Tag: pubmed

Clin Transl Sci. 2026 Aug;19(8):e70690. doi: 10.1111/cts.70690.

ABSTRACT

Identification of modifiable risk factors for prescription opioid use disorder (OUD)-related emergency department (ED) visits (ICD-10 F11.xx) is a clinical priority; however, most published models remain cross-sectional and lack pharmacogenomic (PGx) enrichment or dual-method feature confirmation. Using Virginia All-Payer Claims Database (APCD) data (2016-2019; 6,929,576 patients), we analyzed prescription OUD-related ED visits ( n = 1,505,138 cases; 5:1 matched controls) across seven age bands. CatBoost, XGBoost, and XGBoost-RF ensembles were trained within four utilization-density strata (25-split MCCV; 2016-2018 training; 2019 holdout) using PGx burden and pre-index temporal dynamics. Risk features were identified via a Consensus Filter (SHAP ∩ FFA) requiring SHAP values ≥ 75th percentile and FFA rule support ≥ 0.05. Dynamic Time Warping (DTW) characterized pre-index trajectories. On the 2019 low-density holdout, PR-AUC lift over prevalence ranged from 2.3× to 3.4×; the 25-44 band achieved an AUROC of 0.800 and 3.3× lift ( n = 4942 holdout cases). Top Consensus-Risk features included gabapentin, long-term opioid use (Z79.891), and pgx_num_drugs. DTW yielded three utilization archetypes in the 25-44 band ( n = 59,813), with a mean pre-index time-to-target of 6.8 months. While SHAP/FFA specify how to intervene (medication and care targets), DTW specifies when to act (surveillance window). These findings provide an observational risk-attribution framework for Consensus-Risk priority features and pre-index trajectory windows in claims-based prescription OUD-related ED care rather than identified causal treatment effects. We maintain the association-versus-causation distinction to support safer clinical use and preserve a path to prospective causal validation.

PMID:42543496 | DOI:10.1111/cts.70690

J Oral Rehabil. 2026 Aug 2. doi: 10.1111/joor.70256. Online ahead of print.

ABSTRACT

BACKGROUND: Bruxism and temporomandibular disorders (TMD) are multifactorial conditions in which cognitive and behavioural traits may play an underrecognised role. Hyperfocus, defined as intense and sustained attentional engagement, has been proposed as a potential driver of heightened sensorimotor activity and pain vulnerability, yet its relevance to bruxism and painful TMD remains poorly understood.

OBJECTIVES: To examine whether hyperfocus is associated with probable bruxism and painful TMD (pTMD), and to determine whether probable bruxism mediates the relationship between hyperfocus and pTMD.

METHODS: This cross-sectional observational study included eighty-five adults attending a university dental clinic who underwent standardised assessments for probable bruxism, pTMD, anxiety, depression, hyperactivity, and hyperfocus. Logistic regression models were used to identify factors associated with probable bruxism and pTMD. Mediation analyses tested whether probable bruxism explained the association between hyperfocus and pTMD.

RESULTS: Higher hyperfocus scores were significantly associated with both probable bruxism and pTMD. Each one-point increase in hyperfocus was linked to a 6.5% increase in the odds of PB and a 5.5% increase in the odds of pTMD. Hyperfocus was also associated with self-reported probable bruxism frequency in a dose-response pattern. Probable bruxism did not remain independently associated in the final multivariable model and therefore did not statistically explain the observed association between hyperfocus and pTMD, indicating that hyperfocus may act as an independent factor linked to both conditions.

CONCLUSION: Hyperfocus emerged as a trait associated with probable bruxism and painful TMD in this exploratory cross-sectional study. Longitudinal and mechanistic studies are needed to determine whether these associations reflect causal relationships.

PMID:42543493 | DOI:10.1111/joor.70256

Nurs Health Sci. 2026 Sep;28(3):e70406. doi: 10.1111/nhs.70406.

ABSTRACT

This study aims to examine the relationship between symptom clusters (depressive symptoms, sleep disturbances, and pain) and frailty in older adults, with a specific focus on mediation and moderation effects. Data from two cross-sectional studies in Changsha and Hong Kong were analyzed, including nursing home residents without cancer and older adults with cancer. Study-stratified analyses were conducted in SPSS 26.0 and PROCESS, with adjustment for available covariates. Mediation tested whether sleep disturbances were indirectly associated with depressive symptoms and frailty, and moderated mediation examined whether pain severity or interference conditioned the association between depressive symptoms and sleep disturbances. In both groups, frailty, depressive symptoms, sleep disturbances, and pain were significantly associated. Sleep disturbances showed a significant indirect association between depressive symptoms and frailty in both groups. Pain interference, but not pain severity, moderated the association between depressive symptoms and sleep disturbances only among older adults without cancer. The findings highlight the importance of assessing and managing depressive symptoms, sleep disturbances, and pain-related interference when addressing frailty in older adults, particularly among those without cancer.

PMID:42543491 | DOI:10.1111/nhs.70406

Adv Sci (Weinh). 2026 Aug 2:e76724. doi: 10.1002/advs.76724. Online ahead of print.

ABSTRACT

Objective measurement of tremors is important for assessing the severity and preventing misdiagnosis of Parkinson’s disease (PD). To address this demand, this study presents a multichannel, wireless, patch-type tremor monitoring system that integrates a high-repeatable fibrous crack-based strain (FCBS) sensor with a flexible wireless communication circuit. The FCBS sensor, incorporating crack structures, random fiber orientation, junction melting, and polymer penetration within a 3D conductive fiber network, achieves high sensitivity (gauge factor up to 476.89), a fast response time (≈ 6.64 ms), a wide working range (>200% strain), low Young’s modulus (≈45 kPa), and excellent repeatability (>100 000 cycles). In addition, this study demonstrates the first clinical application of a flexible strain sensor-based tremor monitoring system in patients with PD and ET for simultaneous multilocation tremor measurement. Through clinical trials, our system measured tremor indicators (peak amplitude and fundamental frequency), and tremor indicators obtained from multilocation showed improved correlation and statistical significance with tremor scoring in UPDRS III under specific conditions. These results demonstrate the applicability and potential of the flexible strain sensor-based system as a wearable platform for quantitative and objective tremor measurement.

PMID:42543484 | DOI:10.1002/advs.76724

Matern Health Neonatol Perinatol. 2026 Aug 3;12(1):31. doi: 10.1186/s40748-026-00280-9.

ABSTRACT

BACKGROUND: Accurate estimation of fetal weight is a crucial component of pregnancy management and plays a key role in reducing maternal and neonatal complications. Although ultrasonography is considered the gold standard, its limited availability and cost emphasize the need to assess alternative clinical methods.

METHODS: This cross-sectional study included 132 term pregnant women (37to 41 weeks) selected via non-probability sampling. Fetal weight was estimated prior to childbirth using three methods: ultrasonography (performed within the last two weeks of the third trimester to minimize the impact of rapid fetal weight gain closer to term), Johnson’s formula, and Insler’s formula and was compared with the actual birth weight immediately after childbirth. Data were analyzed using SPSS version 24, with descriptive statistics and regression.

RESULTS: The mean ± SD of estimated fetal weights (EFW) obtained via third-trimester ultrasonography and based on the Johnson and Insler formulas were 3164 ± 382.95 g, 3161.27 ± 302.90 g, and 3309.35 ± 374.05 g, respectively. Regarding diagnostic accuracy, the Johnson formula showed a precision of 69.70% for neonates < 3000 g and 71.21% for macrosomia (> 3500 g), the Insler formula showed a precision of 75.76% for neonates < 3000 g and 68.94% for macrosomia (> 3500 g). In the multivariate regression analysis of estimated fetal weight using the Johnson formula, only fundal height remained a significant independent predictor (β = 149.43, P < 0.001).

CONCLUSION: Although ultrasound is the most accurate method for estimating fetal weight, with the smallest mean difference from the actual weight, clinical methods, particularly the Insler method for normal weight pregnancies and the Johnson method for ruling out macrosomia, have acceptable accuracy.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42543479 | DOI:10.1186/s40748-026-00280-9

Psychiatr Q. 2026 Aug 3. doi: 10.1007/s11126-026-10303-5. Online ahead of print.

ABSTRACT

This letter addresses significant methodological limitations in a recently published systematic review and meta-analysis evaluating the efficacy and safety of xanomeline-trospium (KarXT) in schizophrenia. A critical unit-of-analysis error is identified in the original review’s Table 1, wherein multiple secondary and post hoc publications from a single randomized controlled trial (EMERGENT-1) were extracted and treated as completely independent studies. This unit-of-analysis error violates statistical independence assumptions and likely contributed to an implausible pooled effect size; however, additional discrepancies in data extraction or effect-size calculation may also have influenced the pooled estimate (d = 0.08) that sharply contradicts individual trial data. Additionally, the review lacks registered protocol details, structured risk-of-bias reporting, and safety outcome pooling. Readers and clinicians are cautioned against interpreting the pooled conclusions in isolation.

PMID:42543467 | DOI:10.1007/s11126-026-10303-5

Atten Percept Psychophys. 2026 Aug 2;88(6):170. doi: 10.3758/s13414-026-03313-9.

ABSTRACT

Previous research has shown that people are sensitive to statistical regularities and will implicitly learn to bias attention toward locations and features frequently associated with search targets. However, most prior work has involved a single biasing contingency. In Experiment 1, we investigate whether individuals can simultaneously learn and implement two distinct contingencies: one based on location and another based on color. The results suggest that both contingencies are learned implicitly and exert independent effects on attentional allocation. Experiments 2 and 3 examine whether shifting one feature to the volitional system via endogenous cues affects the implicit learning and implementation of contingencies for the other feature. The findings indicate that endogenous cues for one feature do not block implicit learning of contingencies in the other. However, the influence of implicit contingencies on attentional allocation depends on the validity of the volitional cues: they are effective when cues are neutral or valid, but not when invalid. This pattern suggests that the implicit and volitional systems operate hierarchically, with the volitional system taking precedence. SIGNIFICANCE STATEMENT: Efficient attentional guidance is key to effective visual search. While both volitional control and statistical learning can guide attention, little is known about how attention is influenced when multiple guidance mechanisms compete. Using a task with competing statistical regularities, one for target location and one for color, we show that both statistical learning biases independently influence attention. Shifting a feature to the volitional control system does not disrupt the statistical learning of the other, but invalid volitional cues eliminate statistical learning effects, suggesting a hierarchical relationship. These findings offer new insight into how multiple guidance systems shape attentional allocation. OPEN PRACTICES STATEMENT: Subject level data and SPSS analysis syntax available on the Open Science Framework at: https://osf.io/5vt74/overview . The experiments were not preregistered, but the data, and analysis syntax are publicly available at https://osf.io/5vt74/overview .

PMID:42543466 | DOI:10.3758/s13414-026-03313-9

Environ Monit Assess. 2026 Aug 3;198(8):902. doi: 10.1007/s10661-026-15753-9.

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs) are persistent organic pollutants widely distributed in the environment and linked to adverse health effects. Yet integrated assessments across multiple media, exposure pathways, and environmental scenarios remain limited. Here, we applied a multi-media, multi-pathway framework to estimate population exposure to PAHs and associated carcinogenic risks in China. PAH concentrations in air, water, soil, dust, and food were compiled from studies published between 2010 and 2024. Average daily doses (ADDs) were calculated for dietary intake, inhalation, oral ingestion, and dermal contact pathways, while carcinogenic risks were quantified using benzo[a]pyrene equivalents (BaP_eq) and incremental lifetime cancer risk (ILCR). PAH levels differed markedly by medium and scenario: industrial areas showed higher concentrations in air and water, while urban areas were characterized by elevated dust and soil burdens; rural areas were generally lower. In the primary assessment, dietary intake contributed substantially to both total PAH exposure and carcinogenic risk. A percentile-based dietary scenario analysis showed that the industrial-urban-rural risk ranking remained stable within each age group, although absolute total ILCR values and some age-group comparisons were sensitive to dietary-pathway uncertainty. Monte Carlo and sensitivity analyses further indicated that pathway-specific ILCR variability was most strongly associated with medium-specific BaPeq concentrations.

PMID:42543456 | DOI:10.1007/s10661-026-15753-9

Geroscience. 2026 Aug 3. doi: 10.1007/s11357-026-02456-9. Online ahead of print.

ABSTRACT

Global population aging challenges acute, disease-centric healthcare models and highlights the need for functional markers of aging. The World Health Organization’s intrinsic capacity (IC) framework, encompassing cognition, vitality, locomotion, psychological well-being, and sensory function, provides a multidimensional measure of functional reserve. However, most longitudinal studies have collapsed IC into a single score, limiting insight into domain-specific trajectories and interrelationships. In this longitudinal cohort study, we examined 7-year changes in composite and domain-specific IC scores, stratified by age and sex, and assessed associations between changes across domains among community-dwelling adults aged 50 years and older participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). The analytic sample included 27,107 participants (56.5% women; mean age 65.1 ± 8.2 years) with complete IC data at baseline (Wave 6, 2015) and follow-up (Wave 9, 2022). IC was operationalized as a 0-50 composite score derived from five domains, each standardized to a 0-10 scale using SHARE-specific measures. Over 7 years, composite IC declined statistically significantly (mean difference – 1.57 points; 95% CI – 1.63 to – 1.50; p < 0.001), with greater decline in men than women (- 1.71 vs – 1.46; p < 0.001). Locomotion domain contributed most to overall decline across age groups. Changes in vitality were moderately correlated with changes in locomotion (r≈0.30) and psychological well-being (r≈0.25), suggesting that vitality may function as a physiological node linking physical and psychological domains. These findings demonstrate that IC declines progressively from midlife, with steeper trajectories in men, and support domain-specific monitoring to better characterize age-related functional decline.

PMID:42543444 | DOI:10.1007/s11357-026-02456-9

Eur Arch Otorhinolaryngol. 2026 Aug 3. doi: 10.1007/s00405-026-10524-1. Online ahead of print.

ABSTRACT

PURPOSE: To examine the association between human immunodeficiency virus (HIV) infection and thyroid cancer (TC) risk.

METHODS: A systematic search of PubMed, Embase, Web of Science, and Cochrane Library from inception to September 1, 2025 for population-based registry studies that reported standardized incidence ratios (SIRs) of TC in people living with HIV (PLHIV) compared with the general population was conducted. A random-effects model was used to pool SIRs, with subgroup analyses by national income level, highly active antiretroviral therapy (HAART) era and geographical region. Sensitivity analyses and publication bias tests were also performed.

RESULTS: Fourteen population-based registry studies involving 2,419,564 PLHIV and 1,088 incident TC cases were included. The pooled analysis showed that PLHIV had a lower risk of TC than the general population (SIR = 0.63, 95% CI 0.52-0.75). Subgroup analyses revealed a decreased risk in high-income countries (SIR = 0.59, 95% CI 0.51-0.68), while the risk estimate for low- and middle-income countries was based on only one study (SIR = 7.17, 95% CI 2.35-21.92). A lower risk was observed in the HAART era (SIR = 0.59, 95% CI 0.49-0.71), whereas no statistically significant difference in TC risk was detected in the pre-HAART era (SIR = 2.64, 95% CI 0.30-23.42). By region, risk was reduced in both North America (SIR = 0.61, 95% CI 0.54-0.70) and Europe (SIR = 0.50, 95% CI 0.29-0.85), while no statistically significant difference was observed in the Asian subgroup.

CONCLUSION: A reduced risk of TC was observed among PLHIV, but this association was modified by country income level, geographical region and treatment era.

PMID:42543426 | DOI:10.1007/s00405-026-10524-1