Tag: pubmed

J Cardiothorac Surg. 2026 Jun 19. doi: 10.1186/s13019-026-04414-0. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to evaluate residual apical space (RAS) as a predictor of pneumothorax recurrence in patients undergoing video-assisted thoracoscopic surgery (VATS) for primary spontaneous pneumothorax (PSP) and to assess its impact by surgical treatment type.

METHODS: Data of 463 patients undergoing VATS for PSP at three Italian high-volume thoracic surgery centers (January 2012-March 2023) were retrospectively reviewed. Exclusions included secondary pneumothorax, patients < 18 years, and those undergoing thoracotomy. Four surgical approaches were analyzed, with RAS measured using the Collins method (4.2% equivalent to 0 cm RAS) on chest X-ray before discharge. The primary outcome of interest was the recurrence rate stratified by surgical procedure. Statistical analyses were performed to correlate RAS, clinical and surgical variables with pneumothorax recurrence.

RESULTS: The overall recurrence rate was 6.9% (32 patients). The mean hospitalization was 6.5 ± 3.5 days, with an average RAS before discharge of 9.7 ± 5.4%=1.15 cm. Mechanical pleurodesis alone had an higher recurrence risk (*p* = 0.0027), while apicectomy with chemical pleurodesis significantly reduced recurrence risk (*p* < 0.0001). Increased RAS (> 9.7%) was associated with a higher recurrence rate (*p* = 0.063). Multivariate analysis confirmed that increased RAS significantly predicts recurrence (*p* = 0.002), particularly in patients aged > 34 years. Stratifying by type of surgery, an increased RAS value was associated to higher rate of recurrence (*p* = 0.001) in patients who underwent apicectomy combined to mechanical pleurodesis.

CONCLUSIONS: Apicectomy combined with chemical pleurodesis is still the most protective approach for recurrence. However, despite its proven efficacy, this strategy is being progressively used less. Residual apical space may represent a procedure-dependent radiological marker associated with recurrence, particularly in patients undergoing apicectomy and mechanical pleurodesis and may be considered to reduce recurrence rates.

PMID:42321834 | DOI:10.1186/s13019-026-04414-0

J Cardiothorac Surg. 2026 Jun 19. doi: 10.1186/s13019-026-04416-y. Online ahead of print.

ABSTRACT

BACKGROUND: The increasing prevalence of obesity worldwide has led to conflicting research on its cardiovascular effects. Although obesity is an established risk factor for cardiovascular disease (CVD), certain evidence indicates that a higher body mass index (BMI) might unexpectedly reduce the risk of vascular calcification. This study was designed to examine the association between BMI and the presence of abdominal aortic calcification (AAC) within a general population.

METHODS: We analyzed data from 3,116 adults participating in the 2013-2014 National Health and Nutrition Examination Survey (NHANES). Severe AAC was diagnosed using the Kauppila score based on dual-energy X-ray absorptiometry (DXA) scans. The relationships between BMI (treated both continuously and categorically) and severe AAC were evaluated using logistic regression. To investigate potential variations and non-linear patterns, subgroup analyses and restricted cubic spline regression were performed.

RESULTS: After comprehensive adjustment. higher BMI was significantly associated with lower odds of severe AAC (OR = 0.89, 95% CI: 0.81-0.98, p = 0.013). When compared to individuals with normal weight, obese participants had 62% lower odds of severe AAC (OR = 0.38, 95% CI: 0.16-0.94, p = 0.037). This inverse relationship remained significant in subgroups including males, elderly individuals, and those without hypertension or diabetes. Restricted cubic spline analysis indicated a significant non-linear trend (p for nonlinearity = 0.0023).

CONCLUSIONS: An inverse association was observed between BMI and AAC prevalence, implying that overweight and obesity may paradoxically confer a protective effect against vascular calcification. These results contribute evidence supporting the existence of an “obesity paradox” in the context of vascular health.

PMID:42321831 | DOI:10.1186/s13019-026-04416-y

BMC Oral Health. 2026 Jun 19. doi: 10.1186/s12903-026-08949-5. Online ahead of print.

ABSTRACT

BACKGROUND: Alar base widening is a common soft tissue change following Le Fort I osteotomy. Although alar cinch sutures are commonly used to limit this change, their long-term stability remains variable. Nasal sill resection may provide a direct resective option for managing horizontal excess at the alar base; however, its use concomitantly with maxillary orthognathic surgery has not been well described. This retrospective clinical series aimed to describe longitudinal nasal base width changes and patient-reported aesthetic outcomes following nasal sill resection performed concomitantly with maxillary orthognathic surgery.

MATERIALS AND METHODS: Twenty-three patients who underwent nasal sill resection concomitantly with maxillary orthognathic surgery under submental intubation between 2018 and 2020 were included. Alar base width was measured from the right and left alar curvature points to the subnasale/midcolumellar point, and total nasal base width was calculated as the sum of both measurements. Measurements were recorded preoperatively (T0), following osteotomy and fixation (T1), following nasal sill resection (T2), and at 1, 3, 6, and 12 months postoperatively. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was administered preoperatively and at 6 and 12 months postoperatively. Repeated measures analyses with Bonferroni correction were used for longitudinal comparisons, and intra-observer reliability was assessed using the intraclass correlation coefficient.

RESULTS: The mean preoperative total nasal base width was 39.56 ± 3.12 mm. Following osteotomy and fixation, total nasal base width increased to 47.87 ± 3.64 mm, and after nasal sill resection it decreased to 30.78 ± 2.95 mm. Nasal base width gradually increased during follow-up, reaching 36.61 ± 5.96 mm at 12 months. Although the 12-month value was descriptively lower than the preoperative baseline, this difference was not statistically significant after Bonferroni correction (p = 0.693). ROE scores improved from 10.91 ± 2.68 preoperatively to 17.78 ± 2.54 at 6 months and 18.09 ± 2.27 at 12 months (p < 0.001), with no statistically meaningful difference between the 6- and 12-month follow-ups. No major adverse outcomes related to nasal sill resection were documented during the 12-month follow-up period.

CONCLUSION: In this retrospective clinical series, nasal sill resection performed concomitantly with maxillary orthognathic surgery was associated with maintenance of nasal base width close to the preoperative baseline at 12 months, despite an initial postoperative narrowing. Patient-reported nasal aesthetic scores improved during follow-up. However, because of the uncontrolled retrospective design, limited sample size, and absence of objective functional assessment, these findings should be interpreted as descriptive clinical observations and should be further investigated in prospective controlled studies.

PMID:42321823 | DOI:10.1186/s12903-026-08949-5

BMC Med Genomics. 2026 Jun 19. doi: 10.1186/s12920-026-02396-5. Online ahead of print.

ABSTRACT

BACKGROUND: Fluoroquinolone-resistant Escherichia coli is a major global clinical threat, particularly in low- and middle-income countries like Nigeria. However, the full genomic landscape, including the relative contributions of chromosomal mutations, plasmid-mediated resistance, and the role of high-risk clones, remains poorly characterized in this setting. This study aimed to define the genomic mechanisms, clonal distribution, and genotype-phenotype relationships of fluoroquinolone resistance in clinical E. coli isolates from Nigeria.

METHODS: A cross-sectional study of 107 clinical E. coli isolates was conducted. Phenotypic susceptibility to ciprofloxacin and nalidixic acid was determined using VITEK 2 and broth microdilution. Whole-genome sequencing was performed, and analysis included detection of quinolone resistance determining region (QRDR) mutations (gyrA, parC, parE) and plasmid-mediated quinolone resistance (PMQR) genes, multilocus sequence typing (MLST), and phylogenetic analysis. Statistical associations were evaluated using chi-squared tests or Fisher’s exact tests.

RESULTS: Ciprofloxacin non-susceptibility was high at 86.0%. Resistance was primarily driven by a conserved chromosomal mutation profile; the combination of gyrA S83L, gyrA D87N, and parC S80I was present in 85 isolates and was associated with ciprofloxacin non-susceptibility in all affected isolates in this cohort. Isolates with only gyrA mutations were resistant to nalidixic acid but susceptible to ciprofloxacin, consistent with a stepwise resistance pathway. In this cohort, the triple QRDR signature (gyrA S83L + gyrA D87N/Y + parC S80I) was a perfect positive predictor of ciprofloxacin non-susceptibility (85/85; 100%). The ST131 lineage dominated, accounting for 21.5% of isolates and universally carrying the complete triple QRDR profile; notably, no ST131 isolate carried a PMQR determinant. Plasmid-mediated quinolone resistance (PMQR) genes were detected in 15.0% of isolates but were not independently associated with ciprofloxacin non-susceptibility in this cohort in the absence of concomitant QRDR mutations. Efflux pump genes were ubiquitous and non-predictive. Notably, six isolates, all from urine, were non-susceptible (R/I) despite lacking all known QRDR and PMQR determinants, pointing to uncharacterized mechanisms. In a multivariable logistic regression model that included ST131 status, PMQR carriage, and parE mutation status, ST131 was associated with ciprofloxacin non-susceptibility (adjusted OR 5.96, 95% CI 1.21-29.4, p = 0.028), whereas PMQR carriage was not (adjusted OR 0.94, 95% CI 0.18-4.85, p = 0.94). The triple QRDR signature was not included in this model because it perfectly predicted ciprofloxacin non-susceptibility in this cohort. Resistance patterns varied by clinical source, with the highest burden in bloodstream and wound infections. This stepwise hierarchy from first-step gyrA mutations to the classic triple QRDR profile is summarised in the graphical abstract, Fig. 1.

CONCLUSIONS: Fluoroquinolone resistance in Nigerian clinical E. coli is predominantly driven by chromosomal QRDR mutations within successful clones like ST131. PMQR genes and efflux pumps appeared to play a supplementary role rather than being independent drivers of ciprofloxacin resistance in this cohort. These data support prioritising key QRDR mutations in genomic reporting and local stewardship decisions, while the QRDR-negative resistant urine isolates require further investigation.

PMID:42321812 | DOI:10.1186/s12920-026-02396-5

J Environ Manage. 2026 Jun 19;412:130206. doi: 10.1016/j.jenvman.2026.130206. Online ahead of print.

ABSTRACT

Accurately apportioning organic pollution sources in mixed land-use watersheds remains challenging due to the limited tracer capacity of conventional fluorescence-based approaches. Traditional methods condense multidimensional excitation-emission matrix (EEM) spectra into a few summarized indices (e.g., BIX, HIX, FI), creating a mismatch between available fluorescence tracers and the number of pollution sources, thereby limiting source discrimination when multiple sources overlap. This study presents an analytical framework for source apportionment integrating three elements. First, full-spectrum EEM images are used as source-specific end-members to preserve spectral information for source-pattern characterization. Second, a statistical assessment of end-member independence and separability performed using SSIM and ANOSIM. Third, a CNN-unmixing architecture was developed to learn source-discriminating patterns from full-spectrum EEM images and estimate source-associated contributions in mixed-source EEMs based on candidate end-member representations. An EEM dataset was constructed from pollution source samples collected in mixed land-use watersheds. Statistical assessment of end-member similarity and separability showed high within-group similarity (Pearson’s r = 0.882-0.988; SSIM = 0.838-0.970) and significant between-group separation among the eight end-members in EEM spectral space (ANOSIM R = 0.876; PERMANOVA R² = 0.899). The framework was evaluated using ground-truth mixtures (2-5 components) and field stream samples. In controlled mixtures, CNN-unmixing showed R² > 0.7 and MAE <0.07 and generally reproduced dominant-source contributions and rankings across mixture complexities. The field application in the study watershed showed reasonable spatial consistency between the predicted dominant-source contributions and observed pollution-load distribution patterns, supporting the preliminary field-scale applicability of the framework for source-priority assessment in mixed land-use watersheds.

PMID:42320213 | DOI:10.1016/j.jenvman.2026.130206

J Environ Manage. 2026 Jun 19;412:130228. doi: 10.1016/j.jenvman.2026.130228. Online ahead of print.

ABSTRACT

Arctic lakes are exceptionally vulnerable to climate change, yet the depth-specific responses of their water quality remain largely unexplored, primarily due to the scarcity of long-term, depth-resolved water quality data. This study investigates how climatic and ice phenology conditions influence water quality in the surface and deep layers of Lake Inari, a large, oligotrophic arctic lake with minimal human-induced disturbance. Leveraging a 44-year dataset of in-situ measurements (1980-2023), we utilize canonical correlation analysis (CCA) to assess the potential interactions among key water quality parameters in the surface and deep layers of this stratified lake and climatic-ice factors. The results show a relatively robust statistical relationship between surface water quality and climatic-ice factors (R² = 0.67, p < 0.05). These climatic-ice factors account for approximately 53% of the variance in the lake’s surface water quality. In contrast, deep-water quality exhibits a relatively moderate but statistically non-significant correlation with climatic-ice factors (R² = 0.42, p > 0.05). The absence of statistical significance, likely a false negative due to limited power of our CCA analysis, suggests that deep-water quality responses may be delayed or indirect, potentially mediated by thermal stratification and reduced mixing. Both surface water quality and deep-water quality display exceptionally strong multivariate interactions (R² = 0.94, p < 0.05), driven by shared variability in turbidity, chemical oxygen demand, and electrical conductivity. The overall statistically significant redundancy between surface water quality and deep-water quality is around 60% for the latter. These findings suggest that surface-layer observations, including satellite and automated-sensor data, may help inform assessments of deep-water quality in large, oligotrophic, dimictic Arctic lakes. If further validated, this approach could support more cost-effective monitoring and strengthen climate-resilient lake-management planning.

PMID:42320202 | DOI:10.1016/j.jenvman.2026.130228

Comput Biol Chem. 2026 Jun 16;124(Pt 2):109199. doi: 10.1016/j.compbiolchem.2026.109199. Online ahead of print.

ABSTRACT

Coronavirus main protease (Mpro) is a conserved antiviral target, yet most generative AI pipelines optimize surrogate-predicted affinity without enforcing electronic plausibility or cross-target consistency. We present PRISM-Gen (Physics-guided Robust Inhibitor Selection Method – Generative Module), a multi-fidelity framework coupling fragment-tree molecular generation with a three-tier electronic screening cascade – GFN2-xTB semi-empirical descriptors, Gaussian Electronic Moderation (GEM) scoring, and B3LYP/6-31 G* DFT validation – followed by conservative worst-case docking across SARS-CoV-2, SARS-CoV-1, and MERS-CoV Mpro. Applied to 4136 generated candidates, the pipeline identifies 36 broad-spectrum-consistent inhibitor candidates whose top-ranked members exhibit predicted worst-case binding energies comparable to those of the non-covalent reference inhibitor ensitrelvir under identical docking conditions, while sharing no Bemis-Murcko scaffolds with nirmatrelvir, ensitrelvir, or GC376. Stage-wise statistical validation confirms that each tier exerts non-redundant, orthogonal selection pressure. Retrospective analysis demonstrates that replacing GEM’s continuous moderation with a conventional hard electronic cutoff would eliminate 48.0% of candidates, including 55.6% of the final 36 molecules, disproportionately depleting scaffold diversity. These results establish that continuous, physics-informed electronic moderation integrated within a multi-fidelity generative pipeline can recover structurally novel chemotypes that binary exclusion filters would irreversibly discard – a design principle applicable to generator-agnostic molecular discovery workflows.

PMID:42320197 | DOI:10.1016/j.compbiolchem.2026.109199

Comput Biol Chem. 2026 Jun 12;124(Pt 2):109184. doi: 10.1016/j.compbiolchem.2026.109184. Online ahead of print.

ABSTRACT

Pulmonary abnormality detection via analysis on respiratory sound is a novel method that shows promising results in early identification and detection of respiratory disorders. Researchers and physicians can benefit greatly from the Respiratory Sound Database that includes recordings of different respiratory sounds belonging to both healthy and unhealthy lung activities. By utilizing the latest developments in signal processing and ML methodologies, this work aims to create a new method termed as stacked ensemble model based Pulmonary abnormality detection (SEM based PAD) that can automatically identify and categorize abnormalities from the recordings of sounds. This article deploys Improved Wiener filtering (IWF) for preprocessing the sound signal. Subsequently, extraction of varied features takes place with improvement in Statistical parameter determination (ISPD). Then, Improved chi-square is used to choose the features, thereby, lessening the length of features. Finally, stacked ensemble model (SEM) that combines Squeeze Net, SVM and CNN is deployed for detecting the pulmonary abnormalities. The final outcomes are determined using Improved Score Level Fusion (ISLF).

PMID:42320196 | DOI:10.1016/j.compbiolchem.2026.109184

Poult Sci. 2026 Jun 9;105(9):107240. doi: 10.1016/j.psj.2026.107240. Online ahead of print.

ABSTRACT

Electrical water bath stunning remains the predominant method for poultry slaughter in Europe, yet its welfare implications are still debated. This study assessed the current status of stunning effectiveness in broiler chickens under commercial conditions, providing a foundation for future comparisons with controlled atmosphere stunning. Behavioral observations were made in 1 slaughterhouse over 2 study years (2021 and 2022) and were analyzed separately for each year across broilers from 4 fattening methods (LIT: light conventional fattening method, HEV: heavy conventional fattening method, LBL: label fattening method, ORG: organic fattening method). The analysis aimed to explore whether stunning performance differs according to fattening method, animal age, transport duration, carcass weight, weather conditions, and total electrical current in the electrical water bath. Stunning effectiveness was evaluated in 3 phases: pre-stunning (shackling), during stunning, and post-stunning. In each phase, key behavioral indicators, such as signs of inadequate stunning (e.g., wing flapping, body movements, rhythmic breathing), were systematically recorded. The results showed that pre-stunning behavior varied among fattening methods in 2022 (defensive reactions: ORG [0.82%] vs. LBL [0.05%]; wing flapping: LIT [29.00%] vs. OGR [17.00%], HEV [21.00%], and LBL [12.60%]), with older and lighter animals showing more pronounced defensive or flapping responses. After stunning in 2021, only ORG broilers showed cases of inadequate stunning (0.01%), whereas no incidences were observed in LIT (0.00%) and HEV broilers (0.00%). These findings highlight that even minor differences in handling and animal characteristics can significantly affect stunning effectiveness and animal welfare.

PMID:42320186 | DOI:10.1016/j.psj.2026.107240

Am J Otolaryngol. 2026 Jun 6;47(4):104868. doi: 10.1016/j.amjoto.2026.104868. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate clinical characteristics, associated comorbidities, management strategies, and factors associated with surgical intervention in children with laryngomalacia managed at a tertiary pediatric airway referral center in Eastern India.

METHODS: This retrospective cohort study included children aged 0-60 months diagnosed with laryngomalacia between January 2019 and December 2024 at Institute of Child Health. Diagnosis was confirmed by flexible nasopharyngolaryngoscopy. Clinical features, disease severity, feeding dysfunction, gastroesophageal reflux disease (GERD), synchronous airway lesions (SALs), management details, and outcomes were analyzed. Additional variables were extracted from institutional records following peer-review recommendations to improve methodological reporting. Factors associated with surgical intervention were evaluated using univariate analysis and exploratory multivariable analysis where statistically feasible.

RESULTS: A total of 68 children were included (male:female ratio 1.9:1). Median age at symptom onset was 2.5 months (IQR 1.5-4.0 months), and median age at diagnosis was 5 months (IQR 3-7 months). Feeding difficulty occurred in 47.1%, aspiration in 17.6%, failure to thrive in 22.1%, GERD in 30.9%, and SALs in 26.5%. Most children (82.4%) were successfully managed conservatively, while 17.6% required Supraglottoplasty. Fifty-nine children (86.8%) completed at least 12 months follow-up. Complete resolution of stridor occurred in 48/59 children (81.4%), and surgical success was observed in 10/12 children (83.3%). Feeding dysfunction and SALs were significantly associated with surgical intervention.

CONCLUSIONS: Most children with laryngomalacia improve with conservative management. However, feeding dysfunction and synchronous airway lesions may identify children at higher risk of requiring surgery. Early multidisciplinary airway evaluation may improve outcomes.

PMID:42320176 | DOI:10.1016/j.amjoto.2026.104868