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461 papers

Skin Closure Techniques After Cardiac Implantable Electronic Device Implantation and Their Impact on Pocket Complications: A Systematic Review and Meta-Analysis.

Mashayekhi Y et al. · Jul 1, 2026

Background Cardiac implantable electronic device (CIED) implantation, including pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy systems, is increasingly performed worldwide. Despite advances in implantation techniques, device pocket-related complications such as infection, hematoma, and wound dehiscence remain clinically important. The optimal skin closure technique for preventing these complications remains uncertain. Objective To evaluate and compare the safety and effectiveness of different skin closure techniques following CIED implantation. Methods A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed/MEDLINE, Embase, Scopus, Web of Science, and CINAHL were searched from database inception to March 2026. Studies evaluating wound closure techniques after CIED implantation were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Primary outcomes included pocket infection, hematoma, and wound dehiscence. Results Nine studies involving 1616 patients were included. Closure methods evaluated included conventional sutures, cyanoacrylate tissue adhesives, skin staplers, and noninvasive closure devices. Pooled analysis showed no significant difference in pocket infection between closure techniques (OR 0.91, 95% CI 0.58-1.42; p = 0.68; I 2 = 29%). Similarly, no significant differences were observed for pocket hematoma (OR 1.08, 95% CI 0.67-1.74; p = 0.74; I 2 = 34%) or wound dehiscence (OR 1.14, 95% CI 0.52-2.51; p = 0.75; I 2 = 21%). Conclusion Different wound closure techniques following CIED implantation demonstrate comparable safety outcomes. Closure method selection may therefore be guided by operator preference, procedural efficiency, and cosmetic considerations.

Medicine

Preschoolers' Early Sentence Comprehension: Comparing Bilingual and Monolingual Children and the Role of Executive Function and Vocabulary Development.

Rodenhurst N et al. · Jul 1, 2026

Previous research into children's comprehension of syntactic structures has investigated early awareness of transitive and intransitive structures amongst monolingual children but research into bilingual children's understanding of the same sentence structures is lacking. This study compared 46 3-5-year-old bilingual children who spoke English and an additional language with 64 monolingual, English-speaking children, in their ability to associate transitive sentences with a causal scene, and intransitive sentences with a non-causal scene. In contrast to previous studies, the current study used still images instead of videos to create eight trials per structure, increasing the number of trials and testing structure as a within-participants manipulation. Children's vocabulary and executive function skills were also tested to observe interactions with the sentence comprehension task. Both groups showed the same overall pattern of effects, though the monolingual children were reliably more likely to match the causal scene to a transitive than bilingual children: Older children associated the transitive trials with causal scenes more than the intransitive trials, whereas 3-year-olds tended to associate both the transitive and intransitive sentences with causal scenes. Executive function performance did not differ between bilingual and monolingual children and was not related to sentence interpretation, but monolingual children had higher English vocabulary scores and children with greater vocabularies were better able to distinguish causal scenes as a match for transitive sentences. The results suggest that differences in comprehension of syntactic structures are more likely to be related to age and language ability, rather than differences in the number of languages spoken. SUMMARY: Bilingual and monolingual children showed similar patterns in their ability to comprehend transitive and intransitive sentences, though monolinguals more reliably associated transitives with causal scenes. 4- and 5-year-olds were better at associating transitives with causal scenes and intransitives with either causal or non-causal, whereas 3-year-olds associated both sentences with causal scenes. Age was a better predictor of differences in interpreting transitivity than the number of languages children speak. No executive function differences between bilinguals and monolinguals were found, monolinguals had larger English verb vocabularies; vocabulary was related positively to causal scene/transitive associations.

Psychology

Comparative Evaluation of Smartphone-Based Fundus Imaging Systems in Dogs and Cats.

Michaud B. · Jul 1, 2026

Objective To compare the feasibility, image quality, acquisition time, and evaluator preference of four smartphone-based fundus imaging (SBFI) systems in dogs and cats using a handheld fundus camera as a reference device. Animals studied Twenty client-owned animals, including 10 dogs and 10 cats. Procedures Fundus images were obtained from 40 eyes (20 mydriatic and 20 non-mydriatic) using four SBFI systems (iExaminer Panoptic, NUN WFE-02S, OQVet, and VistaView) and a handheld infrared fundus camera (Aurora). Image acquisition success and acquisition time were recorded for each device. Image quality was independently graded using a 10-point Likert scale by a masked panel of 32 veterinary ophthalmologists. Evaluators also selected their preferred image among the four SBFI systems. Results Image acquisition was successful in all animals for all devices under both mydriatic and non-mydriatic conditions (100%). Image quality differed significantly between devices. Among SBFI systems, OQVet achieved the highest median score (7; interquartile range [IQR] 6-8), followed by VistaView (6; IQR 5-8), NUN (5; IQR 4-7), and iExaminer (4; IQR 3-5). OQVet received approximately 50% of evaluator preference votes. The reference camera achieved the highest image quality in 77.5% of imaging sets but was outperformed by OQVet (15%) and VistaView (7.5%) in some examinations. Pupil dilation did not significantly influence image quality or acquisition time. Conclusions Smartphone-based fundus imaging enables reliable retinal imaging in dogs and cats and represents an accessible option for retinal documentation and screening in veterinary practice.

Medicine

Advances in the Study of Endometrial Receptivity and Glucose Metabolism Mechanisms in Insulin Resistance.

Huang SY et al. · Jul 1, 2026

Introduction Insulin resistance (IR) is one of the important pathologic bases of polycystic ovary syndrome (PCOS) and an important factor contributing to infertility. In patients with PCOS, IR acts not only on insulin-sensitive tissues, such as skeletal muscle, adipose tissue, and liver, but also on the ovaries and endometrium. Localised endometrial IR is closely associated with impaired endometrial receptivity, and proper glucose metabolism is a key factor for embryo implantation. Methods This paper describes the signalling pathways of endometrial glucose metabolism and the transcription factors regulated by endometrial glucose metabolism signalling pathways. Results The purpose of this paper is to explore the mechanism of endometrial glucose uptake in local IR and find key intersections in this mechanism. For example, Foxo1, as the intersection of the Insulin Receptor Substrate-Phosphatidylinositol3-kinase-Protein Kinase B-Glucose Transporters (IRS-PI3K-Akt-GLUTs) pathway and the Cyclic Adenosine Monophosphate- Protein Kinase A- Calcium ion (cAMP-PKA-Ca 2+ ) pathway, and as an important biomarker for evaluating endometrial receptivity. It is of great significance for studying the improvement of endometrial receptivity. Conclusions This article summarises the therapeutic approaches targeting insulin resistance and the enhancement of endometrial receptivity based on the above pathways, so as to provide references and suggestions for future therapeutic strategies.

Immunology and Microbiology

A Combined MS/MS and IMS Study Into the Fragmentation Pathway of Nifedipine.

Han P et al. · Jul 1, 2026

Collision-induced dissociation (CID) of small molecules, typically with a molecular mass below 1500 Da, is widely applied for the structural identification of drug metabolites, synthetic by-products and unknown compounds. Nonetheless, the interpretation of MS/MS spectra derived from protonated or sodiated molecules mainly relies on the comparison with literature data and proposed structures usually lack rigorous mechanistic justification and conclusive evidence. The commonly applied even-electron rule, as implemented in most literature and prediction software, does not support radical loss from protonated molecules. Similarly, fragmentation pathways of sodium adduct ions remain insufficiently explored and lack mechanistic rationalization. To improve the understanding of radical loss from even-electron nitro-containing compounds, a mechanistic study of fragmentation patterns of nifedipine, m-nifedipine, and related analogues was performed. Fragment ions generated from [M+H] + and [M+Na] + of nifedipine revealed distinct mechanisms compared with its positional isomers, while showing similarities with analogues like nisoldipine and aranidipine. The nitro group at the ortho position significantly influences fragment stability, leading to a unique fragmentation mechanism described as ortho effect. The mechanism was further investigated using isotope labelled analogs, ion mobility spectrometry (IMS), precursor ion scan (PIS), and density functional theory (DFT) calculations. Different approaches in combining IMS with MS/MS demonstrated strong capability for elucidation of fragmentation pathways.

Chemistry

Food Insecurity and Mental Health Among High School Students: Evidence From National and Virginia Youth Risk Behavior Surveillance Data.

James N et al. · Jul 1, 2026

Background Youth mental health problems are rising nationally. Virginia ranks among the lowest states in youth mental health access and has concentrated pockets of food insecurity (FI), underscoring the urgency of policy responses. FI is a known risk factor, yet surveillance often relies on single-item measures. We introduce a multidimensional Food Insecurity Index (FII) to examine associations with adolescent mental health. Methods We analyzed 2023 Youth Risk Behavior Surveillance System data from Virginia (n = 1866) and the United States (n = 10,724). The FII combined five indicators capturing acute scarcity and chronic dietary compromise. Survey-weighted logistic regression estimated adjusted odds ratios (AORs) for persistent sadness or hopelessness. Results Each 1-point increase in FII was associated with higher odds of persistent sadness or hopelessness in Virginia (AOR = 1.066, 95% CI: 1.005-1.130) and nationally (AOR = 1.087, 95% CI: 1.062-1.112). Female students had higher odds than males, and bullying was a strong correlate. A dose-response pattern was observed. Implications for school health policy, practice, and equity Integrating FI screening with nutrition and behavioral health supports may help identify and address overlapping risks. Conclusions Multidimensional FI is consistently associated with poorer mental health among high school students.

Health Professions

Sarcopenia Predicts Mortality and Hepatic Encephalopathy After TIPS in Older Adults With Cirrhosis and Improves Prognostic Scores.

Saltini D et al. · Jul 1, 2026

Background and aims The role of transjugular intrahepatic portosystemic shunt (TIPS) in older adults remains controversial because of limited risk-stratification tools. We aimed to assess whether sarcopenia and myosteatosis are independently associated with post-TIPS mortality and overt hepatic encephalopathy (OHE) in patients aged ≥ 70 years, and whether adding sarcopenia to established prognostic scores improves discrimination for post-TIPS mortality. Methods This multicenter retrospective study included 115 consecutive patients with cirrhosis aged ≥ 70 years undergoing TIPS for refractory ascites or secondary prophylaxis of variceal bleeding. Sarcopenia and myosteatosis were assessed by computed tomography at L3. Post-TIPS mortality and time to first OHE episode were analysed using Kaplan-Meier and Cox regression. Sarcopenia was integrated into established prognostic scores, and predictive performance was evaluated using time-dependent ROC analyses. Results Sarcopenia and myosteatosis were present in 60% and 80% of patients, respectively. During follow-up, 49% died and 45% developed OHE. Sarcopenia was independently associated with both mortality and OHE, whereas myosteatosis and adipose-tissue indices were not. Incorporating sarcopenia improved the discriminative performance of all scores, with MELD 3.0-sarcopenia showing the highest accuracy (AUC 0.845). Predicted survival probabilities clearly separated patients across MELD 3.0 categories according to sarcopenia status. For OHE, sarcopenia increased the risk while underdilated TIPS was protective, defining four distinct risk profiles. Conclusions Sarcopenia is highly prevalent and independently predicts both mortality and OHE after TIPS in older adults. Its integration into prognostic tools enhances risk stratification and supports individualised decision-making in this vulnerable population.

Medicine

Pre-Sport Cardiac Evaluation in Children: Detection of Risks Other Than Sudden Cardiac Death.

Öncül M et al. · Jul 1, 2026

Objective Sudden deaths may occur in children and adolescents due to unexpected cardiac problems during sports. This study aimed to screen for abnormalities that may lead to future morbidity in addition to the risk of sudden death and to investigate the importance of electrocardiography and echocardiography in detecting cardiac problems before sports license. Method Pediatric patients who visited the Pediatric Cardiology outpatient clinic of Malatya Training and Research Hospital between April 2022 and April 2024 to obtain a sports license report and who did not have any known heart disease before were included. Data were analyzed using SPSS 22.0. Results A total of 2432 patients were admitted to our hospital for pre-sport evaluation within 2 years. In 2089 of those, there were no known heart problems. Various heart problems were detected in 195 (9.3%) of the 2089 cases. In our study, 169 (8.1%) patients had echocardiography (ECHO) and 33 (1.7%) had electrocardiography (ECG) abnormality. Eight patients (0.3%) showed pathological findings on both ECHO and ECG. In addition, elevated arterial blood pressure was detected in three (0.14%). Of the cases with cardiac abnormality, 110 (56%) were male and 85 (46%) were female, and the average age was 12 (5-18). Conclusion Our study shows that approximately one out of every 10 patients in the population may have cardiological problems and 2.3% of these patients have major cardiac problems. Therefore, we recommend that all pediatric patients undergo a detailed cardiac evaluation at least once in the early stages of their lives.

Medicine

Anatomical and Histological Characterization of the Intestine of Artibeus lituratus.

de Oliveira Magalhães M et al. · Jul 1, 2026

The order Chiroptera is highly diverse and is the second richest among mammals. Approximately 181 species are known in Brazil, with varied feeding habits that make them essential for ecological functions such as seed dispersal and plant regeneration. Despite the importance of their ecosystem services, the anatomical and histological aspects of the digestive system of these animals are still little explored. The aim of this study was to describe the anatomical and histomorphological aspects of the intestines of A. lituratus. Six individuals were captured in peri-urban areas of Rio Branco, Acre. After euthanasia, the intestines were removed, fixed in 10% formaldehyde and processed for macroscopic and histological analysis using Haematoxylin-Eosin staining. Macroscopically, it was not possible to accurately distinguish the small and large intestine portions. Microscopically, all the typical intestinal layers were present, with cells, glands and structures compatible with a frugivorous diet. The findings contribute to the knowledge of the species' digestive morphology and provide subsidies for future investigations into physiological adaptations related to its diet and ecology.

Agricultural and Biological Sciences

Young Adults' Views on Priority Health Issues and Their Involvement in Shaping Responses: A Qualitative Exploration in South Australia.

Castleton P et al. · Jul 1, 2026

Introduction Young people must be central to health response design to ensure they are relevant and effective. It requires a clearer understanding of the opportunities and expectations surrounding youth engagement. Therefore, this study aims to gain a deeper understanding of the health priorities of young adults residing in South Australia (SA) and their engagement in the design of health programmes. Methods In-depth interviews were conducted with 13 young adults aged 18-24 years (all genders) in SA to identify priority health concerns, contributing factors and preferred solutions. We also explored their interest and expectations of being involved in the health programme design. Thematic analysis was conducted. Results Mental health and vaping emerged as the predominant health concerns. Key drivers of health concern amongst young adults included a lack of awareness of vaping and eating disorders, peer pressure, living costs, poor work-life balance and limited mental health services. Participants recommended early, school-based interventions, and free accessible services. They underscored the need for structural changes at policy-level to create supportive environments. Participants expressed interest in contributing to intervention design when aligned with their interests, skills and availability, but reported limited opportunities. Conclusion Young adults are eager to be involved in health programme design and have unique skills that should be better leveraged upon through co-design of research and programmes. Effective solutions to pressing health concerns must align with the lives of young adults and actively involve them in the design, implementation and evaluation of programmes and policies. WHAT'S NEXT?: The study results suggest employing the motivation and insights of young adults can lead to more relevant, effective and engaging health solutions tailored to their needs.

Social Sciences