Tag: pubmed

Diabetes Obes Metab. 2026 Jun 12. doi: 10.1111/dom.70932. Online ahead of print.

ABSTRACT

AIMS: Diabetes distress (DD) is common and evolves heterogeneously over time. We aimed to estimate minimal clinically important differences (MCID) for the Problem Areas in Diabetes (PAID) scale and its sub-dimensions and to identify predictors of worsening over 1 year in people with type 1 diabetes (PwT1D).

MATERIALS AND METHODS: MCIDs for PAID total and sub-dimension scores were derived using the standard error of measurement approach. One-year DD worsening, stability and improvement were defined using the ±1 MCID threshold. We analysed changes in DD using data from the SFDT1 cohort. Logistic regression models identified predictors of worsening for PAID total and sub-dimensions, adjusting for baseline DD, age, sex and social vulnerability.

RESULTS: We analysed data from 2457 adults with type 1 diabetes (51.6% female, 41.3 years old (SD 14.0), 23.7 years diabetes duration (SD 14.0)). The MCID for PAID total was 5.0 points, with sub-scale MCIDs ranging from 8.5 (emotional distress) to 14.3 points (management distress). Over 1 year, 42% experienced clinically meaningful worsening of total DD, 30% improved and 28% remained stable. Worsening of total PAID was associated with social vulnerability, HbA1c increase and treatment burden. Distress trajectories varied across sub-dimensions, with emotional distress and burnout most frequently worsening (34% each); initiation of automated insulin delivery was solely associated with lower odds of worsening on the burnout dimension.

CONCLUSIONS: This study provides MCID values for the PAID scale and its sub-dimensions. The high temporal variability observed suggests a need for regular monitoring and clinically informed assessment of DD in PwT1D.

PMID:42283146 | DOI:10.1111/dom.70932

Physiother Theory Pract. 2026 Jun 12:1-18. doi: 10.1080/09593985.2026.2684760. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review aimed to characterize the peer-reviewed ethics literature published between 2000 and 2023 (types of literature, authors, countries, audience, and topics) and to examine how these characteristics have changed compared to literature from 1970 to 2000 using systematic ethics review methods and ethics-specific quality criteria.

METHODS: A systematic search of eight databases (PubMed, CINAHL, Web of Science, Scopus, PsycINFO, JSTOR, Philosopher’s Index, Embase) identified articles (2000-through December 2023). Descriptive statistics and thematic synthesis were used to analyze data.

RESULTS: Searches yielded 287 articles from 2,974 records. Empirical publications (63.4%) outnumbered normative (22.6%). Thematic synthesis produced five themes: 1) Significant change and development; 2) Increase in publications, journals, authors, and countries; 3) Shift from predominantly normative to predominantly empirical ethics (empirical turn); 4) Enduring and changing topics; 5) Diverse perspectives.

CONCLUSION: This was the first systematic ethics review in physical therapy to use ethics-specific quality criteria. Results provide insight into the changes, growth, limitations, and future directions for physical therapy ethics. While physical therapy ethics matured in volume and diversity from 2000 to 2023, future publications should address current limitations: scant publications in physical therapy clinical specialty journals; underrepresentation of patient, physical therapist assistant, and non-Western perspectives; and integrating empirical (what is being done) and normative analysis (what ought to be done). Systematic ethics review offers a practical pathway for advancing ethical inquiry across physical therapy research, practice, and education.

PMID:42283124 | DOI:10.1080/09593985.2026.2684760

Euro Surveill. 2026 Jun;31(23). doi: 10.2807/1560-7917.ES.2026.31.23.2600443.

ABSTRACT

Because of high vaccination rates, the Northern Territory of Australia had not seen locally transmitted toxigenic Corynebacterium diphtheriae since the 1990s, until cutaneous diphtheria cases emerged in May 2025 and respiratory cases in March 2026. By 30 April 2026, there had been 131 cases (34 respiratory, 97 cutaneous) in an ongoing outbreak characterised by a high proportion of cutaneous cases with transmission driven by crowding and consequent poor skin health. Most patients have had mild disease due to prior vaccination.

PMID:42283111 | DOI:10.2807/1560-7917.ES.2026.31.23.2600443

Clin EEG Neurosci. 2026 Jun 12:15500594261458860. doi: 10.1177/15500594261458860. Online ahead of print.

ABSTRACT

PurposeThis study aimed to systematically assess ictal scalp electroencephalography (EEG) evolution by examining both ictal onset characteristics and late significant patterns (LSPs) in adults with focal epilepsy. We aimed to investigate their individual and collective descriptive roles in seizure lateralization and localization, as well as their correlation with seizure semiology, interictal EEG findings, and structural magnetic resonance imaging (MRI) within a multimodal presurgical assessment framework.MethodsWe retrospectively analyzed 67 adults with drug-resistant focal epilepsy who underwent extended video-EEG monitoring, during which 242 seizures were documented. The ictal EEG findings were categorized based on the morphology of the onset and subsequent rhythmic patterns. The yields of lateralization and localization were evaluated independently for ictal onset patterns, LSPs, and combined ictal interpretations. Cohen’s κ statistics were used to look at multimodal concordance between ictal EEG, seizure semiology, interictal EEG, and MRI findings.ResultsThe most common types of ictal onset were non-rhythmic or unclassifiable activity (29.3%) and low-voltage fast activity (28.5%). Late significant patterns were detected in 36.8% of seizures, predominantly manifesting as rhythmic theta-alpha activity, followed by repetitive spikes or sharp waves. The integration of LSPs resulted in enhanced lateralization and localization yields, in contrast to the analysis of onset patterns in isolation. At the individual patient level, combined ictal interpretation lateralized seizures in 68.6% of cases and localized seizure-onset regions in 70.1% of cases. There was a high degree of agreement between ictal and interictal EEG (κ = 0.775, strict right-left), a high degree of agreement between ictal EEG and MRI (κ = 0.710), and moderate-to-high agreement between ictal EEG and seizure semiology (κ = 0.647).ConclusionA systematic evaluation of ictal EEG evolution, including the identification of LSPs, provides additional descriptive data that augments conventional ictal-onset analysis in focal epilepsy. The integration of ictal evolution findings with semiology, interictal EEG, and MRI validates a multimodal interpretative framework for presurgical evaluation. These results highlight the possible clinical importance of incorporating seizure evolution analysis into conventional scalp EEG interpretation, although further validation with surgical outcome data is required.

PMID:42283103 | DOI:10.1177/15500594261458860

J Natl Cancer Inst. 2026 Jun 11:djag180. doi: 10.1093/jnci/djag180. Online ahead of print.

NO ABSTRACT

PMID:42283081 | DOI:10.1093/jnci/djag180

Int Health. 2026 Jun 12:ihag056. doi: 10.1093/inthealth/ihag056. Online ahead of print.

ABSTRACT

BACKGROUND: Micronutrient deficiencies in vitamin A, iron and zinc continue to threaten the growth, immunity and cognitive development of school-age children (SAC) in low- and middle-income countries. However, infection-related distortion of micronutrient biomarkers and limited evidence leave the burden and determinants in Malawi insufficiently understood. This study investigated the relationships between infection, inflammation and indicators of micronutrient status including retinol-binding protein (RBP), ferritin and zinc among SAC in Malawi.

METHODS: A secondary analysis of cross-sectional data from the 2015-2016 Malawi Micronutrient Survey was conducted. Infection and inflammation were assessed using caregiver-reported illness, malaria testing, haematuria, C-reactive protein (CRP) and α-1-acid glycoprotein (AGP). Descriptive and inferential statistical analyses were performed. Multivariable generalized linear models were used to examine associations between infection and inflammation indicators and micronutrient biomarkers (RBP, inflammation-adjusted ferritin and serum zinc) while controlling for demographic, nutritional and household covariates. All analyses were conducted using R version 4.3.0.

RESULTS: Elevated CRP and AGP were significantly associated with lower RBP and zinc concentrations and with higher ferritin levels. Recent fever and malaria positivity were also associated with alterations in micronutrient biomarker concentrations. Older children (11-14 y) had higher RBP levels. Regional differences were observed, with children in the Central and Southern regions showing lower RBP and ferritin compared with those in the Northern region.

CONCLUSIONS: Infection and inflammation are important determinants of micronutrient biomarker concentrations among SAC in Malawi. These findings highlight the importance of adjusting micronutrient assessments for inflammation and strengthening integrated public health strategies that combine micronutrient interventions with infection prevention and control to improve child nutritional status.

PMID:42283074 | DOI:10.1093/inthealth/ihag056

Pract Lab Med. 2026 Jun 1;50:e00542. doi: 10.1016/j.plabm.2026.e00542. eCollection 2026 Jul.

ABSTRACT

OBJECTIVE: To investigate the distribution characteristics of potential high-risk pathogens for early-onset neonatal infection in maternal vaginal secretions, and to perform a head-to-head comparative evaluation of detection performance for target pathogens between metagenomic next-generation sequencing (mNGS) and real-time quantitative polymerase chain reaction (qPCR), with conventional bacterial culture as the reference standard.

METHODS: A total of 294 valid maternal vaginal secretion samples were prospectively collected and tested in parallel using qPCR, mNGS, and conventional bacterial culture. The Chi-square test was used to compare the differences in pathogen detection rates among the three methods. Receiver operating characteristic (ROC) curve was plotted to calculate the area under the curve (AUC) and 95% confidence interval (CI), to systematically evaluate the detection performance of the two methods for target pathogens.

RESULTS: The spectrum of potential early-onset neonatal pathogens in maternal vaginal secretions, ranked by detection rate, was as follows: Staphylococcus aureus, Streptococcus agalactiae, Ureaplasma urealyticum, Listeria monocytogenes, and Campylobacter fetus. The detection rates of these target pathogens by qPCR, mNGS, and bacterial culture showed high consistency, with no statistically significant difference in detection rates among the three methods (all P > 0.05). ROC curve analysis showed that the AUC values of both qPCR and mNGS for the above major pathogens were all above 0.90, which were significantly different from the null hypothesis of AUC = 0.5 (all P < 0.05), indicating good detection performance; while there was no significant difference in AUC values between qPCR and mNGS (all P > 0.05). In addition, Listeria monocytogenes (3 cases) and Campylobacter fetus (1 case) were only detected by qPCR and mNGS, while not isolated by conventional culture.

CONCLUSION: This head-to-head comparative study confirms that both mNGS and targeted qPCR have high accuracy and consistency for detecting potential early-onset neonatal pathogens in maternal vaginal secretions. We propose a tiered antenatal screening strategy for maternal vaginal pathogenic colonization: qPCR is recommended as the first-line tool for routine antenatal screening due to its high cost-effectiveness and rapid turnaround time, while mNGS is reserved for high-risk pregnant women (e.g., preterm premature rupture of membranes, clinical chorioamnionitis), culture-negative suspected infection cases, or scenarios requiring comprehensive pathogen profiling, to take full advantage of its unbiased, broad-spectrum detection capability. This integrated screening strategy requires further prospective validation with paired neonatal clinical outcome data to confirm its value in the prevention and early intervention of early-onset neonatal infection.

PMID:42283066 | PMC:PMC13251199 | DOI:10.1016/j.plabm.2026.e00542

Patient Prefer Adherence. 2026 Jun 8;20:595537. doi: 10.2147/PPA.S595537. eCollection 2026.

ABSTRACT

PURPOSE: This pilot study examined whether patients who had experienced medical care in both urban and rural areas perceived differences in healthcare service experiences, negative emotions, and unvoiced concerns. The study focused on comparative perception and silent dissatisfaction that may not be captured by conventional patient satisfaction surveys.

PATIENTS AND METHODS: A cross-sectional, anonymous, self-administered paper questionnaire was conducted at a cooperating dental clinic in Tokyo. The questionnaire addressed hospital visit experiences in urban and rural areas by the same healthcare recipient. The dental clinic was used as a pragmatic field site; the survey asked about medical care experiences rather than dental satisfaction. Descriptive statistics were calculated for 90 respondents.

RESULTS: Among 90 respondents, 38 (42.2%) reported that they strongly or somewhat perceived differences between urban and rural care experiences, whereas 48 (53.3%) reported little or no difference and 4 (4.4%) were missing. Among the 38 respondents who perceived differences, 17 (44.7%) reported negative emotions such as inconvenience, discomfort, dissatisfaction, or endurance. Among the 20 respondents for whom expression of concerns was applicable, 7 (35.0%) communicated their concerns to the facility, whereas 13 (65.0%) did not. Among respondents with perceived differences who answered the comparison item, 8 of 32 (25.0%) reported that they recognized the feelings because they compared facilities across regions.

CONCLUSION: High satisfaction scores and low complaint rates should not be interpreted as evidence that dissatisfaction is absent. These pilot findings are consistent with, but do not directly test, a reference-point interpretation. Larger multi-site studies using validated instruments are needed to examine the proposed mechanism and its implications for patient feedback systems.

PMID:42283055 | PMC:PMC13251057 | DOI:10.2147/PPA.S595537

Ann Neurosci. 2026 Jun 9:09727531261445199. doi: 10.1177/09727531261445199. Online ahead of print.

ABSTRACT

BACKGROUND: Autoimmune encephalitis (AE) is a major cause of acute and subacute neuropsychiatric syndromes.

PURPOSE: While neuronal autoantibody testing aids diagnosis, results are often delayed or negative in seronegative cases. Cerebrospinal fluid (CSF) cytokine profiling may provide a rapid diagnostic adjunct.

METHODS: In this cross-sectional study, we analysed CSF from 43 AE patients (29 seronegative, 9 N-methyl-d-aspartate receptor antibody-positive, 3 leucine-rich glioma-inactivated 1 (LGI1)-positive, and 2 with rare antibodies) and 34 controls (33 idiopathic intracranial hypertension and 1 viral encephalitis). Cytokine levels (IL-6, IL-7, IL-13, IL-21, CXCL10 and CXCL13) were quantified using a multiplex immunoassay.

RESULTS: All measured cytokines were significantly elevated in AE compared with controls (p < .001). CXCL10 and CXCL13 showed the largest differences between AE and controls, with CXCL13 particularly high in LGI1-positive cases. IL-6 correlated positively with IL-13 (r = 0.47, p = .0013) and CXCL13 (r = 0.41, p = .0064), while IL-7 correlated with IL-21 (r = 0.33, p = .029). Cytokine profiles in seronegative AE were comparable to antibody-positive AE, with no statistically significant differences.

CONCLUSIONS: CSF cytokines-particularly CXCL10, CXCL13, IL-6 and IL-13-are consistently elevated in AE and reflect shared intrathecal immune activation across antibody-positive and seronegative cases. These findings are exploratory, and cytokines are proposed as adjunctive immunological markers rather than standalone diagnostic tools.

PMID:42283050 | PMC:PMC13249606 | DOI:10.1177/09727531261445199

Pan Afr Med J. 2026 Jan 29;53:45. doi: 10.11604/pamj.2026.53.45.46297. eCollection 2026.

ABSTRACT

INTRODUCTION: with the aim of guiding the strategic response to major viral infections, this study aimed to determine the epidemiological profile of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) in the Far North region of Cameroon.

METHODS: we conducted a cross-sectional epidemiological surveillance study in the Mayo-Tsanaga Division and surrounding localities in the Far North region of Cameroon from August 1 to September 20, 2024. After obtaining informed consent, each participant was given a standard questionnaire and tested for the three infections (HIV, HBV, and HCV) in accordance with the national testing algorithm. The collected data were analyzed using Excel 2019 and Power BI software, with a statistical significance threshold set at p < 0.05.

RESULTS: a total of 3,188 participants were tested (60% female, median age 34 years [IQR 20-46]), of whom 396 tested positive overall, including 13 who were HIV-positive, 373 who were HBV-positive, and 10 who were HCV-positive. According to each type of infection, HIV, HBV and HCV seropositivity rates were 0.41% (13/3,170), 11.7% (373/3,188) and 0.31% (10/3,188), respectively. Despite the high endemicity of HBV (>8%), no statistically significant differences were observed by age or sex (p > 0.05).

CONCLUSION: the low prevalence rates (<1%) of HIV and HCV suggest that their elimination is effectively underway among populations in the Far North region of Cameroon. However, the high endemicity of HBV indicates ongoing transmission and underscores the urgent need to prioritize vaccination as the primary preventive intervention toward elimination.

PMID:42283047 | PMC:PMC13252071 | DOI:10.11604/pamj.2026.53.45.46297