Tag: pubmed

Front Oncol. 2026 Apr 27;16:1479189. doi: 10.3389/fonc.2026.1479189. eCollection 2026.

ABSTRACT

PURPOSE: For surgical guidance applications, supine breast MRI tumor contrast should be non-inferior to prone MRI, currently considered the standard-of-care. However, comparing image contrast quantitatively between different MRI sequences and breast orientations presents a significant challenge. Herein, we present a method for quantitatively comparing regional tumor contrast in the prone and supine breast MRI orientations for the purpose of tumor localization, and we apply this framework to assess the performance of two investigational supine scans (i.e. independent and prone-to-supine, P2S) compared to diagnostic prone MRI.

METHODS: Patient tumors from two studies (NCT03573804, NCT03573661) were outlined slice-by-slice by a breast radiologist using Gd-enhanced, T1-weighted MRI. Image data were derived from subjects undergoing standard-of-care prone imaging (n = 78), independent supine imaging (n = 17), and P2S supine imaging (n = 61). Normalized tumor contrast was computed between the segmented tumor and neighboring normal tissue regions and compared for statistical differences amongst cohorts and non-inferiority to prone MRI.

RESULTS: The independent supine cohort possessed non-inferior tumor-to-fibroglandular contrast compared to prone (p = 0.002), while tumor-to-fibroglandular contrast from the P2S supine cohort was found inferior to the prone cohort. However, both investigational supine scans produced non-inferior tumor-to-adipose contrast when compared to prone MRI (p< 0.001 in both cases).

CONCLUSIONS: Regional contrast between tumor and surrounding fibroglandular tissue suffered at later timepoints observed in the P2S supine study, resulting in inferior tumor contrast. However, when contrast-enhanced supine breast MRI is acquired independently, ratiometric comparisons indicate that tumor contrast is non-inferior to prone MRI.

PMID:42125694 | PMC:PMC13158090 | DOI:10.3389/fonc.2026.1479189

Pulm Circ. 2026 May 11;16:e70314. doi: 10.1002/pul2.70314. eCollection 2026 Jun.

ABSTRACT

Red blood cell distribution width (RDW)-derived indicators have increasingly been recognized as biomarkers reflecting systemic inflammation and hematological disorders. However, the prognostic value of these indicators in critically ill patients with pulmonary hypertension (PH), especially the dynamic implications of their temporal changes, remains insufficiently elucidated. A total of 990 adult patients diagnosed with PH in the intensive care unit (ICU) based on ICD-9/10 codes were enrolled from the MIMIC-IV database. The association between baseline levels of three key indicators and the 1-year all-cause mortality risk was assessed using Cox proportional hazards models and restricted cubic spline (RCS) analysis, and the consistency of this association was assessed for external consistency in the eICU-CRD cohort (n = 298) and NWICU cohort (n = 182). In the subgroup of patients with ≥ 3 consecutive laboratory tests (n = 316), group-based multi-trajectory modeling (GBTM) was employed to identify the joint longitudinal trajectory patterns of these three indicators. The robustness of the prediction results was then evaluated using machine learning models as secondary exploratory analysis. In the MIMIC-IV cohort, higher baseline RAR (aHR = 1.17, 95% CI: 1.08-1.27) and RPR (aHR = 2.31, 95% CI: 1.38-3.86) were significantly associated with increased 1-year mortality risk, whereas higher HRR exerted a protective effect (aHR = 0.31, 95% CI: 0.17-0.58). Across the multiple cohorts, only RAR remained statistically significant in the multivariate model of the eICU-CRD cohort (p = 0.009); although RPR and HRR showed a consistent association, the results did not reach statistical significance. GBTM identified three distinct joint trajectory patterns. Compared with the reference group (Class 2), the high-risk trajectory group (Class 3, n = 35) exhibited a significantly elevated mortality risk (aHR = 2.48). In the exploratory analysis, the support vector machine (SVM) demonstrated moderate discriminative ability (AUC = 0.782). RDW-derived indicators are independently associated with the mortality risk in critically ill patients with ICD-code defined PH. Both their baseline levels and short-term change trajectories may reflect the severity of the underlying disease and systemic stress response. These findings suggest that RDW-derived indicators play an important role in risk phenotyping; however, prospective studies are warranted to confirm their clinical significance.

PMID:42125633 | PMC:PMC13158876 | DOI:10.1002/pul2.70314

AEM Educ Train. 2026 May 11;10:e70172. doi: 10.1002/aet2.70172. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: The American Board of Emergency Medicine (ABEM) has recently introduced a new Certifying Exam, which incorporates assessment of performance in a simulated clinical environment. Simulation-based assessments allow for reproducible, controlled evaluations. The residency program has a responsibility to prepare residents for the Certifying Exam and to verify resident competency. We sought to determine the feasibility of a simulation-based assessment program encompassing three domains (resuscitation, procedural skills, and communication) with assessments against pre-determined Minimum Competency Scores (MCS) to provide evidence for program director attestations of competence.

METHODS: Eight stations were chosen based on ABEM’s Certifying Exam content, the Accreditation Council for Graduate Medical Education (ACGME) Milestones, and proposed Entrustable Professional Activities. Simulation-based case scenarios and assessment checklists were created with standard settings performed using the Mastery Angoff process. These stations were categorized into three different domains: resuscitation (Adult Medical, Pediatric Medical, Trauma, and Neonatal), procedural skills (Direct Laryngoscopy, Cricothyrotomy, and Central Venous Catheter Placement), and communication (Breaking Bad News). Results were summarized with descriptive statistics.

RESULTS: Thirty emergency medicine residents at an academic Midwestern residency program underwent assessments over one year. None of the residents achieved the MCS on all eight assessments. Residents achieved the MCS on an average of 4.24 stations. There was large performance variability, particularly for the Pediatric Medical (27%-100% items correct), Neonatal Resuscitation (30%-100%), and Breaking Bad News (31%-100%) scenarios. A greater percentage of residents met the MCS for procedural assessments.

CONCLUSIONS: This pilot study demonstrated the feasibility of a simulation-based assessment program designed to provide objective evidence of clinical competency. Assessment outcomes and associated feedback can be used by learners to guide the development of educational plans for performance improvement. Educators can use the resulting data to assess readiness for independent practice, prepare for the Certifying Exam, and identify content areas that may require additional program-wide education.

PMID:42125624 | PMC:PMC13159544 | DOI:10.1002/aet2.70172

Data Brief. 2026 Apr 7;66:112735. doi: 10.1016/j.dib.2026.112735. eCollection 2026 Jun.

ABSTRACT

This dataset provides full metabolomic data for root and stem samples of Sophora flavescens, a commonly used Chinese medicine. Metabolites were extracted separately from root and stem samples and subjected to high-resolution LC-MS in positive and negative modes. Raw spectral data were used for peak detection, alignment, normalization, and metabolite annotation using established metabolomic pipelines and public databases. Principal component analysis and partial least-squares discriminant analysis were used to obtain tissue-specific metabolic profiles. Differential metabolite analysis was conducted to determine the metabolites that were more enriched and depleted in roots and stems, and pathway enrichment analysis was performed to determine the metabolic pathways related to these metabolites. The dataset contains raw LC-MS files, processed feature tables, annotated metabolite lists, and statistical analysis results in a standard format. In these data, there are important materials for studying the tissue-specific metabolism different of S. flavescens, as well as for conducting research on the different distribution of medicine materials and studying biosynthesis routes and quality identification of medicinal plants. The same will be helpful for comparative metabolomics, integrative multi-omics, and natural products.

PMID:42125596 | PMC:PMC13158778 | DOI:10.1016/j.dib.2026.112735

Indian J Community Med. 2026 Mar-Apr;51(2):423-429. doi: 10.4103/ijcm.ijcm_173_25. Epub 2026 Mar 26.

ABSTRACT

Stigma associated with tuberculosis among the general population can lead to fear and encourage discrimination. It is an obstacle to the elimination of tuberculosis from India. The study aimed at estimating the gender-based prevalence of tuberculosis-associated stigma and its predictors in India. The study used unit level data on men and women from the nationally representative survey National Family Health Survey (NFHS 5), 2019-2021. Descriptive statistics and logistic regression analysis were done. It was found that tuberculosis-associated stigma is present in 22.9% of men and 15.6% of women. Among both men and women, tuberculosis-associated stigma was significantly higher among illiterate individuals (men: OR = 1.33; women: OR = 1.13), those belonging to higher wealth status (men: OR = 1.20; women: OR = 1.25), and those with comprehensive knowledge of the mode of transmission of this disease (men: OR = 1.24; women: OR = 1.32). In contrast, knowledge that tuberculosis is curable was associated with lower odds of stigma (men: OR = 0.59; women: OR = 0.83). It is recommended that health awareness activities on tuberculosis should emphasize comprehensive knowledge of disease transmission along with its curability.

PMID:42125591 | PMC:PMC13160205 | DOI:10.4103/ijcm.ijcm_173_25

Artif Organs. 2026 May 12. doi: 10.1111/aor.70166. Online ahead of print.

ABSTRACT

BACKGROUND: Mechanical circulatory support (MCS) has emerged as a life-saving intervention and may be a potential alternative to organ transplant for patients with end-stage heart failure. The Heartmate III (HM3) left ventricular assist device (LVAD) is a magnetically levitated centrifugal pump and the most advanced LVAD on the current MCS market. The BrioVAD is a newly developed LVAD featuring a fully magnetically suspended blood pump and has recently been approved by the FDA for the INNOVATE trial in the US. However, device-related complications, which are highly related to blood damage by the pump, remain a major concern for patients with MCS. This study aimed to compare device-induced blood damage by the HM3 and BrioVAD pumps in vitro in a circulatory loop.

METHODS: The device-assisted circulatory loop was filled with fresh, healthy human blood. Both pumps were operated under the same clinically relevant condition, i.e., a blood flow rate of 4.5 L/min and an afterload pressure head of 75 mmHg, for 4 h. Hourly blood samples were collected to assess device-induced damage to blood components, including red blood cells, platelets, neutrophils, and von Willebrand factor (VWF).

RESULTS: Both pumps had comparable impacts on blood components, with no statistically significant difference between them in all the measured parameters (except one neutrophil activation marker). After the four hours of device-assisted circulation, both pumps caused minimal hemolysis and moderate platelet damage but had significant impacts on VWF and neutrophils.

CONCLUSIONS: This study provides a comprehensive comparative in vitro analysis of blood damage caused by the HM3 and BrioVAD pumps under a clinically relevant condition. The results provide valuable insight into the potential implications for clinical use of the two devices and guidance for the design of new LVADs.

PMID:42121007 | DOI:10.1111/aor.70166

BMC Med Genomics. 2026 May 12. doi: 10.1186/s12920-026-02386-7. Online ahead of print.

ABSTRACT

BACKGROUND: Genome-wide association analyses (GWASs) have identified numerous genetic variants associated with type 2 diabetes, but the utility of polygenic risk scores (PRSs) derived from these associations for predicting future incident diabetes remains uncertain. We analyzed utility of PRSs to predict incident diabetes in longitudinal studies, consisting of African Americans (AfrAm) and European Americans (EurAm) from the publicly available dbGAP resource.

METHODS: Data consisted of 3,886 AfrAm and 17,345 EurAm with GWAS data, who were initially without diabetes; there were 688 incident diabetes cases in AfrAm and 2,304 in EurAm. Strength of association was assesed by the hazard ratio (HR), while ability to discriminate between those who did and did not develop diabetes was assessed by change in the C statistic (ΔC), and ability to correctly reclassify diabetes risk was assessed by the net reclassficiation information (NRI). Decision curve analysis was used to model potential benefits of using the PRS to select individuals for a preventive intevention across a range of thresholds for implementation.

RESULTS: Among the 8 PRSs evaluated, PGS002308 (1.2 M variants, from a multi-ancestry GWAS) provided the best performance. With adjustment for age, sex, parental history of diabetes, body mass index (BMI) and fasting glucose levels, the HR was 1.50 per 5000 risk alleles (95% confidence interval, 1.41-1.60). The NRI was 0.313 (0.229-0.397) and ΔC was 0.010 (0.007-0.014). In comparison, NRI was 0.401 (0.338-0.464) for BMI and 0.257 (0.188-0.327) for serum lipid levels. The PRS provided a 5.9% (1.6-10.4) improvement in area under the decision curve. For most measures of predictive utility there was little heterogeneity between AfrAm and EurAm. In contrast, measures of predictive utility were stronger in younger, than in older, individuals.

CONCLUSIONS: PRSs for type 2 diabetes, as currently constructed, provide utility for clinical prevention purposes that is similar to that provided by commonly used clinical predictors; utility is likely greater in younger than in older individuals. Further studies of diabetes risk assessment and those that aim to determine optimal target populations for diabetes prevention efforts would be strengthened by incorporating PRSs.

PMID:42120982 | DOI:10.1186/s12920-026-02386-7

Asian J Endosc Surg. 2026 Jan-Dec;19(1):e70311. doi: 10.1111/ases.70311.

ABSTRACT

PURPOSE: Laparoscopic cholecystectomy is common, but bile duct injury occurs in 0.3% of cases. Moderate to severe cholecystitis increases operative difficulty, and subtotal cholecystectomy is recommended as a preventive procedure. This study evaluated the outcomes of reconstituting subtotal cholecystectomy for cholecystitis at our institution.

METHODS: We retrospectively analyzed 2707 patients who underwent cholecystectomy between January 2010 and December 2022. Of these, 109 patients underwent reconstituting subtotal cholecystectomy. Patients were classified into a laparoscopic group (36 cases) and an open conversion group (73 cases). Short- and long-term outcomes were compared.

RESULTS: No bile duct injuries or operation-related deaths occurred. The laparoscopic group had significantly less blood loss and a shorter postoperative hospital stay. In almost all open conversion cases, the gallbladder stump was closed with sutures, whereas stapler closure was mainly used laparoscopically. Three cases of retained stone cholecystitis occurred in the laparoscopic stapler group, whereas no cases occurred in the laparoscopic suture group or open conversion group.

CONCLUSIONS: Laparoscopic reconstituting subtotal cholecystectomy is an acceptable surgical approach; however, retained stone-related complications require particular attention when stapled stump closure is performed, as the stump closure method may be more closely associated with these complications than the surgical approach.

PMID:42120958 | DOI:10.1111/ases.70311

J Chem Theory Comput. 2026 May 12. doi: 10.1021/acs.jctc.5c01985. Online ahead of print.

ABSTRACT

Fold-switching metamorphic protein sequences defy the classical “one sequence – one fold” paradigm. The ability of metamorphic proteins to reversibly switch between distinct folds make them attractive de novo protein engineering candidates since they can function as environment-sensitive molecular switches. However, the underlying thermodynamic design principles that drive their fold-switching behavior is poorly understood. Gaining insights into the molecular driving forces leading to fold switching behavior is crucial for the rational design of new metamorphic proteins based molecular switches, sensors and stimulus responsive nanomaterials. In this study, we perform a detailed thermodynamic analysis of a designed fold-switching protein [Solomon et al. PNAS 2023, 120 (4), e2215418120] that transitions between a 3α fold and α/β fold upon changes in temperature. We use an efficient advanced sampling molecular simulation based free energy calculation approach called Confine-Desolvate-Convert-Solvate-Release (CDCSR), which subjects the protein through the complete range of thermodynamic cycle and deconvolutes the enthalpic and entropic driving forces at each stage of the cycle. We find that while 3α fold is stabilized at low temperatures by enthalpic contributions from favorable water-water and protein-water interactions, the transition to the α/β fold at high temperatures is driven by the gain of entropy from the release of ordered water molecules surrounding the 3α fold. Our study elucidates the molecular driving forces governing temperature-induced fold-switching behavior and provides a rigorous statistical thermodynamic framework that can help in the design and engineering of future synthetic and functional metamorphic proteins. Significance: Recent success in the de novo protein design for molecular function is powered by the transformative AI methods and interpreted using the classical wisdom from the Physics-based modeling approaches. Stimuli-sensitive fold switching proteins that can take multiple shapes based on environmental factors are the next frontier in de novo protein engineering. In this work, we unravel the thermodynamic driving forces behind a recently designed temperature-sensitive artificial protein and provide a physics-based framework to understand the design principles leading to fold switching behavior. Our work complements the ongoing AI methods that are being explored to unravel the hidden evolutionary embeddings inherent in fold-switching proteins and also highlights the importance of thinking in terms of entropy-based design principles for natural systems.

PMID:42120955 | DOI:10.1021/acs.jctc.5c01985

Int J Dent Hyg. 2026 May 12. doi: 10.1111/idh.70087. Online ahead of print.

ABSTRACT

AIM: This study aimed to compare the clinical and biochemical effectiveness of using an oral irrigator (OI) and an interdental brush (IB) during fixed orthodontic treatment.

METHODS: A total of 30 patients with fixed orthodontic treatment were included in the study. All participants were randomly divided into two equal groups: patients using OI (OI-group) and patients using IB (IB-group). The patients were followed regularly; clinical evaluations were performed at 4 different times (baseline, 2nd, 4th, and 8th weeks), and gingival crevicular fluid samples were collected simultaneously. Total and concentration levels of IL-1β, IL-10, MMP-1, and MMP-8 from the collected gingival crevicular fluid samples were evaluated by the ELISA method. Clinical and biochemical differences that occurred at different times between the two groups were statistically examined.

RESULTS: The GI and BOP values at the 8th week (p < 0.001) and PI values at the 2nd (p = 0.004), 4th (p = 0.003), and 8th weeks (p < 0.001) were found to be statistically lower in the OI-group. Total IL-1β values in the 2nd week (p = 0.016), and total MMP-8 values in the 4th (p = 0.006) and 8th weeks (p = 0.01) were statistically lower in the OI-group. There were no significant differences in MMP-1 and IL-10 values between the groups at any time interval of the study (p > 0.05).

CONCLUSION: This study demonstrated that the use of an oral irrigator in conjunction with a toothbrush resulted in lower levels of gingival inflammation markers and plaque compared to an interdental brush in patients undergoing fixed orthodontic treatment, suggesting that the oral irrigator served as a beneficial tool for supporting periodontal health during orthodontic treatment.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05562986.

PMID:42120952 | DOI:10.1111/idh.70087