Tag: pubmed

JMIR Cancer. 2026 Jan 15;12:e78968. doi: 10.2196/78968.

ABSTRACT

BACKGROUND: Cancer survivors face significant challenges in maintaining adequate physical activity levels, which are essential for overall health and quality of life. Telehealth-based interventions offer promising opportunities to provide accessible support and promote healthier lifestyles throughout the cancer survivorship continuum. HealthScore is a telehealth coaching program designed to optimize the health of cancer survivors.

OBJECTIVE: This study assessed the effectiveness of HealthScore in improving physical activity metrics among cancer survivors compared to controls. We also evaluated participants’ qualitative experiences with the program to understand its impact on motivation, accountability, and overall health-related quality of life.

METHODS: We performed a secondary analysis of a randomized controlled study of cancer survivors who participated in a comprehensive health coaching intervention called HealthScore. Participants in control and intervention groups received a Fitbit activity tracker that collected heart rate, step counts, active minutes, and calories burned. These metrics were analyzed using statistical methods to compare overall averages and temporal trends between intervention and control groups. Eleven exit interviews were conducted with intervention arm participants to ascertain their experiences with HealthScore. Inductive thematic analysis was performed to identify emerging themes. Data were collected between May 2020 and March 2022.

RESULTS: Of the 32 participants enrolled, 20 (62%) were in the intervention group. Compared to the control group, intervention participants had significantly higher average daily steps (mean 3660, SD 3344; 95% CI 3557-3764 vs mean 3408, SD 3288; 95% CI 3299-3518; P=.001) and more moving average daily steps (mean 4813, SD 1723; 95% CI 4680-4946 vs mean 4581, SD 1224; 95% CI 4494-4669; P=.003). Moving average daily step counts in the intervention arm showed an increasing trend, which was significantly higher than that of the control group (regression slope=5.89 vs 2.80; P<.001). Compared to the control group, the intervention participants had significantly higher average daily walking distance (mean 2.6, SD 2.5; 95% CI 2.5-2.7 vs mean 2.4, SD 2.3; 95% CI 2.3-2.5; P<.001) and more moving average daily walking distance (mean 3.5, SD 1.3; 95% CI 3.4-3.6 vs mean 3.2, SD 0.8; 95% CI 3.1-3.3; P<.001). Moving average daily walking distances among intervention participants increased, which was also significantly higher than that of the control group (regression slope=0.0046 vs 0.0017; P<.001). Participants in the intervention group reported a growing sense of accountability and motivation. One barrier was completing weekly monitoring of patient-reported outcome surveys, which focused on symptoms and physical function and did not always align with participants’ goals.

CONCLUSIONS: The HealthScore telehealth coaching program improved physical activity levels among cancer survivors and enhanced motivation and accountability. These findings support the integration of telehealth-based health coaching into posttreatment care, promoting healthier lifestyles and improved quality of life for cancer survivors.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04923997; https://clinicaltrials.gov/study/NCT04923997.

PMID:41538790 | DOI:10.2196/78968

JMIR Form Res. 2026 Jan 15;10:e68698. doi: 10.2196/68698.

ABSTRACT

BACKGROUND: University students show a high prevalence of diverse mental health problems, requiring adaptable interventions to assist them in improving their mental health.

OBJECTIVE: This study aimed to evaluate the feasibility of transdiagnostic internet-delivered cognitive behavioral therapy (ICBT) for anxiety and depression in preparation for a randomized controlled trial. ICBT incorporated 2 innovative approaches to increase precision: user-steered content personalization and within-treatment adaptive modification based on early symptom trajectory.

METHODS: This single-group, open-label study was conducted online in Sweden in the autumn of 2021, recruiting from students who had completed the World Health Organization (WHO) World Mental Health International College Student (WMH-ICS) mental health survey. Participants were eligible if they scored 5-19 on the Patient Health Questionnaire-9 (PHQ-9), or ≥5 on the Generalized Anxiety Disorder-7 (GAD-7), or both. Participants completed an 8-week ICBT program with therapist support. They initially personalized their program by selecting a primary problem orientation, anxiety or depression, and choosing additional elective modules, and could consult their therapist regarding these choices. At midtreatment, stepped care was piloted, in which participants without symptom improvement were randomized to adaptive enhancement of therapist support or to continue treatment as before. The main feasibility outcomes included data on reach and uptake, intervention acceptability, stepped care procedures, and assessment retention up to 6 months. The GAD-7 and PHQ-9 were the primary outcome measures, with changes in scores calculated using mixed effects models.

RESULTS: Of 749 invited students, 55 (7%) completed the study screening, and 28 (4%) were included. The GAD-7 baseline score was 9.5 (SD 4.4), and the PHQ-9 baseline score was 11.2 (SD 5.2). Participants opened 6.2 (SD 2.2) out of the 8 treatment modules. The user-directed personalization yielded 27 unique treatment configurations across 28 participants. At week 4, 16/27 (59%) participants remaining in treatment were randomized in the stepped care procedure. Ratings on self-report measures showed acceptable to good therapeutic alliance and treatment satisfaction. Eleven participants reported increased stress associated with the treatment. Reductions in depression and anxiety symptoms were observed at postmeasurement and 6 months follow-up, with 43% attrition at those times.

CONCLUSIONS: This pioneering study of personalized ICBT with adaptive change among university students demonstrated the overall feasibility of the treatment. To enhance the design of a future definitive trial, modifications are necessary to mitigate assessment attrition and reduce treatment-related stress.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05509660; https://clinicaltrials.gov/study/NCT05509660.

PMID:41538789 | DOI:10.2196/68698

Ann Plast Surg. 2026 Jan 16. doi: 10.1097/SAP.0000000000004627. Online ahead of print.

ABSTRACT

BACKGROUND: High-voltage electrical burns of the extremities often result in deep tissue destruction with exposure of vital structures, necessitating free flap reconstruction. However, the optimal timing for reconstruction remains uncertain, particularly in the presence of evolving tissue viability.

METHODS: This retrospective study included 23 patients with full-thickness high-voltage electrical burns involving the extremities who underwent free flap reconstruction. Patients were divided into two groups based on timing of flap coverage: early (<21 days) and delayed (>21 days, after at least 2 debridements). Outcomes assessed included flap survival, complications, reexploration rate, operative time, and hospital stay.

RESULTS: The cohort was predominantly male (male-to-female ratio of 10:1) with an age range of 15 to 60 years. The upper limb was involved in 16 patients; and the lower limb, in 7. The overall flap survival rate was 87% (20/23). Flap failure occurred in 1 of 6 early cases and 2 of 17 delayed cases (P = 1.00). Complications were more common in the early group (66.7%) compared to the delayed group (47.1%) but were not statistically significant (P = 0.34). Four flaps required reexploration, with one successfully salvaged. Operative time and hospital stay were slightly longer in the delayed group but did not reach statistical significance.

CONCLUSION: Free flap reconstruction remains a reliable option for limb salvage in high-voltage electrical burns. A biologically timed approach-delaying reconstruction until tissue demarcation and vascular stability-may minimize complications while maintaining high flap survival rates.

PMID:41538784 | DOI:10.1097/SAP.0000000000004627

J Comput Chem. 2026 Jan 15;47(2):e70308. doi: 10.1002/jcc.70308.

ABSTRACT

Large language models (LLMs) demonstrate strong performance in natural language tasks, but their capacity for genuine in-context learning (ICL) in scientific regression remains unclear. We systematically assessed seven LLMs on molecular property prediction using a controlled framework of 56 transformed tasks that isolate shortcut learning and are designed to induce functional out-of-distribution (OOD) behavior. LLMs performed nearly perfectly on raw molecular weight prediction via shortcut cues but deteriorated under nonlinear transformations, whereas machine learning (ML) baselines showed greater robustness, yielding a performance crossover. Meta-analysis revealed that distributional descriptors and structure-activity landscape indices (SALI) predict task favorability, providing a framework for selecting between LLM- and ML-based approaches in chemistry.

PMID:41538780 | DOI:10.1002/jcc.70308

J Invasive Cardiol. 2026 Jan 8. doi: 10.25270/jic/25.00171. Online ahead of print.

ABSTRACT

OBJECTIVES: Transfemoral (TF) access for transcatheter aortic valve replacement (TAVR) may be challenging in patients with peripheral arterial disease (PAD). Alternative access through intra- and extrathoracic approaches can be performed. Recently, a facilitated TF access strategy, which involves the use of intravascular lithotripsy to optimize the iliofemoral arteries prior to TAVR, has been utilized. The aim of this study was to evaluate early outcomes of facilitated TF access compared to alternative access in patients with severe PAD.

METHODS: Patients with severe PAD who underwent TAVR from 2021 to 2023 were included in the study and were divided into 2 groups: facilitated and alternative access. The primary endpoint was a composite of mortality, stroke, and vascular complications. Mortality was evaluated in-hospital and at 1-month follow-up.

RESULTS: Of 150 TAVR patients with severe PAD, 24 underwent facilitated access. Baseline characteristics including age, Society of Thoracic Surgeons score, and mean gradients were similar between the 2 groups. The most common alternative access was transsubclavian, followed by transcarotid. Primary outcomes were numerically higher in the alternative access group (14% vs 8%); however, this did not reach statistical significance (P = .49). General anesthesia use and postoperative length of stay were higher in the alternative access group. Postoperative and 1-month mortalities were similar between the 2 groups.

CONCLUSIONS: Although the primary endpoint did not reach statistical significance, the numerical trend toward better outcomes in the facilitated TAVR group indicates a potential advantage. Large-scale prospective studies are required to determine the appropriate access strategy for TAVR in patients with severe PAD.

PMID:41538775 | DOI:10.25270/jic/25.00171

Dermatol Surg. 2026 Jan 14. doi: 10.1097/DSS.0000000000004987. Online ahead of print.

ABSTRACT

BACKGROUND: Patient satisfaction with Mohs micrographic surgery is dependent on multiple clinical and surgical factors. This study implements a novel survey to assess patient satisfaction in multiple domains.

OBJECTIVE: (1) To assess whether satisfaction changes over time and (2) to evaluate predictors of patient satisfaction in multiple satisfaction domains.

MATERIALS AND METHODS: The Oxford Skin Cancer Treatment Scale (OxSCanTr) assesses patient satisfaction with scar aesthetics, treatment choice, surgical experience, and postoperative concerns. Surveys were completed immediately after surgery and at 1 week and 4 weeks postoperatively. Clinical and demographic data were collected. Statistical analysis included repeated-measures analysis of variance, univariate, and multivariate repeated-measures linear regression.

RESULTS: Satisfaction does not vary significantly over time. Diabetes, immunosuppression, and linear closure methods are associated with higher total satisfaction. Linear closure method predicts higher total, aesthetic outcome, and treatment experience satisfaction. Patient age, number of Mohs stages, noncutaneous cancer history, tumor location, skin cancer history, postoperative defect size, and absorbable top sutures predict patient satisfaction in at least one domain.

CONCLUSION: This study increases awareness of the clinical and surgical factors that contribute to patient satisfaction with Mohs procedures, which can help to advance patient-centered care.

PMID:41538767 | DOI:10.1097/DSS.0000000000004987

JCO Glob Oncol. 2026 Jan;12:e2500182. doi: 10.1200/GO-25-00182. Epub 2026 Jan 15.

ABSTRACT

PURPOSE: Treatment completion (TC), defined by completing the recommended treatment regimen, and treatment adherence (TA), defined by completing the prescribed treatment in the expected time frame, are critical for improving breast cancer (BC) mortality. Therefore, we conducted this study to measure TC and TA in Tanzania.

METHODS: BC treatment data from 2019 to 2020 at Ocean Road Cancer Institute (ORCI) were collected. Demographic, socioeconomic, and clinical profiles were identified. TC and TA were measured by comparing chemotherapy and radiotherapy prescribed regimens to received treatment.

RESULTS: Overall, 813 patients were seen at ORCI between 2019 and 2020. Mean age of patients was 51 ± 12.5 years; 97.9% identified as female; and 67.6% resided outside of Dar es Salaam. Stage III/IV disease was identified in 43.8% patients, with 24.1% showing clinical evidence of metastasis on arrival. TC across treatments ranged between 46.8% and 47.4%, while overall TA was 21.2%. TC was associated with not having metastasis on arrival (P = .01) and residing in proximity to ORCI (P = .04). TA was associated with having insurance (P < .0001) and attending a follow-up appointment after treatment (P < .0001).

CONCLUSION: Poor TC and TA rates in Tanzania pose a significant risk to treatment efficacy. Interventions are needed to specifically target patients with advanced-stage disease and greater geographic distance to treatment to increase treatment compliance.

PMID:41538753 | DOI:10.1200/GO-25-00182

J Clin Oncol. 2026 Jan 15:JCO2500826. doi: 10.1200/JCO-25-00826. Online ahead of print.

ABSTRACT

PURPOSE: First-line treatment options for cisplatin-ineligible patients with metastatic urothelial cancer (mUC) are limited. We conducted a phase II study of erdafitinib, alone or with cetrelimab, in FGFR-altered mUC.

METHODS: Adults with mUC and select FGFR alterations who are ineligible for cisplatin were randomly assigned 1:1 in a noncomparative design to once-daily erdafitinib 8 mg (with pharmacodynamically guided uptitration to 9 mg) or erdafitinib 8 mg plus intravenous cetrelimab 240 mg once every 2 weeks at cycles 1-4 and 480 mg once every 4 weeks thereafter. Primary end points were investigator-assessed confirmed overall response rate (ORR) and safety; secondary end points included duration of response (DOR), progression-free survival, and overall survival (OS). No statistical hypotheses were tested.

RESULTS: At data cutoff, 87 patients were randomly assigned and treated (erdafitinib, n = 43; erdafitinib plus cetrelimab, n = 44). Of 64 patients with PD-L1 expression data, 56 (87.5%) had low levels of PD-L1 expression (combined positive score <10). Median survival follow-up was 14.2 months. Investigator-assessed confirmed ORR for erdafitinib was 44.2% (95% CI, 29.1 to 60.1) with one complete response (CR); median DOR and median OS were 9.7 months (95% CI, 4.6 to not estimable [NE]) and 16.2 months (95% CI, 8.3 to NE), respectively. Investigator-assessed confirmed ORR for erdafitinib plus cetrelimab was 54.5% (95% CI, 38.8 to 69.6), with six (13.6%) CRs; median DOR and median OS were 11.1 months (95% CI, 8.8 to NE) and 20.8 months (95% CI, 12.0 to NE), respectively. The most frequent treatment-related adverse events (TRAEs) were hyperphosphatemia (83.7% and 68.2% in erdafitinib and erdafitinib plus cetrelimab groups, respectively), stomatitis (69.8% and 56.8%), and dry mouth (37.2% and 56.8%). Grade ≥3 TRAEs occurred in 46.5% and 45.5% of patients receiving erdafitinib and erdafitinib plus cetrelimab, respectively.

CONCLUSION: First-line erdafitinib monotherapy and erdafitinib plus cetrelimab demonstrated antitumor activity and a manageable safety profile in cisplatin-ineligible patients with mUC.

PMID:41538748 | DOI:10.1200/JCO-25-00826

J Clin Oncol. 2026 Jan 15:JCO2501660. doi: 10.1200/JCO-25-01660. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the clinical benefit of extended endocrine therapy (eET) after 5 years of adjuvant treatment with luteinizing hormone-releasing hormone agonists (LHRHa) in premenopausal women with node-positive, hormone receptor-positive early breast cancer (eBC).

METHODS: We conducted a cohort study analysis on two prospectively collected data sets (the Young Women’s Breast Cancer Study and IEO Breast Cancer Cohort). Eligible patients were diagnosed with eBC at age ≤40 years (between 2005 and 2016), had node-positive, hormone receptor-positive disease, and remained premenopausal after 5 years of adjuvant LHRHa with no evidence of recurrence. The primary end point was invasive breast cancer-free survival (IBCFS), calculated from the sixth year after the initiation of adjuvant endocrine therapy (ET; study baseline), and adjusted through the propensity score (PS) weighting analysis.

RESULTS: A total of 501 patients were included in the analysis: 287 received eET for a median duration of 3.7 years (IQR, 2.3-5.0), including 48% tamoxifen monotherapy and 52% LHRHa plus tamoxifen or aromatase inhibitor. After a median follow-up of 7.3 years from the study baseline, the PS weighted IBCFS rates at 5 years were 85% in the eET group and 78% in the non-eET group (hazard ratio [HR], 0.63 [95% CI, 0.44 to 0.89]; P = .0135). The PS weighted distant recurrence-free survival rates at 5 years were 91% and 83% in the eET and non-eET group, respectively (cause-specific HR, 0.49 [95% CI, 0.31 to 0.79]). In both groups, bone fractures and major cardiovascular events were reported in 1% of patients.

CONCLUSION: In this cohort study analysis, extending ET in premenopausal patients with node-positive eBC after 5 years of LHRHa treatment was associated with a clinically meaningful reduction in both invasive and distant breast cancer recurrences.

PMID:41538747 | DOI:10.1200/JCO-25-01660

Cad Saude Publica. 2026 Jan 9;41(12):e00012225. doi: 10.1590/0102-311XPT012225. eCollection 2026.

ABSTRACT

The aim of the present study was to assess generational differences in food consumption among Brazilian adults born between 1928 and 1988. Data from the 2008-2009 (n = 25,324) and 2017-2018 (n = 36,480) Brazilian National Dietary Surveys were analyzed. Foods were classified according to the degree of processing using the NOVA classification. Differences in consumption between generations were assessed by comparing individuals in the same age group in each survey. To assess the effect of income on the consumption of ultra-processed foods, a linear regression model was developed for each income quartile. A reduction in total calorie intake was found in younger generations in both sexes and all age groups. In 2017-2018, younger generations (20 to 39 years of age) with lower income levels consumed a greater frequency of ultra-processed foods compared to older generations. The percentage contribution of each NOVA classification group to total caloric intake was similar across generations. The analyses demonstrated generational differences in food consumption among Brazilian adults born between 1928 and 1988. Among individuals 20 to 39 years of age, those belonging to younger generations had a greater consumption of ultra-processed foods compared to older generations, but only among lower income groups.

PMID:41538696 | DOI:10.1590/0102-311XPT012225