Tag: pubmed

Stud Health Technol Inform. 2026 Feb 12;334:35-41. doi: 10.3233/SHTI260011.

ABSTRACT

Challenges in access to specialty care in Canada lead to long wait times and poorer outcomes. The eConsult Centre of Excellence at The Ottawa Hospital (TOH) developed Triaging Referrals to eConsult (TReC), embedding specialist advice into routine referral workflows within health information systems (HIS). Following a successful proof-of-concept, TReC expanded to Women’s College Hospital (WCH) in 2023 and the Children’s Hospital of Eastern Ontario (CHEO) in 2025. We applied the RE-AIM framework to evaluate implementation across study the three study sites. Reach was assessed by utilization; effectiveness by response times and surveys; adoption by specialist participation; implementation by delivery and cost; maintenance by ongoing use. Data sources included administrative data and surveys of patients and providers. Specialist participation included 160 at TOH, 22 at WCH, and 26 at CHEO. Since launch, >10,000 eConsults were completed at TOH, >880 at WCH, and >360 at CHEO, spanning 15, 8, and 10 clinical areas, respectively. Median response times ranged from 2-8 days across sites, versus Ontario’s 23-week average for in-person care. Median cost per TReC case was $37 CAD (10 minutes spent per case), substantially lower than in-person visits. Surveys showed high acceptability: 84% of referring providers at TOH and 91% at WCH found advice actionable; 70% of TOH patients felt concerns were addressed; and 91% of TOH specialists perceived TReC to improve access. TReC scaled successfully across three hospitals and improved timely access. High acceptability supports expansion and potential to improve equitable access across Ontario. Future evaluation will assess post-TReC healthcare utilization.

PMID:41685469 | DOI:10.3233/SHTI260011

J Adolesc. 2026 Feb 13. doi: 10.1002/jad.70119. Online ahead of print.

ABSTRACT

INTRODUCTION: Parental education has been linked to childhood health and wellbeing outcomes. Intergenerational transfer of parental education into childhood health and wellbeing outcomes operates through multiple pathways, however the mediating influence of neighbourhood conditions remains understudied.

METHODS: Drawing on data from the Longitudinal Study of Australian Children (LSAC) (n = 6432, 51% male, ages 14-15 years) we conduct a causal mediation analysis using a Regression-with-Residuals (RWR) approach to examine the mediating effect of neighbourhood social environment, neighbourhood built environment, and neighbourhood socio-economic advantage in the relationship between parental education and children’s health and wellbeing at age 14 years.

RESULTS: The results show neighbourhood quality, in particular neighbourhood social environment and neighbourhood advantage, mediates a small but statistically significant proportion of the association between parental education and child health and wellbeing.

CONCLUSIONS: Our findings suggest that spatial stratification during childhood is likely to play an important role in the intergenerational reproduction of socio-economic gradients in health.

PMID:41685451 | DOI:10.1002/jad.70119

Stroke. 2026 Feb 13. doi: 10.1161/STROKEAHA.125.054073. Online ahead of print.

ABSTRACT

BACKGROUND: Poststroke dysphagia is associated with poor functional recovery and psychological consequences, including depression and fatigue, which may impede successful rehabilitation. Here, we investigate whether antidepressants may improve dysphagia recovery after acute ischemic stroke.

METHODS: In this prospective cohort study, patients with acute ischemic stroke (aged ≥18 years; consecutively enrolled in the STROKE-CARD trial 2014 to 2019 and registry 2020 to 2023 in Innsbruck, Austria) were examined for poststroke dysphagia (by standardized clinical and instrumental examinations) and antidepressant intake at hospital admission, discharge, and inpatient 3-month follow-up. The outcome was full oral diet resumption 3 months poststroke. Associations were analyzed using multivariable logistic regression and are presented as adjusted odds ratios, adjusting for age, sex, stroke severity, dysphagia severity, depression severity, stroke localization, thrombolysis, cognitive impairment, functional disability before stroke and at hospital discharge, and study type.

RESULTS: Poststroke dysphagia affected 380 (18.6%) of the total cohort of 2046 patients at hospital admission (mean age, 72.7±14.1 years; 37.8% females) and persisted in 290 (14.7%) and 95 (4.6%) patients until hospital discharge and 3-month follow-up, respectively. Among the 290 patients with persistent dysphagia at discharge included in the outcome analysis, antidepressant intake increased from 4.8% before stroke to 27.6% at hospital discharge and 49.0% at 3 months (P<0.001). A total of 195 (67.2%) of 290 patients with persistent dysphagia regained full oral diet by 3 months, with significantly higher recovery rates in those who were discharged on antidepressants (78.8% versus 62.9%; P=0.010). Antidepressant intake at hospital discharge was independently associated with improved dysphagia recovery at 3 months (adjusted odds ratio, 2.98 [95% CI, 1.51-5.87]; P=0.002).

CONCLUSIONS: Antidepressant intake was associated with better dysphagia recovery after acute ischemic stroke. As these findings are observational, randomized trials are required to clarify whether antidepressants can support dysphagia rehabilitation.

PMID:41685445 | DOI:10.1161/STROKEAHA.125.054073

Alzheimers Dement. 2026 Feb;22(2):e71146. doi: 10.1002/alz.71146.

ABSTRACT

INTRODUCTION: Cerebrovascular dysfunction may contribute to Alzheimer’s disease (AD) pathogenesis. We examined how novel cerebral hemodynamic markers relate to neuroimaging phenotypes associated with AD dementia in cognitively impaired and unimpaired older adults.

METHODS: Statistical hemodynamic indices were computed for each participant from stochastic dynamic models relating resting-state spontaneous arterial blood pressure and end-tidal CO₂ fluctuations to transcranial doppler-derived blood velocity and near infrared spectroscopy-derived cortical tissue oxygenation. Linear regressions related these hemodynamic indices to hippocampal volume, WMH volume, cortical thickness in an AD-signature region, and brain amyloid burden measured by PET.

RESULTS: Higher hemodynamic indices, indicating proximity to normal cerebrovascular function correlated with neuroimaging phenotypes typically associated with better cognitive status: greater hippocampal volume and lower amyloid burden.

DISCUSSION: Our findings provide further support for the role of cerebrovascular dysfunction in AD pathogenesis and for the potential clinical utility of model-based indices of cerebral hemodynamics.

PMID:41685442 | DOI:10.1002/alz.71146

Cancer Med. 2026 Feb;15(2):e71564. doi: 10.1002/cam4.71564.

ABSTRACT

BACKGROUND: Same-day discharge following radical prostatectomy has become increasingly common, with single-institution series suggesting it reduces healthcare costs without increasing adverse events. However, this practice has not been studied nationally, outside of specialized centers. This study assesses 30-day readmissions, observation stays, and emergency department visits among men with prostate cancer undergoing prostatectomy.

STUDY DESIGN: We used national Medicare data to identify men undergoing prostatectomy for prostate cancer between 2016 and 2021. We focused on patients discharged either the same day or the day after surgery to include only those with an uneventful postoperative course presumably eligible for same-day discharge. We used multivariable logistic regression to measure relationships between discharge day (same-day vs. next-day) and 30-day readmissions, adjusted for patient factors. We also assessed the association between the day of discharge and a secondary outcome, a composite of readmission, observation stay, or emergency department visits within 30 days.

RESULTS: Our cohort included 528 men discharged the same day and 11,513 discharged the next day. By 2021, same-day discharges rose to 9.2%. Same-day discharge was associated with an almost two-fold increase in the odds of a readmission within 30 days (adjusted OR: 1.93; 95% CI 1.35-2.76; p < 0.01). However, the odds of an acute care event, measured by a composite of any readmission, observation stay, or emergency department visit, were similar in both groups (adjusted OR: 1.16; 95% CI 0.90-1.50; p = 0.27).

CONCLUSIONS: Same-day discharges after prostatectomy have increased substantially but were associated with a two-fold increase in odds of a readmission within 30 days. However, global adverse events, as measured by our composite outcome, were similar.

PMID:41685432 | DOI:10.1002/cam4.71564

Org Biomol Chem. 2026 Feb 13. doi: 10.1039/d6ob00094k. Online ahead of print.

ABSTRACT

Alzheimer’s disease (AD) is the most common type of dementia, accounting for at least two-thirds of dementia cases in people aged 65 and older. Numerous approaches have been studied for the treatment of this disease, including the cholinergic hypothesis. Acetylcholinesterase (AChE) is the most promising target studied within the cholinergic hypothesis for the treatment of AD. Therefore, it is necessary to develop predictive models for the identification of AChE inhibitors. Thus, general drug design models can assist chemical synthesis groups and biochemical testing laboratories by enabling virtual screening and drug design. In this work, the objective is to build a generic molecular screening prediction model for public, online and free use based on pIC₅₀, using a random forest model (RF). For this, a dataset with approximately 16 000 compounds and 134 classes of descriptors was used, resulting in more than 2 000 000 calculated descriptors. Other algorithms were studied, such as gradient boosting, XGBoost, LightGBM, and RF with descriptors from principal component analysis (PCA), but none demonstrated significantly superior results compared to the RF model. The final model studied obtained an R² = 0.76 with a 15% test set and obtained an R² = 0.73 with a 30% test set, with rigorous Y-scrambling confirming the absence of chance correlation. External validation performed on an independent test set comprising 10% of the data yielded an R² of 0.77 and an RMSE of 0.67, statistically confirming that the model retains high predictive accuracy for novel chemical scaffolds and is free from overfitting. It is suggested that compounds containing oxime groups (RR’C = NOH) and those with high structural branching (higher Balaban index) tend to be less potent AChE inhibitors (negative correlation). In addition, some descriptors indicate that electronic charge distribution, molecular surface area, and hydrophobicity play important roles in correlating with the inhibitory activity (pIC₅₀) of the compounds. The presence of linear alkane chains also seems relevant to activity (positive correlation and greater importance). The data and models are available at the following link: (https://colab.research.google.com/drive/1gMcuXAsrqTIBMNnsCEWG9xfkK7aaZAbn?usp=sharing).

PMID:41685429 | DOI:10.1039/d6ob00094k

J Clin Rheumatol. 2026 Feb 13. doi: 10.1097/RHU.0000000000002324. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVE: Depression among physicians is a growing concern due to its impact on personal health and clinical performance. This study aimed to determine the prevalence of depressive symptoms in rheumatologists from Latin America and identify demographic, professional, and psychosocial factors associated with depressive symptoms.

METHODS: This is a cross-sectional study between August and November 2020, using a multilingual (Spanish and Portuguese) online survey distributed by national rheumatology societies under the Pan-American League of Associations for Rheumatology. The survey included the Patient Health Questionnaire (PHQ-9) to assess depression and the Maslach Burnout Inventory for burnout. Depression was defined as a PHQ-9 score ≥10. Descriptive statistics, χ2, t tests, and multivariate logistic regression were used for analysis. A total of 297 rheumatologists over the age of 25 actively practicing in 15 Latin American countries were included.

RESULTS: Of 297 participants, 15.8% had moderate to severe depression, and 33% had mild symptoms. Burnout affected 56.6%. Depression was more prevalent among younger physicians, those with fewer years in practice, lower income (≤$25,000/year), shorter vacation time, and those experiencing burnout. In multivariate analysis, burnout and lower happiness were independently associated with depression.

CONCLUSIONS: Nearly half of Latin American rheumatologists reported depressive symptoms. Burnout and psychosocial stressors were major contributors. Early identification and institutional strategies to promote well-being and mental health are critical.

PMID:41685422 | DOI:10.1097/RHU.0000000000002324

Hematology. 2026 Dec;31(1):2626211. doi: 10.1080/16078454.2026.2626211. Epub 2026 Feb 13.

ABSTRACT

OBJECTIVES: Several observational studies have suggested an association between sleep traits and leukaemia. This study aimed to determine the causal association between sleep traits and leukaemia using two-sample Mendelian Randomization (MR) analysis.

METHODS: Publicly available databases were used to retrieve summary statistics from genome-wide association studies (GWAS) related to sleep traits (UK BioBank) and leukaemia (FinnGen database). Inverse Variance Weighted (IVW) method was utilized for the primary MR analysis. Subsequently, we conducted a reverse MR analysis. Sensitivity analyses and statistical power calculation validated the robustness of the research findings. The Steiger directionality test was employed to ascertain the direction of causality.

RESULTS: Univariable MR identified nominal associations between chronotype and higher risk of acute lymphoblastic leukaemia (OR = 2.15, P = 0.014) and chronic myeloid leukaemia (OR = 1.27, P = 0.016), as well as between short sleep duration and lower lymphoid leukaemia risk (OR = 0.06, P = 0.035). However, none remained significant after FDR correction. Sensitivity analyses revealed no evidence of heterogeneity or horizontal pleiotropy. Adjusting for smoking and BMI in multivariable MR abolished all associations. Colocalization suggested shared genetic variants, but reverse MR indicated a significant effect only from acute lymphoblastic leukaemia to chronotype (P_FDR = 0.0017).

CONCLUSIONS: Our MR study found several nominal associations that sleep traits causally influence leukaemia subtypes. Nominal associations were not significant after multiple testing correction, attenuated by adjustment for smoking and BMI, and potentially affected by pleiotropy or reverse causation.

PMID:41685402 | DOI:10.1080/16078454.2026.2626211

Cancer Med. 2026 Feb;15(2):e71634. doi: 10.1002/cam4.71634.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer deaths in the United States for men and women combined but is preventable with timely screening. Evidence-based interventions (EBIs) provide promising opportunities to increase screening. There are few descriptive examples of the processes used to assess and implement EBIs to increase CRC screening.

PROJECT DESCRIPTION: The Colorectal Cancer Prevention Network (CCPN) in South Carolina facilitated an intensive quality improvement technical assistance project aimed to increase CRC screening in 25 primary care clinics. In this paper we provide a detailed description of the process used to implement EBIs, report on the changes in CRC screening rates, and examine the impact of the interventions across clinics with different attributes (such as clinic size and rurality).

METHODS: We used Chi-square to explore changes in screening rates from baseline to years two and three of clinic implementation. We used Difference-in-Differences analysis to assess changes in screening rates from baseline to third year for clinics with different attributes.

RESULTS AND CONCLUSIONS: Across all clinics, the CRC screening increased from 45% to 51% (p < 0.05) from baseline to third year of participation. Sixteen of out 25 clinics saw an increase in screening rates for their second year, and 14 out of 25 saw an increase in their third year. Clinics with smaller patient populations, rural clinics, clinics with fewer uninsured patients, and clinics with lower baseline rates saw greater percentage point improvements. Clinics onboarded in the second year saw the lowest gains. We conclude that a structured tailored approach to the selection of EBIs can have positive effects on CRC screening rates, but positive change may vary depending on clinic attributes.

PMID:41685389 | DOI:10.1002/cam4.71634

J Public Health Res. 2026 Feb 10;15(1):22799036251410258. doi: 10.1177/22799036251410258. eCollection 2026 Jan.

ABSTRACT

BACKGROUND: Over the past three decades, Iran’s fertility rate has declined sharply from 6.5 to 1.7, posing a critical demographic and public health challenge, a global trend that highlights the need to tackle multifaceted influences on childbearing intentions, including economic, social, emotional, and attitudinal factors.This study examined the factors influencing childbearing intentions among women.

DESIGN AND METHODS: This cross-sectional study surveyed 450 reproductive-age women in Tabriz, Iran. Data were collected using self-administered questionnaires to assess sociodemographic/obstetric characteristics, attitudes toward fertility/childbearing, subjective norms, marital satisfaction, perceived social support, childbearing/parental anxiety, and hope. Data were analyzed with SPSS v24 via descriptive statistics, chi-square/Fisher’s exact tests, independent t-tests, and hierarchical multiple logistic regression to identify predictors of childbearing intention.

RESULTS: Only 34.2% (95% CI: 29.8-38.8) of participants intended to have children. Adjusted logistic regression identified positive associations with childbearing intention for positive attitudes (OR = 1.113, 95% CI: 1.057-1.172), subjective norms (OR = 1.458, 95% CI: 1.292-1.646), social support (OR = 1.093, 95% CI: 1.020-1.172), hope (OR = 1.165, 95% CI: 1.043-1.172), and religious beliefs (OR = 12.789, 95% CI: 1.029-158.990); conversely, negative associations for pregnancy/childbirth anxiety (OR = 0.633, 95% CI: 0.422-0.949), age > 40 years (OR = 0.01, 95% CI: 0.000-0.279), and poor financial status (OR = 0.007, 95% CI: 0.000-0.347).

CONCLUSION: The findings highlight the multifaceted economic, social, emotional, and attitudinal influences on childbearing intentions among Iranian women. To promote fertility rates, targeted public health strategies are recommended, including counseling for emotional barriers, economic supports like infertility subsidies and family incentives, and community-based education on reproductive health benefits.

PMID:41685375 | PMC:PMC12891384 | DOI:10.1177/22799036251410258