Tag: pubmed

Biomed Rep. 2026 Apr 17;24(6):73. doi: 10.3892/br.2026.2146. eCollection 2026 Jun.

ABSTRACT

Sedation is a critical component of modern anesthesia and procedural medicine, particularly outside the operating room. Dexmedetomidine and remimazolam have emerged as prominent sedatives due to their unique pharmacological profiles. However, the comparative efficacy and safety of these agents remain incompletely understood, especially regarding recovery times and adverse events. In the present study, a systematic review and meta-analysis as performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted across PubMed, Cochrane Library and Scopus from inception until March 2025. The eligible studies compared the sedation efficacy, safety and recovery time of the dexmedetomidine group with the remimazolam group. Data extraction was independently conducted by two reviewers using a standardized data collection form. The methodological quality of observational studies was assessed using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool, while randomized controlled trials (RCTs) were evaluated using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool. Meta-analyses were conducted using random-effects models, and heterogeneity was evaluated through prediction interval analysis and sensitivity testing. A total of 9 studies were included, 4 of which were RCTs and judged to have low risk of bias across all domains. The remaining 5 observational studies, with most rated as having moderate risk of bias and 1 study rated as serious due to confounding and outcome measurement concerns. The forest plot analysis revealed that there was no statistically significant difference in the sedation efficacy between the dexmedetomidine group and the remimazolam group [standardized mean difference (SMD), 0.049; 95% confidence interval (CI), -0.101 to 0.198; P=0.523]. However, the remimazolam group consistently demonstrated significantly shorter full alertness times compared with the exmedetomidine group (SMDs ranging from -0.511 to -1.852, all P<0.001). There was no significant difference in the overall risk of adverse events between the two groups [odds ratio (OR), 1.509; 95% CI, 0.246-9.153; P=0.654]; however, the subgroup analysis showed that the risk of arrhythmia in the dexmedetomidine group was significantly higher than that in the remimazolam group (OR, 2.152; 95% CI, 1.158-3.999; P=0.015). In conclusion, both dexmedetomidine and remimazolam achieved similar sedation success rates, indicating no significant difference in procedural efficacy. However, remimazolam was associated with significantly faster recovery times and a lower risk of arrhythmia, making it particularly attractive for short-duration or outpatient procedures where rapid emergence and hemodynamic stability are prioritized.

PMID:42125761 | PMC:PMC13159053 | DOI:10.3892/br.2026.2146

Laryngoscope Investig Otolaryngol. 2026 May 11;11:e70434. doi: 10.1002/lio2.70434. eCollection 2026 Jun.

ABSTRACT

OBJECTIVES: Transoral robotic surgery (TORS) and transoral videolaryngoscopic surgery (TOVS) have been increasingly adopted for the treatment of head and neck tumors. However, their effectiveness and the differences in their effects on postoperative quality of life (QOL) have not been established. We aimed to evaluate and compare the postoperative QOL of patients who underwent TORS and TOVS.

METHODS: This study included 103 patients with head and neck tumors treated with TOVS (83 patients) and TORS (20 patients) between 2016 and 2024. QOL was assessed preoperatively and 1, 3, 6, 12, and 18 months postoperatively using QOL questionnaires (EORTC QLQ-C30 and QLQ-H&N35).

RESULTS: Pain and mouth opening limitation were significantly worse at 1 month postoperatively than preoperatively for the TOVS and TORS groups. However, when comparing both groups, no statistically significant difference was observed in postoperative QOL symptom scores, including pain and mouth opening limitation. Multivariate analysis revealed that pain was associated with neck dissection, and mouth opening limitation was associated with neck dissection and oropharyngeal cancer.

CONCLUSION: Postoperative QOL after TORS and TOVS was associated with pain and mouth opening limitation. However, no statistically significant difference in postoperative QOL was observed between TOVS and TORS.

LEVEL OF EVIDENCE: 3.

PMID:42125760 | PMC:PMC13160656 | DOI:10.1002/lio2.70434

Resusc Plus. 2026 Apr 22;29:101341. doi: 10.1016/j.resplu.2026.101341. eCollection 2026 May.

ABSTRACT

BACKGROUND: Cardiac arrest is a leading cause of death; timely intervention with basic life support (BLS) is crucial for healthcare providers, including dentists. This study aimed to assess awareness, educational level, and knowledge regarding the application of BLS and the use of an automated external defibrillator (AED) among dentists in Greece.

METHODS: A cross-sectional survey using an online questionnaire was conducted to collect demographic data, knowledge of BLS/Advanced Life Support (ALS), and experience in managing medical emergencies in dental practices. The results were statistically analysed, with the level of significance set at P < 0.05.

RESULTS: Overall, the national response rate among Greek dentists was 2.5%. A total of 354 dentists across Greece participated in the study. Attendance at CPR/AED courses was recorded for 67.5% of participants, while 29.4% reported holding active certification. A small proportion of the surveyed dentists had an AED in their dental practices (8.5%), and 47.4% did not possess a self-injectable adrenaline. Syncope was the most common medical emergency during dental procedures (50.3%). Dentists who attended BLS training sessions demonstrated more appropriate practice in managing medical emergencies (P < 0.05).

CONCLUSIONS: Continuous training and ongoing professional development for dentists are essential for effectively handling medical emergencies. This study promotes a more proactive approach to enhancing competency in emergency care and the appropriate management of medical emergencies in dental practices.

PMID:42125740 | PMC:PMC13158416 | DOI:10.1016/j.resplu.2026.101341

Biomed Eng Comput Biol. 2026 May 4;17:11795972261438666. doi: 10.1177/11795972261438666. eCollection 2026.

ABSTRACT

In biomedical and engineering research, entropy metrics have become well-established tools for assessing the complexity of dynamic and physiological systems. This scoping review examines the relationship between information theory quantifiers (ITQs), bioelectrical signals, and time series, and the limited diagnostic value of these measures in functional dyspepsia (FD). Three main variables were defined in this study: entropy, health experiments, and FD. Eighty-five academic documents were analyzed using the PRISMA methodology, following 4 phases: (i) heuristic; (ii) classification and systematic review; (iii) hermeneutic analysis; and (iv) presentation of results. ITQs are currently applied in the study of neurodegenerative diseases, cardiological conditions, and, to a lesser extent, gastric disorders, thereby opening new avenues for diagnosis and comprehensive clinical management. The review of the documents shows that, despite the methodological robustness, statistical testing, classification approaches, and the breadth of entropy measures employed, significant challenges remain when integrating these techniques due to the intrinsic complexity and heterogeneity of bioelectrical signals in FD. Furthermore, knowledge gaps persist, particularly in digestive disorders such as FD, underscoring the need to deepen and diversify analytical methodologies.

PMID:42125732 | PMC:PMC13158506 | DOI:10.1177/11795972261438666

Front Psychol. 2026 Apr 24;17:1752831. doi: 10.3389/fpsyg.2026.1752831. eCollection 2026.

ABSTRACT

Vocal performance anxiety is a common psychological barrier among vocal students, severely impacts their skill development, stage performance, and overall wellbeing. This study aims to comprehensively evaluate the short-term and long-term effects of an integrated pedagogical model for anxiety management, constructed based on music psychology theories, through a mixed-methods study with a pre-test, post-test, and 3 month follow-up. We recruited 60 undergraduate vocal performance majors and randomly assigned them to an experimental group (receiving a 12-week “Awareness-Skill-Simulation-Reflection” four-stage integrated pedagogical intervention) and a control group (receiving traditional technical instruction). We collected data on students’ state anxiety in performance, vocal performance quality (expert blind ratings), psychological resilience, self-efficacy, and Heart Rate Variability (HRV) at three time points: pre-intervention (T1), post-intervention (T2), and 3 months post-intervention (T3). Additionally, reflective journals from the experimental group were subjected to qualitative analysis. Quantitative findings indicate: (1) Compared to the control group, the integrated intervention significantly reduced the experimental group’s vocal performance anxiety and enhanced their performance quality, psychological resilience, and HRV levels. These positive effects remained stable 3 months after the intervention concluded. (2) The intervention’s effectiveness was moderated by students’ initial trait anxiety levels, meaning the intervention was more potent for students with high trait anxiety. (3) Psychological resilience was identified as a potential statistical mediator of the relationship between the pedagogical intervention and the reduction in anxiety levels. Qualitative results revealed profound subjective experiences among students across four dimensions: “Shifting Mindsets,” “Enhanced Bodily Control,” “Reconstructing the Stage Experience,” and “Trust in Teacher-Student Relationship.” This study provides evidence for the effectiveness and durability of this integrated pedagogical model and explores its potential mechanisms, offering a scientific reference for modern vocal education reform.

PMID:42125720 | PMC:PMC13159198 | DOI:10.3389/fpsyg.2026.1752831

Front Oncol. 2026 Apr 27;16:1750773. doi: 10.3389/fonc.2026.1750773. eCollection 2026.

ABSTRACT

BACKGROUND: Distinguishing pulmonary cryptococcosis (PC) from lung adenocarcinoma (LAC) remains clinically challenging in practice. The purpose of this study was to investigate the utility of intranodular and perinodular radiomics features derived from non-contrast CT in differentiating PC from LAC.

MATERIALS AND METHODS: A total of 244 patients with PC and LAC from two centers were randomly divided into a training set and a testing set at a ratio of 7:3. Logistic regression analysis was used to establish the clinical model. Radiomics features were extracted from the lesions and lesion margins of 10 mm. Support vector machine (SVM) was used to construct the intranodular, perinodular, and combined radiomics models. The areas under the receiver operating characteristic curve (AUCs) and decision curve analysis (DCA) were employed to assess the diagnostic performance, while the DeLong test was applied for model comparisons.

RESULTS: The three radiomics models exhibited excellent diagnostic performance for identifying PC and LAC, with the combined radiomics model achieving the highest AUC value in both the training (AUC = 0.936, sensitivity = 0.838, specificity = 0.898, accuracy = 0.859) and testing sets (AUC = 0.922, sensitivity = 0.854, specificity = 0.808, accuracy = 0.892). In the testing set, the AUC of the combined radiomics model was significantly higher than that of the clinical model (p = 0.005), while no statistically significant difference was found when compared with the intranodular or the perinodular model (p > 0.05). The combined model outperformed the other three models according to the DCA in terms of net benefit.

CONCLUSION: A combined radiomics model integrating intranodular and perinodular features can effectively improve diagnostic accuracy in differentiating PC from LAC.

PMID:42125701 | PMC:PMC13158070 | DOI:10.3389/fonc.2026.1750773

Front Oncol. 2026 Apr 27;16:1813333. doi: 10.3389/fonc.2026.1813333. eCollection 2026.

ABSTRACT

CPX-351 for the treatment of acute myeloid leukemia (AML) has demonstrated better efficacy compared with standard chemotherapy regimens, with an excellent safety profile. We aimed to assess the determinants of response, relapse, and survival in patients treated with CPX-351 as the first-line therapy for AML. In this retrospective monocentric study, we analyzed 60 consecutive patients treated with CPX-351 for therapy-related AML or AML with myelodysplastic-related changes. We observed a 61% overall response rate, with 58% complete response. The presence of complex karyotype at diagnosis predicted lower response rates. Among patients who achieved complete response, the relapse rate was 50%, with a median relapse-free survival of 154 days. The median overall survival was 412 days. We found that the biological profile at diagnosis is associated with survival. Leukocytosis at diagnosis, complex karyotype, and mutations of IDH1 and SRSF2 were correlated with lower survival in the univariable analysis. In the multivariable analysis, leukocytosis and complex karyotype retained their statistical significance.

PMID:42125699 | PMC:PMC13158078 | DOI:10.3389/fonc.2026.1813333

Front Oncol. 2026 Apr 27;16:1780492. doi: 10.3389/fonc.2026.1780492. eCollection 2026.

ABSTRACT

BACKGROUND: Nutritional status and immune function are pivotal to the progression of cancer. The present study is designed to explore the associations between the prognostic nutritional index (PNI) score, hemoglobin-albumin-lymphocyte-platelet (HALP) score, and lymph node metastasis (LNM) in breast cancer patients.

METHODS: A total of 799 breast cancer patients were enrolled in this retrospective study, and their clinical data were collected. The PNI and HALP score were calculated for all patients. According to the status of LNM, the patients were divided into LNM-positive patients and LNM-negative cohort. The differences in PNI and HALP score between the two groups were compared, and statistical analysis was performed to clarify the relationship between these two scores and LNM.

RESULTS: 412 cases (51.6%) were confirmed with LNM, whereas the remaining 387 (48.4%) were LNM-free. The median levels of both HALP (37.9 (28.2, 46.8) vs. 42.0 (33.4, 54.6), p < 0.001) and PNI (51.2 (48.3, 53.8) vs. 52.6 (50.2, 55.3), p < 0.001) were notably lower in patients with LNM than in those without this condition. When LNM was designated as the endpoint for receiver operating characteristic (ROC) curve analysis of HALP and PNI levels, the optimal cutoff values were determined to be 39.95 for HALP and 52.45 for PNI. Logistic regression analysis showed that low PNI levels (odds ratio [OR]: 1.481, 95% confidence interval [CI]: 1.016-2.159, p = 0.041) was associated with LNM, but HALP not (p = 0.257).

CONCLUSIONS: Low PNI is a potential risk factor for LNM in breast cancer. Clinically, PNI can be used as a convenient warning tool for LNM in breast cancer, and attention should be paid to nutritional and immune intervention before and after surgery.

PMID:42125695 | PMC:PMC13158087 | DOI:10.3389/fonc.2026.1780492

Front Oncol. 2026 Apr 27;16:1479189. doi: 10.3389/fonc.2026.1479189. eCollection 2026.

ABSTRACT

PURPOSE: For surgical guidance applications, supine breast MRI tumor contrast should be non-inferior to prone MRI, currently considered the standard-of-care. However, comparing image contrast quantitatively between different MRI sequences and breast orientations presents a significant challenge. Herein, we present a method for quantitatively comparing regional tumor contrast in the prone and supine breast MRI orientations for the purpose of tumor localization, and we apply this framework to assess the performance of two investigational supine scans (i.e. independent and prone-to-supine, P2S) compared to diagnostic prone MRI.

METHODS: Patient tumors from two studies (NCT03573804, NCT03573661) were outlined slice-by-slice by a breast radiologist using Gd-enhanced, T1-weighted MRI. Image data were derived from subjects undergoing standard-of-care prone imaging (n = 78), independent supine imaging (n = 17), and P2S supine imaging (n = 61). Normalized tumor contrast was computed between the segmented tumor and neighboring normal tissue regions and compared for statistical differences amongst cohorts and non-inferiority to prone MRI.

RESULTS: The independent supine cohort possessed non-inferior tumor-to-fibroglandular contrast compared to prone (p = 0.002), while tumor-to-fibroglandular contrast from the P2S supine cohort was found inferior to the prone cohort. However, both investigational supine scans produced non-inferior tumor-to-adipose contrast when compared to prone MRI (p< 0.001 in both cases).

CONCLUSIONS: Regional contrast between tumor and surrounding fibroglandular tissue suffered at later timepoints observed in the P2S supine study, resulting in inferior tumor contrast. However, when contrast-enhanced supine breast MRI is acquired independently, ratiometric comparisons indicate that tumor contrast is non-inferior to prone MRI.

PMID:42125694 | PMC:PMC13158090 | DOI:10.3389/fonc.2026.1479189

Pulm Circ. 2026 May 11;16:e70314. doi: 10.1002/pul2.70314. eCollection 2026 Jun.

ABSTRACT

Red blood cell distribution width (RDW)-derived indicators have increasingly been recognized as biomarkers reflecting systemic inflammation and hematological disorders. However, the prognostic value of these indicators in critically ill patients with pulmonary hypertension (PH), especially the dynamic implications of their temporal changes, remains insufficiently elucidated. A total of 990 adult patients diagnosed with PH in the intensive care unit (ICU) based on ICD-9/10 codes were enrolled from the MIMIC-IV database. The association between baseline levels of three key indicators and the 1-year all-cause mortality risk was assessed using Cox proportional hazards models and restricted cubic spline (RCS) analysis, and the consistency of this association was assessed for external consistency in the eICU-CRD cohort (n = 298) and NWICU cohort (n = 182). In the subgroup of patients with ≥ 3 consecutive laboratory tests (n = 316), group-based multi-trajectory modeling (GBTM) was employed to identify the joint longitudinal trajectory patterns of these three indicators. The robustness of the prediction results was then evaluated using machine learning models as secondary exploratory analysis. In the MIMIC-IV cohort, higher baseline RAR (aHR = 1.17, 95% CI: 1.08-1.27) and RPR (aHR = 2.31, 95% CI: 1.38-3.86) were significantly associated with increased 1-year mortality risk, whereas higher HRR exerted a protective effect (aHR = 0.31, 95% CI: 0.17-0.58). Across the multiple cohorts, only RAR remained statistically significant in the multivariate model of the eICU-CRD cohort (p = 0.009); although RPR and HRR showed a consistent association, the results did not reach statistical significance. GBTM identified three distinct joint trajectory patterns. Compared with the reference group (Class 2), the high-risk trajectory group (Class 3, n = 35) exhibited a significantly elevated mortality risk (aHR = 2.48). In the exploratory analysis, the support vector machine (SVM) demonstrated moderate discriminative ability (AUC = 0.782). RDW-derived indicators are independently associated with the mortality risk in critically ill patients with ICD-code defined PH. Both their baseline levels and short-term change trajectories may reflect the severity of the underlying disease and systemic stress response. These findings suggest that RDW-derived indicators play an important role in risk phenotyping; however, prospective studies are warranted to confirm their clinical significance.

PMID:42125633 | PMC:PMC13158876 | DOI:10.1002/pul2.70314