Tag: pubmed

Nurs Crit Care. 2026 Mar;31(2):e70351. doi: 10.1111/nicc.70351.

ABSTRACT

BACKGROUND: Maternal mental health issues such as depression, anxiety and stress are prevalent among mothers of neonates in the neonatal intensive care unit (NICU). These psychological challenges can impact both maternal well-being and the mother-neonate bond.

AIM: This meta-analysis aims to evaluate the effectiveness of nursing interventions in improving maternal mental health outcomes, including depression, anxiety, stress, mother-neonate interaction and sleep quality in NICU settings.

STUDY DESIGN: Systematic review and meta-analysis were conducted in databases including PubMed, Scopus, Cochrane Library, CINAHL and PsycINFO. Data were pooled using standardised mean differences (SMDs) and analysed using a random effects model. Heterogeneity was assessed using I² statistics, and publication bias was evaluated with funnel plots and Egger’s test.

RESULTS: Final number of included studies was 36. Nursing interventions significantly reduced maternal depression (SMD = -0.296, p = 0.002), stress (SMD = -1.326, p < 0.001) and anxiety (SMD = -0.694, p = 0.001). However, no significant effects were observed for mother-neonate interaction (SMD = 0.071, p = 0.903). Heterogeneity was high for stress (I² = 95.0%) and anxiety (I² = 89.2%), while there was no publication bias detected for depression, anxiety or stress.

CONCLUSION: Nursing interventions significantly reduce maternal depression, anxiety and stress in the NICU. However, their impact on mother-neonate interaction and sleep quality remains unclear.

RELEVANCE TO CLINICAL PRACTICE: Given the substantial impact of stress and anxiety on maternal well-being, implementing structured interventions such as psychoeducation, stress management and mindfulness could significantly reduce the psychological burden on mothers.

PMID:41614336 | DOI:10.1111/nicc.70351

Cancer Med. 2026 Feb;15(2):e71555. doi: 10.1002/cam4.71555.

ABSTRACT

BACKGROUND: The optimal therapeutic strategy for patients with T2-3N0-3 M0 or T1N1-3 M0 hypopharyngeal squamous cell carcinoma (HPSCC) and the use of postoperative radiotherapy with or without systemic therapy for patients with T1-2N1M0 HPSCC remain controversial. We aimed to determine whether these additional treatments improve the prognosis in HPSCC.

METHODS: We retrospectively analyzed the databases held by the SEER (surveillance, epidemiology, and end results) program and a tertiary referral center in China to evaluate the survival outcomes of surgical intervention for T2-3N0-3 M0 and T1N1-3 M0 HPSCC and of postoperative radiotherapy for T1-2N1M0 disease.

RESULTS: The SEER contained data for 1235 patients with T2-3N0-3 M0 or T1N1-3 M0 HPSCC, of whom 220 underwent surgery as their first treatment and 737 received non-surgical treatment. There was no statistically significant difference in overall survival (OS) between these two groups. Data were also available for 30 patients in the SEER who were treated by surgery alone (n = 11), surgery plus postoperative radiotherapy (n = 7), or surgery plus postoperative radiotherapy with systemic therapy (n = 12). Similarly, 23 patients at our hospital were identified to have been treated by surgery alone (n = 7), surgery plus postoperative radiotherapy (n = 10), or surgery plus postoperative radiotherapy with systemic therapy (n = 6). The SEER data indicated that postoperative radiotherapy improved OS (hazard ratio 0.281, 95% confidence interval 0.079-0.998; p = 0.036). This finding was supported by the data from our hospital, although the improvement in OS was not statistically significant (hazard ratio 0.360, 95% confidence interval 0.057-2.261; p = 0.224). Postoperative radiotherapy with systemic therapy seemed not to improve OS beyond that achieved by postoperative radiotherapy alone.

CONCLUSIONS: There was no significant difference in OS in patients with T2-3N0-3 M0 or T1N1-3 M0 HPSCC according to whether or not they underwent surgery as first-line treatment. Surgery plus postoperative radiotherapy was associated with a more favorable prognosis than surgery alone in patients with T1-2N1M0 HPSCC.

PMID:41614332 | DOI:10.1002/cam4.71555

J Am Heart Assoc. 2026 Jan 30:e046142. doi: 10.1161/JAHA.125.046142. Online ahead of print.

ABSTRACT

BACKGROUND: The DCP (Diuretic Comparison Project), a pragmatic trial, evaluated whether chlorthalidone compared with hydrochlorothiazide would reduce the risk of nonfatal cardiovascular disease or noncancer-related death. The intent-to-treat analysis found no difference in such comparison (hazard ratio, 1.04 [95% CI, 0.94-1.16]). The objective of the current study is to estimate the per-protocol effect of chlorthalidone (12.5/25 mg daily) compared with hydrochlorothiazide (25/50 mg daily) in preventing major adverse cardiovascular events among older patients with hypertension.

METHODS: The effect of adhering to treatment strategies was assessed by censoring at first instance of nonadherence, defined as a gap (>90-day gap in drug coverage), switch (switching between study medications), and discontinuation (stop taking chlorthalidone/hydrochlorothiazide altogether for >90 days before the end of the study). The primary outcome was a composite of nonfatal myocardial infarction, stroke, heart failure resulting in hospitalization, urgent coronary revascularization for unstable angina, and noncancer-related death. Using inverse probability weighting, we evaluated the per-protocol effect of chlorthalidone and hydrochlorothiazide using DCP trial data.

RESULTS: Nonadherence was found in 5476 (40%) participants; among 8047 (60%) adherents, 3905 (49%) were randomized to chlorthalidone and 4142 (51%) to hydrochlorothiazide. After censoring time when participants deviated from the assigned treatments, the estimated 5-year risk ratio of the composite primary outcome of nonfatal cardiovascular disease and noncancer-related death was 1.36 (95% CI, 0.96-2.12) in chlorthalidone compared with hydrochlorothiazide.

CONCLUSIONS: The per-protocol analysis indicated a lower risk with hydrochlorothiazide compared with chlorthalidone in preventing nonfatal cardiovascular disease and noncancer-related death; however, this difference was not statistically significant using dispensation data to identify adherence.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02185417.

PMID:41614323 | DOI:10.1161/JAHA.125.046142

J Am Heart Assoc. 2026 Jan 30:e046558. doi: 10.1161/JAHA.125.046558. Online ahead of print.

ABSTRACT

BACKGROUND: Artificial intelligence (AI)-enabled electrocardiography has emerged as a tool for detecting cardiac dysfunction. The prognostic relevance of AI-enabled electrocardiography-derived diastolic dysfunction (DD) in patients undergoing transcatheter aortic valve replacement had not been assessed.

METHODS: We analyzed 3197 patients undergoing transcatheter aortic valve replacement for severe aortic stenosis between 2010 and 2023 with baseline 12-lead ECGs processed by a validated AI model to classify diastolic function (grades 0-3). Multivariable Cox models and nested model comparisons assessed associations with all-cause mortality, including a prespecified analysis in patients with indeterminate echocardiographic grading. Trajectories were defined by change in AI-enabled electrocardiography DD grade (<2 versus ≥2) from baseline to 30-day or 1-year follow-up.

RESULTS: At baseline, 21% had grade 3, 57% had grade 2, 8% had grade 1, and 14% had grade 0 AI-enabled electrocardiography DD. Higher grades were associated with adverse cardiac remodeling and comorbidities. Over a median follow-up of 3.4 years, grade 3 AI-enabled electrocardiography DD independently predicted mortality (hazard ratio [HR], 1.80 [95% CI, 1.47-2.20]; P<0.001). AI-enabled electrocardiography DD improved prognostic discrimination beyond clinical and echocardiographic measures (ΔHarrell concordance statistic, 0.016; Δχ²=57; P<0.001). Among 1259 patients with indeterminate echocardiographic grading, AI-enabled electrocardiography added prognostic value (ΔHarrell concordance statistic, 0.02; Δχ²=13; P=0.006). Worsening or persistently high-risk trajectories were associated with increased mortality (HRs, 1.45-1.80; all P<0.05).

CONCLUSIONS: AI-enabled electrocardiography-derived DD independently predicts mortality after transcatheter aortic valve replacement, adds value beyond echocardiographic grading, and enables dynamic risk stratification through longitudinal tracking.

PMID:41614319 | DOI:10.1161/JAHA.125.046558

Prim Health Care Res Dev. 2026 Jan 30;27:e16. doi: 10.1017/S1463423625100753.

ABSTRACT

OBJECTIVES: Smartphones have become essential, making our daily lives more manageable; however, excessive use may cause problems. University students are particularly vulnerable to smartphone addiction. This study examines the relationship between smartphone addiction and health-promoting lifestyles among university students.

METHODS: A cross-sectional study was conducted with 911 students at Dokuz Eylul University, Izmir, Turkey. Data were collected via Smartphone Addiction Scale-Short Version (SAS-SV) and Health Promotion Lifestyle Profile II (HPLP II). The printed forms were used, and the researcher administered the survey in person and recorded the responses.

RESULTS: Prevalence of smartphone addiction was 34.1%. Several factors were significantly associated, including female gender (p = 0.049), being single (p = 0.042), self-perceived smartphone addiction (p < 0.001), daytime sleepiness (p < 0.001), and poor sleep quality (p < 0.001). Students with smartphone addiction had significantly lower HPLP II scores (p = 0.001).Logistic regression analysis showed that gender was no longer a significant factor. Those without a partner (OR: 1.47, 95% CI: 1.07-2.03), those who considered themselves smartphone addicts (OR: 6.86, 95% CI: 4.99-9.42), and those with daytime sleepiness (OR: 1.52, 95% CI: 1.08-2.14) had higher odds of smartphone addiction. Higher HPLP II scores were protective against smartphone addiction (OR: 0.99, 95% CI: 0.98-0.99).

CONCLUSIONS: This study highlights that students with smartphone addiction engage in less health-promoting behaviours and experience poor sleep quality and daytime sleepiness. Self-perceived smartphone addiction was strongly associated with actual addiction, while a healthier lifestyle appeared to have a protective effect. There is a need for strategies to promote healthy habits and reduce smartphone addiction among university students.

PMID:41614313 | DOI:10.1017/S1463423625100753

Ir J Psychol Med. 2026 Jan 30:1-10. doi: 10.1017/ipm.2026.10170. Online ahead of print.

ABSTRACT

OBJECTIVES: Understanding service users’ knowledge of and attitudes towards the rapidly progressing field of mental health technology (MHT) is an important endeavour in clinical psychiatry.

METHODS: To evaluate the current use of and attitudes towards MHT (mobile apps, online therapy and counselling, telehealth, web-based programmes, chatbots, social media), a 5-point Likert-scale survey was designed based on previous studies and distributed to attendees of an adult community mental health service in Ireland. Chi-square tests were used and corrected for multiple comparisons.

RESULTS: 107 mental health service users completed the survey (58% female, aged 18-80). 86% of respondents owned a smartphone. 27.1% reported using a mental health application, while 33.6% expressed interest in using one in the future. 61.7% reported they had not used and were not interested in using AI for their mental health, and 51.4% indicated they would not feel comfortable using it. 46.8% were not comfortable with psychiatrists utilising AI in their care. The majority (86.9%) preferred face-to-face appointments, while 52.6% would consider using MHT while on a waiting list. Younger participants reported significantly greater comfort using mental health apps and higher self-rated knowledge of AI.

CONCLUSION: There were low levels of knowledge about and comfort using MHT, accompanied by concerns about confidentiality and privacy. Younger service users tended to be more comfortable with and knowledgeable about MHT. Despite the growing interest in digital approaches, there remains a clear preference for face-to-face appointments, underscoring the importance of addressing privacy and safety concerns, together with training and education.

PMID:41614310 | DOI:10.1017/ipm.2026.10170

J Am Heart Assoc. 2026 Jan 30:e045631. doi: 10.1161/JAHA.125.045631. Online ahead of print.

ABSTRACT

BACKGROUND: The risk of ischemic stroke is highest during the first year following a new diagnosis of cancer, but no tools exist to identify patients at highest risk.

METHODS: Using linked clinical and administrative databases, we conducted a population-based retrospective cohort study of adults in Ontario, Canada, with newly diagnosed cancer from 2010 to 2021. Patients were randomly selected for prediction model derivation (60%) or validation (40%). The final model predicting ischemic stroke within 1 year following cancer diagnosis was derived using multivariable Fine-Gray regression with candidate predictors selected via backward elimination. Subdistribution-adjusted hazard ratios and 95% CIs were calculated, where all-cause mortality was treated as a competing event. Performance of the prediction model was assessed in the validation cohort based on the C statistic and calibration plots for discrimination and calibration, respectively.

RESULTS: There were 698 566 eligible patients, with 418 911 in the derivation cohort and 279 576 in the validation cohort. The overall rate of stroke per 1000 person-years was 6.7 (95% CI, 6.4-6.9). The final model included 22 predictors, including age, sex, demographic factors, cancer characteristics, and treatment characteristics. Discrimination was good, with a C statistic of 0.73. The model was well calibrated, with points following the desired 45-degree line.

CONCLUSIONS: We derived and validated the PRIME (Predicting Risk of Ischemic Stroke in Malignancy Estimation) tool with good discrimination for ischemic stroke in patients with a new cancer diagnosis. The model was built into an online calculator (https://study.ohri.ca/PRIME/) and has the potential to stratify patients with cancer based on their risk of stroke within a year following their diagnosis.

PMID:41614295 | DOI:10.1161/JAHA.125.045631

Alzheimers Dement. 2026 Feb;22(2):e71160. doi: 10.1002/alz.71160.

ABSTRACT

INTRODUCTION: Recent work has identified unique cognitive profiles for early-onset Alzheimer’s disease (EOAD) relative to late-onset Alzheimer’s disease (LOAD), however, examination has been limited in determining whether the association between age and cognitive severity at presentation also differs across conditions.

METHODS: A series of linear spline regression models was conducted across baseline cognitive data from 325 EOAD and 314 LOAD participants, after accounting for education, sex, and apolipoprotein ε4 status.

RESULTS: Significant differences existed in the relationship between baseline age and cognitive performance between EOAD and LOAD samples for Processing Speed/Attention, Executive Functioning, and Episodic Immediate Memory. Younger participants from both EOAD and LOAD groups performed disproportionately worse on non-amnestic cognitive domains, with this occurring to a greater extent in EOAD than LOAD.

DISCUSSION: In the age of disease-modifying treatments, results highlight the importance of assessing for cognitive declines in individuals starting much earlier than age 65.

HIGHLIGHTS: Early-onset Alzheimer’s disease (EOAD) and late-onset Alzheimer’s disease (LOAD) participants each displayed cognitive impairments relative to same-aged peers across most domains. Both groups displayed positive relationships between impairment among non-amnestic cognitive domains and baseline age. This relationship displayed a significantly greater effect in EOAD than LOAD, with domains of Processing Speed/Attention and Executive Functioning skills being the most pronounced. Of those participants developing AD, age displayed a disproportionate impact on their symptom onset.

PMID:41614286 | DOI:10.1002/alz.71160

Nurs Crit Care. 2026 Mar;31(2):e70282. doi: 10.1111/nicc.70282.

ABSTRACT

BACKGROUND: Tracheostomy is a common procedure in intensive care units (ICUs), with a rising number of patients requiring specialised nursing care. Effective tracheostomy management is critical for preventing complications such as tube blockage, infection and bleeding. Critical care nurses play a pivotal role in ensuring patient safety, highlighting the need for innovative approaches to enhance their knowledge and clinical performance.

AIM: To evaluate the effect of implementing a Tracheal nursing care bundle on critical care nurses’ knowledge and performance in the ICU.

STUDY DESIGN: A quasi-experimental design was conducted involving critically ill adult patients with tracheostomies and ICU nurses. Data were collected using three tools: (i) a self-administered questionnaire to assess nurses’ knowledge, (ii) a pre-post observational checklist to evaluate nurses’ performance in applying the Tracheal nursing care bundle and (iii) a patient outcome sheet documenting demographic characteristics, adverse events and tracheostomy-related complications.

RESULTS: A total of 60 critical care nurses and 60 ICU patients participated in the study. Post-implementation of the Tracheal nursing care bundle, there was a statistically significant improvement in nurses’ knowledge and practice, with 81.7% achieving adequate performance levels. The overall complication rate significantly decreased (pre 28.3% (n=17) vs. post 8.3% (n=5), p=0.006).

CONCLUSIONS: The Tracheal nursing care bundle enhanced ICU nurses’ knowledge and performance, leading to a reduction in tracheostomy-related complications and improved patient outcomes.

RELEVANCE TO CLINICAL PRACTICE: Implementation of structured care bundles, such as the Tracheal nursing care bundle, strengthens evidence-based tracheostomy management in ICUs. By standardising nursing practice, the bundle reduces preventable adverse events, reinforces patient safety and supports high-quality care delivery. Incorporating such interventions into routine ICU practice can optimise patient outcomes and empower nurses with the confidence and competence required for managing tracheostomies effectively.

PMID:41614279 | DOI:10.1111/nicc.70282

Climacteric. 2026 Jan 30:1-6. doi: 10.1080/13697137.2026.2615391. Online ahead of print.

ABSTRACT

OBJECTIVE: Adhesive capsulitis (AC) is considered idiopathic, yet typically affects women aged 40-60 years. The purpose of this study was to determine whether hormone therapy is protective against AC in menopausal women. The study hypothesized that patients prescribed hormone therapy would have lower odds of AC than those not using hormone therapy.

METHOD: Medical record extraction for a single health maintenance organization was used to identify postmenopausal women aged 40- 60 years and assess the utilization of hormone therapy and diagnosis of AC. The distribution of AC and endocrine disorders was compared between treatment groups using chi-squared tests and the odds ratio (OR) was reported.

RESULTS: The cohort included 1952 patients (152 hormone therapy, 1800 without hormone therapy). No statistically significant differences were found between treatment groups for endocrine disorders. A higher percentage of AC was noted in patients without hormone therapy compared to patients with hormone therapy (7.65% vs. 3.95%), although the association was not statistically significant (OR 1.99; 95% confidence interval 0.86-4.58; p = 0.10).

CONCLUSION: This pilot study did not demonstrate a statistically significant difference in odds of AC in menopausal women with and without hormone therapy. Larger prospective studies are needed to further explore potential protective effects of hormone therapy against AC.

PMID:41614260 | DOI:10.1080/13697137.2026.2615391