Tag: pubmed

Bone Marrow Transplant. 2026 Apr 8. doi: 10.1038/s41409-026-02827-y. Online ahead of print.

ABSTRACT

The selection of the best available donor is crucial for patients’ outcome after allogeneic stem cell transplantation (allo-SCT). In the absence of fully Human leucocyte antigen (HLA) -matched donors, mismatched unrelated donor (9/10-MUD) or haploidentical donor (haplo) can be considered. No consensus has been reached on the best alternative and large real-world data are warranted to support decisional processes. We compared the outcome of 1413 patients with myeloid malignancies undergoing allo-SCT from 9/10-MUD with anti-thymocyte-globulin (ATG) (n = 1134) or haplo with post-transplant cyclophosphamide (PT-Cy, n = 279) between 2009 and 2020 in 48 German centres. Donor type with related graft versus host disease (GvHD) prophylaxis showed in multivariable analysis no significant impact on acute GvHD development, both grade II-IV (HR 0.90, 95% CI 0.69-1.19, p = 0.469) and severe (HR 1.22, 95% CI 0.82-1.81, p = 0.319), nor on moderate to severe chronic GvHD (HR 0.78, 95% CI 0.59-1.03, p = 0.077). Moreover, no influence from donor type was observed on GVHD-relapse-free survival (HR 1.12, 95% CI 0.92-1.36, p = 0.227), progression-free survival (HR 1.2, 95% CI 0.95-1.51, p = 0.121), non-relapse mortality (HR 1.1, 95% CI 0.81-1.51, p = 0.542) and overall survival (HR 1.16, 95% CI 0.91-1.48, p = 0.235). Our real-world data demonstrate that haplo allo-SCT with PT-Cy is not inferior to 9/10-MUD allo-SCT with ATG.

PMID:41951842 | DOI:10.1038/s41409-026-02827-y

NPJ Digit Med. 2026 Apr 8. doi: 10.1038/s41746-026-02606-5. Online ahead of print.

ABSTRACT

While thousands of AI prediction models are published annually, few are adopted into routine practice, partly because improved statistical performance does not necessarily translate into meaningful impact on clinical decision-making. We conducted a prospective randomized multi-reader multi-case study to evaluate how a machine learning-based prognostic tool influences clinician performance in colorectal liver metastases (CRLM). In a prospective, randomized multi-reader multi-case trial (NCT07027605; Registration Date: January 1, 2025), 12 surgical oncologists assessed 166 retrospective CRLM cases with and without tool assistance in a crossed design with a 5-week washout. The primary endpoint was the difference in AUC for predicting 3-year mortality. Between January and July 2025, 12 readers completed 3984 assessments. Model assistance significantly improved the AUC for 3-year mortality prediction (mean difference 0.091; 95% CI 0.001-0.181; P = 0.048) and consistently improved accuracy across secondary prognostic endpoints. It also reduced decision time (2.53 vs. 3.04 minutes) and increased reader confidence. Benefits were greatest for junior to mid-level surgical oncologists. This exploratory study demonstrates that a machine learning prognostic tool can significantly improve accuracy, efficiency, and confidence in CRLM evaluation.

PMID:41951838 | DOI:10.1038/s41746-026-02606-5

Sci Rep. 2026 Apr 8. doi: 10.1038/s41598-026-47594-4. Online ahead of print.

ABSTRACT

The primary objective of this research is to explore changes in brain activity among astigmatism patients, employing functional near-infrared spectroscopy (fNIRS). A prospective cross-sectional study comprising 57 participants (99 eyes) was conducted and segmented into three distinct sections. In PART I, 24 participants (48 eyes) with astigmatism (Group A) and 18 participants (36 eyes) without astigmatism (Group B) were assessed using fNIRS to investigate the variations across different brain regions and channels. PART II involved 15 participants with monocular astigmatism (15 eyes), who received complete spherical optical correction, followed by fNIRS assessments after visual stimulation using E-Prime software. The study examined the activation levels of the occipital visual cortex and the functional connectivity strength of the brain, comparing these metrics pre- and post-cylindrical correction.

PART III: Following the correction of the initial refractive error in Group A, + 2.00 diopter cylinder (DC) lenses were employed to induce astigmatism at various axes. These axes were categorized into three groups: oblique astigmatism group, with-the-rule astigmatism (WTR), and against-the-rule astigmatism (ATR). fNIRS was conducted during task performance to assess the strength and activation level of brain functional connectivity across different astigmatism axes of the same diopter.

PART I: The functional connectivity strength of HbO₂-based occipital cortex was stronger in group B than in group A (P < 0.001).

PART II: Significant differences in the β values of the left and right visual cortex were detected in cases of monocular astigmatism before and after astigmatism correction. (P = 0.002 and P = 0.004). The functional connectivity strength in the post-cylindrical correction condition exceeded that in the pre-cylindrical correction condition; nevertheless, this variation did not attain statistical significance (P > 0.05).

PART III: The functional connectivity strength and activation level of the HbO₂-based occipital visual cortex exhibited significant variations across different astigmatism axes (P < 0.001 and P = 0.045). Specifically, the functional connectivity strength in the oblique astigmatism group was greater than that observed in both the WTR and ATR groups. Conversely, the degree of brain activation in the oblique astigmatism group was lower compared to the ATR group (P = 0.042). These observations imply that astigmatism may decrease both the activation of the occipital visual cortex and the strength of brain functional connectivity. The functional activities of the occipital cortex can be enhanced to a certain degree following optical correction of astigmatism. The strength of functional connectivity and the degree of activation in the occipital visual cortex vary with different axes of astigmatism.Trial Registration This study was registered in the China Clinical Trials Registry (registration number: ChiCTR2300070613, date of registration: 2023-04-18), and the study followed the ethical principles required by the Declaration of Helsinki, and the subjects were informed and signed the informed consent form, and it has been reviewed and approved by the Medical Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (Approval No. 2022ER541-1).

PMID:41951802 | DOI:10.1038/s41598-026-47594-4

J Perinatol. 2026 Apr 8. doi: 10.1038/s41372-026-02648-3. Online ahead of print.

ABSTRACT

We sought to characterize bedside nurses’ perceptions of providing intensive care to patients with trisomy 18 (T18) in a level IV neonatal intensive care unit (NICU). NICU nurses were anonymously surveyed with an electronic, mixed-methods survey. Items included quantitative questions about whether T18 is “incompatible with life,” whether interventions should be offered, open-ended free-text questions, and demographic items. Survey results were analyzed with descriptive statistics and thematic analysis. There were 145 responses (response rate 46%). Most (53%) agreed that T18 was “incompatible with life”, and 59% felt that this diagnosis should impact interventions offered. Two major themes emerged from 114 free-text responses, including “perceptions of prognosis” and “ethical considerations.” Though most nurses believe that T18 is “incompatible with life” and interventions should be restricted, a substantial minority endorse other perspectives. A range of ethical considerations shape nurses’ diverse views, suggesting that they are morally rooted and may contribute to ethical distress.

PMID:41951800 | DOI:10.1038/s41372-026-02648-3

Sci Rep. 2026 Apr 8. doi: 10.1038/s41598-026-47790-2. Online ahead of print.

ABSTRACT

Adolescent depression is a public development crisis that needs to be paid attention to and addressed under the rapid development of the Internet. It is of great significance to investigate the associations among adolescent depression, family relationship and physical activity (PA) for promoting adolescent mental health. A total of 3990 valid questionnaires were obtained through self-reports from adolescents. Data were collected using measurement tools for adolescent depression, parental marital conflict (PMC), and PA, followed by statistical analysis. Adolescent depression and PMC was significantly positive correlation (β = 0.315, p < 0.001) and PA is significantly negatively correlated (β = – 0.093, p < 0.001). After introducing moderating variables, PMC is still a significant positive correlation and adolescent depression (β = 0.303, p < 0.001). The study provides preliminary support for the association between PMC and adolescent depression, as well as the potential moderating roles of gender and PA in this association. These findings generate hypotheses for future research on the roles of PA and family relationships in adolescent depression, rather than providing direct evidence for prevention or intervention strategies.

PMID:41951798 | DOI:10.1038/s41598-026-47790-2

J Nutr Health Aging. 2026 Apr 7;30(5):100837. doi: 10.1016/j.jnha.2026.100837. Online ahead of print.

ABSTRACT

BACKGROUND: The effects of exercise snacks interventions on physical function in healthy or sub-healthy adults remain unclear. Exercise snacks intervention is defined as breaking up daily physical activity into brief, frequent bouts performed intermittently throughout the day (e.g., 1-2 min of stair climbing or bodyweight training hourly). This study aims to evaluate the effectiveness of exercise snacks interventions in improving physical function in this population.

METHODS: The systematic search covered the China National Knowledge Infrastructure (CNKI), China Science and Technology Journals (VIP), Wanfang, PubMed, Embase, CINAHL, Web of Science, Cochrane Library, and Scopus databases, screening relevant randomized controlled trials published up to July 31, 2025. The risk of bias in the included studies was assessed using the Cochrane risk of bias tool, and data analysis was performed with RevMan 5.3.

RESULTS: This study included 11 eligible randomized controlled trials involving 472 participants. Meta-analysis results demonstrated that exercise snacks interventions significantly increased absolute peak power output [MD = 16.53, 95%CI (2.93, 29.77), P = 0.02], maximal oxygen uptake [MD = 0.19, 95%CI (0.02, 0.36), P = 0.03], the number of repetitions in the 60-second sit-to-stand test [MD = 4.38, 95%CI (1.00, 7.77), P = 0.01], while significantly reducing body fat percentage [MD = -3.12, 95%CI (-5.51, -0.73), P = 0.01]. However, no statistically significant differences were observed in improving fatigue levels or BMI.

CONCLUSION: Among healthy and sub-healthy adults, exercise snacks interventions enhance cardiorespiratory endurance by increasing Wpeak and VO_2max. Concurrently, they improve functional movement capacity by increasing the number of 60-second sit-to-stand repetitions and reducing body fat percentage. As a feasible, convenient, and easily integrated exercise method, exercise snacks demonstrate significant potential for health promotion.

PMID:41950555 | DOI:10.1016/j.jnha.2026.100837

Arch Oral Biol. 2026 Mar 25;187:106576. doi: 10.1016/j.archoralbio.2026.106576. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the inhibition of Toll-like receptor 2 (TLR2) signaling in lipoteichoic acid-induced NF-κB activation and interleukin-6 (IL-6) production in primary human dental pulp stromal cells (DPSCs).

DESIGN: Primary human DPSCs were cultured with lipoteichoic acid from Staphylococcus aureus (LTA-SA; 10, 25, 50 µg/ml) for up to 72 h to assess time- and concentration-dependent IL-6 production. IL-6 secretion was quantified by ELISA, while cell counts were determined via cell counter. To evaluate TLR2-dependent signaling, cells were pre-incubated with the TLR2 inhibitor C29 (100 µM) prior to LTA-SA stimulation. IL6 gene expression was analyzed by RT-qPCR, and NF-κB nuclear translocation was assessed by Western blot analysis. Non-parametric statistical analyses were applied to compare all groups and time points (Mann-Whitney U test or Kruskal-Wallis test; α = 0.05).

RESULTS: LTA-SA stimulation induced a significant, time- and concentration-dependent increase in IL6 gene expression and IL-6 secretion, accompanied by enhanced NF-κB nuclear translocation. Inhibition of TLR2 with C29 reduced nuclear translocation of NF-κB, along with a decrease in IL6 gene expression and IL-6 secretion, exhibiting both time- and concentration-dependent effects.

CONCLUSIONS: LTA induces IL-6 production in DPSCs via TLR2-mediated activation of the canonical NF-κB pathway. Targeted modulation of TLR2 signaling may represent a potential strategy for controlling pulpal inflammation.

PMID:41950554 | DOI:10.1016/j.archoralbio.2026.106576

Eur J Obstet Gynecol Reprod Biol. 2026 Apr 5;322:115095. doi: 10.1016/j.ejogrb.2026.115095. Online ahead of print.

ABSTRACT

OBJECTIVE: Pelvic organ prolapse (POP) impairs quality of life in aging women. Vaginal hysterectomy (VH) is a standard approach for advanced POP, yet large single-center series are limited. We evaluated concomitant procedures and perioperative outcomes of VH and explored associations of age, parity, and concomitant adnexal or reconstructive surgery with perioperative measures.

STUDY DESIGN: This retrospective cohort included 416 patients who underwent VH for POP between 2017 and 2025. Demographics, prolapse stage, concomitant procedures, perioperative complications, length of hospital stay, perioperative hemoglobin change, and pathological/specimen characteristics were recorded. Subgroup analyses compared patients undergoing additional reconstructive and/or adnexal surgery. Statistical analyses included t-test/ANOVA and Spearman correlation, with p < 0.05 considered statistically significant.

RESULTS: Mean age was 62.6 ± 9.2 years and mean parity 3.2 ± 1.7. POP was stage 3 in 41.6% and stage 4 in 34.6%. Anterior colporrhaphy was performed in 69.7%. Apical suspension accompanied VH in 72.4% of cases, including McCall culdoplasty (52.4%) and sacrospinous fixation (20.2%). Increasing age was associated with higher prolapse stage (p = 0.033). Vaginal deliveries were associated with cystocele and rectocele (p = 0.027 and p = 0.028). Concomitant adnexal surgery was associated with longer hospitalization and lower postoperative hemoglobin (p < 0.001 and p = 0.03). Postoperative complications occurred in 1.4% and were associated with lower mean age (p = 0.038).

CONCLUSIONS: VH for advanced POP demonstrated favorable perioperative outcomes with a low complication rate. Age, parity, and concomitant procedures influenced perioperative measures, supporting VH with apical suspension as a reliable real-world surgical option.

PMID:41950546 | DOI:10.1016/j.ejogrb.2026.115095

J Am Soc Mass Spectrom. 2026 Apr 8. doi: 10.1021/jasms.5c00444. Online ahead of print.

ABSTRACT

Imidacloprid (IMI) is a widespread neonicotinoid insecticide of environmental concern because of its ecotoxicity and persistence. Tracing its commercial sources and environmental transformation is difficult with concentration-based approaches. We explored electrospray ionization Orbitrap isotope ratio mass spectrometry ((ESI) Orbitrap MS-Based Isotope Ratio Analysis) for compound- and fragment-specific stable isotope analysis of IMI at natural abundance. This approach enables direct measurement of ¹³C, ¹⁵N, ³⁷Cl, and multiple substituted isotopologue ratios. Experimental parameters were optimized to control sources of bias in isotopologue ratios. A dual-inlet bracketing protocol enabled normalization and drift correction. IMI from seven different commercial sources could be distinguished by their isotopic fingerprints. We demonstrate that principal component analysis (PCA) can exploit the expanded set of isotopic variables. Two PCAs with distinct variable sets were performed: a fragment-only, nonoverlapping isotopologue subset for source material attribution, and a combined molecular-average and fragment-level subset to maximize manufacturer discrimination. Alkaline hydrolysis (pH ≈ 12, 30 °C) based on compound-average δ¹³C and δ¹⁵N values measured by (ESI) Orbitrap MS-Based Isotope Ratio Analysis revealed significant carbon isotope fractionation (ε_C = -4.3 ± 1.4 ‰) and a statistically negligible nitrogen fractionation (ε_N = 0.6 ± 1.6 ‰), consistent with initial OH^– attack at the nitroimine carbon as the primary pathway. (ESI) Orbitrap MS-Based Isotope Ratio Analysis can elucidate transformation mechanisms in analytically challenging polar analytes. The chemometric approach of using MS¹/MS² data can be transferred to other (agro-)chemicals either to enhance isotopic discrimination or to discover patterns.

PMID:41950525 | DOI:10.1021/jasms.5c00444

JMIR Med Educ. 2026 Apr 8;12:e82136. doi: 10.2196/82136.

ABSTRACT

BACKGROUND: Virtual reality (VR) is increasingly used in medical education for training and examination purposes; yet, learners’ performance in VR-based assessments may be influenced by more than clinical competence alone. Immersive competence (IC) has been proposed as a relevant factor in VR-based performance assessment. While general IC captures application-independent VR interaction skills, domain-specific applications may require an additional construct, specific immersive competence (specific IC), reflecting context-dependent interaction proficiency.

OBJECTIVE: This study aimed to develop and examine the initial psychometric characteristics of a newly developed in situ checklist for assessing specific IC, to explore the relationship between specific and general IC as well as related human abilities and characteristics, and to capture preliminary associations between both IC measures and medical performance in a VR-based objective structured clinical examination (OSCE) station.

METHODS: In this observational follow-up study, 21 final-year medical students who had previously completed a curricular OSCE including a VR-based emergency medicine station were recruited. General IC was assessed using the VR competence app, and specific IC using a checklist embedded in the original VR simulation. Additional measures included self-reported technological affinity, spatial ability, and OSCE performance scores. Analyses focused on descriptive statistics and exploratory associations, including item difficulty, item-total correlations, and internal consistency for the specific IC checklist. Pearson r was used to examine associations among variables.

RESULTS: The final 13-item specific IC checklist demonstrated acceptable internal consistency for an early-stage instrument (Cronbach α=0.79) and balanced item difficulty (mean P 0.56, SD 0.28). Specific IC showed a strong exploratory association with general IC (r=0.56; P=.008) and with prior 3D application experience (r=0.57; P=.007), but no relevant association with spatial ability. Both general and specific IC showed borderline, moderate associations with VR-OSCE performance (r=0.41; P=.06 and r=0.37; P=.09, respectively), while neither was related to overall analog OSCE performance.

CONCLUSIONS: In this pilot sample, specific IC emerged as a psychometrically accessible construct aimed to capture context-sensitive VR interaction skills. The proposed in situ approach offers a feasible and scalable method to assess this construct within domain-specific VR applications. Although associations with medical performance were exploratory and limited by sample size, the findings suggest the relevance of IC as a potential source of construct-irrelevant variance in VR-based assessments and support further investigation in larger, confirmatory studies.

PMID:41950510 | DOI:10.2196/82136