Tag: pubmed

Eur J Pediatr. 2026 Jul 29;185(8):623. doi: 10.1007/s00431-026-07268-9.

ABSTRACT

Continuous Positive Airway Pressure (CPAP) is the first-line respiratory support for preterm neonates with respiratory distress, but 15-30% fail and require invasive mechanical ventilation (IMV). Lung ultrasound (LUS) has emerged as a radiation-free, point-of-care imaging modality with demonstrated superiority over chest radiography for diagnosing neonatal respiratory conditions, whose serial performance for predicting IMV across a broad preterm cohort is not well characterised. Objective: To evaluate the diagnostic accuracy of serial LUS scores on Days 1-3 for predicting IMV within 7 days in preterm neonates (< 37 weeks), and to identify independent predictors of IMV. Methods: This prospective diagnostic accuracy cohort study was conducted in a Level III NICU between November 2022 and November 2024. 207 preterm neonates with respiratory distress underwent standardised 6-zone, 18-point lung ultrasound (LUS) scoring on Days 1, 2, and 3. ROC analysis determined optimal LUS score cut-offs for predicting IMV, while multivariable logistic regression identified independent predictors after multicollinearity assessment, model performance was evaluated using goodness-of-fit testing. Results: Among 207 preterm neonates (gestational age 32.5±2.5 weeks; birth weight 1779±626 g), 28 (13.5%) required IMV by Day 7. Day-1 LUS ≥4 predicted IMV with AUC 0.72 (95% CI 0.59-0.84), sensitivity 64%, specificity 78%, NPV 93%; Day-2 LUS ≥2 improved specificity (87%) and NPV (97%); Day-3 LUS showed limited accuracy (AUC 0.61). Surfactant use, shock, and SNAPPE-II score independently predicted the requirement of IMV within the first 7days of life.

CONCLUSIONS: Serial lung ultrasound scoring demonstrated good clinical utility, with a high negative predictive value (NPV) of the Day-1 LUS score (cut-off ≥ 4) for identifying preterm neonates unlikely to require invasive mechanical ventilation within the first 7 days of life. Integration with clinical scoring may optimize early respiratory triaging in resource-limited NICUs. Multicentre validation against newer consensus frameworks is needed before routine adoption.

WHAT IS KNOWN: • LUS is an accurate, radiation-free bedside tool for diagnosing neonatal respiratory disorders, predicting surfactantrequirement in preterm infants. • Most studies have used single-time-point LUS assessments and focused on a single outcome.

WHAT IS NEW: •A Day-1 LUS score ≥4 identifi ed infants at low risk of invasive mechanical ventilation (NPV 93%). • Surfactant requirement (OR 28.60), shock (OR 6.18), and SNAPPE-II (OR 1.06 per point) independently predictedIMV.

PMID:42525288 | DOI:10.1007/s00431-026-07268-9

Environ Monit Assess. 2026 Jul 29;198(8):891. doi: 10.1007/s10661-026-15708-0.

ABSTRACT

The expansion and intensification of agriculture in the Argentine Pampas have increased pesticide use, raising concerns about groundwater contamination in aquifers used for drinking water. In this context, contamination risk assessment is a key tool for environmental management, although results may vary depending on the methodology applied. This study compares two approaches for assessing pesticide-related groundwater contamination risk in the Quequén Grande River watershed (Argentina). Risk was defined as the interaction between aquifer contamination hazard and population vulnerability. Hazard was estimated by combining aquifer vulnerability (DRASTIC-P) with two representations of contaminant load: (i) a land-use-based approach derived from LANDSAT imagery, and (ii) an empirical model based on pesticide leaching experiments relating mobility to soil organic matter. Social vulnerability was assessed using a census-based index. All analyses were conducted within a GIS framework. Results show that the two approaches produce markedly different spatial risk patterns. These differences were evaluated through methodological comparison and preliminary field evidence, but not through a comprehensive independent basin-wide validation. The land-use-based method identified a larger proportion of high-risk areas (20.1%), whereas the laboratory-based approach yielded more restrictive estimates (9.4%) and greater spatial differentiation. These differences reflect the conceptual assumptions underlying each method. The results highlight that method selection strongly influences risk assessment outcomes and should be aligned with management objectives, data availability, and acceptable levels of uncertainty.

PMID:42525282 | DOI:10.1007/s10661-026-15708-0

Eur Radiol. 2026 Jul 29. doi: 10.1007/s00330-026-12763-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the malignancy risk of peripheral lung lesions with non-diagnostic percutaneous transthoracic needle biopsy (PTNB) findings and to evaluate contrast-enhanced ultrasound (CEUS) guidance for reducing non-diagnostic outcomes.

MATERIALS AND METHODS: This retrospective study included patients who underwent PTNB at three institutions between October 2018 and March 2023. PTNB results were categorized as diagnostic (malignancy or specific benignity) or non-diagnostic (nonspecific benignity, atypical epithelia, insufficient samples, or sampling failure). The risk factors for malignancy and the effectiveness of CEUS for guiding PTNB were analyzed.

RESULTS: This study included 1591 peripheral lung lesions from 1558 patients (median age: 63 y; range: 18-87 y). Among these patients, 1072 were male, and 486 were female. Approximately 40% of PTNBs yielded non-diagnostic results. Malignancy risk increased with increasing lesion size (p < 0.001). Granulomatous inflammation/organizing pneumonia was a protective factor. Compared with atypical cells of undetermined significance, atypical cells suspicious of malignancy conferred a higher malignancy risk (p < 0.001). No significant difference in malignancy rates was observed between insufficient samples and sampling failures (p > 0.05). Compared with non‑contrast enhanced US guidance, CEUS guidance demonstrated a significantly greater sampling success rate, higher diagnostic accuracy, and higher sensitivity, particularly for lesions measuring 3.1-5.0 cm (all p < 0.05).

CONCLUSION: In terms of non-diagnostic PTNB results, lesions with atypical epithelia have the highest malignancy risk, whereas nonspecific benign lesions have the lowest risk. This study suggests that CEUS-guided PTNB is significantly effective for diagnosing lesions ranging from 3.1 to 5.0 cm in size, aiding the selection of imaging guidance.

KEY POINTS: Question What is the malignancy risk in peripheral lung lesions of non-diagnostic PTNB results, and can CEUS guidance effectively improve diagnostic accuracy and reduce inconclusive outcomes? Findings Malignancy risk varies significantly across different non-diagnostic pathological categories, while CEUS guidance demonstrated improved overall diagnostic performance, particularly for lesions measuring 3.1 to 5.0 cm. Clinical relevance This study provides a risk-stratification framework for managing non-diagnostic biopsies and demonstrates that integrating CEUS can optimize sampling success, reduce repeated procedures, and ensure timely, accurate diagnosis for patients with peripheral lung lesions.

PMID:42525281 | DOI:10.1007/s00330-026-12763-6

Strabismus. 2026 Jul 29:1-8. doi: 10.1080/09273972.2026.2708089. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the influence of ocular misalignment on social trait attribution in children and to evaluate whether isolated variations in ocular alignment affect early social perception.

METHODS: In this prospective, cross-sectional study, 100 children aged 8-14 years evaluated standardized visual stimuli depicting characters that differed in ocular alignment (orthotropic, esotropic, and exotropic). The illustrations were neutrally designed to control for facial expression, symmetry, gender, and skin tone. Four questionnaire forms were created, each containing three images, and each participant completed only one form. Within each form, one image represented each ocular alignment condition, so that no child viewed more than one alignment version of the same base character. This design was intended to reduce direct comparison bias. Participants assigned predefined social traits – including intelligence, bravery, success, and friendliness – to each character. Responses were recorded in a binary format and statistically compared across alignment conditions.

RESULTS: Characters with ocular misalignment were less frequently assigned favorable attributes. Orthotropic characters were significantly more likely to be rated as intelligent, successful, and brave compared with both esotropic and exotropic characters (p < .05 for all comparisons). For friendliness, orthotropic characters were more frequently perceived as friendly than exotropic characters (p = .002). No significant differences were observed between esotropic and exotropic depictions. Age subgroup analysis (8-11 vs. 12-14 years) revealed similar perception patterns across groups.

CONCLUSION: Ocular alignment appears to influence social trait attribution in childhood. Even under controlled visual conditions, misalignment was associated with reduced attribution of positive characteristics. These findings highlight the potential role of early perceptual bias in the psychosocial experience of children with strabismus and underscore the broader clinical and societal relevance of ocular alignment beyond visual function.

PMID:42522688 | DOI:10.1080/09273972.2026.2708089

Cult Health Sex. 2026 Jul 29:1-13. doi: 10.1080/13691058.2026.2702631. Online ahead of print.

ABSTRACT

In this study we examine how intersecting gendered and ethnic identities shape access to sexual and reproductive health (SRH) information among Zezuru and Karanga people in rural Zimbabwe. While SRH policies in Zimbabwe promote universal access, they overlook intra-ethnic differences that produce uneven patterns of knowledge, service engagement, and autonomy. Using the theory of intersectionality, we investigate how cultural norms, religious beliefs, and socio-economic structures interact to create differentiated access to information and services. Data were collected through a cross-sectional quantitative survey conducted in Mashonaland East and Masvingo. The sample consisted of 418 respondents aged 18-49, selected using stratified multistage sampling. To analyse the data, we used descriptive and inferential statistics. Results show significant disparities where 84.3% (Karanga) compared to 55.9% (Zezuru) reported limited access to information. Additionally, men reported lower engagement with SRH information and services than women. Access to SRH information was shaped by intersecting factors including gender, ethnicity, religion, education, and livelihood insecurity. Findings call for SRH programmes and interventions that are locally entrenched, culturally responsive, and supported by strengthened community-based health systems.

PMID:42522653 | DOI:10.1080/13691058.2026.2702631

Pediatr Emerg Care. 2026 Jul 29. doi: 10.1097/PEC.0000000000003666. Online ahead of print.

ABSTRACT

OBJECTIVE: Standardized training and education are priorities for improving system-level quality and outcomes for pediatric trauma patients. The objective of this study is to identify common educational needs of pediatric trauma clinicians in the United States and the gaps in currently available education courses, to inform future curriculum development.

METHODS: An anonymous, IRB-approved, 30-item cross-sectional survey was developed and distributed to pediatric trauma clinicians via e-mail. Demographic and quantitative data were analyzed with descriptive statistics. Open-ended responses were analyzed using reflexive thematic analysis.

RESULTS: Two hundred four surveys were analyzed. Respondents were faculty physicians (40.7%), nurses (23.5%), trauma program managers (18.6%), advanced practice providers (11.3%), EMS (4.4%), and trainee physicians (1.5%) representing thirty-seven states. 70% worked at a pediatric trauma center. 65% had taken the ATLS course, but only 50% felt that the course prepared them to care for pediatric trauma patients. 97% had taken PALS, but only 45% felt the course prepared them for pediatric trauma care. Respondents ranked comfort with specific pediatric trauma skills. Confidence was lowest for chest tube placement (mean=5.7/10) and dosing intubation medications (6.1/10). Confidence was highest for tourniquet placement (8.2/10) and assigning a GCS to a school-aged child or teen (8.1/10). Qualitative themes included: (1) Neither ATLS nor PALS provide comprehensive pediatric trauma education; (2) Comfort with pediatric trauma comes from experience rather than course completion; (3) There is a desire for additional pediatric-specific education, and (4) Multiple specific topics were identified as educational needs.

CONCLUSION: ATLS and PALS alone do not meet the need for comprehensive pediatric trauma education in the United States. Experience is most helpful for proficiency, putting low-volume centers at a disadvantage. Pediatric-specific trauma education is desired, including simulation-based courses and app-based reference materials. Pediatric procedural skills, age-specific assessment and physiology, and evidence-based best practices should be targeted.

PMID:42522642 | DOI:10.1097/PEC.0000000000003666

Sheng Wu Gong Cheng Xue Bao. 2026 Jul 25;42(7):3304-3320. doi: 10.13345/j.cjb.260265.

ABSTRACT

To establish and validate an anion-exchange high-performance liquid chromatography (AEX-HPLC) method for the determination of the empty-to-full capsid ratio in recombinant adeno-associated virus (rAAV), and to systematically evaluate its detection accuracy by comparing with the gold standard method of analytical ultracentrifugation (AUC), thereby providing a reliable technical approach for the quality control of rAAV empty-to-full capsid ratio. A UniCore^TM Q strong anion-exchange chromatographic column was used, with 20 mmol/L Bis-Tris propane-acetic acid buffer as the mobile phase A, while the mobile phase B consisted of mobile phase A supplemented with 2.5 mol/L tetramethylammonium chloride. Gradient elution was performed over 17 minutes with a fluorescence detector (λ_ex 280 nm, λ_em 348 nm), and systematic methodological validation of the method was conducted. The method showed good specificity. The spiked recovery rate was >87%, and the relative standard deviations (RSD) of the empty-to-full capsid ratio for repeatability and intermediate precision were 4.91% and 0.99%, respectively, indicating good precision. The method had a good linear relationship within the concentration range of 5.54×10¹¹-4.16×10¹² vg/mL (R²≥0.99). Both the limit of detection and limit of quantitation reached 2.77×10¹⁰ vg/mL, and the sensitivity met the requirements for the detection of low-concentration samples. No significant differences in the results were observed when the pH of the mobile phase fluctuated within the range of 9.2-9.4 or the column temperature varied by ±3 ℃, showing good robustness. Compared with the AUC method, there was no statistically significant difference in the determination results (P=0.156). The AEX-HPLC method established in this study has been fully validated, and all performance indicators meet the requirements for the quality control of rAAV empty-to-full capsid ratio. The method can be directly applied to the detection of the empty-to-full capsid ratio in marketed rAAV drugs. The results obtained by this method are consistent with those obtained by the gold standard AUC method, demonstrating reliable accuracy. By virtue of its charge separation principle, the method possesses unique detection advantages and is simple to operate. Furthermore, it overcomes the limitations of the AUC method, such as high equipment cost, low detection throughput, time-consuming detection, and limited accessibility. It is suitable for the detection of rAAV drug intermediates and the release of final products, and holds significant practical value for promoting the establishment of the quality control system for rAAV drug industrialization.

PMID:42522633 | DOI:10.13345/j.cjb.260265

Sheng Wu Gong Cheng Xue Bao. 2026 Jul 25;42(7):3006-3018. doi: 10.13345/j.cjb.260131.

ABSTRACT

Premature ovarian failure (POF) severely impairs women’s reproductive health and quality of life. Cyclophosphamide (CTX) is a common chemotherapeutic drug that clinically induces ovarian function damage. However, the potential metabolic regulatory mechanism underlying CTX-induced POF remains unclear, and it is urgent to reveal its pathogenesis from a metabolic perspective. Based on the CTX-induced POF mouse model, this study obtained serum metabolomic data from mice in the normal group and the model group, screened and identified 41 qualitatively differential metabolites, among which lipids and lipid-like molecules accounted for 54%, and clarified the significant alterations in the serum metabolic profile of POF model mice. Eight SPF-grade female C57BL/6 mice were randomly divided into the normal control group and the POF model group. The model group received an intraperitoneal injection of CTX to establish the POF model, and the successful establishment of the model was verified by hematoxylin-eosin (HE) staining. UPLC-HRMS technology combined with multivariate statistical analysis was used to screen differential serum metabolites, followed by KEGG pathway enrichment analysis. This study reveals that abnormal choline metabolism and glycerophospholipid metabolism are the core regulatory links of CTX-induced POF, and confirms that the coordinated disorder of multiple metabolic pathways is involved in POF progression. It provides foundational data and scientific evidence for the screening of early diagnostic biomarkers, the elucidation of pathogenesis, and the development of targeted intervention strategies for POF.

PMID:42522614 | DOI:10.13345/j.cjb.260131

J Nerv Ment Dis. 2026 Jul-Aug 01;214(4):71-73. doi: 10.1097/NMD.0000000000001879. Epub 2026 Jul 29.

NO ABSTRACT

PMID:42522604 | DOI:10.1097/NMD.0000000000001879

Mater Horiz. 2026 Jul 29. doi: 10.1039/d6mh00706f. Online ahead of print.

ABSTRACT

Humidification-dehumidification (HDH) desalination technology, leveraging low-grade waste heat or renewable and sustainable energy sources (e.g., solar, wind, and geothermal energy), represents a promising method for producing freshwater. A significant trend in current research involves the development of hybrid systems that integrate HDH with electricity or energy generation technologies, such as photovoltaics, mechanical vapor compression, and organic Rankine cycles. These hybrid systems aim to simultaneously address water and energy demands. However, challenges remain in scaling these systems for broader applications, particularly concerning cost-effectiveness and maximizing freshwater yield across diverse environmental conditions. Optimizing the packing materials, which serve as the core component where approximately 90% of the heat and mass transfer occurs, is critical for advancing the commercialization of HDH technology. The packing materials within humidifiers play a fundamental role by maximizing water holdup and sustaining mass-transfer capacity through enhanced contact area and prolonged interaction time between water and air streams. This study systematically reviews and classifies the packing materials and structures utilized in HDH humidifiers. Packing materials exhibit substantial diversity, encompassing cellulose papers, plastic packings, fiber-based materials, metal wire mesh, ceramics, wood-based materials, and biomimetic structures. Analysis indicates that structured packings, such as corrugated plates, have dominated long-term HDH applications despite their higher costs and maintenance complexities due to their compact design and superior thermal performance. Material utilization statistics reveal that cellulose-based packings are the most prevalent, followed by plastics and fiber-based materials, collectively accounting for approximately 60% of deployments. Cellulose and wire mesh demonstrate superior humidification performance, while structured corrugated plates and biomimetic configurations are favored for their structural advantages. To further enhance humidification efficiency and overall system performance, future packing designs should not only emphasize high humidification efficiency but also prioritize key characteristics, such as wettability, durability, and environmental sustainability. This review provides a comprehensive classification and overview of packing materials to assist researchers in improving HDH system efficiency and advancing its commercialization potential.

PMID:42522600 | DOI:10.1039/d6mh00706f