Tag: pubmed

J Mater Sci Mater Med. 2026 Apr 24. doi: 10.1007/s10856-026-07047-w. Online ahead of print.

ABSTRACT

Significant clinical challenges are posed by large bone defects, necessitating the use of scaffolds that combine mechanical stability with osteoinductive properties. While polycaprolactone (PCL) lends itself well to 3D printing, its limited bioactivity means it needs to be modified with bioactive additives. Various additives have been proposed to enhance PCL scaffolds, but a systematic comparative evaluation of their mechanical and biological effects is lacking. This hinders the optimal selection of materials for specific applications. In this study, we compared the effects of four additives-silver nanoparticles (AgNPs), osteogenon (OST), zinc oxide (ZnO) and vitroceramic calcium phosphate (CaPNPs)-when incorporated at a concentration of 0.5 wt% into 3D-printed PCL scaffolds. We comprehensively evaluated the mechanical properties, thermal characteristics, and osteoblast biocompatibility using tensile testing, differential scanning calorimetry, and SaOS-2 cell culture assays (MTT test, activity of alkaline phosphatase, production of collagen I and fluorescent staining with acridine orange or phalloidin). ZnO modification significantly enhanced the mechanical properties (834% strain at break versus 658% for pure PCL and an increased Young’s modulus), as well as supporting cell viability (87 and 85%). Meanwhile, CaPNPs demonstrated the highest level of early-stage cell viability (103% after 24 h), although this was not statistically significant. All additives exhibited non-cytotoxic profiles with >80% cell viability and demonstrated time-dependent increases in alkaline phosphatase activity, but further evaluation for clinical application is essential. These findings provide evidence-based guidance for selecting PCL scaffold additives based on specific application requirements: ZnO is optimal for mechanically demanding applications, while CaPNPs could be optimal for facilitating rapid cell integration.

PMID:42029947 | DOI:10.1007/s10856-026-07047-w

Eur Radiol. 2026 Apr 24. doi: 10.1007/s00330-026-12547-y. Online ahead of print.

ABSTRACT

BACKGROUND: Ventilation/perfusion single-photon emission computed tomography (V/Q-SPECT) is the standard first-line imaging method for chronic thromboembolic pulmonary hypertension (CTEPH), but it lacks anatomical detail. Photon-counting computed tomography (PCCT) enables high-resolution assessment of perfusion, vasculature, and parenchyma in one scan, potentially improving diagnostic accuracy.

OBJECTIVES: To compare quantitative lobar lung perfusion between PCCT and V/Q-SPECT in patients with suspected or confirmed CTEPH.

MATERIALS AND METHODS: This retrospective single-centre study included twenty-three patients (ten females, thirteen males; mean age 67.9 ± 10.7 years). The median interval between PCCT and V/Q-SPECT imaging was 3 days (range: 0-11 days). Lung perfusion was analysed on a lobar basis using PCCT-derived perfused blood volume (PBV) maps and V/Q-SPECT perfusion images. Data were normalised using a z-score approach based on the 95% confidence interval. Lobar segmentation was performed with TotalSegmentator. Pearson correlation and Bland-Altman analyses compared lobar and whole-lung perfusion metrics. Perfusion defect volumes were quantified from normalised maps.

RESULTS: Whole-lung perfusion correlated strongly between PCCT and V/Q-SPECT (r = 0.72, p < 0.05). Lobar correlations ranged from r = 0.62 to r = 0.85. PCCT yielded slightly higher perfusion values (mean PBV 0.50 ± 0.04) than V/Q-SPECT (0.49 ± 0.09). Bland-Altman analysis showed a bias of +0.015 (limits -0.13 to +0.16). Perfusion defect volumes correlated moderately (whole-lung r = 0.60, lobes r = 0.49-0.77, p < 0.05).

CONCLUSION: PCCT-based perfusion imaging shows high concordance with V/Q-SPECT in this cohort, supporting its feasibility as a single-modality tool for functional and anatomical lung evaluation in CTEPH.

KEY POINTS: Question PCCT perfusion may address the unmet need for a combined functional and anatomical evaluation of CTEPH in a single examination. Findings PCCT showed strong correlation with V/Q-SPECT for lobar and whole-lung perfusion, with minimal bias and consistent quantitative agreement. Clinical relevance PCCT enables simultaneous high-resolution assessment of perfusion, vasculature, and parenchyma, potentially improving diagnostic confidence and streamlining CTEPH work-up in clinical practice.

PMID:42029914 | DOI:10.1007/s00330-026-12547-y

Arch Gynecol Obstet. 2026 Apr 24;313(1):172. doi: 10.1007/s00404-026-08445-9.

ABSTRACT

PURPOSE: To develop a practical risk-stratification framework for unplanned cesarean delivery (CD) among term nulliparous individuals with hypertensive disorders of pregnancy (HDP) undergoing induction of labor (IOL).

METHODS: This was a retrospective cohort study at a single tertiary care center (January 2010-March 2025) of nulliparous individuals with singleton gestations diagnosed with HDP undergoing IOL at ≥ 37 + 0 weeks. We excluded multiple gestations, major fetal anomalies, planned CD, or intrauterine fetal death. We included demographic and pregnancy characteristics available prior to induction and evaluated association with unplanned CD. Stepwise backward logistic regression was used to build a model for identifying independent predictors of unplanned CD. Sensitivity, specificity, and likelihood ratios (LR) were calculated.

RESULTS: Among 1,326 eligible individuals, 347 (26.2%) underwent unplanned CD. Independent predictors of CD were age > 35 years (adjusted odds ratio [aOR] 1.97, 95% CI 1.45-2.66), body mass index ≥ 30 kg/m² (aOR 2.07, 95% CI 1.58-2.70), HDP with severe features (aOR 1.71, 95% CI 1.17-2.49), thrombocytopenia (aOR 2.66, 95% CI 1.17-6.06), and need for cervical ripening (aOR 1.63, 95% CI 1.23-2.16). Cesarean risk increased stepwise with accumulation of risk factors: 28.4% with ≥ 1 factor, 36.7% with ≥ 2, 44.7% with ≥ 3, and 64.7% with ≥ 4. The presence of ≥ 4 factors yielded a positive LR of 5.17 (95% CI 1.92-13.99).

CONCLUSION: In term nulliparous individuals with HDP undergoing induction, approximately one in four require CD. A simple model based on five routinely available pre-induction factors enables individualized counseling and shared decision-making at the bedside.

PMID:42029903 | DOI:10.1007/s00404-026-08445-9

Radiol Oncol. 2026 Apr 16. doi: 10.2478/raon-2026-0021. Online ahead of print.

ABSTRACT

BACKGROUND: Endometrial carcinoma is the most common gynecological malignancy globally. Its rising incidence is closely linked to the increasing prevalence of morbid obesity (body mass index [BMI] > 40 kg/m²), which elevates the technical difficulty of surgery and the risk of perioperative complications. Identifying the optimal surgical approach is critical for this high-risk population.

PATIENTS AND METHODS: This retrospective study with prospectively collected data compared laparoscopic (LPSC) versus open abdominal (LAP) surgical approaches for low risk endometrioid carcinoma in morbidly obese patients. Data were collected over an eleven-year period (January 2013-December 2023) and included 73 patients (58 LPSC, 15 LAP) who met the inclusion criteria (BMI > 40 kg/m², low-grade, early-stage endometrioid carcinoma). Outcomes measured included operative time, intraoperative blood loss, length of hospital stay, and intraoperative/postoperative complications, which were rigorously classified using the Clavien-Dindo system.

RESULTS: Baseline patient characteristics were comparable between the two groups. The LPSC group demonstrated significantly superior perioperative outcomes. The average postoperative hospital stay was markedly shorter in the LPSC group (4.5 days) compared to the LAP group (12.7 days). Furthermore, LPSC was associated with lower rates of reoperation, transfusions, and postoperative anemia. Crucially, LPSC resulted in a statistically lower occurrence of severe postoperative complications (Clavien-Dindo Grade II and III).

CONCLUSIONS: he laparoscopic approach offers clear and significant perioperative advantages over open abdominal surgery for morbidly obese patients with low-risk endometrial carcinoma. Given the improved safety profile, LPSC or robotic-assisted surgery should be established as the preferred initial surgical approach in these technically challenging cases.

PMID:42029898 | DOI:10.2478/raon-2026-0021

Can J Public Health. 2026 Apr 24. doi: 10.17269/s41997-026-01204-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe the demographic and health profiles of Black people in the African Caribbean Track Study (A/C Study) who consented to linkage to administrative databases, examine variations in healthcare use, and compare these patterns to those observed in the general population to inform efforts to reduce health disparities.

METHODS: Using a matched cohort design, participants who consented to administrative data linkage in the A/C Study were matched 1:10 to general population controls based on age (± 5 years), sex, and census metropolitan area. We compared sociodemographic characteristics, HIV prevalence, and healthcare use using descriptive statistics and logistic regression.

RESULTS: Of the 1380 A/C Study participants, 309 provided consent and 115 (8.3%) were successfully linked to administrative data and matched to 1150 controls (total N = 1265). A/C Study participants were significantly more likely to reside in areas of higher material deprivation and residential instability. HIV prevalence was substantially higher in the A/C cohort compared to the general population (OR = 29.87; 95% CI, 8.10-110.12). A/C participants also had significantly higher odds of ER use (OR = 2.16; 95% CI, 1.38-3.40). No significant differences were observed in primary care visits, hospitalizations, specialist visits, or UPC index.

CONCLUSIONS: This study highlights disparities in HIV burden and emergency care use among Black communities in Ontario, underscoring persistent inequities in access to timely, preventive care. These findings demonstrate the value of data linkage for equity-focused health system research and emphasize the need for culturally responsive interventions to improve outcomes among Black populations in Canada.

PMID:42029872 | DOI:10.17269/s41997-026-01204-y

Sports Med Open. 2026 Apr 24;12(1):49. doi: 10.1186/s40798-026-01023-y.

ABSTRACT

BACKGROUND: Reaction speed represents a fundamental cognitive-motor capacity in sport, yet empirical findings regarding its psychological predictors remain inconsistent, particularly across stages of athletic expertise. This study aimed to investigate the associations of performance level and stress tolerance with latent reaction speed in athletes and to determine whether these associations differ across competitive levels.

RESULTS: A cross-sectional sample of 304 competitive athletes (amateur, pre-elite, and elite) completed standardized computerized psychophysiological assessments. Latent reaction speed was modeled as a unified cognitive-motor construct indicated by simple and choice reaction speed and motor execution measures. Performance level and stress tolerance were assessed as task-based indices of performance efficiency and cognitive load tolerance under standardized conditions. Structural equation modeling was used to examine predictors of latent reaction speed, followed by multi-group analyses across athlete competitive levels. Both performance level (β = 0.19, p = 0.004) and stress tolerance (β = 0.17, p = 0.010) showed small but statistically significant positive associations with latent reaction speed, together explaining 14.2% of its variance. Age was negatively associated with latent reaction speed, while gender effects were small. Multi-group analyses revealed that performance level (β = 0.28, p < 0.001) and stress tolerance (β = 0.17, p = 0.028) significantly predicted latent reaction speed only among pre-elite athletes, whereas no significant associations were observed in amateur or elite groups.

CONCLUSIONS: These findings suggest that the contribution of performance-related psychological factors to reaction speed is stage-specific, with relevance during the pre-elite phase of athletic development. The findings indicate statistically significant but modest associations between performance-related psychological factors and latent reaction speed across stages of athletic development.

PMID:42029866 | DOI:10.1186/s40798-026-01023-y

Ginekol Pol. 2026 Apr 24. doi: 10.5603/gpl.105702. Online ahead of print.

ABSTRACT

OBJECTIVES: In this study, we aimed to investigate serum alarin levels during the 24th to 28th weeks of gestation in women with newly diagnosed gestational diabetes mellitus (GDM), and to explore the possible correlation between alarin levels and maternal and neonatal clinical outcomes.

MATERIAL AND METHODS: A prospective cohort study including 64 women with pregnancies complicated by GDM and 64 women with healthy pregnancies (control group) was performed. Serum alarin levels were quantified using the enzyme-linked immunosorbent assay (ELISA) method, and their diagnostic utility was assessed through receiver operating characteristic (ROC) curve analysis. Furthermore, the relationships between alarin levels and various clinical parameters were statistically analysed.

RESULTS: The mean maternal serum alarin levels were notably elevated in the GDM group compared to the control (12.3 ± 1.4 ng/mL vs 7.8 ± 0.8 ng/mL; p < 0.05). ROC curve analysis demonstrated a high discriminatory capacity, with an AUC of 0.84 (95% CI: 0.77-0.92). However, no statistically significant correlations were observed between alarin levels and obstetric or neonatal parameters, including gestational age at delivery, polyhydramnios, preterm birth, hypertensive complications, fetal growth restriction, APGAR scores and NICU admissions.

CONCLUSIONS: Our results highlight the possible role of alarin as a promising biomarker for the identification of GDM.

PMID:42028676 | DOI:10.5603/gpl.105702

Scand J Caring Sci. 2026 Jun;40(2):e70247. doi: 10.1111/scs.70247.

ABSTRACT

AIM: To obtain information on what kinds of patient safety incidents were reported between different healthcare organisations, which professional groups reported them, and what kind of development measures were planned to prevent recurrence of the patient safety incidents.

DESIGN: The data of this retrospective register study consisted of interorganisational patient safety incident reports (n = 1225) entered in the electronic incident reporting system from 2015 to 2021.

METHODS: The reports were sent to the university hospital from other healthcare organisations belonging to the university hospital’s specific catchment area in Finland. Numeric data were analysed using descriptive statistical methods and open-ended answers reporting development measures (n = 139) with inductive content analyses.

RESULTS: The majority of reported incidents between organisations were related to information flow and management (57%). The second most reported concerned medication, fluid therapies, blood transfusions, contrast, and marker patient safety incidents. Most of the reports were prepared by nurses, followed by physicians and other stakeholders. Many of the patient safety incidents reported were categorised as insignificant or low risk (67%). The type of incidents was usually ‘incidents occurring to the patients’, causing minor risk to the patient. Only a few interorganisational development measures were suggested.

CONCLUSIONS: Collaboration between healthcare organisations should be improved to ensure timely and high-quality information transfer regarding the safe continuity of patient care. Incidents should be regularly reviewed and the planning of preventive measures for recurrent incidents should be conducted by interorganisational multi-professional teams, with the information in each organisation being disseminated at the unit level to improve safe care pathways.

IMPLICATIONS FOR THE PROFESSION: To avoid variations in patient safety incident risk assessment and increase its reliability, the risk assessment should be performed by qualified assessors.

IMPACT: This study showed that patient data transfer with adequate documentation and communication must be ensured for the continuity of care and patient safety. Development of interorganisational collaboration between professionals is needed to safeguard patient transfers from one healthcare organisation to another and ensure the patient’s integrated care pathway.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:42028670 | DOI:10.1111/scs.70247

Clin Trials. 2026 Apr 24:17407745261439661. doi: 10.1177/17407745261439661. Online ahead of print.

ABSTRACT

BACKGROUND: Although the analysis of event-based clinical trials commonly relies on assumptions about the underlying hazard functions, in practice it is rare to see estimates of those functions.

METHODS: I describe conventional and novel methods for estimating the hazard function using discrete and discretized continuous survival models. The conventional approach involves parametric modeling; the novel approach applies Bayesian model averaging to flexible modeling by splines or fractional polynomials. I evaluate the methods in a Monte Carlo study and illustrate them in the analysis of three historical clinical trials.

RESULTS: Although flexible models can capture features of the hazard functions-such as multimodality-that parametric models miss, they are not foolproof. Spline modeling was generally the most reliable, in the sense of yielding good coverage probabilities for the mean and median with modest loss of efficiency. In the examples, the discreteness of the measurements-days, weeks, or months-had little effect on the shape of estimated hazard functions. All three data sets showed some evidence of departure from the proportional hazards assumption, but in only one did a test for proportionality detect this departure.

CONCLUSION: Flexible parametric models, estimated in the Bayesian model averaging framework, offer a robust approach to recovering the shape of the hazard function. Analyses of three clinical trial databases suggest that visualization of the hazard function can be a valuable adjunct to conventional survival analysis.

PMID:42028665 | DOI:10.1177/17407745261439661

Anthropol Anz. 2026 Apr 24. doi: 10.1127/anthranz/1961. Online ahead of print.

ABSTRACT

Urban slums are characterized by informal settlements, poor living conditions and inadequate access to basic amenities. Poverty remains the largest structural determinant of health, with an increasing concentration of economically disadvantaged populations in urban areas. The present study aims to evaluate the somatotype and body fat percentage of adult inhabitants living in the urban slums of Guwahati using standardized anthropometric measurements. Assessment of somatotype provides valuable insight into body composition patterns and their potential association with susceptibility to non-communicable diseases (NCDs) in both sexes, thereby facilitating early risk identification. A total of 1,078 adults of 1860 years of age participated in the study. They were from eight slum settlements in Guwahati, representing a heterogeneous population comprising speakers of Bihari, Bengali, Assamese, and Punjabi, along with a small proportion of Telugu-speaking individuals. Anthropometric assessments included linear dimensions, circumferences (girth measurements), skinfold thicknesses, and skeletal breadths. Somatotype classification of the participants was performed using the HeathCarter method and analysed with R Statistical Software. The findings indicate that the maximum stature recorded among both males and females residing in the Guwahati slums was higher than the reported average adult height for the state of Assam. Endomorphic Mesomorph as the most prevalent somatotype indicating higher muscle and fat components with greater risk of obesity and metabolic disorders. The inhabitants face risks associated with both their somatotype and their fat percentage. Age-related declines in physical activity collectively may be is contributing to increased adiposity among the slum residents. Educating the slum residents may play a significant role in helping to understand about their overall health and active lifestyle.

PMID:42028655 | DOI:10.1127/anthranz/1961