Tag: pubmed

Clin Biomech (Bristol). 2026 May 14;137:106870. doi: 10.1016/j.clinbiomech.2026.106870. Online ahead of print.

ABSTRACT

BACKGROUND: Rupture of the anterior cruciate ligament is a well-known cause of knee instability. However, even after reconstruction, some patients continue to experience residual instability, which has raised interest in the anterolateral ligament as a secondary stabilizer of the knee. This study aimed to investigate in-vivo knee kinematics during level walking after combined single-bundle anterior cruciate and anterolateral ligament reconstruction to assess restoration of normal knee kinematics.

METHODS: Ten individuals who underwent combined reconstruction and ten healthy controls participated in treadmill gait trials using a biplanar fluoroscopic imaging system. The subject-specific 3D model and tibiofemoral kinematics were reconstructed using a statistical shape and intensity model and 2D3D registration. Tibial kinematics were compared among operated, contralateral, and healthy knees using statistical parametric mapping and a cumulative-change analysis.

FINDINGS: The operated knees exhibited significantly increased anterior tibial translation throughout 17-85% of the stance phase compared with both contralateral and normal knees (p < 0.05). Internal tibial rotation was also significantly greater in operated knees during early stance (15-37%) compared with normal knees. Cumulative changes in internal-external rotation and anterior-posterior translation during early stance were significantly increased in operated knees than in contralateral and normal knees.

INTERPRETATION: Anatomical single-bundle reconstructions combined with anterolateral ligament reconstruction do not fully restore normal joint kinematics. Increased anterior translation and internal rotation persist, indicating residual instability. These findings support rotational laxity of single-bundle techniques and suggest the potential need to address dynamic instability.

PMID:42150244 | DOI:10.1016/j.clinbiomech.2026.106870

Environ Int. 2026 May 12;212:110302. doi: 10.1016/j.envint.2026.110302. Online ahead of print.

ABSTRACT

BACKGROUND: Exposure to per- and polyfluoroalkyl substances (PFAS) and phthalates is widespread during adolescence, a critical developmental period for metabolic regulation.

AIM: To assess associations of serum PFAS and urinary phthalate/DINCH metabolites-individually and as mixtures-with a unified panel of metabolic biomarkers representing adipose-brain-liver cross-talk and oxidative stress in European teenagers.

METHODOLOGY: Serum PFAS and urinary phthalate/DINCH metabolites were measured in 1033 European teenagers (12-17 years) from the Human Biomonitoring Initiative for Europe (HBM4EU) Aligned Studies. Metabolic biomarkers representing adipose (HDL, LDL, cholesterol, and triglycerides)-brain (leptin, adiponectin, and kisspeptin)-liver (glucose, insulin) cross-talk and oxidative stress (8-hydroxy-2′-deoxyguanosine, 8OHdG) were measured. The Body Mass Index z-score (zBMI) was calculated. Single pollutant models, multivariate MANOVA, quantile g-computation, and BKMR models were fit, including interaction terms with sex.

RESULTS: Single pollutant models showed positive associations of PFAS and phthalate/DINCH metabolites with 8OHdG. PFAS were associated with higher leptin, HDL, LDL, and cholesterol, while some phthalate/DINCH metabolites were associated with lower kisspeptin, HDL, triglycerides, cholesterol, zBMI, and higher adiponectin. We observed weak but statistically significant associations between PFAS and phthalate/DINCH metabolites with the entire set of metabolic biomarkers in the MANOVA. The PFAS mixture was associated with higher kisspeptin, LDL, HDL, cholesterol, and 8OHdG. The phthalate/DINCH mixture was associated with lower HDL.

CONCLUSIONS: Exposure to these contaminants may be related to dyslipidemia in teenagers. PFAS and phthalate/DINCH metabolites may exert opposite associations on metabolism, with the exception of increasing oxidative stress. Given the cross‑sectional design and potential residual confounding, longitudinal studies are warranted.

PMID:42150235 | DOI:10.1016/j.envint.2026.110302

Soc Sci Med. 2026 May 14;403:119401. doi: 10.1016/j.socscimed.2026.119401. Online ahead of print.

ABSTRACT

BACKGROUND: South Asian gay, bisexual, and queer men (SA GBQM) living in Canada report that racism and heterosexism negatively impact their sexual health. There is a paucity of research examining associations between these forms of stigma, migration status, and sexually transmitted infection (STI) testing for this population.

METHODS: We conducted a pooled analysis of Sex Now 2019 and 2021 – online, national, cross-sectional surveys of GBQM. We used modified Poisson regression models (adjusted for age, income, education, disability, and pre-exposure prophylaxis use for HIV) to examine the effects of migration status (born in Canada versus not) and past-year discrimination (racism and heterosexism) on recent STI testing. Using causal mediation decomposition, we estimated the pure direct, pure indirect, mediated interaction, and total effects.

RESULTS: Among 197 SA GBQM, 59% were migrants and 62% were recently tested for STIs. Past-year experiences of racism and heterosexism were self-reported by 64% and 34% of participants, respectively. Recent STI testing was higher among non-migrants compared to migrants [unadjusted prevalence ratio: 1.65 (95% confidence interval: 1.10-2.49)]. Past-year racism was higher among migrants compared to non-migrants (1.32; 1.05-1.66). However, there was no statistically significant difference in experiencing past-year heterosexism between these two groups. Only the pure direct effect estimate for the multivariable racism models was statistically significant (1.80; 1.15-3.37), indicating non-migrant SA GBQM who did not experience racism were more likely to be recently tested than migrants.

CONCLUSIONS: Addressing intersectional stigma and barriers to sexual health services experienced by migrant SA GBQM may improve testing over time.

PMID:42150226 | DOI:10.1016/j.socscimed.2026.119401

Clin Neurol Neurosurg. 2026 May 14;268:109486. doi: 10.1016/j.clineuro.2026.109486. Online ahead of print.

NO ABSTRACT

PMID:42150222 | DOI:10.1016/j.clineuro.2026.109486

Cir Cir. 2026 May 18. doi: 10.24875/CIRU.24000394. Online ahead of print.

ABSTRACT

OBJECTIVE: Ankyloglossia, known as tongue-tie, is a common congenital malformation that restricts the movement of the tongue. It is seen in 4.8% of newborns and is more prevalent in males compared to females. This study aims to evaluate the knowledge and attitudes of dentists in Turkey regarding ankyloglossia.

METHODS: Our survey was conducted online with dentists in Turkey who examine and treat patients. The data were analyzed using IBM Statistical Package for the Social Sciences V.21 software. Frequency distributions and percentages were examined, and relationships between nominal variables were assessed using the χ2 test. A significance level of p < 0.05 was accepted.

RESULTS: The results showed that 76.14% of the participants could recognize ankyloglossia in children, and 87.14% believed it to be a congenital anomaly. In addition, 91.49% of the participants thought that ankyloglossia negatively affects breastfeeding, and 98.34% believed that it could cause speech disorders.

CONCLUSIONS: Our study emphasizes the importance of increasing awareness of ankyloglossia and the significance of early diagnosis and treatment.

PMID:42150169 | DOI:10.24875/CIRU.24000394

JMIR Mhealth Uhealth. 2026 May 18;14:e79642. doi: 10.2196/79642.

ABSTRACT

BACKGROUND: As digital health solutions gain traction, there is an urgent need for effective, person-centered stress management tools for employees. Advances in wearable stress monitoring and machine learning now enable the collection of high-resolution, real-time data and the delivery of personalized interventions with respect to both timing and content. Despite this technological progress, there remains a notable paucity of mobile health (mHealth) interventions that capitalize on these capabilities to implement just-in-time adaptive interventions (JITAIs).

OBJECTIVE: This pilot study aimed to examine the preliminary effects of the RELAX mHealth app, which uses a JITAI framework to reduce occupational stress, with a particular focus on initial indications of stress reduction, the influence of the app’s degree of personalization on these effects, and overall user experience.

METHODS: A 2-arm randomized trial was conducted with 46 employees across two phases of 3 weeks each. Participants used the RELAX mHealth app, which adapts intervention timing based on real-time stress data and tailors content according to users’ preferences. Stress was assessed via multiple heart rate variability (HRV) parameters measured with wearable sensors, alongside subjective questionnaires and ecological momentary assessment (EMA) questionnaires. Usability and user satisfaction were also evaluated. In the second phase, a group randomization was implemented, with two groups of different degrees of in-app personalization.

RESULTS: The findings were mixed. While selected subjective stress indicators decreased from baseline to the end of the study, one physiological measure increased. Retrospective chronic stress (P=.048) and arousal related to the most recent stress event prior to EMA entry (P=.02) were reduced; however, the low frequency (LF)-to-high frequency (HF) ratio of HRV increased (P=.03). Other stress variables, such as work-related stress, valence of daily experiences, and momentary arousal, showed no change over the course of the study. No between-group differences were observed with respect to the assigned degree of personalization. Additionally, usability increased (P<.001), whereas satisfaction decreased at a trend level (P=.05).

CONCLUSIONS: Although the results provide selective preliminary indications of stress reduction with app use, the variability of outcomes raises concerns about its current practical utility. The effects are also discussed with regard to the specific design of the prototype and the study setup. Technical issues and user discomfort were noted despite increasing usability over the study period, indicating areas for improvement in the developed prototype. Given the absence of a control group and the use of interventional arms only, no definitive conclusions about effects can be drawn. Nevertheless, this study highlights both the potential and the challenges of a personalized mHealth approach to occupational stress management. Further refinement of the app and more comprehensive evaluations are needed to fully understand the impact and functional usability of this JITAI-based approach in real-world settings.

PMID:42150167 | DOI:10.2196/79642

J Agric Saf Health. 2026 May 22;32(2):75-101. doi: 10.13031/jash.16385.

ABSTRACT

HIGHLIGHTS: Moderate handle lift angles (27°-56°) and handle lift heights (545-1111 mm) reduce hip/shoulder flexion. Lighter tools (<2.0 kg) lower MSD risk; heavier ones boost leverage for taller users. D-grip handles with natural curves enhance wrist alignment and comfort (64% preference). Adjustable designs can accommodate diverse anthropometrics to mitigate physical strain.

ABSTRACT: The design and characteristics of agricultural hand tools, including shovels and pitchforks, are essential for reducing physical strain and enhancing task efficiency among women farmers. This study investigates the ergonomic performance of conventional shovels and pitchforks in reducing physical strain among women farmers. A sample of seven female participants performed simulated farm tasks, scooping and throwing straw using 10 shovels and 8 pitchforks selected from an initial pool of 24 and 19, respectively. Tool mechanical parameters (weight, handle lift height, handle length, and handle lift angle) were measured with digital instruments, while user posture and biomechanical strain were assessed via 3D pose estimation using commercial AI-based ergonomic software (TuMeke). The software provided peak joint angles and calculated RULA and REBA scores as approximate indicators of musculoskeletal risk, and mechanical advantage was calculated using measured effort and resistance arm lengths. Two-way ANOVA analyses revealed statistically significant differences (p < 0.05) in hip and shoulder angles and mechanical advantage between tool types (shovels versus pitchforks) and handle grip designs (D-grip with natural inward curve versus straight handles). Results indicate that tools featuring moderate handle angles (27°-56°), handle lift heights aligning with typical standing elbow heights (545-1,111 mm), and lighter weights (<1.5-2.0 kg) effectively reduced awkward postures, as evidenced by lower peak hip and shoulder flexion angles and improved RULA/REBA scores. Conversely, heavier tools, while offering a higher mechanical advantage, imposed greater strain on the upper body. Additionally, approximately 64% of participants preferred D-grip handles with natural inward curves, which enhanced wrist alignment and overall comfort. This study highlights the importance of tool designs tailored to anthropometric variability. Tools with adjustable handle lift heights and moderate handle lift angles might improve health, reduce physical strain, and enhance productivity. Future research should explore broader anthropometric diversity, advanced analytical methods, and additional tool configurations to refine ergonomic recommendations.

PMID:42150159 | DOI:10.13031/jash.16385

JMIR Res Protoc. 2026 May 18;15:e86168. doi: 10.2196/86168.

ABSTRACT

BACKGROUND: Neck pain poses a significant and growing public health challenge, with rising prevalence among younger populations and negative impacts on both quality of life and socioeconomic costs. Clinical manifestations are diverse, including restricted movement, muscle spasms, headaches, and upper limb numbness. Although drug therapy is widely used, its long-term use is limited by adverse effects. Traditional Chinese medicine (TCM) exercises offer a promising alternative, but high-quality evidence directly comparing their efficacy and safety to oral medications is currently lacking.

OBJECTIVE: This study aims to compare the efficacy and safety of TCM exercises and oral medication in treating neck pain.

METHODS: We will identify relevant randomized controlled trials (RCTs) through a systematic search of multiple databases (including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure [CNKI], Chinese Biomedical Literature Database [CBM], VIP, and Wanfang) from inception through September 2025. Only RCTs directly comparing TCM exercise to oral medication will be included. Study quality will be assessed using the Cochrane RoB2 tool, and the overall evidence will be graded via the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. For heterogeneity, the I² statistic and Cochran Q test will be applied. A fixed-effect model will be adopted if I²<50% and P≥.10; otherwise, subgroup analysis will be performed. Should heterogeneity persist, sensitivity analysis or a random-effects model will be employed, leading to a reduction in the GRADE rating.

RESULTS: This is a study protocol; therefore, no results are available at this stage. The systematic review is scheduled to commence in August 2025, with the literature search from August to September 2025, study screening from September to December 2025, data extraction and analysis from January to May 2026, and manuscript submission by June 2026.

CONCLUSIONS: This protocol outlines a systematic review and meta-analysis designed to compare the efficacy and safety of TCM exercises versus oral medications for neck pain. The completed review aims to synthesize the available evidence and clarify whether TCM exercises offer a comparable or superior alternative to pharmacotherapy. By systematically evaluating direct head-to-head RCTs, this study seeks to provide evidence-based insights to inform clinical decision-making. Potential limitations of the forthcoming review may include heterogeneity in exercise protocols, challenges in blinding, and a possible limited number or geographic concentration of available trials, which could affect the generalizability of the findings. These limitations will be considered when interpreting the results.

PMID:42150155 | DOI:10.2196/86168

Am J Respir Crit Care Med. 2026 May 18:aamag251. doi: 10.1093/ajrccm/aamag251. Online ahead of print.

NO ABSTRACT

PMID:42150113 | DOI:10.1093/ajrccm/aamag251

J Bras Nefrol. 2026 Jul-Sep;48(3):e20250294. doi: 10.1590/2175-8239-JBN-2025-0294en.

ABSTRACT

INTRODUCTION: Kidney transplantation remains the most cost-effective treatment for end-stage renal disease (ESRD); however, persistent organ scarcity and immunological barriers contribute to prolonged waiting times and inequitable access. Human leukocyte antigen (HLA) sensitization and homozygosity represent major challenges inadequately addressed by previous allocation models.

OBJECTIVES: This study aimed to assess the impact of HLA sensitization and HLA homozygosity on access to kidney transplantation in the regional sector of Minas Gerais.

METHODS: We conducted a cross-sectional analysis of deceased-donor kidney transplant recipients and active candidates listed in the Brazilian National Transplant System (SNT) from January 2010 to August 2024 in a regional allocation sector of Minas Gerais. We assessed the impact of HLA sensitization and HLA-DRB1 homozygosity on access to transplantation, contextualizing the findings within recent national regulatory updates.

RESULTS: Of 2,907 patients analyzed, 1,794 (61.7%) underwent transplantation and 1,113 (38.3%) remained active on the waiting list. Diabetes mellitus (HR 1.177; p = 0.030) and blood groups A (HR 1.206; p < 0.001) and AB (HR 1.419; p = 0.002) were associated with increased access to transplantation. Higher levels of sensitization and HLA-DRB1 homozygosity were the strongest predictors of prolonged waiting time. These findings are consistent with inequities targeted by the Brazilian SNT regulatory revisions implemented in September 2025.

CONCLUSION: Our results support recent Brazilian allocation reforms aimed at prioritizing hypersensitized and immunogenetically disadvantaged patients. Incorporating both the degree of sensitization and HLA-DR homozygosity into allocation algorithms represents a critical step toward improving equity in deceased-donor kidney transplantation.

PMID:42150098 | DOI:10.1590/2175-8239-JBN-2025-0294en