Tag: pubmed

J Eval Clin Pract. 2026 Aug;32(5):e70514. doi: 10.1111/jep.70514.

ABSTRACT

AIMS: This study was designed as a descriptive and correlational study to assess the burden experienced by caregivers of palliative care patients with pressure injuries, to identify the factors influencing this burden and to examine the role of perceived social support.

METHODS: Data were collected from 138 informal caregivers of palliative care patients with pressure injuries in a state hospital. The Burden Interview and the Multidimensional Perceived Social Support Scale were used to collect data. Descriptive statistics, correlation analyses and hierarchical regression were conducted to identify factors associated with caregiver burden.

RESULTS: Caregivers reported a high level of burden. Lower income status, difficulty experienced during caregiving and negative effects on family and social life were associated with greater burden. Higher perceived social support was associated with lower burden, indicating that social support plays a protective role for caregivers of patients with pressure injuries.

CONCLUSION: Caregivers of palliative care patients with pressure injuries experience substantial burden influenced by socioeconomic and caregiving-related factors. Increased perceived social support contributes to reducing this burden and should be considered an essential component of caregiver-focused interventions.

PMID:42378645 | DOI:10.1111/jep.70514

J Magn Reson Imaging. 2026 Jun 30. doi: 10.1002/jmri.70424. Online ahead of print.

ABSTRACT

BACKGROUND: Histological grade and Ki-67 expression are prognostic risk factors in patients with soft tissue sarcoma (STS). These assessments require biopsy, which may be affected by tumor heterogeneity and is invasive.

PURPOSE: To develop an automated MRI-based pipeline to assess STS grade and Ki-67 expression.

STUDY TYPE: Retrospective.

POPULATION: 186 patients with pathological confirmation of STS (89 low-grade, 97 high-grade; 87 low Ki-67 expression, 99 high Ki-67 expression) across three hospitals, with 130 and 56 patients in the training and validation cohorts.

FIELD STRENGTH/SEQUENCE: 1.5 T and 3.0 T/Fat-suppressed T2-weighted imaging, fat-suppressed gadolinium-enhanced T1-weighted imaging, and diffusion-weighted imaging.

ASSESSMENT: An automatic STS segmentation model was developed and compared with manual segmentations. Clinical-imaging signature (CS) models were developed to distinguish STS grade and Ki-67 expression using: (i) structural MRI (T1WI and T2WI) radiomics features, (ii) structural MRI and ADC radiomics features, and (iii) structural MRI and ADC radiomics features combined with clinical information and MRI semantic features. The diagnostic performance of radiologists (with 6, 8, and 38 years’ experience) for assessing grade and Ki-67 expression was evaluated with and without the assistance of the best-performing models.

STATISTICAL TESTS: Dice coefficient, Cohen’s κ and weighted κ, chi-square test or Fisher’s exact test, logistic regression analyses, decision curve analysis, area under the receiver operating characteristic curve (AUC), and DeLong’s test. A p value < 0.05 was considered significant.

RESULTS: The segmentation model achieved good segmentation performance (0.80 in extremity cases and 0.73 in trunk cases). LR and SVM CS models showed the best performance for grading and Ki-67 assessment, respectively. (AUC in validation cohort: 0.846 and 0.742). Using the model significantly improved the diagnostic performance of the two more-junior radiologists for grade (AUC: 0.720-0.832 and 0.735-0.835) and Ki-67 expression (AUC: 0.665-0.717 and 0.659-0.741).

DATA CONCLUSION: The CS model may assess STS grade and Ki-67 expression and improve the diagnostic performance of less-experienced radiologists.

EVIDENCE LEVEL: 3.

TECHNICAL EFFICACY: 2.

PMID:42378640 | DOI:10.1002/jmri.70424

J Anim Physiol Anim Nutr (Berl). 2026 Jun 30. doi: 10.1111/jpn.70089. Online ahead of print.

ABSTRACT

This study hypothesises that a high-starch (HS) diet during the last month of gestation enhances colostrum yield and composition as well as the dam and goat kid metabolism, immune status and performance. Thirty multiparous and pregnant Majorera dairy goats were randomly assigned to a prepartum dietary treatment (CON vs. HS) on wk -4 relative to the expected parturition. Goats were fed either a control (n = 15; 25% DM of starch) or HS (n = 15; 32% DM of starch) diet during the last month of gestation. Blood samples were collected on wk -4, -3, -2 and -1 relative to expected parturition, immediately at parturition (d0) and on d 1, 2, 3, 5, 10, 15, 30 postpartum in dams and goat kids. Colostrum and milk yield were recorded, and gross chemical composition, somatic cell count (SCC), Brix degrees and immunoglobulin G (IgG) concentration were determined on d 0, 1, 2, 3, 5, 10, 15, 30 postpartum. In addition, dam and goat kid blood serum metabolites and plasma IgG concentrations were determined. Data was analysed using linear mixed models in SAS (SAS 9.4) including the prepartum diet, time (T), and the interaction between both as fixed effects. The statistical significance was set as p ≤ 0.05. The high-starch diet did not have any effect either on colostrum nor on milk yield, gross chemical composition, SCC and Brix degrees. However, the excess of starch on the prepartum diet increased colostrum IgG concentration on d 0 (i.e. first milking) in the HS group compared to the control group (i.e. 85.4 and 61.2 mg/mL, respectively). Serum BHB concentration in the HS group increased progressively from wk -3 to parturition (i.e. 0.20 and 0.24 mmol/L, respectively), whereas the control group showed a sharp increase from wk -1 to parturition (i.e. 0.22 and 0.29 mmol/L, respectively). Calcium, total protein, lactate dehydrogenase, urea and albumin concentrations were lower in the HS group compared to the control group during the prepartum period. The high-starch diet prepartum did not influence serum metabolites in the postpartum period except for lactate dehydrogenase, being lower in the first 5 days after parturition in the HS group. In the goat kids, body weight (BW), milk intake and plasma IgG concentrations were not affected by the high-starch diet offered to the dams prepartum except for an increased serum total protein concentration observed on d 1 in the HS group compared to the CON group (i.e. 7.1 vs. 6.5 g/dL, respectively). The present results indicate that a high-starch diet during the last month of gestation does not affect either colostrum yield or composition but increases colostrum IgG concentration, although it did not affect circulating IgG concentrations in goat kids from both groups. Based on the slower fat mobilisation in the HS group, high-starch diets prepartum could promote a smoother transition from late gestation to early lactation in dairy goats. However, other metabolic variables should be considered in future studies.

PMID:42378621 | DOI:10.1111/jpn.70089

Int J Mycobacteriol. 2026 Apr 1;15(2):95-103. doi: 10.4103/ijmy.ijmy_243_25. Epub 2026 Jun 30.

ABSTRACT

BACKGROUND: Ziehl-Neelsen (ZN) staining is routinely used for tuberculosis (TB) diagnosis, but cannot differentiate viable from nonviable bacilli. This limitation is particularly relevant in smear-positive pulmonary TB patients, where assessment of treatment response is essential. Fluorescein diacetate/ethidium bromide (FDA/EtBr) viability microscopy detects live Mycobacterium tuberculosis based on metabolic activity. This study compared the diagnostic performance of FDA/EtBr microscopy with ZN staining, using culture and drug susceptibility testing (DST) as the reference standard.

METHODS: A cross-sectional study was conducted on 300 smear-positive pulmonary TB patients at Santosh Medical College, Ghaziabad, and National Institute of TB and Respiratory Diseases, New Delhi. After n-acetyl-l-cysteine-sodium hydroxide decontamination, sputum samples were examined using ZN staining, FDA/EtBr viability microscopy, and mycobacteria growth indicator tube 960 culture/DST. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), and diagnostic accuracy were calculated, and paired statistical comparision were performed and statistical significance ( P < 0.05) was assessed for diagnostic outcomes. Inter-test agreement was evaluated using Cohen’s κ-statistic.

RESULTS: FDA/EtBr microscopy demonstrated significantly higher sensitivity (94.4% vs. 88.9%; absolute increase 5.5%, P = 0.018) and higher diagnostic accuracy (91.0% vs. 86.7%; absolute increase 4.3%, P = 0.04) compared to ZN staining. While ZN staining showed marginally higher specificity (66.7% vs. 60.0%; P = 0.42), FDA/EtBr provided a significantly improved NPV (54.5% vs. 40.0%; absolute increase 14.5%, P = 0.03). Agreement with culture/DST was almost perfect for FDA/EtBr (κ = 0.85) and substantial for ZN staining (κ = 0.72).

CONCLUSION: FDA/EtBr viability microscopy offers statistically significant improvements in sensitivity, NPV, and diagnostic accuracy over ZN staining in smear-positive pulmonary TB patients, supporting its prioritized use for treatment monitoring and programmatic decision-making in resource-limited, high-burden settings.

PMID:42378605 | DOI:10.4103/ijmy.ijmy_243_25

Indian J Pathol Microbiol. 2026 Apr 1;69(2):275-280. doi: 10.4103/ijpm.ijpm_471_25. Epub 2026 Jun 30.

ABSTRACT

INTRODUCTION: Cancer is the second most common cause of mortality in developing countries after cardiac diseases. Oral squamous cell carcinoma (OSCC) is the most common form of oral cancer. Sex hormones, such as estrogen and progesterone, can modulate various biological processes resulting in cell proliferation, evasion, and apoptosis. While the involvement of estrogen and progesterone has been proven in multiple cancers, including laryngeal, hypopharyngeal, breast, and prostate, the present study attempted to explore the role of these hormones in OSCCs within the South Indian population.

OBJECTIVE: To assess the expression pattern of estrogen receptor alpha (ERα) and progesterone receptor (PR) in dysplastic and OSCC tissues in comparison to normal tissues.

MATERIALS AND METHODS: Thirty participants, each with normal, dysplastic, and OSCC tissues (Groups A, B, and C, respectively), were recruited based on the inclusion criteria. Formalin-fixed, paraffin-embedded tissue samples were used to assess the ERα and PR expression by quantitative polymerase chain reaction using the kit method.

RESULTS: The difference in the expression pattern of ERα and PR among OSCC, dysplastic, and normal groups was shown to be statistically significant ( P < 0.001), according to the Kruskal-Wallis test. A pairwise comparison of ERα and PR expression using the post hoc Bonferroni test also showed a significant association ( P < 0.001) between the groups.

CONCLUSION: The precise role of hormones in OSCC has been less explored in the literature. Therefore, the significant expression of ERα and PR observed in dysplastic and OSCC groups in this study may elucidate their roles in tumor development and progression.

PMID:42378587 | DOI:10.4103/ijpm.ijpm_471_25

Indian J Ophthalmol. 2026 Jul 1;74(7):1067-1072. doi: 10.4103/IJO.IJO_1003_25. Epub 2026 Jun 29.

ABSTRACT

PURPOSE: Accurate and accessible autorefractors are essential for refractive error assessment, particularly in resource-limited settings. This study evaluates the accuracy and reliability of Instaref R20 with a light barrier (Instaref R20 LB) compared to a tabletop autorefractor (AR) and subjective refraction (SR) in an adult population. A light barrier (wearable polaroid filter) was used to reduce ambient illumination and stabilize pupil size, thereby improving measurement reliability under bright conditions.

METHODS: A prospective study was conducted at a tertiary eye institute in Mumbai, enrolling 200 adults (mean age: 44.33 ± 13.97 years). All the participants underwent a comprehensive eye examination including objective refraction, subjective acceptance, and anterior and posterior segment evaluation. Non-cycloplegic refraction was assessed using Instaref R20, Instaref R20 LB, AR, and SR. Agreement between methods was analyzed using Bland-Altman plots, assessing power vector components (M, J0, J45). Statistical comparisons were performed using the Wilcoxon signed-rank test.

RESULTS: Instaref R20 LB demonstrated strong agreement with SR (M: 0.10D, P = 0.13; J0: -0.05D, P = 0.05; J45: 0.01D, P = 0.44), while Instaref R20 showed slight variance (M: 0.17D, P < 0.001). The agreement within ± 0.50D of SR was 64.64% (M), 85.35% (J0), and 89.39% (J45). Under bright illumination, Instaref R20 failed to capture readings in six cases, whereas Instaref R20 LB obtained stable measurements in all participants, demonstrating superior reliability in bright environments. Subgroup analysis showed higher accuracy in myopic eyes, while AR exhibited significant deviations in hyperopes.

CONCLUSION: The Instaref R20 LB improves measurement accuracy and reliability, particularly under bright illumination. Its strong agreement with SR and portable design make it a viable tool for refractive error assessment in resource-constrained settings.

PMID:42378571 | DOI:10.4103/IJO.IJO_1003_25

JMIR Serious Games. 2026 Jun 30;14:e77875. doi: 10.2196/77875.

ABSTRACT

BACKGROUND: As a neurodegenerative disorder, Parkinson disease (PD) demonstrates significant prevalence worldwide. As the population ages, the number of patients with PD increases. Individuals with PD are susceptible to varying degrees of cognitive and psychological impairments. Virtual reality (VR)-based therapy is an emerging technology used for cognitive recovery and mental health treatment, yet controversy remains.

OBJECTIVE: This study aimed to assess the impact of VR-based therapies on cognitive function and depression in patients with PD.

METHODS: An extensive database search was conducted through PubMed, Web of Science, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) that investigated the impact of VR on patients with PD. Studies published before March 31, 2026, which met our inclusion and exclusion criteria, were included. A total of 13 RCTs involving 430 patients with PD were included. The Cochrane risk-of-bias tool was used to assess the risk of bias, indicating the included studies generally had a low risk of bias in randomization but a high or unclear risk concerning allocation concealment and blinding. Random-effects meta-analyses were performed using standardized mean differences (SMDs) with 95% CIs. Hartung-Knapp adjustments were applied, and prediction intervals (PIs) were calculated to assess the expected distribution of effects across future settings. The certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation).

RESULTS: In the meta-analysis, VR-based therapies were associated with statistically significant average improvements in global cognitive function (SMD=0.40, 95% CI 0.11-0.70; 95% PI 0.10-0.70; P=.01; I2=0%) and depressive symptoms (SMD=-0.77, 95% CI -1.42 to -0.12; 95% PI -1.82 to 0.27; P=.03; I2=31%). However, the PI for depression crossed the line of no effect, suggesting that this effect may vary across future settings. No significant average effects were observed for executive function (SMD=0.06, 95% CI -0.31 to 0.44; P=.66), memory (SMD=0.48, 95% CI -0.30 to 1.25; P=.15), attention (SMD=0.01, 95% CI -0.28 to 0.31; P=.94), or quality of life (QoL) outcomes (SMD=0.01, 95% CI -0.46 to 0.47; P=.97).

CONCLUSIONS: The results suggest that VR-based therapies may be associated with improvements in global cognitive function and depressive symptoms in patients with PD, although evidence for executive function, attention, memory, and QoL remains inconclusive. This review provides an updated synthesis that differs from previous reviews by focusing on both global and domain-specific cognitive outcomes, as well as depressive symptoms and QoL, rather than mainly on motor outcomes. By incorporating recent RCTs and considering PIs, risk of bias, and GRADE certainty, this review offers a more cautious interpretation of the evidence. In practice, VR-based therapies may serve as an engaging adjunct to conventional rehabilitation, but larger and methodologically rigorous trials are needed before clinical recommendations can be made.

PMID:42378559 | DOI:10.2196/77875

J Chem Inf Model. 2026 Jun 30. doi: 10.1021/acs.jcim.6c00912. Online ahead of print.

ABSTRACT

Synthetic ligands of retinoic acid receptor γ (RARγ) and vitamin D receptor (VDR) can act as agonists or antagonists by reshaping receptor conformation and cofactor recruitment, yet the structural and energetic determinants of this selectivity remain incompletely defined. Here, we present an integrated structural and thermodynamic analysis combining conformational characterization, molecular dynamics simulations, and molecular mechanics Poisson-Boltzmann surface area calculations to compare representative agonists and antagonists of human RARγ and VDR. Binding free energies and effective enthalpic contributions were evaluated for selected ligands, whereas the apparent entropic term, estimated indirectly as –TΔS_app = ΔG_bind – ΔH_eff, was used only as a qualitative internal descriptor. The thermodynamic profiles indicate that effective enthalpic stabilization is a more informative comparative descriptor than binding free energy alone, with clear agonist-antagonist separation for RARγ and a directional, less statistically resolved trend for VDR. These energetic patterns were interpreted alongside ligand-dependent stabilization of helix 12 and receptor-ligand interaction networks. Newly determined MicroED structures of AGN194310 and AGN205728 were incorporated as ligand-specific conformational references, improving structural definition without being treated as direct evidence of receptor-bound bioactive conformations. Comparative analysis of RARγ and VDR suggests that functional selectivity is not governed solely by affinity but emerges from the interplay among ligand-binding energetics, interaction networks, and receptor conformational dynamics. These results provide a retrospective mechanistic benchmark for interpreting agonist- and antagonist-associated behavior in nuclear receptors and may guide future studies on functionally selective modulators.

PMID:42378554 | DOI:10.1021/acs.jcim.6c00912

J Int Adv Otol. 2025 Dec 26;21(6):1-9. doi: 10.5152/iao.2025.252110.

ABSTRACT

BACKGROUND: The study aims to demonstrate the possible protective effects of carbon monoxide-releasing molecule-3 (CORM-3) on the auditory system after noise exposure through electrophysiological measurements and histopathological methods.

METHODS: Twenty-four albino Wistar male rats were included in the study. They were equally divided into 3 groups. The control group was administered intraperitoneal physiological saline for 7 days. Eight rats in the second group were exposed to 4 kHz octave band noise at 120 dB SPL intensity for 4 hours, and then intraperitoneal saline was administered for 7 days. Group 3, after exposure to noise with the same characteristics, was administered 10 mg/kg of CORM-3 intraperitoneally for 7 days. Hearing levels were measured at baseline, on the first, and seventh days with distortion product otoacoustic emissions (DPOAEs) and auditory evoked brainstem potentials at 4, 6, and 8 kHz. After the measurements, the cochlear structures of all rats were dissected, and the cochlear structures were evaluated by light microscopy.

RESULTS: Auditory evoked brainstem potential test results showed that the CORM-3 group had better hearing thresholds at all frequencies than the other group exposed to noise. These findings were statistically significant (P < .05). The DPOAE responses disappeared after acoustic trauma. Histopathological evaluation showed cellular damage caused by noise in the cochlea.

CONCLUSION: The findings suggest that CORM-3 may be an effective protective and therapeutic agent against noise-induced hearing loss. However, additional research is needed to prove this protective effect.

PMID:42378550 | DOI:10.5152/iao.2025.252110

J Int Adv Otol. 2025 Dec 26;21(6):1-10. doi: 10.5152/iao.2025.252097.

ABSTRACT

BACKGROUND: The retrolabyrinthine (RLB) approach, first described in the 1970s, has been largely forgotten due to its technical complexity and longer operative time. Despite this, it remains the only extradural route that allows access to internal auditory canal (IAC) without compressing the brain or cerebellum, while aiming to preserve hearing. Its versatility and safety are often underestimated.

METHODS: The authors conducted a retrospective analysis of 121 patients operated via the RLB approach or its variants between 1995 and 2024. The study aimed to assess hearing preservation, facial nerve outcomes, and complication rates and to describe the surgical technique and its variations. A systematic literature review was also performed to compare outcomes.

RESULTS: Among the 121 cases included, the main indications were vestibular neurotomy (55), vestibular schwannoma (36), and cerebellopontine angle meningioma.17 Overall hearing preservation was achieved in 67% of cases, and normal facial nerve function (House-Brackmann Grade I/II) was preserved in 95.8%. Cerebrospinal fluid leak occurred in only 2.4% of the patients and was managed conservatively. No cases of mortality or meningitis were reported. Comparative statistical analysis confirmed that outcomes varied mainly according to indication but not according to the specific RLB variant. The approach demonstrated flexibility, allowing adaptation to different anatomical situations and pathologies through multiple variations and extensions.

CONCLUSION: The RLB approach is a safe and effective extradural technique with low complication rates and excellent functional outcomes. Its ability to preserve hearing and facial nerve function, combined with its adaptability to various skull base pathologies, supports its inclusion as a valuable tool in lateral skull base surgery.

PMID:42378549 | DOI:10.5152/iao.2025.252097