Tag: pubmed

J Pediatr Nurs. 2026 Apr 1;88:635-644. doi: 10.1016/j.pedn.2026.03.041. Online ahead of print.

ABSTRACT

BACKGROUND: Children with disabilities increasingly encounter digital environments with opportunities and risks, while relationships among digital parenting self-efficacy, parental self-efficacy, and family support remain understudied.

METHODS: This cross-sectional, descriptive, and correlational study was conducted with 195 parents of children aged 0-18 years with disabilities registered in a disability services unit in Türkiye. Data were collected using a sociodemographic form, the Digital Parenting Self-Efficacy Scale, the Parental Self-Efficacy Scale, and the Family Support Scale. Data were analyzed using descriptive statistics, Pearson correlation analysis, and multiple linear regression. Missing data were handled using multiple imputation with the fully conditional specification method, and pooled estimates were calculated according to Rubin’s rules.

RESULTS: Most children used the internet daily and for extended periods, and some exhibited behaviors suggestive of problematic use. Parents demonstrated moderate-to-high levels of digital literacy, digital security awareness, and digital communication skills. Parental self-efficacy showed positive associations with digital competencies and perceived family support. In the adjusted regression model controlling for maternal age, maternal education, family income, and social security status, digital security and perceived family support emerged as significant predictors of parental self-efficacy, with digital security representing the strongest predictor.

CONCLUSIONS: Digital security and family support play important roles in strengthening parental self-efficacy among families raising children with disabilities.

IMPLICATIONS FOR PEDIATRIC NURSING: Pediatric nurses can play a key role in assessing digital use in families of children with disabilities, strengthening parents’ digital literacy and self-efficacy, and designing family-centred interventions to reduce digital risks and enhance family support.

PMID:41930534 | DOI:10.1016/j.pedn.2026.03.041

Heart Lung. 2026 Apr 1;78:102775. doi: 10.1016/j.hrtlng.2026.102775. Online ahead of print.

ABSTRACT

BACKGROUND: Inspiratory muscle weakness is common among patients with chronic heart failure undergoing cardiac resynchronization therapy (CRT). Home-based inspiratory muscle training (IMT) could be a vital therapeutic strategy, particularly for those with limited access to cardiac rehabilitation programs.

OBJECTIVES: This study aimed to investigate the effects of a 12-week home-based IMT program on inspiratory muscle strength, cardiac function, NT-proBNP levels, exercise capacity, quality of life, and daily activities. It examined the relationships between changes in NT-proBNP levels, walking distance, maximal inspiratory pressure (MIP), and left ventricular ejection fraction (LVEF) in patients with heart failure at least one year after CRT implantation.

METHODS: In this randomized controlled trial, 32 patients with CRT devices were assigned to either the IMT group (n = 19) or the control group (n = 13). Outcome measures included MIP, LVEF, NT-proBNP levels, the 6-minute walk test, performance of activities of daily living (PMADL-8), and quality of life (Nottingham Health Profile-NHP).

RESULTS: Compared to the control group, the IMT group showed statistically significant improvements in MIP (p < 0.001), LVEF (p = 0.025), NT-proBNP levels (p = 0.003), walk distance (p < 0.001), PMADL-8 score (p < 0.001), and NHP total score. Significant correlations were observed among the changes in NT-proBNP, MIP, LVEF, and walk distance.

CONCLUSION: In this small-sample study home-based IMT was associated with improvements in respiratory strength, cardiac function, functional capacity, patient-reported functionality, and quality of life. This confirms the role of home-based IMT as a supportive preventive strategy for CRT patients who lack access to rehabilitation. Larger-scale, long-term studies are needed to confirm its effects on remodeling and clinical outcomes.

PMID:41930533 | DOI:10.1016/j.hrtlng.2026.102775

Comput Biol Chem. 2026 Mar 27;123:109039. doi: 10.1016/j.compbiolchem.2026.109039. Online ahead of print.

ABSTRACT

Disruption of transcription termination (DoTT) occurs when RNA polymerase II reads past a gene’s normal 3′ end, generating downstream “readthrough” RNA. DoTT has been reported under stresses such as viral infection and metabolic perturbation. But, many existing detection tools analyze samples one at a time or rely on rigid downstream windows, limiting direct condition-to-condition testing. We present DoTT-ML, a condition-aware pipeline for detecting transcription termination disruption from conventional short-read RNA-seq. This pipeline extends gene annotations downstream by a tunable window, applies an optional gap to reduce termination-proximal noise, and applies differential analysis between conditions using a robust statistical workflow. An optional machine learning approach provides a post-hoc prioritization when curated reference annotations are available. We benchmarked DoTT-ML against ARTDeco and DoGFinder across three public datasets: influenza A virus total RNA-seq, HSV-1 nascent 4sU-RNA, and HSV-1 Z-RNA RIP-seq. DoTT-ML showed comparably to, or better than, existing tools (high ROC AUC across datasets). Finally, in an in-house mouse, high-carbohydrate diet (HCD) liver model, DoTT-ML identified diet-associated readthroughs at metabolic genes. Experimental validation confirmed a stable readthrough transcript at the Scd1 locus under dietary stress, serving as a proof of principle for the pipeline’s biological relevance. Together, DoTT-ML provides a practical framework for condition-aware, readthrough detection and comparison across diverse RNA-seq assays.

PMID:41930502 | DOI:10.1016/j.compbiolchem.2026.109039

Mol Med Rep. 2026 May;33(5):156. doi: 10.3892/mmr.2026.13866. Epub 2026 Apr 3.

ABSTRACT

Lung cancer is an aggressive malignancy associated with a rapid progression and poor prognosis, for which immunotherapy only exhibits modest efficacy in most patients. In lung cancer, high lactate is associated with a low immunotherapy response and shortened survival; however, causal lactylation‑related genes remain to be elucidated. In the present study, candidate genes were screened using Mendelian randomization (MR) analysis, with expression quantitative trait loci data and genome‑wide association study summary statistics used as analytical resources. A total of 46 lactylation‑related genes were included in the MR analysis, and multiple testing correction was performed using the false discovery rate (FDR) and Bonferroni methods to control the false‑positive risk. MR identified three core genes [platelet‑type phosphofructokinase; SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily a, member 4; and stathmin 1 (STMN1)]. Among these genes, only STMN1 was significantly associated with increased lung cancer risk (inverse variance weighting original P=0.005, FDR‑corrected P=0.014995, Bonferroni‑corrected P=0.014995, odds ratio=1.741, 95% confidence interval: 1.182‑2.564), with robust results confirmed by heterogeneity/pleiotropy/sensitivity analyses. Subsequently, transcriptomic analysis was conducted to assess STMN1 expression in lung cancer tissues and its association with patient survival. In vitro (cell proliferation, migration, invasion and apoptosis assays) and in vivo experiments (murine tumor models) were also conducted to explore the function of STMN1. STMN1 exhibited upregulation in lung cancer tissues, and was associated with a shorter survival, reduced antitumor immune cell infiltration and an immunosuppressive tumor microenvironment (TME) phenotype. STMN1 knockdown inhibited lung cancer malignancy both in vitro and in vivo, and modulated key markers, whereas its overexpression exhibited the opposite effects. Additionally, STMN1 promoted global histone lactylation and histone H3 lysine 18 lactylation in lung cancer cells, establishing a direct functional link between STMN1 and the lactylation pathway. In conclusion, STMN1 is a lactylation‑related causal oncogene in lung cancer, driving progression via malignant phenotypes, and its high expression is associated with an immunosuppressive TME that may synergistically facilitate tumor progression. Therefore, STMN1 may be considered a novel target for lung cancer therapy.

PMID:41930463 | DOI:10.3892/mmr.2026.13866

Pacing Clin Electrophysiol. 2026 Apr 3. doi: 10.1111/pace.70228. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiac implantable electronic device (CIED) related complications occur frequently. Given the uncertainties, a comprehensive investigation of predictive factors is crucial. This study aimed to identify the determinants influencing the occurrence of CIED-related complications and to evaluate their predictive capability for the onset of CIED-related complications.

METHODS: This retrospective cohort study recruited 870 patients who underwent CIED implantation. The primary outcome was overall complications, and the secondary was pocket hematomas (PH). Logistic regression model was used to estimate the odds ratio (OR) with the 95% confidence interval (CI), and to establish the prediction models for all complications and PH.

RESULTS: 43 cases (4.95%) developed complications during follow-up, including 24 (2.8%) PH and 19 others. After adjusted for potential confounders, body mass index (BMI), having diabetes and chronic kidney disease (CKD), usage of anticoagulants and antiplatelets, device type, device replacement, and device electrode quantities were all associated with the risk of both the complications and PH. The prediction model with these variables displayed a good performance in predicting the complications occurrence, with AUC and C-statistic being 0.886 and 0.886 in training dataset, and 0.780 and 0.761 in the test dataset. Similar good performance in predicting PH onset were also observed.

CONCLUSION: The results indicate that BMI, diabetes, CKD, anticoagulants, antiplatelets, device types, device replacement, and device electrode quantities are critical risk factors, which can help predict the onset of the complications and PH.

PMID:41930459 | DOI:10.1111/pace.70228

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2026 Mar;42(3):230-236.

ABSTRACT

Objective To investigate the concordance of programmed death ligand-1 (PD-L1) expression between primary non-small cell lung cancer (NSCLC) and paired brain metastasis, analyze its relationship with clinicopathological characteristics, and evaluate the feasibility of using primary tumor PD-L1 status to predict brain metastasis status. Methods Thirty-two paired primary NSCLC and brain metastasis samples, pathologically diagnosed between January 1, 2017 and July 1, 2022, were collected. PD-L1 expression was detected by immunohistochemistry and interpreted using the Tumor Proportion Score (TPS), with cut-off values set at 1% and 50%. The Chi-square test was used to analyze the relationship between PD-L1 expression and clinicopathological features. Paired Chi-square and Kappa consistency tests were employed to assess the concordance of PD-L1 expression between primary and metastatic sites. Results PD-L1 expression showed no significant correlation with patient gender, age, treatment history, or histologic type. At the 1% cut-off, the overall PD-L1 expression showed moderate concordance between primary and metastatic sites (Kappa=0.624). Subgroup analysis revealed high concordance in untreated patients (Kappa=0.761, P=0.001), whereas the treated group showed weak concordance without statistical significance (Kappa=0.324, P=0.205). At the 50% cut-off, both the treatment group and the untreated group showed weak concordance without statistical significance. Although the chemotherapy subgroup showed perfect agreement (Kappa=1.000) at the 50% cut-off, the high-expression concordance rate was only 20.00%, indicating limited clinical reference value. Conclusion The strong concordance of PD-L1 expression in the untreated group patients supports the use of primary tumor PD-L1 status to guide clinical decision-making when brain metastasis tissue is unavailable. Treatment status (mainly including chemotherapy) may be an important factor affecting the consistency of high PD-L1 expression between primary NSCLC and brain metastasis.

PMID:41930444

J Cosmet Laser Ther. 2026 Apr 3:1-8. doi: 10.1080/14764172.2026.2652488. Online ahead of print.

ABSTRACT

This study aimed to evaluate pain levels, patient satisfaction, and preferences for different anesthetic techniques during the cosmetic application of botulinum toxin A in the upper third of the face. A randomized, double-blind, split-face clinical trial was conducted with 100 women undergoing esthetic procedures for facial wrinkle reduction. Patients were assigned to three groups: vibratory anesthesia versus placebo (Group I), topical anesthesia versus placebo (Group II), and vibratory anesthesia versus topical anesthesia (Group III). Pain levels were assessed using the visual analog scale (VAS). Patients identified the side with better pain control, expressed satisfaction, and provided recommendations for each technique. Group I (vibration 5.02 ± 2.56 vs. placebo 6.00 ± 2.75, p = .034), Group II (topical anesthetic 4.69 ± 2.45 vs. placebo 5.50 ± 2.38, p = .039), and Group III (topical anesthetic 4.89 ± 2.29 vs. vibration 6.06 ± 2.22, p = .048). While satisfaction levels showed no statistically significant differences between techniques, topical anesthesia in Group III received the highest recommendations (p = .010). This study suggests that topical anesthesia and vibratory stimulation both offer small-to-medium analgesic benefits over placebo during BoNT-A injections. Despite comparable satisfaction scores, patients preferred topical anesthesia for future use.

PMID:41930421 | DOI:10.1080/14764172.2026.2652488

Monaldi Arch Chest Dis. 2026 Apr 2. doi: 10.4081/monaldi.2026.3644. Online ahead of print.

ABSTRACT

Interstitial lung diseases (ILDs) comprise a heterogeneous group of disorders characterized by varying degrees of inflammation and fibrosis, necessitating precise epidemiological characterization. This ambispective observational study evaluated the clinical spectrum and diagnostic distribution of 1201 patients at a tertiary center in North India, utilizing a multidisciplinary discussion (MDD) framework for final diagnostic consensus. The mean age of the cohort was 52.7 (±13.04) years, with a female predominance of 55.6%. Idiopathic interstitial pneumonia (IIP) was the most prevalent diagnosis (48.8%), followed by connective tissue disease-associated ILD (CTD-ILD; 19.8%) and hypersensitivity pneumonitis (14.6%). Within the IIP subgroup, idiopathic pulmonary fibrosis predominated (49.7%), followed by nonspecific interstitial pneumonia (39.2%). Statistical analysis identified tobacco use as a significant driver for IIP phenotypes (odds ratio: 3.36; 95% confidence interval: 2.37-4.75; p<0.01). Physiological assessment revealed a restrictive ventilatory defect in 83.9% of the cohort. Patients with sarcoidosis (13.4%) exhibited significantly higher functional reserve (mean forced vital capacity %: 74.1±17.9%) compared to more fibrotic subtypes (p<0.01), and demonstrated superior exercise capacity (mean 6-minute walk distance: 392.4±85.6 m vs. 347.7±90.1 m in CTD-ILD; p<0.01). These findings establish that fibrotic IIPs constitute the primary disease burden in North India, highlighting the clinical necessity of standardized, MDD-based pathways to ensure accurate phenotype differentiation and timely initiation of targeted therapies in a region characterized by complex environmental triggers.

PMID:41930418 | DOI:10.4081/monaldi.2026.3644

Worldviews Evid Based Nurs. 2026 Apr;23(2):e70137. doi: 10.1111/wvn.70137.

ABSTRACT

BACKGROUND: Chronic diseases require sustained medication adherence, yet nonadherence remains common, leading to poor outcomes and increased healthcare costs. Digital self-management technologies such as mobile health (mHealth) apps, SMS reminders, and web-based platforms offer scalable ways to support adherence, but evidence on their overall effectiveness across diverse contexts is fragmented.

AIM: To systematically review and meta-analyze the effectiveness of self-management technologies in improving medication adherence among adults with chronic diseases and to examine potential moderators of intervention impact.

METHODS: Following PRISMA guidelines, we searched PubMed, Scopus, Web of Science, CINAHL, and JMIR for peer-reviewed studies (January 2010-June 2025) evaluating digital self-management interventions with adherence outcomes and comparator groups. Eligible designs included RCTs, quasi-experimental, and controlled before-after studies in adults with chronic disease. Random-effects meta-analysis estimated pooled effect sizes (Cohen’s d). Heterogeneity (I²), subgroup analyses, and publication bias (Egger’s, Begg’s, trim-and-fill) were assessed.

RESULTS: Fifty-two studies were included, spanning 2015-2025. Early interventions (2015-2019) focused on feasibility, using SMS and basic web tools; later years (2021-2025) showed technological maturity, dominated by mHealth apps integrating monitoring, reminders, and education. The pooled random-effects effect size was d = 0.268 (95% CI 0.123-0.414, p = 0.0003), indicating a small-to-moderate benefit. Heterogeneity was high (I² = 89%). Medium-duration (10.8-24 weeks) interventions had the largest effect (d = 0.50), and effects varied markedly by country (e.g., Iran d = 2.29; Taiwan d = -0.94). Begg’s test suggested possible publication bias; trim-and-fill adjustment increased the pooled effect to d = 0.366.

LINKING EVIDENCE TO ACTION: Digital self-management technologies yield a statistically significant, small-to-moderate improvement in medication adherence across chronic diseases, with potential underestimation due to selective reporting. Effectiveness is moderated by temporal trends, geography, intervention duration, and study design, underscoring the need for context-specific adaptation and methodological rigor. Future research should prioritize large, well-controlled trials, pre-registration, and exploration of cultural and systemic determinants to optimize intervention impact.

PMID:41930416 | DOI:10.1111/wvn.70137

Health Soc Care Deliv Res. 2026 Apr 1:1-26. doi: 10.3310/TNFT6414. Online ahead of print.

ABSTRACT

BACKGROUND: Domestic abuse and suicidal ideation are highly prevalent in the United Kingdom, often co-occurring. Numerous practical and psychosocial barriers inhibit help-seeking. This study explored whether community pharmacy could offer an accessible setting for a domestic abuse and suicidal ideation response service.

METHODS: The design was a randomised cluster feasibility trial. Twelve pharmacies were recruited from one pharmacy organisation, randomised into eight intervention pharmacies and four controls. Thirty-seven pharmacy staff were trained to deliver the Lifeguard Pharmacy intervention, which involved providing a consultation and structured referral or signposting to customers identified as experiencing domestic abuse and/or suicidal ideation. Staff learning from the training was evaluated using the validated Continuing Professional Development reaction questionnaire, analysed using a paired t-test. The intervention ran from January to July 2023 and was accompanied by a nested process evaluation consisting of staff focus groups and a multistakeholder final evaluation workshop with a mix of lay, pharmacy staff and representatives from referral organisations. Data were collected on number and category of client contacts from intervention and control pharmacies; descriptive analyses were performed.

RESULTS: After intervention training, pharmacy staff showed statistically significant improvements in their levels of perceived ability, ease and confidence in responding to and referring people in need of help for domestic abuse and suicidal ideation with increased confidence in the ability of other pharmacy staff to support domestic abuse and suicidal ideation. During the intervention period, staff responded to 24 cases in intervention pharmacies: 8 for suicidal ideation, 9 for domestic abuse and 7 for both domestic abuse and suicidal ideation. Of these, 22 were staff-initiated and 2 were client-initiated. Two cases (one suicidal ideation and one domestic abuse) were identified in control pharmacies. Staff participants had a positive perception of the service and its impact on them and their clients. The multistakeholder workshop findings confirmed the feasibility of a staff-initiated response service for both domestic abuse and suicidal ideation in a community pharmacy setting. However, there were challenges marketing and delivering a client-initiated service, and the study was not able to collect all of the information required to inform a future trial.

LIMITATIONS: There were challenges to collecting data and obtaining informed consent from Lifeguard Pharmacy clients, especially when distressed or time-pressured. Consequently, full data sets were only collected from 4 of the 24 people who used the service. All 12 participating pharmacies were located in 1 region of England, hence a future study would need to test implementation across a broader range of settings.

CONCLUSIONS: It is feasible to implement a staff-initiated response service for domestic abuse and/or suicidal ideation in selected pharmacies. The combination of staff training, consultation guide, referral tool and client support resources and organisational support empowered staff to proactively identify people experiencing domestic abuse and/or suicidal ideation.

FUTURE WORK: Further development work would be needed before a client-initiated service could be delivered, and a future implementation study is contingent on finding ways to safely consent and collect data from clients. Some preliminary health economic work was conducted but a full health economic analysis would be needed as part of a future study.

FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR133132.

PMID:41930409 | DOI:10.3310/TNFT6414