning group had a longer hospital stay (z = -5.180, P < 0.001) and higher hospitalization costs (z = -6.500, P < 0.001), and the differences between groups were statistically significant (P < 0.001). Among the top three admission categories-respiratory, neurological, and hematologic diseases-children in the PEWS early warning group had significantly longer hospital stays and higher hospitalization costs, with statistically significant differences between groups (P < 0.01). The β coefficient for length of hospital stay was 0.053 (SE=0.010), Waldχ²=5.533, OR=1.055 (95% CI: 1.035-1.075); while the β coefficient for hospitalization costs was 0.001 (SE=0.000), Waldχ²=6.075, OR=1.001 (95% CI: 1.001-1.001).

CONCLUSIONS: Compared with the non-early-warning group, the early-warning group had significantly longer hospital stays and higher hospitalization costs; similar patterns were observed within respiratory, neurological, and hematologic disease categories. It shows differences between children who triggered the warning and children who did not, providing a reference for identifying critically ill children and for targeted care.

PMID:41995245 | DOI:10.2196/89306

Echocardiography. 2026 Apr;43(4):e70461. doi: 10.1111/echo.70461.

ABSTRACT

BACKGROUND: Right ventricular (RV) dysfunction in chronic kidney disease (CKD) remains underrecognized. The tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio (TAPSE/sPAP) reflects RV-pulmonary arterial coupling, but its relationship with CKD severity is unknown. To evaluate the association between TAPSE/sPAP ratio and CKD stage severity and assess age-related effect modification.

METHODS: This cross-sectional study enrolled 120 participants: 40 patients with stage I-II CKD, 40 with stage III-IV CKD, and 40 healthy controls. All underwent echocardiography and nephrologist evaluation. Proportional odds regression models adjusted for cardiovascular risk factors evaluated the TAPSE/sPAP-CKD association. ROC analysis assessed discriminatory performance. Age-stratified analyses (<65 vs. ≥65 years) evaluated effect modification.

RESULTS: TAPSE/sPAP ratio declined progressively across CKD stages (controls: 0.67 ± 0.11, stage I-II: 0.61 ± 0.13, stage III-IV: 0.53 ± 0.13 mm/mmHg; p < 0.01). Each 0.10-unit decrease was independently associated with advanced CKD (adjusted OR 2.08, 95% CI 1.49-2.89, p < 0.001). TAPSE/sPAP ratio achieved the highest AUC (0.734, 95% CI 0.625-0.833), outperforming TAPSE alone (AUC 0.615; DeLong p = 0.049), while statistically comparable to sPAP (AUC 0.715; DeLong p = 0.400). Age-stratified analysis revealed excellent performance in patients <65 years (AUC 0.819, sensitivity 78.6%, specificity 86.8%) but limited utility in those ≥65 years (AUC 0.579; p = 0.015). Random forest analysis identified age (35.8%) and TAPSE/sPAP (22.0%) as dominant predictors.

CONCLUSIONS: TAPSE/sPAP ratio is an independent marker of CKD severity enabling non-invasive detection of RV-PA uncoupling, with excellent discriminatory performance in younger but limited utility in older patients, suggesting that age-specific interpretation and integration with renal biomarkers are recommended.

PMID:41995221 | DOI:10.1111/echo.70461

Clin Transplant. 2026 Apr;40(4):e70543. doi: 10.1111/ctr.70543.

ABSTRACT

BACKGROUND: Before KAS250 (circles-based allocation), donor service area (DSA) of listing was the largest contributor to deceased donor kidney transplantation (DDKT) rate disparities. Both before and after KAS250, it is unclear to what extent DSA-level disparities are attributable to center-level practice variation. We aimed to disentangle contributions to DDKT rate variation from: (1) center practices, (2) kidney distribution within sharp policy boundaries (DSAs, OPTN Regions), and (3) other geographic variation in kidney scarcity.

METHODS: With national transplant registry data, we studied transplant rate variation in the pre-KAS250 era, which prioritized patients based on DSAs and Regions, and under KAS250, which prioritizes patients within 250 nautical mile circles. We modeled candidate DDKT rates with multilevel Poisson regression, adjusting for candidate factors, and calculated median incidence rate ratios (MIRR) to summarize variation attributable to DSAs, OPTN regions, states, census divisions, and to centers within those units.

RESULTS: DSA-level MIRR declined sharply from _1.311.35_1.39 to _1.131.17_1.21 after KAS250 implementation. Under KAS250, 93.4% of geographic variability in transplant rates was attributable to center-level (within-DSA) variation (MIRR: centers _1.761.82_1.86, DSAs _1.131.17_1.21), while before KAS250, only 81.7% of geographic variability in transplant rates was attributable to center-level (within-DSA) variation (MIRR: centers _1.831.89_1.95, DSAs _1.311.35_1.39). Adjusted center-level DDKT rates under KAS250 were highly associated with offer acceptance rates (ρ = 0.60, p < 0.001).

CONCLUSIONS: Though geographic disparities are driven primarily by center-level practice differences including offer acceptance, KAS250 did reduce DSA-level disparities. Further allocation policy changes are unlikely to substantially reduce geographic variation in DDKT rates.

PMID:41995213 | DOI:10.1111/ctr.70543