Tag: pubmed

JAMA Netw Open. 2026 Apr 1;9(4):e267024. doi: 10.1001/jamanetworkopen.2026.7024.

ABSTRACT

IMPORTANCE: Identification of health care access-related factors associated with lower rates of cancer screening may help inform targeted interventions to mitigate barriers and ameliorate screening disparities.

OBJECTIVE: To examine the multifaceted obstacles associated with screening for breast, cervical, colorectal, lung, and prostate cancer in a diverse population.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included longitudinal data from the National Institutes of Health’s All of Us (AoU) Research Program (2017-2023). Nonincarcerated individuals aged 18 years or older residing in the US were eligible to participate by enrolling either online or through 1 of approximately 67 health care organizations. Identified participants within the AoU Research Program met US Preventive Services Task Force screening criteria for breast, colorectal, cervical, lung, or prostate cancer. Data were analyzed from October 2024 to January 2026.

MAIN OUTCOMES AND MEASURES: Participants self-reported whether 9 potential barriers delayed their medical care in the past year. Multivariable-adjusted odds ratios were estimated for the association between each barrier, the barrier burden, as well as for patterns of interrelated barriers identified using factor analysis and adherence to cancer screening recommendations.

RESULTS: In total, 160 691 participants were eligible for cancer screening including 42 908 participants in the breast (median age at last follow-up, 60 [IQR, 52-67] years; 100% female), 45 791 in the cervical (median age at last follow-up, 46 [IQR, 35-56] years; 100% female), 55 986 in the colorectal (median age at last follow-up, 66 [IQR, 57-73] years; 63% female), 3358 in the lung (median age at last follow-up, 66 [IQR, 59-72] years; 53% female), and 12 648 in the prostate cancer (median age at last follow-up, 63 [IQR, 59-66] years; 100% male) screening cohorts. Out-of-pocket costs, nervousness about seeing clinicians, and inability to get time off work were the most cited barriers. Participants reporting 3 or more barriers to care had significantly lower screening rates compared with those who reported no barriers for all cancer types, ranging from 18% (odds ratio [OR], 0.82; 95% CI, 0.76-0.88) for colorectal cancer to 32% (OR, 0.68; 95% CI, 0.46-0.97) for lung cancer. Three latent factors were consistently identified across cancer sites reflecting cost concerns, logistical barriers (eg, transportation), and competing obligations (eg, time off work). In multivariable analyses, cost concerns were associated with odds of screening for breast cancer (OR, 0.73; 95% CI, 0.66-0.80), cervical cancer (OR, 0.80; 95% CI, 0.73-0.87), and colorectal cancer (OR, 0.85; 95% CI, 0.77-0.94) and logistical barriers for breast cancer (OR, 0.75; 95% CI, 0.63-0.89), cervical cancer (OR, 0.78; 95% CI, 0.65- 0.93), and colorectal cancer (OR, 0.78; 95% CI, 0.65-0.94).

CONCLUSIONS AND RELEVANCE: In this cohort study of participants eligible for cancer screening, barriers to access and barriers related to cost concerns and logistics were associated with lower screening rates. Policies and interventions must target multiple dimensions of access simultaneously to increase cancer screening.

PMID:41979877 | DOI:10.1001/jamanetworkopen.2026.7024

Int J Surg Pathol. 2026 Apr 14:10668969261422683. doi: 10.1177/10668969261422683. Online ahead of print.

ABSTRACT

BackgroundPhyllodes tumors (PT) are fibroepithelial breast lesions with variable clinical behavior and histological features that frequently overlap with those of fibroadenomas. Accurate differentiation is critical, as PT may exhibit aggressive behavior. However, their distinction is particularly challenging in core needle biopsy, especially for benign and borderline PT, due to the limited amount of tissue provided by this technique. This meta-analysis investigates histological features that improve the distinction between fibroadenomas and PT in core needle biopsies.MethodsWe searched databases for studies comparing the core needle biopsy histologic features of lesions diagnosed as fibroadenoma or PT in the follow-up histopathological evaluation of the surgical specimen.ResultsWe included 14 studies, comprising 1413 patients. The PT group exhibited significantly higher rates of infiltrative margins (OR 6.06; 95% CI 2.13-17.22; P < .01), peri-epithelial stromal accentuation (OR 3.66; 95% CI 1.62-8.24; P < .01), stromal fragmentation (OR 6.93; 95% CI 2.66-18.04; P < .01), stromal overgrowth (OR 5.06; 95% CI 2.46-10.38; P < .01), cellular atypia (OR 9.04; 95% CI 5.15-15.89; P < .01), mitotic activity (OR 11.88; 95% CI 5.26-28.87; P < .01), and stromal hypercellularity (OR 9.67; 95% CI 5.58-16.78; P < .01). However, no statistically significant differences were found between the groups regarding the presence of adipose tissue within the lesion (OR 2.69; 95% CI 0.78-9.23; P = .12) or the presence of intracanalicular pattern (OR 1.02; 95% CI 0.55-1.92; P = .94). PTs were more frequent among older patients (MD 2.88; 95% CI 0.85-4.91; P < .01) and were larger (MD 1.07; 95% CI 0.79-1.35; P < .01).

PMID:41979873 | DOI:10.1177/10668969261422683

Drug Saf. 2026 Apr 14. doi: 10.1007/s40264-026-01673-7. Online ahead of print.

ABSTRACT

INTRODUCTION: Antipsychotic-associated sexual adverse drug reactions (ADRs) are well known in clinical practice, although efforts to understand differences between antipsychotics and distinct types of sexual ADRs are limited.

OBJECTIVE: The aim of this study was to assess and prioritize the profile of each antipsychotic regarding sexual ADRs reporting, and to account for potential confounders.

METHODS: We used VigiBase^® to conduct a case/non-case study using a customized clinically guided search strategy of antipsychotic-related sexual ADRs. The reporting odds ratio (ROR) and Bayesian information component (IC) with relevant 95% confidence intervals (95% CIs) were used as disproportionality measures to identify signals of disproportionate reporting (SDRs). Antipsychotics were compared with all other drugs and with thiazides (positive control). Sensitivity analyses included non-serious reports, excluding patients with potentially confounding co-medication(s), excluding adolescent and elderly patients, and including cases with co-reported hyperprolactinemia. Analyses were stratified by sex. Antipsychotics were ranked in terms of clinical priority using qualitative and quantitative criteria.

RESULTS: We included 5195 cases of antipsychotic-related sexual ADRs (43.1% serious, median time to onset of 61 days, 36.1% physician-reported). Several SDRs emerged in males (erectile dysfunction [3487 reports; ROR 2.49, 95% CI 2.40-2.57]; priapism [2372 reports; ROR 15.55, 95% CI 14.82-16.32]) and females (decreased libido [373 reports; ROR 1.61, 95% CI 1.46-1.79]) for all antipsychotic classes, except for muscarinic antagonists in females (ROR 0.64, 95% CI 0.55-0.73; IC – 0.65, 95% CI – 0.86 to – 0.45). In both sexes, the highest number of reports were for risperidone, aripiprazole and olanzapine. The SDRs disappeared in the sensitivity analysis including only non-serious cases and cases with co-reported hyperprolactinemia. Sexual ADRs for all antipsychotics were classified as of moderate priority, with the exception of fluspirilene (low priority).

CONCLUSIONS: Notwithstanding limitations, including inability to infer causality, these findings raise the hypothesis that sexual ADRs could be a class effect of antipsychotics, yet possibly reversible, in both women and men.

REGISTRATION: The protocol is registered to the Open Science Framework: https://osf.io/96eq7 .

PMID:41979819 | DOI:10.1007/s40264-026-01673-7

Psychon Bull Rev. 2026 Apr 14;33(4):137. doi: 10.3758/s13423-026-02875-x.

ABSTRACT

Novel strings of letters (i.e., pseudowords) lack established meaning(s), yet they may still evoke systematic, distributional signals that influence human behavior. Here, we tested whether distributional determinants of word memorability generalize to these novel strings. To do so, we leveraged a word-embedding model that was able to represent in a vector space not only attested words but also unmapped strings as bags of character n-grams. A ridge model trained on item-level word memorability norms learned a linear mapping from 300-dimensional embeddings to recognition memorability and achieved strong out-of-fold performance. We then applied this model zero-shot to predict memorability for 2,100 phonotactically legal pseudowords, whose baseline predictability was captured by orthographic and frequency features. Adding the zero-shot distributional score significantly improved the baseline model. These findings show that distributional representations derived from subword statistics carry mnemonic information that is not reducible to orthographic familiarity, and that novel strings are interpreted within a shared representational space learned from language experience. More broadly, they support the view that memorability is an intrinsic attribute predictable from representational information, even in the absence of learned meanings.

PMID:41979777 | DOI:10.3758/s13423-026-02875-x

Arch Osteoporos. 2026 Apr 14;21(1):67. doi: 10.1007/s11657-026-01699-5.

ABSTRACT

PURPOSE: This study aimed to reevaluate a simple radiographic measurement, the cortical thickness index (CTI), using standard plain radiographs to investigate its association with the presence of hip fracture in older persons.

METHODS: The study group (SG) consisted of 46 patients (35 females, 11 males) aged 65 years and older who presented to the emergency department with hip fractures. Two control groups were formed: One comprising 46 older persons aged 65 years and older (CG-G) and another of young adults aged 20-30 (CG-YA), both referred to the outpatient clinic and had available plain hip radiographs. CTI was measured for all participants by the first author. Additionally, two observers independently measured CTI to assess intraobserver and interobserver agreement.

RESULTS: Intraobserver and interobserver agreement was almost perfect based on Cohen’s kappa classification ( $\kappa$ > 0.8). The mean CTI for the SG was 0.389 ± 0.05, while the mean CTI for the CG-G was 0.571 ± 0.048, and for the CG-YA was 0.585 ± 0.048. A statistically significant difference was found between the SG and both CG-G and CG-YA groups (p < 0.001). No significant difference was observed between CG-G and CG-YA (p > 0.05). A CTI threshold of 0.485 demonstrated high discriminative ability for distinguishing older persons with hip fracture from those without fracture, yielding a sensitivity of 97.83% and a specificity of 95.65%.

CONCLUSION: CTI is significantly reduced in older persons with hip fracture. As a quick and accessible measurement on standard radiographs, CTI may assist clinicians in distinguishing individuals with hip fracture from those without fracture in outpatient settings.

PMID:41979765 | DOI:10.1007/s11657-026-01699-5

Appl Biochem Biotechnol. 2026 Apr 14. doi: 10.1007/s12010-026-05688-9. Online ahead of print.

ABSTRACT

Marine-derived endophytic fungi have long been recognised as valuable sources of therapeutic metabolites. In the present study, the endophyte Penicillium rubens strain PrubVJ was studied for optimised production of bioactive compounds using Response Surface Methodology (RSM). Experimental data predicted that incubation time was identified as the most influential variable, with maximum protein yield (190 mg/L) observed at day 20, antioxidant activity (74%) at 10-15 days and total phenolics (1,724 ± 19 µg GAE g⁻¹ DW) at day 25. The optimal fermentation conditions (25 °C, pH 3.6, 4 g/L salinity, 10 days incubation) with a desirability of 0.92, yielding 158 ± 1.325 mg/L protein, 1,798 ± 18 µg GAE g⁻¹ DW phenolics, and 84.9% antioxidant activity were predicted from the RSM model. Experimental validation under these conditions achieved protein yield of 190 mg/L, phenolics of 1,724 µg GAE g⁻¹ DW, and 74% antioxidant activity, confirming the reliability and robustness of the model. The developed quadratic models exhibited strong statistical reliability with stochastic parameters such as F-value and p-value, and coefficients of determination (R², adjusted R² and predicted R²) above 80% for all responses, validating model adequacy. Collectively, these findings establish P. rubens strain PrubVJ as a promising microbial platform, providing a reliable framework for optimising fungal fermentation. This study recommends the optimized strategy for large-scale pharmaceutical bioprocessing of fungal metabolites, to reduce production costs and accelerate the discovery of novel bioactive metabolites with pharmaceutical relevance, particularly for anticancer, antimicrobial, and antioxidant applications.

PMID:41979742 | DOI:10.1007/s12010-026-05688-9

J Gen Intern Med. 2026 Apr 14. doi: 10.1007/s11606-026-10392-9. Online ahead of print.

ABSTRACT

PURPOSE: International medical graduates (IMGs) and Puerto Rican medical graduates (PRMGs) are integral to the United States (U.S.) physician workforce yet face unique immigration-related and professional challenges. We conducted a study to investigate reasons for migration, perceived barriers, discrimination, satisfaction, and factors influencing IMGs’ and PRMGs’ decisions to remain in the U.S. versus return to their home countries.

METHODS: We conducted a cross-sectional, online survey of foreign-born physicians who obtained their medical degrees outside the continental United States and were currently training or practicing in the U.S. The survey captured demographic and professional characteristics, migration history, cultural adaptation, discrimination, and overall professional experiences. Descriptive statistics summarized responses. Among physicians who completed training and were practicing independently in the U.S., we compared overall experience ratings and discrimination-related distress between the training and independent practice phases using the Wilcoxon signed-rank test and McNemar’s test.

RESULTS: Of 352 respondents, most were IMGs (82.1%) and 16.8% were PRMGs. Nearly half reported racial and/or ethnic discrimination (49.6%) and language discrimination (37.8%) during training. In paired analyses among those currently in independent practice, overall experience ratings shifted from the training to independent practice phase, with “excellent” ratings more common during training than independent practice. Among participants who experienced language discrimination in both phases, distress levels decreased over time. Despite high rates of discrimination and pressure to assimilate, most participants reported excellent (63.6%) or good (52.9%) overall experiences during training and practice, respectively. Only 9.3% had returned to their home country, most of whom reported extreme happiness after returning.

CONCLUSION: High rates of racial, ethnic, gender, and language discrimination, along with pressures to assimilate, characterize IMGs’ and PRMGs’ journeys in the U.S. healthcare system. Nevertheless, most report high professional satisfaction. Interventions are needed to address discrimination, support cultural identity, and promote sustainable careers for this essential segment of the U.S. workforce.

PMID:41979730 | DOI:10.1007/s11606-026-10392-9

J Gen Intern Med. 2026 Apr 14. doi: 10.1007/s11606-026-10390-x. Online ahead of print.

ABSTRACT

BACKGROUND: Food insecurity (FI) is a driver of chronic disease. Produce prescription (PRx) interventions pair access to produce with education, but evidence among Medicaid-insured adults remains limited.

OBJECTIVE: Evaluate the impact of PRx on FI, fruit and vegetable (FV) intake, and psychosocial and clinical outcomes among adults with chronic conditions.

DESIGN: Prospective, non-randomized cohort study with a matched comparison group.

PARTICIPANTS: A total of 125 Medicaid-insured, food-insecure adults with chronic metabolic conditions were enrolled in the intervention cohort and 92 matched to the Supplemental Nutrition Assistance Program (SNAP)-only cohort.

INTERVENTION: Weekly home-delivered produce, registered dietitian-led coaching, and education over 12 months.

MAIN MEASURES: FI (USDA 10-item Food Security Survey Module), FV intake (National Cancer Institute screener), depression (PHQ-9), loneliness (UCLA 3-item), fatigue (FACIT-F), healthcare utilization and costs, and blood pressure (BP). For the comparison cohort, some measures were obtained for 6 months of follow-up.

KEY RESULTS: At 6 months, based on between-group differences, PRx was associated with greater improvements in FV intake (difference in change: + 0.3 vs. + 0.03 cups/day, p = 0.002) and greater reductions in loneliness (difference in change: -0.6 points, p = 0.022). Between-group differences for FI (-8.2 percentage points, p = 0.26) and moderate-to-severe depression (-10.8 percentage points, p = 0.07) favored PRx but were not statistically significant. At 12 months, no significant between-group differences in healthcare utilization and costs were observed. Among the 105 (84%) intervention participants who completed 12-month follow-up, between the pre- and post-intervention periods, FI declined by 17.1% (p = 0.003), FV intake increased by 0.4 cups/day (p < 0.001), fatigue improved by 3.1 points (p = 0.019), and among participants with elevated baseline BP (n = 73), systolic BP decreased by 8.6 mmHg (p = 0.003).

DISCUSSION: In this study, PRx was associated with improved diet quality and loneliness compared with a SNAP-only comparison. Within-group analyses demonstrated improvements across dietary, psychosocial, and BP outcomes, supporting further evaluation using randomized or comparative designs.

PMID:41979725 | DOI:10.1007/s11606-026-10390-x

Atten Percept Psychophys. 2026 Apr 14;88(4):106. doi: 10.3758/s13414-026-03249-0.

ABSTRACT

The relationship between time perception and brightness perception remains poorly understood. Here we present a computational account linking the two domains, grounded in established principles of neural information processing in visual cortex. A nonlinear transducer maps luminance to population spike rate, while correlated gain fluctuations impose an upper bound on achievable signal-to-noise ratios. Perceptual magnitudes in both domains are decoded from the same spike-count statistics, yielding a reciprocal trade-off in perceptual resolution: brighter stimuli improve temporal precision but impair brightness sensitivity, whereas longer stimuli enhance brightness sensitivity but degrade temporal resolution. We tested this conjectured trade-off in two psychophysical experiments manipulating stimulus duration and luminance. Model predictions closely matched the behavioral data, revealing a fundamental coding limit in vision: the time-intensity uncertainty principle. This limit provides a unified explanation for near-miss relations to Weber’s law for time perception and intensity perception, Bloch-like temporal summation effects governing brightness discrimination sensitivity, and luminance-dependent shifts in duration discrimination sensitivity.

PMID:41979719 | DOI:10.3758/s13414-026-03249-0

Ann Hematol. 2026 Apr 14;105(5):245. doi: 10.1007/s00277-026-06979-1.

NO ABSTRACT

PMID:41979693 | DOI:10.1007/s00277-026-06979-1