Tag: pubmed

Environ Monit Assess. 2026 Aug 15;198(9):953. doi: 10.1007/s10661-026-15802-3.

ABSTRACT

Near-surface ozone (O₃) has become an increasingly important air-quality and public-health concern in China, particularly in regions where reductions in nitrogen oxides have not been accompanied by corresponding decreases in photochemical pollution. The Huaihe River Basin is a densely populated and economically important region in eastern China, but long-term basin-scale evidence on the divergent evolution of O₃ and nitrogen dioxide (NO₂) and the associated health burden remains limited. In this study, we used high-resolution satellite-derived near-surface O₃, expressed as the maximum daily 8-h average, and NO₂ concentrations to assess their spatiotemporal patterns, long-term trends, hotspot redistribution, and persistence characteristics across the Huaihe River Basin during 2013-2024. Pixel-wise linear regression and the Hurst exponent were applied to diagnose historical trends and persistence, and BenMAP-CE was used to estimate O₃-attributable premature mortality and associated economic losses. Basin-wide O₃ showed a fluctuating but overall increasing trend, with a mean concentration of 104.15 μg m^-3 and OLS-derived annual linear trend of 2.792 μg m^-3 yr^-1. In contrast, NO₂ declined continuously, with a mean concentration of 29.86 μg m^-3 and OLS-derived annual linear trend of -1.385 μg m^-3 yr^-1. Both pollutants exhibited a pronounced north-south gradient, with higher concentrations mainly concentrated in southern Shandong, especially along the Jining-Linyi corridor, and lower levels in the western and southern mountainous margins. Seasonal patterns were also contrasting: O₃ peaked in summer and reached its minimum in winter, whereas NO₂ showed the opposite pattern. Spatial trend and hotspot analyses revealed an outward expansion of O₃-affected areas but a marked contraction of NO₂ hotspots, indicating a redistribution of exposure under divergent pollutant responses. Hurst-based diagnostics further showed that O₃ had a more spatially coherent historical persistence signal than NO₂, particularly in the central basin, suggesting that ozone pollution may remain a regional concern under comparable emission and meteorological conditions. The health assessment showed an overall increase in O₃-attributable premature mortality during the study period, with cardiovascular mortality representing the largest cause-specific component. Jiangsu and Shandong bore the greatest health and economic burdens because of the combined effects of elevated exposure and large exposed populations. By integrating satellite-based environmental monitoring, trend-persistence diagnostics, and health-burden assessment, this study provides basin-scale evidence for identifying persistent ozone-risk areas and prioritizing coordinated air-quality management in the Huaihe River Basin.

PMID:42603231 | DOI:10.1007/s10661-026-15802-3

Oral Maxillofac Surg. 2026 Aug 15;30(1):134. doi: 10.1007/s10006-026-01619-4.

ABSTRACT

PURPOSE: Inferior alveolar nerve transection (IANT) is a severe complication of sagittal split osteotomy (SSO). This study aimed to retrospectively evaluate the long-term sensory recovery in patients who experienced intraoperative IANT compared to those who did not.

MATERIALS AND METHODS: This retrospective cohort study reviewed patients who underwent SSO from 2016 to 2022. Patients were divided into Group A (with IANT, 11 sides) and Group B (without IANT, 151 sides). Sensory perception was assessed using the Semmes-Weinstein (SW) test, static two-point discrimination (s-2PD) test, and a Numerical Rating Scale (NRS) at preoperative baseline and at 1, 3, 6, and 12 months postoperatively. Mann-Whitney U and Dunnett’s tests were used for statistical analysis (p < .05).

RESULTS: Group A demonstrated significantly worse sensory outcomes than Group B on all tests at all postoperative time points (p < .01). In Group B, SW and s-2PD values were significantly worse than baseline at 1 and 3 months but showed no significant difference at 6 and 12 months. In contrast, Group A outcomes remained significantly impaired compared to their own preoperative baseline throughout the 12-month follow-up.

CONCLUSIONS: Complete IANT during SSO, even with immediate nerve repair, results in a substantial and long-term persistent neurosensory deficit. While patients without nerve transection typically recover baseline sensory perception by 6 months, those with IANT experience only minimal improvement and remain significantly impaired at a year post-surgery.

PMID:42603212 | DOI:10.1007/s10006-026-01619-4

Endocrine. 2026 Aug 15;91(1):277. doi: 10.1007/s12020-026-04745-x.

ABSTRACT

PURPOSE: The cardiovascular impact of hypothyroidism remains controversial, particularly regarding the distinction between cardiovascular disease occurrence and cardiovascular prognosis. We performed a systematic review and meta-analysis to separately evaluate the association between hypothyroidism and incident cardiovascular events and cardiovascular mortality.

METHODS: PubMed/MEDLINE, Scopus, and Web of Science were systematically searched for studies published between January 2014 and April 2026 evaluating cardiovascular outcomes in adult patients with overt or subclinical hypothyroidism compared with euthyroid controls. Separate random-effects meta-analyses were performed for cardiovascular events and cardiovascular mortality using pooled odds ratios (ORs) with 95% confidence intervals (CIs). Study quality was assessed using the QUIPS tool.

RESULTS: Nine studies involving 9,662 patients were included. Six studies evaluating cardiovascular events (5,795 participants) showed no significant association between hypothyroidism and incident cardiovascular events (OR 0.92, 95% CI 0.78-1.09; p = 0.35), with low-to-moderate heterogeneity (I² = 24.6%). By contrast, eight studies evaluating cardiovascular mortality (7,526 participants) demonstrated a significantly increased mortality risk among hypothyroid patients (OR 2.73, 95% CI 2.16-3.43; p < 0.0001), with low heterogeneity (I² = 9.7%). Leave-one-out sensitivity analyses confirmed the robustness and stability of the mortality findings. Qualitative synthesis consistently showed worse outcomes in acute and high-risk cardiovascular settings, including acute coronary syndromes, acute heart failure, spontaneous coronary artery dissection, and coronary artery bypass grafting.

CONCLUSIONS: Hypothyroidism was more consistently associated with cardiovascular mortality than with incident cardiovascular events. However, the lack of a statistically significant association with cardiovascular events should not be interpreted as evidence of absence of effect. These findings are consistent with the hypothesis that thyroid dysfunction may be more closely associated with adverse cardiovascular outcomes after disease onset than with incident cardiovascular events.

PMID:42603211 | DOI:10.1007/s12020-026-04745-x

Environ Monit Assess. 2026 Aug 15;198(9):951. doi: 10.1007/s10661-026-15801-4.

ABSTRACT

Open-cast coal mining can alter land cover rapidly, yet annual assessments may overlook the episodic nature of disturbance and partial vegetation recovery. This study examined decadal land-cover dynamics within the Northern Coalfields Limited operational landscape of the Singrauli-Sonbhadra coal belt, India, from 2016 to 2025. Temporally consistent January Landsat 8-9 Collection 2 Level-2 Surface Reflectance imagery was classified into four NDVI-based land-cover classes: barren/mining, sparse vegetation, moderate vegetation, and dense vegetation. Annual class distributions were evaluated using the Mann-Kendall test and Sen’s slope estimator, while a pixel-based 2016-2025 transition matrix quantified gross endpoint transitions. SRTM-derived slope data provided additional topographic context. Across the common mapped domain of approximately 322.17 km², the barren/mining class increased from 114.28 km² in 2016 to 158.05 km² in 2025, equivalent to an increase of 43.77 km² or 13.59 percentage points of landscape coverage. None of the four classes showed a statistically significant monotonic trend (p > 0.05). The largest off-diagonal endpoint transition was from sparse vegetation to barren/mining land (59.80 km²), compared with 16.20 km² in the reverse direction. Slope analysis showed systematic differences in the terrain distribution of land-cover classes, although the largest absolute barren/mining extent occurred on near-level ground. The findings demonstrate the value of combining annual NDVI mapping, non-parametric trend analysis, transition matrices, and terrain context for long-term monitoring of mining-affected landscapes.

PMID:42603206 | DOI:10.1007/s10661-026-15801-4

Eur J Pediatr. 2026 Aug 15;185(9):668. doi: 10.1007/s00431-026-07313-7.

ABSTRACT

During childhood, foot posture, joint hypermobility, and foot and ankle strength may influence lower limb function. However, there is limited evidence analysing these variables together in the paediatric population. The study aims to analyse how foot posture, joint hypermobility, ankle mobility, and foot-ankle strength are related in children aged 5 to 10 years. A cross-sectional study was conducted in 196 healthy children aged between 5 and 10 years. Foot posture was assessed using the Foot Posture Index (FPI), general joint hypermobility using the Beighton score, and lower-limb-specific hypermobility using the Lower Limb Assessment Score (LLAS) and the Foot and Ankle Flexibility Index (FAFI). Ankle dorsiflexion was measured with the Lunge test, and isometric ankle strength was assessed using hand-held dynamometry. Descriptive analyses, correlations, and between-group comparisons were performed. No associations were found between foot posture, ankle dorsiflexion range of motion, or generalized joint hypermobility (Beighton score) and ankle muscle strength. In contrast, region-specific lower-limb hypermobility (LLAS and FAFI) showed only weak associations with ankle muscle strength. After adjustment for age, sex, and BMI-for-age z-score, only a limited number of associations remained statistically significant, and the observed effect sizes were small.

CONCLUSIONS: In healthy children, ankle muscle strength was not associated with foot posture, ankle dorsiflexion range of motion, or generalized joint hypermobility. Region-specific lower-limb hypermobility showed only weak associations with ankle muscle strength, most of which were attenuated after adjustment for age, sex, and BMI-for-age z-score.

WHAT IS KNOWN: • Foot posture and joint hypermobility are common in childhood and may influence lower limb function. • Previous studies have analysed foot type, hypermobility or strength separately, with heterogenous findings.

WHAT IS NEW: • Lower limb specific hypermobility (LLAS), but not Beighton score, was associated with ankle strength. • Hypermobile children showed greater relative ankle strength (BMI-normalised), suggesting threshold effects of joint laxity.

PMID:42603196 | DOI:10.1007/s00431-026-07313-7

Cancer. 2026 Aug 15;132(16):e70571. doi: 10.1002/cncr.70571.

ABSTRACT

BACKGROUND: Nonmetastatic esophagogastric adenocarcinoma require multimodal treatment for management. However, real-world treatment patterns and outcomes in these patients are limited. We evaluated the survival outcomes associated with the common treatment combinations in the National Cancer Database.

METHODS: A total of 4715 patients met the predefined inclusion and exclusion criteria. Four groups were created: group 1, preoperative chemotherapy; group 2, perioperative chemotherapy; group 3, preoperative chemotherapy followed by chemoradiation; and group 4, preoperative chemoradiotherapy. Kaplan-Meier curves were used to assess overall survival. Cox proportional hazard regression estimated hazard ratios (HR) and 95% CIs for associations between covariates and overall survival. Inverse probability of treatment weighting based on propensity scores were used to account for differences in baseline characteristics between treatment groups.

RESULTS: The median age was 63 years; 75.9% were male and 82.9% were non-Hispanic White; overall, 47.5% had clinical stage III disease and 57.8% had regional lymph node involvement. Median follow-up was 79.5 months. Patients who received perioperative chemotherapy had improved median overall survival compared with patients who received preoperative chemoradiotherapy (79.1 vs 74.6 months; p < .001). After adjustment for age, race, Charlson-Deyo Score, facility type, year of diagnosis, presence of regional lymph nodes, clinical stage, the association remained statistically significant (HR = 0.78; 95% CI, 0.66-0.92; p = .003).

CONCLUSION: Although several multimodality treatment strategies are used for esophagogastric adenocarcinoma, perioperative chemotherapy is associated with better overall survival compared to preoperative chemoradiotherapy.

PMID:42603143 | DOI:10.1002/cncr.70571

Risk Anal. 2026 Sep;46(9):e70323. doi: 10.1111/risa.70323.

ABSTRACT

Essential services are necessary for individuals to recover from and adapt to disruptive events, yet the relationship between access to such services and recovery trajectory is poorly understood. Data on household recovery times are typically only available through surveys, which are limited in scale and scope. Further, the availability of all open and accessible essential services facilities in a region may not be recorded anywhere. Location-based services (LBS) data from cell phones offers new opportunities for estimating this relationship. Using LBS data, we approximate facility availability and household recovery times following Hurricane Irma in Southwest Florida in 2017 and then statistically model the importance of access for recovery incorporating social vulnerability, local storm parameters, and infrastructure outage variables. We show that power, cell service, and school outages rank highest in importance, followed by measures of access to essential services. These results underscore the importance of including access metrics for predicting community recovery and evaluating resilience as well as the need for planning and policies that improve access to essential services both in times of stability and disruption.

PMID:42603109 | DOI:10.1111/risa.70323

J Magn Reson Imaging. 2026 Aug 15. doi: 10.1002/jmri.70497. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative identification of short-term survival in glioblastoma may guide management but remains challenging because of clinical and imaging heterogeneity.

PURPOSE: To develop and externally validate a multiscale magnetic resonance imaging (MRI)-based deep learning model for short-term survival assessment and explore transcriptomic correlates.

STUDY TYPE: Retrospective, multicenter.

POPULATION: Adults with pathologically confirmed, newly diagnosed glioblastoma (n = 728): training cohort (n = 290; median age, 55 years; 169 men) and external cohorts 1-3 (n = 225/182/31; median ages, 64/61/56 years; 136/108/20 men, respectively).

FIELD STRENGTH/SEQUENCE: 1.5 T or 3.0 T; axial precontrast T1-weighted, T2-weighted, T2-weighted fluid-attenuated inversion recovery, and postcontrast T1-weighted MRI.

ASSESSMENT: Short-term survival was overall survival of 9 months or less. Whole-brain, three-dimensional tumor, and 2.5-dimensional tumor inputs were integrated and compared with clinical, conventional MRI morphometric, and combined clinical-MRI baselines.

STATISTICAL TESTS: Kruskal-Wallis, Mann-Whitney U/Wilcoxon rank-sum, chi-square, Fisher exact, DeLong, and log-rank tests; Benjamini-Hochberg false discovery rate (FDR) correction; calibration, decision curves, edgeR, and correlation-adjusted mean-rank gene-set testing were used. Areas under the receiver operating characteristic curve (AUCs) with 95% confidence intervals (CIs) summarized discrimination; threshold metrics used the Youden index. Two-sided p < 0.05 or FDR-adjusted p < 0.05 indicated significance.

RESULTS: Apparent training AUC was 0.870 (95% CI: 0.830, 0.910); external AUCs were 0.871 (95% CI: 0.821, 0.920), 0.828 (95% CI: 0.761, 0.895), and 0.798 (95% CI: 0.640, 0.956). AUC gains over the combined clinical-MRI morphometric baseline were 0.161 and 0.131 in external cohorts 1 and 2; only cohort 1 remained significant after FDR correction (cohort 2, FDR-adjusted p = 0.0897). Immune/inflammatory and cell-division/genome-maintenance pathway associations were directionally concordant, significant after FDR correction in both cohorts, and leave-one-out consistent.

DATA CONCLUSION: Multiscale MRI deep learning demonstrated favorable discrimination for short-term survival; model output was associated with immune- and cell-cycle-related transcriptomic programs.

EVIDENCE LEVEL: 3.

TECHNICAL EFFICACY: Stage 2.

PMID:42603108 | DOI:10.1002/jmri.70497

J Med Virol. 2026 Aug;98(8):e71103. doi: 10.1002/jmv.71103.

ABSTRACT

After the COVID-19 emergency, respiratory viruses have re-emerged with changing and region-specific patterns. We aimed to characterize how these shifts affected viral circulation, clinical severity, and management of pediatric viral-associated lower respiratory tract disease (LRTD)across two post-pandemic seasons in Rome, Italy. We conducted a retrospective observational study of children (< 6 years) hospitalized with PCR-confirmed viral LRTDs during the 2022-2023 and 2023-2024 seasons. Of the 1,249 children hospitalized for LRTD, 49.08% were admitted during the 2022-2023 season and 50.92% during the 2023-2024 season. Clinical severity at presentation (PRESS ≥ 4) did not differ between the two seasons; however, a severe in-hospital course (CSS > 3) was more frequent in 2023-2024 (8.96% vs. 4.24%; p = 0.001). In 2023-2024, the corticosteroid use increased (77.20% vs. 72.43%; p = 0.05), whereas antibiotic use decreased (47.80% vs. 39.78%; p = 0.004). Respiratory syncytial virus remained the most common pathogen in both seasons, with no significant variation between them. Similarly, influenza showed no significant difference in prevalence. Compared with 2022-2023, 2023-2024 showed a higher prevalence of rhinovirus (50.31% vs. 37.36%), enterovirus (24.53% vs. 15.82%), bocavirus (13.99% vs. 8.16%) and viral codetection (51.89% vs. 45.02%) while adenovirus was more frequent in 2022-2023 (7.39% vs. 13.21%). Multivariable analysis identified the 2023-2024 season (OR 2.37; 95% CI 1.45-3.87), younger age (OR 0.96 per month; 95% CI 0.94-0.98), and comorbidities (OR 2.91; 95% CI 1.66-5.11) as independent predictors of severe in-hospital course. Male sex, viral codetection, and viral clinical categories were not associated with severity. In conclusion, in Rome’s regional context, the evolving viral ecology highlights the need for continued local surveillance to guide clinical preparedness and optimize management in forthcoming seasons.

PMID:42603107 | DOI:10.1002/jmv.71103

Int J Urol. 2026 Aug;33(8):e70598. doi: 10.1111/iju.70598.

ABSTRACT

BACKGROUND: Clinical trials in locally advanced or metastatic urothelial carcinoma (mUC) often enroll younger and fitter patients than those treated in routine practice, limiting applicability to real-world populations. We developed a simple descriptive metric, the eligibility gap (EG) score, to place trial and real-world cohorts on a common scale and summarize differences in baseline eligibility profiles.

METHODS: Pivotal clinical trials were identified through a PubMed search, and three real-world datasets from Japan, the United States, and Spain were included. The EG score used three consistently reported domains: age, ECOG performance status, and cisplatin eligibility. Each domain was scaled from 0 to 33.3 points and summed to yield a score from 0 to 99.9, with higher scores indicating younger, fitter populations. Robustness was assessed across alternative model specifications, including prespecified weighting schemes, random-weight simulations, alternative age and ECOG scoring functions, and one-domain-out analyses.

RESULTS: EG scores were generally higher in cisplatin-based trials (74.8-90.1) than in immune checkpoint inhibitors (ICI)-based trials (52.3-81.2) and real-world cohorts (35.1-45.5), while the cisplatin-ineligible trial had the lowest score (24.5). Alternative age transformations and a linear ECOG model did not change ranking. In one-domain-out analyses, omission of ECOG preserved ranking, whereas omission of age or cisplatin-fitness produced minor shifts. Across prespecified weighting schemes, rank-order concordance remained high (Spearman’s rho = 0.982-1.000), and 10 000 random-weight simulations showed a median rho of 0.982.

CONCLUSIONS: The EG score may provide a simple descriptive summary of eligibility domains across mUC studies, with stable cohort ordering across alternative model specifications.

PMID:42603090 | DOI:10.1111/iju.70598