Tag: pubmed

J Mech Behav Biomed Mater. 2026 Jul 18;182:107557. doi: 10.1016/j.jmbbm.2026.107557. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the fracture load (FL) of 3- and 4-unit zirconia fixed dental prostheses (FDP)s fabricated from two strength- and translucency-gradient multilayer zirconia materials before and after thermomechanical aging, and to compare the findings with finite element modeling (FEM).

METHODS: A total of 80 FDPs were milled from two zirconia materials: 5Y-PSZ/3Y-TZP (IPS e.max ZirCAD Prime) and 5Y-PSZ/4Y-PSZ (IPS e.max ZirCAD Prime Esthetic) (n = 40/material). Connector cross-sections were adapted to the material and FDP design: 17.0 and 14.1 mm² (3-unit) and 30.3, 33.1, and 39.2 mm² (4-unit) for 5Y-PSZ/3Y-TZP FDPs; 26.5 and 31.4 mm² (3-unit) and 27.5, 38, and 44.6 mm² (4-unit) for 5Y-PSZ/4Y-PSZ. All FDPs were cemented onto CoCrMo abutments. Half of the specimens were tested on fracture load (FL) under initial conditions, whereas the other half underwent thermomechanical aging in a chewing simulator (2.4 million cycles, 50 N, 1.5 Hz, 12,000 thermal cycles between 5°C and 55°C; 60 s dwell time). Data were analyzed using the Kolmogorov-Smirnov test, univariate analysis with partial eta squared, Mann-Whitney-U-test, Weibull statistics, and the Ciby Geigy method (α = 0.05). In addition, FEM simulations were performed to predict FL and failure location.

RESULTS: For 3-unit FDPs, no difference in initial FL was found between the two materials. After thermomechanical aging, 5Y-PSZ/4Y-PSZ showed higher FL than 5Y-PSZ/3Y-TZP. For 4-unit FDPs, FL was not affected by zirconia material or aging condition. In general, FDP span and thermomechanical aging had no influence on FL. The lowest Weibull modulus was observed for aged 4-unit 5Y-PSZ/4Y-PSZ FDPs, whereas the highest was found for initial 3-unit 5Y- PSZ/3Y-TZP FDPs. All 3-unit FDPs fractured at the connector between abutment and pontic, whereas 4-unit FDPs predominantly fractured in the pontic region between teeth 35 and 36. The FEM-predicted fracture loads were 3080 N and 2181 N for the 3-unit and 4-unit 5Y-PSZ/4Y-PSZ, and 2560 N and 2600 N for the corresponding 5Y-PSZ/3Y-TZP FDPs.

SIGNIFICANCE: Both strength and translucency gradient multilayer zirconia materials exhibited clinically sufficient and largely comparable FL behavior when connector geometry were appropriately designed. Thermomechanical aging did not impair load-bearing capacity under the tested conditions. FEM predictions showed good agreement with the results in terms of both FL magnitude and failure location.

PMID:42472511 | DOI:10.1016/j.jmbbm.2026.107557

Ultrasonics. 2026 Jul 16;168:108227. doi: 10.1016/j.ultras.2026.108227. Online ahead of print.

ABSTRACT

Wavenumber-domain beamforming offers substantial computational advantage over conventional time-domain algorithms in ultrasound image formation. However, these methods are found to introduce distortions at large angles and greater depths, making it nontrivial to replace conventional processing pipelines with wavenumber-domain approaches. This paper presents a wavenumber-domain framework that produces images consistent with conventional delay-and-sum (DAS) beamforming, while retaining the computational efficiency of Fourier-domain processing. Building on recent work on DAS-consistent imaging for multistatic acquisition data, the key utility of this novel algorithm is its applicability in plane-wave, focused-transmit, and diverging-wave imaging. The approach compensates for the implicit spatial-frequency filtering of earlier wavenumber-domain formulations through a modified Fourier-domain weighting and an axial scaling to the reconstructed image. Using data from simulations, phantom experiments, and in-vivo liver imaging, we demonstrate that the proposed method preserves DAS-equivalent amplitude, speckle statistics, resolution, and contrast. Quantitative image comparison confirms a close agreement between DAS and the proposed method with Structural Similarity (SSIM) values exceeding 0.99, whereas SSIM between earlier wavenumber-domain beamformers and DAS is lower, ranging from 0.67 to 0.92 depending on the transmit scheme. The proposed method yields approximately one order-of-magnitude reduction in computational cost compared to conventional DAS, making it well-suited for real-time and resource-constrained ultrasound systems.

PMID:42472506 | DOI:10.1016/j.ultras.2026.108227

Vaccine. 2026 Jul 18;88:128953. doi: 10.1016/j.vaccine.2026.128953. Online ahead of print.

ABSTRACT

BACKGROUND: Tetanus, diphtheria, acellular pertussis (Tdap) vaccination in pregnancy protects newborns against pertussis, but the influence of gestational age (GA) at vaccination on maternal and neonatal immune profiles remains incompletely understood. This study aimed to characterize the effect of GA at Tdap vaccination on several antibody features during pregnancy and at birth, and to assess transplacental antibody transfer.

METHODS: 96 pregnant women received Tdap at different GAs between week 16 and 32 within a Belgian, prospective non-randomized controlled trial. Maternal blood was collected pre-vaccination, at multiple timepoints post-vaccination, and at delivery, alongside cord blood at birth. Tdap-specific total IgG and IgG subclasses were evaluated alongside Fc-mediated effector functions. Multivariate analyses were applied to define composite immune patterns.

RESULTS: Post-vaccination, robust immune responses were observed across cohorts. At delivery, maternal total IgG and IgG1 against PRN, DT, and TT were higher with later vaccination, whereas other subclasses and functional responses were largely comparable. Cord blood profiles partially paralleled maternal patterns without reaching significance, and no significant effect of vaccination-to-delivery interval was detected. IgG transfer ratios generally declined with advancing GA; functional antibody transfer was largely unaffected. Multivariate analyses highlighted higher maternal antibody response profiles at delivery with later vaccination, while cord blood profiles were generally unaffected.

CONCLUSION: Maternal Tdap antibody response profiles at delivery are influenced by vaccination timing, while neonatal antibody profiles at birth appear largely comparable within the limits of the study. These findings support current recommendations for Tdap administration between 16 and 32 weeks of gestation and underscore the flexibility of this window for routine antenatal care.

PMID:42472495 | DOI:10.1016/j.vaccine.2026.128953

Psychol Health Med. 2026 Jul 19:1-30. doi: 10.1080/13548506.2026.2691409. Online ahead of print.

ABSTRACT

Maternal mental health is a major global concern affecting both pregnant women and fetal development. Mindfulness-based interventions (MBIs) have shown benefits in improving maternal mental health. This study assessed the effects of digital and conventional face-to-face MBIs on psychological distress among pregnant women. Two independent reviewers conducted the literature search and study selection. PubMed, SCOPUS, Web of Science, Cochrane Library and ScienceDirect were searched for studies published between 2014 and 2025; 27 studies were included, involving 1,793 participants in the digital MBI group and 2,406 in the face-to-face MBI group. Standardized Mean Difference (SMD) with 95% CI was calculated for psychological distress (depression, stress, and anxiety) outcomes. Heterogeneity was assessed using Chi-square and I² statistics. Due to substantial heterogeneity, a random-effects model and subgroup analyses were applied. MBIs during pregnancy were found to be effective, with overall SMDs of -0.77 for anxiety, -0.57 for depression and -0.64 for stress. In the subgroup analysis, digital MBI studies also showed significant reductions in anxiety (SMD = -0.56, 95% CI: -0.92 to -0.20; p = 0.006), depression (SMD = -0.43, 95% CI: -0.69 to -0.17; p = 0.001), and stress (SMD = -0.70, 95% CI: -1.12 to -0.27; p = 0.001) compared with standard care. MBIs were effective in reducing psychological distress among pregnant women. Both digital and face-to-face MBIs improved maternal psychological well-being, with digital MBIs showing comparable benefits in some studies. However, substantial heterogeneity across studies indicates the need for further high-quality research to confirm these findings.

PMID:42472479 | DOI:10.1080/13548506.2026.2691409

J Obstet Gynaecol. 2026 Dec;46(1):2703754. doi: 10.1080/01443615.2026.2703754. Epub 2026 Jul 19.

ABSTRACT

BACKGROUND: To evaluate the association between the weight-gain-for-gestational-age z-score and preterm birth (PTB) in a large Chinese twin pregnancy cohort.

METHODS: A hospital-based retrospective study included 2832 twin pregnancies between January 1, 2015, and December 31, 2019. The primary composite outcome was defined as PTB. The total gestational weight gain was converted into z-score, and logistic regression models were used to examine the associations between z-scores and PTB.

RESULTS: We developed a weight-gain-for-gestational-age z-score to determine the gestational weight gain during twin pregnancies in Chinese women. Low (<P25) and high (≥P75) z-scores were associated with a higher risk for spontaneous PTB (SPTB) than scores between the 25th and 75th percentiles (adjusted odds ratio [OR]: 1.35, 95% confidence interval [CI]: 1.05-1.74; 1.28, 0.99-1.66; respectively). Similarly, low z-scores (1.40, 1.12-1.76) and high z-scores (1.97, 1.57-2.47) were also associated with an increased risk for iatrogenic PTB (IPTB). Normal weight subgroups exhibited comparable outcomes. In addition, z-scores between the 25th and 75th percentiles indicated an equivalent total gestational weight gain at 37 weeks of 15.8-20.9 kg for underweight, 14.6-20.3 kg for normal weight, and 11.8-18.6 kg for overweight or obese women, which are narrower than the 2009 IOM recommendation.

CONCLUSIONS: Our findings indicate that inadequate gestational weight gain, as evaluated by the z-score, is associated with a significantly increased risk for SPTB, whereas inadequate and excessive gestational weight gain are associated with a significantly increased risk for IPTB, in a large Chinese twin pregnancy cohort.

PMID:42472474 | DOI:10.1080/01443615.2026.2703754

Disabil Rehabil. 2026 Jul 19:1-11. doi: 10.1080/09638288.2026.2704634. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this project was to design, develop and evaluate co-produced, evidence-based patient resources for adults with blunt chest injuries following hospital discharge.

MATERIALS AND METHODS: The project comprised two stages. 1) Face to face co-production workshop in which adults with lived experience of chest injuries and healthcare professionals developed the content for new patient resources. This was followed by an online workshop to design the format and finalise the patient resources. 2) Online surveys to evaluate the co-production process and the project outputs. Data analysis of surveys was completed using descriptive statistics and content analysis.

RESULTS: 18 participants attended the face to face workshop, 14 continued to participate in the online workshop. Two resources were developed and designed; an advice sheet (also an easy read and screen reader/digital Braille software version) and an online animation providing additional information, with voiceover and subtitles. Feedback of the co-production process and final outputs was positive, with useful suggestions for future development.

CONCLUSION: Recovery from blunt chest injuries following hospital is challenging. This co-production project has developed and designed two new patient resources accessible in a number of formats, that can support the patient through the recovery process.

PMID:42472448 | DOI:10.1080/09638288.2026.2704634

J Sports Sci. 2026 Jul 19:1-10. doi: 10.1080/02640414.2026.2703355. Online ahead of print.

ABSTRACT

This study evaluates the statistical properties of commonly used performance metrics in Australian Football (AF) using the meta-metric framework of discrimination and stability. Drawing on data from 1,383 players across 1,823 matches and 9 seasons (2015-2023), 33 player and team-level metrics were analysed to assess their statistical properties and utility for performance evaluation. Results indicate that count-based metrics such as kicks, handballs, disposals, and goals exhibit high discrimination and stability, making them robust indicators of player performance. In contrast, percentage-based metrics (e.g. effective clearance %, effective kick % and effective disposal %) demonstrated lower discrimination and stability, particularly at the team level, due to contextual variability. The advanced performance metrics Ranking Points, and Rating Points also had high discrimination and stability for all positional groups, suggesting their value in capturing overall player performance. Positional analysis revealed that discrimination and stability vary across position, underscoring the importance of contextual interpretation. This study advances the understanding of performance indicators in AF and establishes reference values to inform metric selection for decision-making and performance evaluation. These findings support the use of stable and discriminative metrics for decision-making in professional sport, while highlighting the need for further research integrating contextual data.

PMID:42472445 | DOI:10.1080/02640414.2026.2703355

Orv Hetil. 2026 Jul 19;167(29):1131-1141. doi: 10.1556/650.2026.33600. Print 2026 Jul 19.

ABSTRACT

Acute ischemic and hemorrhagic stroke are among the leading causes of mortality and long-term disability worldwide. In addition to the results of randomized clinical trials, registry data reflecting real-world clinical practice play a key role in evaluating the quality of care. The STROKE platform of the Translational Neuroscience National Laboratory provides a comprehensive overview of the patient population treated at a Hungarian comprehensive stroke center. Our objective was to characterize the STROKE platform and summarize the findings of studies based on its data, to synthesize the main clinical and methodological conclusions, and to present its implications for quality improvement in Hungarian stroke care. The platform is based on standardized data collection of patients admitted to the Department of Neurology or Neurosurgery, University of Pécs within 24 hours due to acute ischemic stroke, transient ischemic attack, or hemorrhagic stroke. Demographic, clinical, imaging, laboratory, therapeutic, and 90-day outcome data were recorded. Outcomes were analyzed using multivariable linear and logistic regression models, propensity score matching, and comprehensive machine learning methods. Based on the platform, 77.0% of admitted patients had ischemic stroke, 16.9% transient ischemic attack, and 6.1% hemorrhagic stroke; the mean age was 72.0 ± 12.5 years. Among patients with ischemic stroke, 62.4% received recanalization therapy. The strongest independent predictors of 90-day functional outcome were neurological status at admission, premorbid functional status, extent of early ischemia, and age. The Stroke-SCORE, based on three parameters (age, premorbid status and neurological deficit), demonstrated strong predictive performance for 90-day outcome (area under the curve = 0.86). In patients undergoing reperfusion therapy, door-to-needle time <60 minutes and door-to-groin time <120 minutes were significantly associated with more favorable outcomes. After multivariable adjustment, neither anticoagulant nor antiplatelet therapy proved to be an independent adverse prognostic factor. The STROKE platform confirms that functional outcome is primarily determined by stroke severity, premorbid status, age, extent of ischemia, and timely, well-organized reperfusion care. Real-world data analyzed with advanced statistical methods substantially contribute to clinical decision-making, the reassessment of contraindications, and quality improvement in Hungarian stroke care. Orv Hetil. 2026; 167(29): 1131-1141.

PMID:42472441 | DOI:10.1556/650.2026.33600

Prostate. 2026 Jul 19. doi: 10.1002/pros.70227. Online ahead of print.

ABSTRACT

BACKGROUND: The modified Glasgow Prognostic Score (mGPS) and systemic immune-inflammation index (SII) are useful prognostic markers for various malignancies. This study aimed to evaluate their prognostic significance in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel (CBZ).

METHODS: We retrospectively reviewed the data of 344 patients with mCRPC who initiated CBZ treatment at Kobe University Hospital and affiliated institutions. The optimal SII cutoff value for predicting overall survival (OS) was determined using the maximally selected rank statistics (Maxstat) method. The prognostic significance of the mGPS and SII was assessed using Cox proportional hazards models.

RESULTS: The median OS of the entire cohort was 15.9 months. The optimal SII cutoff value determined using the Maxstat method was 850.6. A multivariate analysis demonstrated that an mGPS ≥ 1 and an SII ≥ 850.6 were independent predictors of poorer OS, with hazard ratios of 2.10 (95% confidence interval [CI], 1.55-2.85; p < 0.001) and 1.58 (95% CI, 1.13-2.21; p = 0.008), respectively. Notably, among patients with an mGPS of 0, further stratification using the SII cutoff (mGPS 0/SII-low vs. mGPS 0/SII-high) significantly discriminated OS rates.

CONCLUSION: mGPS and SII are significant prognostic biomarkers in patients with mCRPC treated with CBZ. Their combined assessment may provide improved risk stratification and support clinical decision-making in this population group.

PMID:42472432 | DOI:10.1002/pros.70227

Musculoskelet Surg. 2026 Jul 19. doi: 10.1007/s12306-026-00960-x. Online ahead of print.

ABSTRACT

To evaluate the impact of surgical timing on mortality and functional outcomes in elderly patients with proximal femoral fractures (PFFs), specifically investigating whether a 72-h threshold provides a more sensitive clinical discriminator than the traditional 48-h guideline. A retrospective cohort study was conducted on 314 patients aged ≥ 65 years surgically treated for low-energy PFF (AO/OTA 31-A and B) between January 2018 and December 2019. Patients were initially dichotomized by a 48-h threshold (Group A ≤ 48 h, n = 139; Group B > 48 h, n = 175) and subsequently analyzed using a 72-h cutoff. Primary endpoints were 3-month and 1-year mortality. Multivariate logistic regression was performed to adjust for age, sex, and Charlson Comorbidity Index (CCI). Secondary outcomes included postoperative length of stay (LOS), transfusion requirements, and functional recovery assessed via the Barthel Index. No statistically significant difference in 3-month mortality was observed using the 48-h cutoff (Group A: 11.6% vs. Group B: 12.3%; p > 0.05). Conversely, the 72-h threshold emerged as a significant independent predictor of mortality (p < 0.05). Mortality rates for patients operated beyond 72 h were significantly higher at both 3 months (21.2% vs. 9.2%; p < 0.05) and 1 year (25.6% vs. 19.4%). Multivariate analysis confirmed surgical delay > 72 h as an independent risk factor (OR 2.1; 95% CI 1.3-3.4). The highest risk was observed in males aged > 85 years with extracapsular fractures operated beyond 72 h (1-year mortality: 37.5%). Mean LOS was significantly shorter in the early surgery group (7.6 ± 2.1 vs. 8.4 ± 2.8 days; p = 0.044). No significant differences were found in 3-month functional recovery between groups. In a real-world clinical setting, the 72-h threshold represents a critical “red line” for survival in elderly hip fracture patients. While striving for stabilization within 48 h remains ideal, maximum priority should be shifted toward preventing organizational delays that push vulnerable patients, particularly elderly males with extracapsular patterns, beyond the third day.Level of evidence: Level III (Retrospective cohort study).

PMID:42472414 | DOI:10.1007/s12306-026-00960-x