Tag: pubmed

J Clin Neurophysiol. 2026 May 7. doi: 10.1097/WNP.0000000000001261. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate and synthesize current evidence on the cost-effectiveness of EEG monitoring in postcardiac arrest care, with a focus on its utility in neuroprognostication and clinical decision making.

METHODS: A narrative review was conducted to summarize the recent literature on EEG utilization, guidelines, and cost-effectiveness analyses. Studies examining continuous EEG, routine EEG, and point-of-care EEG using cost-utility frameworks, quality-adjusted life year modeling, and health system variability were analyzed.

RESULTS: Despite class I recommendations from the AHA and ACNS, EEG remains underused in postcardiac arrest management. Although continuous EEG provides superior temporal resolution and facilitates prognostic assessment, it comes with significant costs associated with equipment, personnel, and EEG interpretation. Cost-effectiveness analysis shows that small improvements in prognostic specificity of 1% to 4% may render EEG monitoring cost-effective in a closed health care system. Routine EEG and point-of-care-EEG systems offer new strategies for expanding access and reducing costs. However, studies are predominantly retrospective, single-center, and heterogeneous in their analytic methodology, which limits generalizability.

CONCLUSIONS: EEG monitoring after cardiac arrest may be cost-effective if modest gains in prognostic accuracy are achieved. Further data from prospective, multicenter studies and long-term financial and outcome data using standardized statistical metrics will be needed for broader use. By doing so, more robust use guidelines and cost-effectiveness thresholds can be created for postcardiac arrest EEG monitoring.

PMID:42359664 | DOI:10.1097/WNP.0000000000001261

J Clin Neurophysiol. 2026 Apr 3. doi: 10.1097/WNP.0000000000001251. Online ahead of print.

ABSTRACT

Postanoxic encephalopathy is a common consequence of cardiac arrest, characterized by varying degrees of global cerebral hypoxic-ischemic injury. Despite advances in resuscitation science and critical care, neurologic outcome is essentially unchanged over the past decades. Although various treatment approaches to mitigate brain injury have been proposed, none of these has been unequivocally associated with improved neurologic outcome. This review provides an overview of the evidence from previous studies and ongoing clinical trials. Based on successes and limitations in recent research, we recommend EEG-based patient stratification and sufficiently powered subgroups for future trials. We also recommend outcome measures that provide more granularity than the current ordinal outcome scales, such as screening instruments for cognitive and emotional functioning. Adaptive randomized trial designs using a single master protocol and Bayesian statistics can provide an efficient platform for testing multiple treatments against a common control group, simultaneously. Treatments based on active stimulation of neuro- and synaptogenesis instead of prevention of secondary injury are promising.

PMID:42359658 | DOI:10.1097/WNP.0000000000001251

Laeknabladid. 2026 Jul;112(7-08):314-221. doi: 10.17992/lbl.2026.0708.900.

ABSTRACT

INTRODUCTION: Adjuvant endocrine therapy (tamoxifen/aromatase inhibitors) is used after surgery in hormone-receptor-positive breast cancer stage I-III. Administration for 5-10 years reduces recurrence and improves survival. Therapy adherence has not been assessed in Iceland. The main objective was to assess adherence to endocrine therapy among patients diagnosed with breast cancer in Iceland 2013-2018. Prognostic factors and the effect of adherence on prognosis were examined.

MATERIAL AND METHODS: This retrospective, population-based cohort study obtained data from the Icelandic Cancer Registry, the Icelandic Prescription Medicine Register and medical records. Treatment adherence was defined as prescription refills for tamoxifen and/or aromatase inhibitors for five years or until the day of death/recurrence of breast cancer. Patients were considered adherent if prescriptions covered ≥80% of the treatment period. Descriptive statistics, logistic regression analysis, and Kaplan-Meier survival analysis were performed.

RESULTS: The study included 1,008 patients, 990 women and 18 men, with a median age of 62.0 years. Logistic regression identified chemotherapy before and/or after surgery as a positive predictor (OR 2.04; 95%CI 1.36-3.10; < 0.001) and initial treatment with tamoxifen as a negative prognostic factor (OR 0.68; 95%CI: 0.50-0.94; p=0.02). Significant association was observed between treatment adherence and overall survival (p=0.025) and disease-free survival (p=0.0075).

CONCLUSION: Among patients, 27.0% were non-adherent to treatment. Significant association was observed between survival and adherence. It is important to improve treatment adherence, for example through multidisciplinary approaches within the healthcare system and increased patient education.

PMID:42359641 | DOI:10.17992/lbl.2026.0708.900

Bioelectromagnetics. 2026 Jul;47(5):e70064. doi: 10.1002/bem.70064.

ABSTRACT

Tumor treating fields (TTFields) is a non-invasive therapeutic technology that disrupts mitotic division via intermediate-frequency alternating electric fields. For non-small cell lung cancer (NSCLC) at 150 kHz, complex thoracic anatomy and heterogeneous tissue properties often hinder the attainment of the therapeutic threshold (≥ 1 V/cm). To overcome this, high-fidelity Duke (male) and Ella (female) anatomical models were employed for full-wave simulations. The coordinated deployment of orthogonal transducer arrays (AP-20, LR-20, LR-13) with sex-specific tuning substantially enhanced electric-field coverage in the lower and lateral lung regions. Furthermore, modifying lung dielectric parameters by 20% demonstrated that these configurations maintain stable therapeutic coverage, exhibiting robustness against potential physiological or pathological variations. To provide an experimental foundation, in vivo murine measurements were conducted. Rather than attempting to replicate deep spatial complexities of the human body, these experiments served as a translational bridge to validate macroscopic voltage transfer efficiency and system-level losses. By introducing a physically derived correction factor (Roi) to account for voltage delivery drops, statistical analyses confirmed a high agreement between simulated and in vivo datasets, verifying the reliability of the computational framework. Regarding safety, the computed electrode-skin current density remained strictly below 31 mA/cm², which, alongside built-in clinical hardware temperature limits, effectively mitigates the risk of thermal and stimulation-induced injuries. Ultimately, this optimized strategy provides a complementary, independent physical modality that integrates bioelectromagnetic modeling with preclinical validation, offering a reliable theoretical reference to facilitate individualized NSCLC treatment planning.

PMID:42359634 | DOI:10.1002/bem.70064

Phys Chem Chem Phys. 2026 Jun 26. doi: 10.1039/d6cp01351a. Online ahead of print.

ABSTRACT

We establish an interpretable site-resolved framework to screen high-entropy alloy catalysts for the hydrogen evolution reaction (HER). By linking local atomic environments to hydrogen adsorption free energy (ΔG_H), compositions with a higher probability of exposing near-thermoneutral active sites are statistically identified, enabling rational identification of promising HEA catalyst candidates.

PMID:42359627 | DOI:10.1039/d6cp01351a

Int J Food Sci Nutr. 2026 Jun 26:1-11. doi: 10.1080/09637486.2026.2692946. Online ahead of print.

ABSTRACT

Changes in body composition with ageing, such as fat gain and muscle loss, pose significant health challenges. Coffee consumption may influence body composition, but evidence remains inconclusive. This cross-sectional study examined associations between coffee consumption and body composition in an older Finnish population with high habitual coffee intake. The analysis included 528 men and women (mean age 67.7 years). Coffee intake was assessed using a food-frequency questionnaire, and body composition was measured by dual-energy X-ray absorptiometry (DXA). Multivariable-adjusted associations between coffee consumption (<375, 375, and >375 ml/day) and lean mass index, appendicular lean mass index, fat mass index, body mass index, and android/gynoid ratio were analysed using sex-stratified ANCOVA, with Bonferroni correction applied. Mean ± SD coffee intake was 370 ± 214 ml/day. No statistically significant differences between the coffee intake categories were observed for any body composition outcome (p-values > 0.06). In this older Finnish population, coffee consumption was not associated with DXA-assessed body composition.

PMID:42359622 | DOI:10.1080/09637486.2026.2692946

J Cardiovasc Pharmacol. 2026 Jun 4. doi: 10.1097/FJC.0000000000001840. Online ahead of print.

ABSTRACT

Sinus tachycardia is common after heart transplantation (HTx) and may worsen graft function via increased oxygen demand and remodeling. Ivabradine, a selective If channel inhibitor, lowers heart rate independently of sympathetic activity. This meta-analysis evaluates its efficacy and safety versus standard care in HTx recipients. A comprehensive search of PubMed, Embase, WoS, Scopus, and Cochrane was conducted through September 2025. Eligible studies included randomized and non-randomized comparative trials. Data were pooled with a random-effects model to estimate mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes. Six studies, including 852 adult HTx recipients, were included. Ivabradine consistently reduced HR across all time points. Statistical significance was reached at 24 months (MD -16.82 bpm; P=0.04) and 36 months (MD -12.94 bpm; P=0.04). A significant reduction was observed in LVMI (MD -11.10 g/m2; 95% CI -17.15 to -5.06; P<0.05; I^2=0%). While LVM and LVEF showed trends toward improvement at final follow-up (MD = -11.23 for LVM and +2.94% for LVEF), neither reached statistical significance (P = 0.06 and P = 0.48, respectively). No significant differences were found between the ivabradine and control groups regarding all-cause mortality (RR 1.16 at final follow-up; P=0.90), graft rejection (RR 1.14; P=0.87), or systolic blood pressure (MD 0.50 mmHg; P=0.83). Ivabradine lowers heart rate after heart transplantation but shows no clear benefit on mortality, rejection, or ejection fraction. It does not significantly affect blood pressure, supporting its tolerability, particularly when beta-blockers are not tolerated.

PMID:42359616 | DOI:10.1097/FJC.0000000000001840

Afr J Reprod Health. 2026 Jun 26;(12):(Afr J Reprod Health 2026; 30 [12]9-14:).. doi: 10.29063/ajrh2026/v30i12.1.

ABSTRACT

The advancement of sexual and reproductive health and rights (SRHR) in sub-Saharan Africa is fundamentally hindered by “health data poverty”.1 While many high-income countries have made significant progress in strengthening their health data systems, sub-Saharan Africa continues to face significant gaps.1-3 Despite the critical need for evidence-based practice, the regional data landscape is characterized by a pervasive ignorance regarding the intrinsic value of accurate data. Many countries in the region lack regular population censuses, reliable health records, and functional civil registration and vital statistics systems.

PMID:42359608 | DOI:10.29063/ajrh2026/v30i12.1

Asia Pac J Clin Oncol. 2026 Jun 26. doi: 10.1111/ajco.70134. Online ahead of print.

ABSTRACT

BACKGROUND: Neoadjuvant chemotherapy (NAC) exerts selective pressure on tumor biology, frequently altering the expression of ER, PR, and HER2 in residual disease. While guidelines mandate re-biopsy to guide adjuvant therapy, whether these biomarker conversions represent a true prognostic deterioration or a manageable adaptation remains controversial. This study investigates the relative prognostic weight of biomarker conversion and proliferative dynamics (Ki-67) in determining patient survival.

METHODS: We retrospectively analyzed 338 patients with invasive breast cancer who had residual disease following standard NAC and curative surgery. Paired biomarker status (pre-NAC vs. post-NAC) for ER, PR, HER2, and Ki-67 was evaluated. Adjuvant therapy was adapted according to the residual tumor profile, including targeted therapy for patients acquiring HER2 positivity. Survival outcomes were analyzed using Cox regression models.

RESULTS: Biomarker conversion was substantial, with conversion rates of 13.9% for ER, 18% for PR, and 27% for HER2. However, despite this high frequency of receptor conversion, changes in receptor status (loss or gain) did not translate into statistically significant differences in disease-free survival (DFS) or overall survival (OS) (all p > 0.05). In sharp contrast, Ki-67 dynamics emerged as the significant independent prognostic factor. Patients who converted from high-to-low proliferation (Ki-67 < 18%) achieved significantly superior DFS (HR: 0.45, 95% CI: 0.24-0.84, p = 0.011) and OS (HR: 0.36, 95% CI: 0.15-0.85, p = 0.020) compared to those with persistent high expression.

CONCLUSION: While biomarker conversion is a frequent event in residual breast cancer, it does not compromise survival outcomes when adjuvant treatment is adjusted according to the post-NAC immunohistochemical (IHC) profile. Instead, prognosis is predominantly driven by the tumor’s proliferative response. These findings suggest that persistent high Ki-67, rather than biomarker conversion, should be the primary marker for escalating adjuvant therapy and risk stratification.

PMID:42359564 | DOI:10.1111/ajco.70134

Neurourol Urodyn. 2026 Jun 26. doi: 10.1002/nau.70357. Online ahead of print.

ABSTRACT

BACKGROUND: Achieving continence in patients with neurogenic bladder is a difficult goal especially when stress urinary incontinence (SUI) due to intrinsic sphincter deficiency is involved. Two techniques are commonly used in that setting, but they have never been directly compared: the artificial urinary sphincter (AUS) and the fascial pubovaginal sling (PVS). The present study aims to compare the outcomes of AUS and PVS in female neuropathic patients.

METHODS: This retrospective international multicenter study was conducted from 2014 to 2023. We included all women with a past medical history of neurogenic bladder who underwent AUS or a PVS insertion (cadaveric or fascia lata) at three centers. The primary endpoint was the outcomes as assessed by the patient global impression of improvement (PGII) at 3 months and at the last follow-up.

RESULTS: Thirty-five patients were included: 16 with AUS and 19 with PVS. The PVS patients had fewer previous anti-incontinence procedures (10.5% vs. 43.8%; p = 0.02). The maximum cystometric capacity was significantly higher in the AUS group (364.1 vs. 252.8 mL; p = 0.03). All perioperative outcomes were similar in both groups with only two major postoperative complications in each group (12.5% vs. 10.5%; p = 0.99). Many functional outcomes favored AUS, but with no statistically significant difference, except for PGII = very much improved at 3 months (68.8% vs. 31.6%; p = 0.04).

CONCLUSION: AUS and PVS are two procedures yielding satisfactory outcomes in the female neurogenic SUI population, with similar morbidity. The functional outcomes may be more favorable with AUS.

PMID:42359558 | DOI:10.1002/nau.70357