Tag: pubmed

J Gerontol A Biol Sci Med Sci. 2026 May 22:glag135. doi: 10.1093/gerona/glag135. Online ahead of print.

ABSTRACT

Mild cognitive impairment (MCI) is a key stage for early intervention in dementia, and its inflammatory mechanisms remain unclear. Myeloperoxidase (MPO), a key enzyme involved in inflammation and immune regulation, has not been fully studied in MCI. This multicenter longitudinal cohort study prospectively followed 133 patients with MCI for 12 months. Plasma MPO, Alzheimer’s disease (AD)-related biomarkers (p-Tau181, p-Tau217, GFAP, NFL, and Aβ42/40), inflammatory cytokines (IL-1β, IL-6, and TNF-α), neuropsychological performance, and APOE genotype were assessed at baseline and follow-up. During follow-up, 58 patients showed cognitive deterioration and 75 remained non-deteriorated. At both baseline and the 12-month follow-up, the cognitive deterioration group showed higher MPO, IL-1β, and IL-6 levels than the non-deterioration group. Within-group longitudinal changes from baseline to follow-up were modest and were not statistically significant. Cross-sectional analyses showed that MPO was associated with IL-1β, IL-6, Aβ42/40, MMSE, and ADAS-Cog at different assessment time points. Longitudinal delta analyses showed that changes in MPO were significantly correlated with changes in MMSE, IL-1β, and IL-6, but not with changes in ADAS-Cog or Aβ42/40. After adjustment for potential confounders, MPO remained an independent predictor of cognitive deterioration in MCI (OR = 1.018, 95% CI: 1.00-1.03, p = 0.015). Nomogram analysis showed that MPO was the most prominent predictor in the model. These findings suggest that elevated plasma MPO may serve as a clinically accessible prognostic biomarker for risk stratification in patients with MCI.

PMID:42172591 | DOI:10.1093/gerona/glag135

J Pediatr Orthop. 2026 May 22. doi: 10.1097/BPO.0000000000003330. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the clinical efficacy of ultrasound-assisted closed reduction and percutaneous pinning (CRPP) compared with traditional open reduction and internal fixation (ORIF) in the treatment of Song type V lateral condylar humerus fractures (LCHFs) in children.

METHODS: A multicenter retrospective study was conducted on 187 pediatric patients with Song type V LCHFs between August 2019 and August 2023. Among them, 96 patients underwent ultrasound-assisted CRPP, and 91 patients received ORIF. Operative time, number of intraoperative fluoroscopy exposures, fracture healing duration, and postoperative complications were compared between the 2 groups. Radiographic parameters-including the Baumann angle (BA) and shaft-condylar angle (SCA)-and functional outcomes assessed by the Flynn criteria were evaluated at 12 months postoperatively.

RESULTS: The mean operative time was significantly shorter in the CRPP group (37.07±8.95 min) compared with the ORIF group (53.09±18.36 min; P<0.05). Lateral humeral condylar overgrowth was noted in 37 patients in the CRPP group and 40 in the ORIF group, with no statistical difference. At 12 months, radiographic parameters (BA and SCA) and Flynn functional scores showed no significant differences between groups. The excellent and good rate was 98.96% in the CRPP group and 97.80% in the ORIF group (P>0.05).

CONCLUSION: Compared with traditional ORIF, ultrasound-assisted CRPP for Song type V LCHFs in children yields comparable clinical outcomes while significantly reducing operative time and avoiding surgical exposure. This technique facilitates minimally invasive treatment and warrants broader clinical adoption.

LEVEL OF EVIDENCE: Level III.

PMID:42172589 | DOI:10.1097/BPO.0000000000003330

Mil Med. 2026 May 22:usag223. doi: 10.1093/milmed/usag223. Online ahead of print.

ABSTRACT

INTRODUCTION: The use of Zone 1 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for life-threatening trauma has increased and its association with improved survival outcomes compared to resuscitative thoracotomy (RT) has been reported in civilian literature, however data from military settings has been limited. Achieving rapid hemorrhage control is essential to preventing battlefield fatalities. During modern combat casualty care, REBOA offers a solution to non-compressible torso hemorrhage (NCTH) and may reduce complications associated with RT. The purpose of this study is to examine survival rates between Zone 1 REBOA and RT with aortic cross clamping in deployed environments over a 6-year study period.

MATERIALS AND METHODS: This study received IRB approval at Brooke Army Medical Center (BAMC), San Antonio, TX. A retrospective analysis was performed to compare outcomes in deployed military personnel following the use of RT and REBOA with NCTH using data from the Department of Defense Trauma Registry January 2017-May 2022. Comparative, descriptive, and summary statistical analyses were utilized to evaluate relative risk and hazards ratio of death after REBOA placement or thoracotomy (P < .05). Univariate propensity matching was used to control for differences in injury severity score between the 2 cohorts.

RESULTS: A total of 9 REBOA and 23 RT patients were identified, with 88.9% of REBOA patients and 44% of RT patients surviving to evacuation to the next role of care and to hospital discharge (P = .039). No difference in hospital length of stay, ICU stay, or ventilator days was seen between the cohorts. In surviving patients, complications following aortic occlusion with REBOA and RT are reported with no appreciable complication rates following extended aortic occlusion time beyond 30 minutes (max 60 minutes). The small sample and low number of events limit the robustness of these findings and call for cautious interpretation.

CONCLUSIONS: This retrospective analysis comparing Zone 1 REBOA and RT for NCTH in a U.S. military deployed setting demonstrates association of REBOA with improved survival compared to RT. However, these findings are limited by a small sample size and potential selection bias inherent to retrospective design and clinician-driven procedural choice, particularly in cases perceived as survivable. As such, the results should be interpreted with caution and considered hypothesis-generating, warranting further investigation in larger, more robust studies in order to define optimal REBOA use in an austere environment. Despite the limitations, these results highlight REBOA’s potential use in resource limited environments and can improve the ability to triage multiple casualties.

PMID:42172583 | DOI:10.1093/milmed/usag223

J Chem Inf Model. 2026 May 22. doi: 10.1021/acs.jcim.6c00479. Online ahead of print.

ABSTRACT

For complex multicomponent condensed-phase systems, coarse-grained (CG) molecular dynamics often struggles to simultaneously achieve structural fidelity and thermodynamic consistency. Using base asphalt as a representative system, this study proposes and validates a hierarchical hybrid, closed-loop parametrization strategy. Bonded interactions are derived via iterative Boltzmann inversion (IBI) and further stabilized through robust statistical treatment and reduced representations, improving the parameter identifiability and numerical stability. Non-bonded interactions are built on the Martini 3 framework and are calibrated in a low-dimensional manner using only two global scaling factors, followed by geometric fine-tuning for the overall correction. The resulting model reproduces the density-temperature response within the experimentally relevant window and remains consistent with all-atom (AA) references in key structural statistics. Dynamically, it preserves the relative diffusion ranking among components and enables consistent time rescaling to the AA reference. Arrhenius-like diffusion behavior and the temperature dependence of the viscosity are also captured. At the mesoscale, the model reproduces the evolution of asphaltene self-aggregation, representative stacking-like local arrangements of aromatic-core regions, and bee-like morphological features consistent with experimental observations. Overall, this work provides a reproducible and parsimonious paradigm for CG force field construction in complex mixtures, enabling coupled convergence of structure and thermodynamics.

PMID:42172574 | DOI:10.1021/acs.jcim.6c00479

Cir Cir. 2026 May 22. doi: 10.24875/CIRU.25000450. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to investigate the relationship between liver enzymes and lipid profiles in cholecystectomy cases with cholecystitis, cholesterolosis, and cholesterol polyps.

METHODS: The cholecystectomy cases were divided into 3 groups according to their pathological diagnosis; cholesterolosis and cholelithiasis (Group 1), cholesterolosis (Group 2), and cholesterolosis and cholesterol polyp (Group 3). The groups were subjected to statistical analysis based on age, gender, cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein (HDL), alkaline phosphatase, gamma-glutamyl transferase (GGT), and C-reactive protein values.

RESULTS: Of the 227 cases included, 39 (17.2%) were male, and 188 (82.8%) were female. HDL value was significantly lower in men than in women (p = 0.00), while GGT (p = 0.00), aspartate aminotransferase (p = 0.01), and alanine aminotransferase (p = 0.00) values were significantly higher in men. No significant differences were detected in comparisons between pathological diagnostic groups (all p > 0.05).

CONCLUSIONS: No statistically significant findings were found regarding lipid profile and liver enzyme levels in cases of cholesterolosis, cholelithiasis, and cholesterol polyps. Although it is predicted that the HDL level being significantly lower in men than in women will increase the risk of polyp, no significant difference was detected between the pathological diagnosis groups in terms of gender. Studies containing larger case series are needed to reveal this relationship more clearly.

PMID:42172546 | DOI:10.24875/CIRU.25000450

Int J Pharm Pract. 2026 May 22:riag067. doi: 10.1093/ijpp/riag067. Online ahead of print.

ABSTRACT

BACKGROUND: Faced with local and global shortages of academic pharmacists, this study aimed to determine Nigerian pharmacy students’ interest in academia to inform policies for strengthening the academic pharmacist workforce.

METHODS: A cross-sectional survey was conducted among Nigerian pharmacy students between May and August 2024. Data were collected via online and paper-based validated questionnaires covering sociodemographic, academic characteristics, writing self-efficacy, writing apprehension, and research publication needs assessment. Statistical analyses were performed using SPSS version 27, with P < .05 indicating significance.

KEY FINDINGS: Of 607 responses, 56% were women and 95% were under 30 years old. Community pharmacy was the most favoured practice area (35%), while academia was the least (7%). Over 80% desired to publish research and enrol in a research mentorship program. Gender {AOR = 0.573 (0.358-0.916)}, previous peer-reviewed publication {AOR = 1.877 (1.067-3.303)}, preferred pharmacy practice if remuneration was equal across the different pharmacy practice areas {AOR 5.442 (2.285-12.965)}, and research publication needs assessment score {AOR 1.014 (1.001-1.027)} significantly predicted interest in academic pharmacy. The logistic model (X2 (18) = 150.1, P < .001) explained 38% of variance and classified 74.3% of cases correctly.

CONCLUSIONS: A relatively low percentage of students initially prefer academic pharmacy, and less than half show high intrinsic interest. Gender, previous publication, pharmacy practice preferences under equal remuneration, and research needs assessment predict academic pharmacy interest. These findings highlight motivations and structural barriers, such as remuneration and writing-related concerns, suggesting avenues for interventions to enhance Nigeria’s academic pharmacist workforce.

PMID:42172052 | DOI:10.1093/ijpp/riag067

JAMA Netw Open. 2026 May 1;9(5):e2614030. doi: 10.1001/jamanetworkopen.2026.14030.

ABSTRACT

IMPORTANCE: Guideline-adherent management of pediatric in-hospital cardiac arrest (IHCA) remains challenging, and deviations from best practices are common. Augmented-reality (AR)-enabled, role-specific decision support may improve adherence to American Heart Association (AHA) Pediatric Advanced Life Support (PALS) guidance and key performance metrics.

OBJECTIVE: To determine whether an AR-enhanced, role-specific decision support system improves resuscitation performance and adherence to AHA PALS guidelines during simulated pediatric IHCA.

DESIGN, SETTING, AND PARTICIPANTS: This open-label, multicenter, simulation-based randomized clinical trial was conducted from April to May 2025 at 2 tertiary pediatric emergency centers (Geneva, Switzerland and Alberta, Canada). Participants included teams of pediatric nurses and physicians.

INTERVENTION: Teams managed a standardized scenario of a 12-minute IHCA due to hyperkalemia (progressing from nonshockable to shockable rhythms) using the AR-enhanced, role-specific decision support system (intervention) or AHA PALS pocket cards (control).

MAIN OUTCOMES AND MEASURES: The primary outcome was time from recognition of loss of pulse to first epinephrine. Secondary outcomes included adherence to 3- to 5-minute epinephrine dosing intervals, time to first defibrillation, adherence to 2-minute shock and rhythm-check cycles, chest compression fraction, peri-shock pause, medication-dosing accuracy, and user experience and technology acceptance.

RESULTS: A total of 54 participants were randomized into 18 teams (18 team leaders [12 female [71%] and 36 nurses [33 female [87%]), with 9 teams (27 participants) in each group. Mean (SD) time to first epinephrine was shorter in the intervention group (97.2 [38.5] vs 113.8 [44.5] seconds; mean difference, -16.6 seconds; 95% CI, -51.3 to 17.0 seconds; P = .40), but this difference was not significant. For subsequent epinephrine, the intervention group improved consistency: mean (SD) deviation from the 4-minute target was 17.2 (32.5) vs 49.7 (40.3) seconds (mean difference, -32.4 seconds; 95% CI, -58.8 to -5.8 seconds; P = .03), with fewer guideline violations (2 of 19 participants [11%] vs 9 of 21 participants [43%]; risk difference, -0.32; 95% CI, -0.55 to -0.05; risk ratio, 0.25; 95% CI, 0.06 to 0.996; P = .03). Time to first defibrillation and adherence to 2-minute cycles were similar between groups. Estimates for chest compression fraction, peri-shock pauses, and medication-dosing accuracy did not suggest meaningful between-group difference. User experience and technology acceptance were favorable.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, AR support did not clearly improve time to first epinephrine in simulated pediatric cardiac arrest, with estimates compatible with both benefit and little or no effect. It improved adherence to epinephrine dosing intervals without impairing other performance domains.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06376643.

PMID:42172032 | DOI:10.1001/jamanetworkopen.2026.14030

JAMA Netw Open. 2026 May 1;9(5):e2614046. doi: 10.1001/jamanetworkopen.2026.14046.

ABSTRACT

IMPORTANCE: Optimizing participant recruitment is critical to the success and generalizability of clinical research, yet there is limited randomized clinical trial evidence comparing the effects of digital recruitment strategies and message framing on participant engagement.

OBJECTIVE: To determine the impact of various recruitment strategies on engagement with potential research participants.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was embedded within the Research for Personalized Cardiovascular Disease Prevention (RESILIENCE) study and had a 2 × 2 factorial design. This component of the RESILIENCE study was exclusively virtual and completed online within a single large academic health system in the United States. Potential research participants were identified through electronic health records. The study recruited participants between September 2019 and March 2022, with the analysis undertaken in July to December 2025. No follow-up was undertaken for this study.

INTERVENTIONS: Participants were randomized to a recruitment modality (email vs patient portal) and to a type of message content (altruistic vs individualistic).

MAIN OUTCOMES AND MEASURES: The primary outcome was participant interest, defined as logging onto the study website by clicking the link in the message within 6 months. A robust log-linear Poisson model was used to estimate the relative risk (RR) of the primary outcome based on modality and message content.

RESULTS: Of 15 376 potential research participants (9309 [60.5%] female) identified through the electronic health records, 7737 (50.3%) were randomized to the email recruitment modality and 7639 (49.7%) were randomized to the patient portal modality; 7682 (50.0%) received an altruistic recruitment message and 7694 (50.0%) received an individualistic recruitment message. The primary outcome occurred in 1220 participants (7.9%). The email recruitment modality led to a higher likelihood of the primary outcome than patient portal messages (768 [9.9%] vs 452 [5.9%]; RR, 1.68; 99% CI, 1.45-1.95), while no difference was observed by message content type (634 [8.3%] altruistic vs 586 [7.6%] individualistic; RR, 1.08; 99% CI, 0.94-1.25). There was no significant interaction between message modality and content. Exploratory interactions by age and risk phenotype were observed, with altruistic messaging more effective than individualistic messaging in those aged 60 years and younger and email more effective than patient portal in those older than 60 years and in individuals with obesity.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of recruitment strategies, email messaging led to higher participant interest than patient portal messaging, particularly in older individuals. Message content did not significantly impact engagement overall, but altruistic messaging was more effective in younger participants. These results can inform recruitment strategies for future trials.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04551872.

PMID:42172031 | DOI:10.1001/jamanetworkopen.2026.14046

JAMA Netw Open. 2026 May 1;9(5):e2614265. doi: 10.1001/jamanetworkopen.2026.14265.

ABSTRACT

IMPORTANCE: Chimeric antigen receptor T-cell (CAR-T) therapy is a paradigm-changing therapy in treating non-Hodgkin lymphoma (NHL). Although NHL is a leading cause of cancer-attributable deaths for persons living with HIV (PWH) in high-income countries, PWH are frequently excluded from CAR-T clinical trials.

OBJECTIVE: To explore access to CAR-T trials for the general population and PWH.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study queried ClinicalTrials.gov for all interventional CAR-T clinical trials for the treatment of NHL. Zip codes for each trial site were extracted, and travel time to the nearest location was calculated. Trials included had at least 1 trial site in the contiguous US, and were actively recruiting trials for adult patients (aged ≥18 years) as of May 20, 2025.

EXPOSURE: All trials were reviewed for relevance and eligibility of PWH.

MAIN OUTCOMES AND MEASURES: The primary outcomes were median population-weighted travel time to the nearest trial and 1-hour and 3-hour access for the general population, HIV-inclusive trials, and HIV-exclusive trials. Proportions were compared using a χ2 test, and continuous median travel times were compared using unpaired t tests.

RESULTS: In total, 254 trials were eligible for review, and 80 met criteria for inclusion with 11 (13.8%) trials including PWH, 58 (72.5%) excluding PWH, and 11 (13.8%) not mentioning HIV. The median (IQR) population-weighted travel time was 0.73 (0.36-1.64) hours for the general population, 1.15 (0.49-2.38) hours for trials including PWH, and 0.84 (0.40-1.91) hours for trials excluding PWH. Compared with trials that excluded PWH, trials that included PWH had significantly lower 1-hour (46.07% [95% CI, 46.06%-46.07%] vs 55.27% [95% CI, 55.27%-55.28%]; P < .001) and 3-hour (82.22% [95% CI, 82.22%-82.23%] vs 87.76% [95% CI, 87.75%-87.76%]; P < .001) access. Travel time in the South was significantly longer for trials that included PWH compared with trials that excluded PWH (median [IQR], 1.70 [0.69-2.99] hours vs 0.92 [0.46-2.00] hours; P < .001).

CONCLUSIONS AND RELEVANCE: This cross-sectional study of travel time to CAR-T trials found that PWH had to travel significantly longer than the general population to reach the nearest trial. Despite efforts to reduce clinical trial exclusion based solely on HIV status, access for PWH remains disproportionately lower compared with the general population, and particularly poor in the South, where there is the highest prevalence of HIV. Further efforts to increase access to trials for underserved and underrepresented populations, particularly for PWH, are needed.

PMID:42172029 | DOI:10.1001/jamanetworkopen.2026.14265

JAMA Netw Open. 2026 May 1;9(5):e2614337. doi: 10.1001/jamanetworkopen.2026.14337.

ABSTRACT

IMPORTANCE: Urologic cancers have been linked to nonessential chemical elements with no known beneficial role in the body, though associations between low-level environmental exposure and urologic cancer risk are poorly understood.

OBJECTIVE: To systematically synthesize epidemiologic evidence on the association between environmental exposure to nonessential elements and risk of urologic cancers.

DATA SOURCES: English- and Chinese-language databases, including PubMed, Embase, Web of Science, Scopus, Cumulated Index in Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure, and Wanfang, were searched from inception to January 27, 2026, without language restrictions.

STUDY SELECTION: Cohort and case-control studies reporting associations between exposure to at least 1 nonessential element (eg, arsenic, cadmium, lead, vanadium, or nickel) and risk of urologic cancers (prostate, bladder, kidney, urinary tract, or testicular) were included.

DATA EXTRACTION AND SYNTHESIS: Data were extracted independently by 4 author reviewers. Random-effects meta-analyses were conducted to estimate pooled relative risks (RRs) comparing the top vs bottom tertiles of exposure levels and to evaluate dose-response associations. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.

MAIN OUTCOMES AND MEASURES: RRs for urologic cancers associated with exposure to nonessential elements.

RESULTS: Of 23 160 records screened, 68 studies met inclusion criteria and 62 were included in the meta-analysis. Comparing the top vs bottom tertile of exposure levels, pooled RRs for arsenic were 1.72 (95% CI, 1.33-2.22) for all urologic cancers, 1.60 (95% CI, 1.13-2.27) for bladder cancer, 1.19 (95% CI, 1.01-1.40) for prostate cancer, and 3.37 (95% CI, 1.71-6.66) for urothelial carcinoma (renal pelvis, ureter, urethra, and/or bladder). Arsenic exposure was not associated with kidney cancer (RR, 1.38; 95% CI, 0.76-2.52). A nonlinear dose-response association was observed between urologic cancer risk and drinking-water arsenic levels above 10 µg/L but not at or below this level; the RR steadily increased from concentrations of 10 to 429 µg/L. Estimated using the population attributable fraction, reducing arsenic concentrations in drinking water to 10 µg/L could potentially lower age-standardized annual rates of some urologic cancers by 0.1 to 31.8 cases per 100 000 population in high-exposure areas. Pooled RRs for overall urologic cancer risk were 1.38 (95% CI, 1.04-1.82) for top vs bottom tertile of cadmium exposure and 1.15 (95% CI, 1.05-1.26) for vanadium, whereas evidence for other elements was limited.

CONCLUSIONS AND RELEVANCE: In this systematic review and meta-analysis of epidemiologic studies, environmental exposure to arsenic, cadmium, and vanadium was associated with increased risk of urologic cancers, although high heterogeneity across studies limited interpretability. These findings highlight the need for high-quality prospective studies to assess causality and quantify the public health burden from environmental exposure to nonessential elements.

PMID:42172026 | DOI:10.1001/jamanetworkopen.2026.14337