Tag: pubmed

Addiction. 2026 Feb 23. doi: 10.1111/add.70357. Online ahead of print.

ABSTRACT

AIMS: We examined the feasibility and acceptability of pairing portable breathalyzers to assess field alcohol use with mobile ecological momentary assessment (EMA) to assess intimate partner violence (IPV; psychological, cyber, physical and sexual aggression) perpetration and victimization among undergraduates who drink heavily and were recently aggressive.

DESIGN, SETTING AND PARTICIPANTS: We assessed EMA/breathalyzer completion rates, drinking captured via breathalyzer versus self-report, number of IPV events captured, procedural acceptability and reactivity to assessment. Sex differences were examined. Undergraduates aged 18-25 (n = 103; M age = 21 years, SD = 2.0; 52% women; 80.6% heterosexual; 64.1% white; 93.2% non-Hispanic) recruited from a large Mid-Atlantic university in the United States completed a baseline survey then a 30-day EMA wherein they were prompted to complete one morning and three evening surveys (7 PM, 9 PM, 11 PM) daily. After each evening survey, participants were prompted to submit a breath alcohol content (BrAC) sample to a breathalyzer linked to surveys. Participants could self-initiate surveys after drinking or IPV outside of assessment periods. Afterward, participants completed an exit survey.

MEASUREMENTS: Outcome variables were self-reported alcohol use and IPV assessed via EMA surveys, and BrAC assessed via breathalyzer. Self-reported procedural acceptability was assessed in the exit survey. Reactivity to assessment was assessed by analyzing daily trends in IPV and drinking by sex using generalized linear mixed effects models.

FINDINGS: Participants completed 80% of surveys and responded to 91% of breathalyzer prompts. BrAC was captured in 89.4% of self-reported drinking events, 91.4% of self-reported non-drinking events and 95.8% of IPV events, with greater responsiveness to breathalyzer prompts as the evening progressed despite increasing intoxication. More IPV events were captured during evening and event triggered (358 combined total events) than morning surveys (245 events). Results were comparable across women and men. Each additional study day was associated with modest declines in odds of experiencing any IPV [odds ratio (OR) = 0.95, 95% confidence interval (CI) = 0.94-0.97, P < 0.001], IPV perpetration (OR = 0.94, 95% CI = 0.92-0.96, P < 0.001), IPV victimization (OR = 0.97, 95% CI = 0.96-0.99, P = 0.004), any drinking (OR = 0.99, 95% CI = 0.98-1.00, P = 0.01) and positive BrAC readings (OR = 0.99, 95% CI = 0.98-1.00, P = 0.052), suggesting minimal reactivity to assessment. Participants reported high overall satisfaction with study components.

CONCLUSIONS: Pairing ecological momentary assessment with portable breathalyzers to capture data on drinking and intimate partner violence across 30 days among US undergraduates who were previously aggressive and who drink heavily appears to be both feasible and acceptable.

PMID:41725361 | DOI:10.1111/add.70357

Emerg Med Australas. 2026 Feb;38(1):e70232. doi: 10.1111/1742-6723.70232.

ABSTRACT

Peer review is a cornerstone of modern scientific publishing, yet its current form is a relatively recent development that became institutionalised in the mid-20th century. While intended to ensure rigour, credibility and quality control, the peer review system now faces mounting pressures. Rapid growth in manuscript submissions, reliance on unpaid reviewer labour, reviewer fatigue and the rise of predatory journals have strained its effectiveness. These challenges contribute to delays, inconsistent review quality and increasing retraction rates, highlighting vulnerabilities that peer review often fails to detect at scale. Evidence from randomised trials suggests that most proposed reforms offer limited benefit, although adding statistical reviewers and adopting elements of open peer review produce modest improvements. Sustainable reform will require evidence-guided changes, better recognition of reviewer contributions, and careful integration of technological tools to preserve the integrity of scientific publishing.

PMID:41725359 | DOI:10.1111/1742-6723.70232

Appl Neuropsychol Adult. 2026 Feb 23:1-8. doi: 10.1080/23279095.2026.2634178. Online ahead of print.

ABSTRACT

Negative symptoms are among the most robust clinical predictors of adaptive functioning in schizophrenia, particularly in residual or stabilized phases of the disorder. Executive functioning (EF) is also linked to adaptive functioning and partially overlaps with negative symptoms but may capture distinct self-regulatory processes involved in translating intentions into sustained real-world behavior. Most prior evidence relies on performance-based EF measures, which assess executive functioning under highly structured conditions. This study examined whether behavioral ratings of EF provide incremental explanatory value for adaptive functioning beyond negative symptoms in adults with residual-phase schizophrenia. Forty outpatients with residual-phase schizophrenia were assessed using the Life Skills Profile (LSP-39) to measure adaptive functioning, the Scale for the Assessment of Negative Symptoms (SANS), and the informant-report Dysexecutive Questionnaire (DEX). Hierarchical regression models were estimated to test the incremental contribution of behavioral EF beyond negative symptoms, using permutation-based tests for model improvement and bias-corrected and accelerated bootstrap confidence intervals. Behavioral EF ratings showed strong associations with global adaptive functioning and all functional domains. Negative symptoms were also significantly related to functioning, although associations were generally smaller. In hierarchical models, DEX scores accounted for a substantial and statistically significant proportion of additional variance in global adaptive functioning beyond negative symptoms. Similar incremental effects were observed across all LSP-39 subscales, with behavioral EF showing larger standardized coefficients than negative symptoms. These findings indicate that behavioral ratings of executive functioning provide nonredundant and clinically meaningful information about adaptive functioning in residual-phase schizophrenia.

PMID:41725355 | DOI:10.1080/23279095.2026.2634178

Am J Surg. 2026 Feb 17;255:116873. doi: 10.1016/j.amjsurg.2026.116873. Online ahead of print.

ABSTRACT

BACKGROUND: The Merit-Based Incentive Payment System (MIPS) requires physicians to report quality measures along with supplementary metrics that are used to determine an annual percentage adjustment to physician Medicare Part B payments. Unfortunately, during the early years of the MIPS program (2017 to 2020), physicians in non-primary care specialties have had few quality measures to choose from. This has resulted in a disadvantage for physicians of non-primary care specialties to receive a positive Medicare part B adjustment. The aim of this study is to determine if significant variation still exists in the number and characteristics of quality measures in the MIPS program across specialties from 2021 to 2024.

METHODS: This longitudinal quality improvement study uses Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) public use file data from 2021 to 2024 to collect descriptive statistics about the number and characteristics of MIPS measures and Qualified Clinical Data Registry (QCDR) measures available for reporting within the Traditional MIPS reporting pathway. Primary outcomes included the number of measure-and-collection-type combinations, number of unique MIPS measures, number of QCDRs, and number of QCDR measures available for reporting within each medical specialty. Secondary outcomes included quality measure characteristics such as each measure’s Donabedian class, topped out status, and capped status. All outcomes were established prior to data collection.

RESULTS: The average number of unique quality measures and measure-and-collection-type combinations available for reporting by non-primary care specialties is significantly lower than that for primary care specialties (p < 0.001, p < 0.001, respectively). Process measures outnumber outcome and structure measures within all specialties except neurosurgery, orthopedic surgery, and vascular surgery. A large percentage (40.9%) of all measure-and-collection-type combinations in 2024 are topped out and therefore fail to stratify physician performance effectively.

CONCLUSION: In this longitudinal study of MIPS and QCDR quality measures, results show that significant variability still exists in the number of quality measures available for reporting in 2024, with non-primary care specialties having the lowest number of reportable measures. Policymakers should ensure that future modifications to the MIPS program provide equal opportunity for physicians to achieve a positive Medicare Part B payment adjustment.

PMID:41723892 | DOI:10.1016/j.amjsurg.2026.116873

Contact Dermatitis. 2026 Feb 22. doi: 10.1111/cod.70116. Online ahead of print.

ABSTRACT

BACKGROUND: Allergic contact dermatitis (ACD) is a chronic inflammatory skin disorder associated with substantial impairment in quality of life (QoL). Few studies have comprehensively assessed the multidimensional impact of ACD using validated QoL instruments and healthy controls.

OBJECTIVES: To evaluate the impact of ACD on QoL compared to a control group and to explore the association between clinical variables and patient-reported outcomes.

METHODS: This cross-sectional study included 225 patients with confirmed ACD (positive and clinically relevant patch tests) and 225 healthy controls. All participants completed the Dermatology Life Quality Index (DLQI), the EuroQoL-5D (EQ-5D-5L) and the Skindex-29. Disease severity was assessed using the modified Investigator’s Global Assessment (mIGA). Statistical analyses included nonparametric Mann-Whitney U tests for between-group comparisons, correlation analyses, and multivariate linear and ordinal regression models to identify predictors of quality-of-life impairment.

RESULTS: Patients with ACD showed significantly greater impairment across all QoL measures compared to controls (p < 0.001). Pruritus was the most frequently reported symptom (45.0%), and emotional distress and functional limitations were prominent. Higher mIGA scores were significantly associated with poorer QoL across all instruments.

CONCLUSIONS: ACD has a marked negative impact on multiple dimensions of QoL, comparable to that observed in other chronic dermatoses. These findings underscore the importance of integrating standardised QoL assessments into the routine management of ACD and support the adoption of multidimensional approaches in both clinical evaluation and therapeutic decision-making, while also highlighting the relevance of psychosocial screening as an essential component of comprehensive patient care.

PMID:41723879 | DOI:10.1111/cod.70116

Disabil Rehabil Assist Technol. 2026 Feb 22:1-11. doi: 10.1080/17483107.2026.2632735. Online ahead of print.

ABSTRACT

Acquired brain injury (ABI) is a major cause of long-term cognitive and communication impairments and is frequently associated with complex communication needs. Augmentative and alternative communication (AAC) interventions are commonly used to support communication in individuals with severe acquired brain injury (SABI), yet evidence regarding their cognitive and neurophysiological effects remains limited. This pilot feasibility and exploratory study examined preliminary effects of low- and high-tech AAC interventions on cognitive, communicative, functional, and neurophysiological outcomes in individuals with SABI. Twenty participants were quasi-randomly assigned to an experimental group (EG) receiving high-tech AAC (Grid 3) or a control group (CG) receiving low-tech AAC. Cognitive functioning, functional independence, communication abilities, and P300 event-related potential latency were assessed at baseline and post-intervention. Non-parametric statistics were applied due to the small sample size. Within-group changes were examined using Wilcoxon signed-rank tests, and exploratory between-group comparisons were conducted using Mann-Whitney U tests. Effect sizes with 95% confidence intervals were calculated, and Bonferroni correction was applied. Both groups showed significant within-group improvements in functional communication (EG p = 0.007, CG p = 0.014). The EG demonstrated significant gains in cognitive functioning (p = 0.005) and reduced P300 latency (p = 0.003), whereas no significant changes were observed in the control group. Changes in functional independence were modest and not statistically significant in either group. These findings support the feasibility of AAC interventions in SABI and suggest potential benefits for communication and selected cognitive processes. Larger randomised studies are needed to clarify comparative effects and mechanisms.

PMID:41723848 | DOI:10.1080/17483107.2026.2632735

Oncologist. 2026 Feb 22:oyag054. doi: 10.1093/oncolo/oyag054. Online ahead of print.

ABSTRACT

BACKGROUND: The management of initially unresectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) has been revolutionized by conversion therapy combining locoregional and systemic modalities. While successful downstaging followed by salvage surgery offers potential for cure, the optimal duration of postoperative adjuvant targeted-immunotherapy remains poorly defined. This multicenter study aimed to determine the relationship between adjuvant therapy duration and survival outcomes in this specific patient population.

METHODS: We conducted a retrospective cohort analysis of 124 patients with initially unresectable HCC and PVTT who achieved successful conversion using combined local-systemic therapy and subsequently underwent R0 resection at four tertiary medical centers between September 2019 and December 2022. Patients were stratified into four groups according to adjuvant targeted-immunotherapy duration: no adjuvant therapy (0 month, n = 26), short-term therapy (1-3 months, n = 28), medium-term therapy (4-6 months, n = 25), and extended therapy (≥7 months, n = 45). Primary endpoints were overall survival (OS) and progression-free survival (PFS), analyzed using Kaplan-Meier methods and Cox proportional hazards models.

RESULTS: With a median follow-up of 28.3 months, significant differences in both OS and PFS were observed among the four groups (both P < 0.0001). Compared to the no-adjuvant group, all treatment durations showed significant survival benefits, with hazard ratios of 0.49 (P = 0.004) for OS and 0.44 (P = 0.010) for PFS in the 1-3 month group, improving to 0.22 (P < 0.001) for OS and 0.15 (P < 0.001) for PFS in the 4-6 month group. Critically, the medium-term therapy (4-6 months) demonstrated statistical non-inferiority compared to extended therapy (≥7 months) for both OS (P = 0.85) and PFS (P = 0.30), establishing a clear efficacy plateau. Treatment-related adverse events were manageable and comparable across all duration groups.

CONCLUSIONS: This study provides compelling evidence that adjuvant targeted-immunotherapy duration significantly impacts survival outcomes in converted unresectable HCC patients with PVTT. The 4-6 month adjuvant regimen represents the optimal therapeutic window, maximizing survival benefits while avoiding unnecessary extended treatment. These findings should inform clinical practice and guide the design of future prospective trials.

PMID:41723827 | DOI:10.1093/oncolo/oyag054

Acad Med. 2026 Feb 22:wvag047. doi: 10.1093/acamed/wvag047. Online ahead of print.

ABSTRACT

PROBLEM: To advance health equity, residents need preparation to address structural contributors to disparities and mitigate bias in clinical decision-making. Experiential learning around health equity, however, is lacking, and specialty-specific interventions often fail to reflect the interdisciplinary nature of clinical practice. This report describes an institution-wide longitudinal simulation-based health equity educational intervention for first-year residents, comprising experiential education on structural determinants of health (SDOH) and spaced reflection opportunities.

APPROACH: In 2024, first-year residents from all specialties at one academic medical center participated in two simulated encounters with standardized patients (SPs), followed by SP feedback, individual narrative reflection, and group debriefing, which leveraged visual arts-based exercises to generate dialogue. Three to six months later, residents reviewed recordings of their encounters and completed a semi-structured metacognitive activity. Surveys conducted before, immediately after, and 3-6 months after the simulations captured self-reported impacts on decision-making and communication in clinical encounters, understanding SDOH, and performance on the Multidimensional Cultural Humility Scale, which measures dimensions of intercultural interactions (e.g. openness, self-awareness).

OUTCOMES: Of 235 eligible residents, 216 participated. One hundred sixty-four, 116, and 130 consented to have their pre-, immediate post-, and interval- (3-6 months post) responses included for analysis. 99.1% (115) found programming quality to be high. Immediately after simulation experiences, there was a statistically significant improvement in participants’ cultural humility and confidence in addressing stigmatizing language, bias, and SDOH during patient encounters; communicating with diverse patients; and advocating for patients. At interval follow-up, most improvements were sustained; nearly 70% (89) found the experience had impacted their patient interactions.

NEXT STEPS: Next steps include offering advanced iterations of this experience to senior residents. Other institutions may replicate this activity with cases tailored to site-specific patient populations to give learners opportunities to practice equity-focused skills and signal organizational commitment to meeting their patient populations’ needs.

PMID:41723820 | DOI:10.1093/acamed/wvag047

J Anim Sci. 2026 Feb 22:skag054. doi: 10.1093/jas/skag054. Online ahead of print.

ABSTRACT

Water intake (WI) in beef cattle is influenced by animal class, breed, production system, and environmental conditions, yet current models rely on limited, outdated data. We analyzed 130,000+ daily records of individual WI, dry matter intake (DMI), and body weight (BW) across 10 breeds from grazing and drylot systems over five years. WI varied significantly by class (P < 0.001), with bulls consuming the most water (25.62 ± 0.03 L/day), followed by heifers (23.21 ± 0.07 L/day) and steers (21.83 ± 0.06 L/day), but heifers and steers had higher WI per 100 kg BW (P < 0.001). Breed effects were also significant (P < 0.001), with Red Angus and Limousin exhibiting the highest weight-adjusted WI. Drylot cattle drank more than grazing cattle (24.66 vs. 21.60 L/day; P < 0.001). WI increased with heat load; animals in THI ≥ 90 consumed 8.47 ± 0.03 L/100 kg BW compared to 5.53 ± 0.01 in THI < 72. However, relationships between WI and BW or DMI were weak (R2 = 0.06). These results challenge assumptions embedded in current recommendations (e.g., NASEM 2016) and highlight the need for individualized, context-sensitive models. Our findings support future efforts in water-efficient selection, climate resilience, and sustainable beef production.

PMID:41723815 | DOI:10.1093/jas/skag054

Eur Arch Paediatr Dent. 2026 Feb 22. doi: 10.1007/s40368-026-01189-9. Online ahead of print.

NO ABSTRACT

PMID:41723796 | DOI:10.1007/s40368-026-01189-9