Tag: pubmed

Health Serv Res. 2026 Jun;61(3):e70134. doi: 10.1111/1475-6773.70134.

ABSTRACT

OBJECTIVE: To examine how patient engagement with SMS text reminder scan mediate cancer screening completion among patients at Federally Qualified Health Center clinics (FQHCs).

STUDY SETTING AND DESIGN: Patients overdue for cancer screening were randomly assigned to one of two groups: a 3-week interactive SMS intervention or a 6-week theory-informed SMS intervention. The binary outcome was cancer screening completion after 90 days of SMS intervention. A mediation model was used to assess associations between text-message response rates and cancer screening completion. Exposure variables included sociodemographic characteristics, type of SMS intervention, type of cancer screening needed, and health status variables.

DATA SOURCES AND ANALYTIC SAMPLE: Data were obtained from two large FQHC networks in Texas and California in 2023. We included 4,344 patients who participated in the 3-week or 6-week intervention groups, successfully received all interactive messages, had unique phone numbers, and did not opt out of the intervention.

PRINCIPAL FINDINGS: Overall effects were statistically significant, indicating partial mediation. Full mediation was observed for insurance type: compared with Medicaid, private insurance was associated with a 5-percentage-point (PP) higher predicted probability of screening completion (Average marginal effect [AME] = 5.0 PP, 95% CI [0.01, 0.09]). Partial mediation was observed for Medicare (AME = 7.0 PP, 95% CI [0.02, 0.13]), uninsurance (AME = 5.0 PP, 95% CI [0.01, 0.09]), patient with diabetes (AME = -4.0 PP, 95% CI [-0.08, -0.01]), non-primary English language (AME = 8.0 PP, 95% CI [0.05, 0.10], p < 0.001), and large-city residence (AME = 9.0 PP, 95% CI [0.07, 0.10]), all of which were associated with higher predicted probabilities of screening completion.

CONCLUSIONS: Engagement with SMS reminders was a significant mediator of cancer screening completion, suggesting that increasing message interactivity may improve cancer screening uptake. Theory-informed interactive messaging may promote greater patient engagement.

PMID:42206315 | DOI:10.1111/1475-6773.70134

Clin Cosmet Investig Dent. 2026 May 22;18:611537. doi: 10.2147/CCIDE.S611537. eCollection 2026.

ABSTRACT

INTRODUCTION: Sickle cell disease is caused by a point mutation in the β-globin gene, resulting in the production of abnormal hemoglobin. Various oral radiographic changes have been documented in the literature, though they are less frequently reported in patients with severe disease. This study aimed to evaluate specific radiographic features in pediatric patients with severe sickle cell disease.

METHODS: This retrospective comparative study was conducted at the Dental Department of King Faisal Specialist Hospital and Research Centre. A total of 72 pediatric patients (aged 6-14 years) with genetically confirmed severe sickle cell disease and 96 age-matched healthy controls were included. Dental radiographs were evaluated by four calibrated examiners for the presence of radiopaque areas, increased spacing of bony trabeculae, absence of mandibular canal corticalization, faint lamina dura, spiky roots, taurodontism, and haziness of the maxillary sinuses. Statistical analysis was performed using Chi-square test, with significance set at p < 0.05.

RESULTS: The sickle cell group showed a significantly higher prevalence of increased trabecular spacing (58.3% vs. 19.8%), absence of mandibular canal corticalization (68.1% vs. 16.7%), faint lamina dura (19.4% vs. 2.1%), taurodontism (15.3% vs. 9.4%), and haziness of the maxillary sinuses (69.4% vs. 43.8%) (p < 0.05 for all comparisons).

CONCLUSION: Pediatric patients with severe sickle cell disease demonstrated a higher prevalence of specific radiographic changes, particularly increased trabecular spacing, loss of mandibular canal corticalization, and haziness of the maxillary sinuses. This study highlights the importance of recognizing these imaging features in the assessment of disease severity.

PMID:42206307 | PMC:PMC13209138 | DOI:10.2147/CCIDE.S611537

Front Neurol. 2026 May 12;17:1826373. doi: 10.3389/fneur.2026.1826373. eCollection 2026.

ABSTRACT

BACKGROUND: Real-world evidence comparing Tenecteplase and Alteplase for acute ischemic stroke (AIS) remains limited. This study aimed to evaluate the comparative efficacy and safety of these thrombolytic agents in an unselected patient cohort.

METHODS: This single-center retrospective study analyzed AIS patients undergoing reperfusion therapy. Propensity score matching (PSM) was employed to balance baseline covariates between Tenecteplase and Alteplase groups. The primary outcome was functional independence (modified Rankin Scale 0-2) at 90 days. Safety endpoints included symptomatic intracranial hemorrhage (sICH) and mortality.

RESULTS: Among 371 eligible patients, 68 (18.3%) received Tenecteplase. In the matched cohort, Tenecteplase demonstrated comparable efficacy to Alteplase regarding functional independence (p > 0.05). Although the incidence of sICH was numerically higher in the Tenecteplase group, the difference was not statistically significant (p = 0.449). Workflow efficiency, measured by door-to-needle time, was similar between groups.

CONCLUSION: Tenecteplase exhibits a non-inferior efficacy and safety profile compared to Alteplase in a real-world setting characterized by high baseline stroke severity. These findings support Tenecteplase as a practical and effective therapeutic alternative for routine AIS management.

PMID:42206304 | PMC:PMC13201182 | DOI:10.3389/fneur.2026.1826373

Adv Radiat Oncol. 2026 Apr 15;11(7):102059. doi: 10.1016/j.adro.2026.102059. eCollection 2026 Jul.

ABSTRACT

PURPOSE: This study investigates the association between radiation dose to the heart base and other cardiac substructures and overall survival (OS) following stereotactic body radiation therapy (SBRT) for central and ultracentral lung tumors.

METHODS AND MATERIALS: A retrospective analysis was performed on patients treated within the SBRT registry (2011-2023). Autosegmentation was used to contour the whole-heart and cardiac substructures, whereas the heart base-overlapping the ascending aorta and including coronary origins and the sinoatrial node-was manually contoured. Mean (Dmean) and near-maximum doses (D0.03, highest dose to 0.03 cm³) were converted to equivalent 2 Gy fractions (EQD₂, α/β = 3 Gy). Optimal dose cut-points were defined to stratify patients into high- and low-dose groups. Cox regression models, adjusted for age, sex, tumor type, and volume, assessed the association between cardiac dose and OS; additional sensitivity analyses included bronchial Dmax.

RESULTS: Among 82 treated patients, 66 were evaluable for dosimetry of cardiac structures and survival analysis. Median age was 67 years; 68% were male. Most lesions were metastases (62.5%) and evenly split between central (54.5%) and ultracentral (45.5%) locations. Higher EQD₂ Dmean to the left atrium (hazard ratio [HR], 2.89; P = .04) and superior vena cava (HR, 2.56; P = .03), and higher D0.03 to the superior vena cava (HR, 3.12; P = .004) and right ventricle (HR, 2.23; P = .04) were independently associated with worse OS. After sensitivity analysis, associations for the superior vena cava remained significant, whereas others were attenuated to statistical trends. A higher mean dose to the heart base showed a strong trend toward reduced survival (HR, 3.70; P = .05).

CONCLUSIONS: Higher radiation doses to the left atrium, superior vena cava, and right ventricle were independently associated with worse OS after SBRT for central and ultracentral lung tumors, underscoring the importance of cardiac-substructure-specific dose constraints in SBRT planning. Moreover, a clear trend toward reduced survival with higher doses to the base of the heart underscores the importance of this region as a potential target for future dose-sparing strategies.

PMID:42206292 | PMC:PMC13202019 | DOI:10.1016/j.adro.2026.102059

JPRAS Open. 2026 Apr 22;50:258-269. doi: 10.1016/j.jpra.2026.04.008. eCollection 2026 Jul.

ABSTRACT

INTRODUCTION: An axial pattern flap is a single pedicled flap with anatomically recognized blood vessels running along its long axis, allowing it to be harvested with a considerably longer length than a random pattern flap. Distal necrosis is a concern when designing elongated flaps beyond the midline to cover large tissue defects. However, imaging modalities that visualize subcutaneous microvessels preoperatively in three dimensions with sufficient resolution are lacking, individual vessel anatomy is ignored and flaps are designed based on past anatomical research. In this preliminary study, we evaluated the feasibility of harvesting flaps, including an axial artery running across the midline delineated by photoacoustic tomography and its effect on flap viability.

METHODS: Six rats were divided into two groups: MCA group (flaps including the midline-crossing artery visualized by photoacoustic tomography running across the midline, n = 3) and non-MCA group (flaps not including the midline-crossing artery beyond the midline visualized by photoacoustic tomography, n = 3). In both groups, the flaps were designed beyond the midline with the flap pedicle based on the right deep circumflex iliac artery perforator. Flap viability was analyzed on postoperative day 7.

RESULTS: Preoperative photoacoustic tomography revealed the subcutaneous arteries crossing the midline and identified the location of the deep circumflex iliac perforator. The viability of flaps with MCA was better than that in the non-MCA group, although this difference was not statistically significant (p = 0.40).

CONCLUSIONS: This proof-of-concept study suggests that photoacoustic tomography is a useful imaging modality for designing elongated free style flaps.

PMID:42206263 | PMC:PMC13202538 | DOI:10.1016/j.jpra.2026.04.008

JAC Antimicrob Resist. 2026 May 26;8(3):dlag095. doi: 10.1093/jacamr/dlag095. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) is practised worldwide due to the benefits it provides to patients and healthcare systems. However, its full potential remains unrealized due to different implementation challenges. This study aims to identify barriers and facilitators that influence the routine implementation of current practices in the OPAT programme.

METHODS: An international, multi-centre electronic survey was conducted among healthcare facilities providing OPAT services in Australia, Malaysia, the UK, Spain, Turkey and Middle East countries. The survey instrument was developed based on the Consolidated Framework for Implementation Research and guideline recommendations for OPAT. Statistical analyses were performed using SPSS version 30.

RESULTS: The survey received responses from 150 healthcare facilities across 10 countries offering OPAT services. The majority (11 879.7%) of healthcare facilities implement OPAT through a formal structure. The majority (92.2%) had a designated team lead. Most facilities (12 685.7%) reported the implementation of antimicrobial toxicity monitoring. Only 58 facilities (39.5%) reported implementation of regular audits of their OPAT programmes. The most reported barriers to OPAT implementation included wide geographic distribution of patients (50.7%), lack of financial support (42.7%) and the dosing frequency of antimicrobials (40.6%). Facilitators to OPAT implementation include hospital bed savings, clinical safety and efficacy, cost-effectiveness and patient satisfaction.

CONCLUSIONS: The majority of healthcare facilities implement OPAT through a formal structure. However, several challenges continue to hinder its routine implementation. Ongoing efforts to address implementation barriers are crucial for strengthening existing services and supporting the expansion of new services.

PMID:42206239 | PMC:PMC13201090 | DOI:10.1093/jacamr/dlag095

Behav Sci Law. 2026 May 27. doi: 10.1002/bsl.70072. Online ahead of print.

ABSTRACT

This study examined and compared the prevalence and expression of psychopathic traits in a Portuguese sample of prisoners and community members, using the abbreviated version of the Self-Report Psychopathy Scale (SRP-SF). The sample consisted of 766 participants (41.5% prisoners, 58.5% community members) of both sexes. Results indicated that prisoners presented significantly higher levels in all four facets of psychopathy. Males presented higher levels in all facets, regardless of context. The interaction between sex and context was statistically significant only in the affective facet: female prisoners presented similar levels to male prisoners, while females in the community presented lower levels. 31.4% of inmates scored high on psychopathy (≥ 70), compared to 2.2% in the community, demonstrating the discriminant validity of the SRP-SF. The results support the dimensional conceptualization of psychopathy and illustrate the utility of the SRP-SF for forensic screening. Practical implications for forensic assessment, prison intervention, and community prevention are discussed.

PMID:42204381 | DOI:10.1002/bsl.70072

Chirality. 2026 Jun;38(6):e70107. doi: 10.1002/chir.70107.

ABSTRACT

The homochirality of life-the exclusive use of L-amino acids and the universal right-handedness of $\alpha$ -helices-stands as one of the most persistent asymmetries in biology. While often attributed to kinetic or energetic biases, the overwhelming statistical dominance of these chiral forms still lacks a fully compelling thermodynamic and geometric explanation. Here, we propose a geometric mechanism for the stabilization and amplification of biomolecular handedness in open, entropy-producing systems. By introducing a local chirality marker based on the sign of a scalar triple product (equivalently, the sign of a determinant built from atomic coordinate differences and the local helical axis), we show that right-handed $\alpha$ -helices can be can be represented as orientation-preserving sectors of the local configuration space in the local configuration space. Under physically admissible continuous backbone moves, chirality inversion requires crossing a degenerate subset where the marker vanishes, which constitutes a lower dimensional region of effectively zero measure in the feasible configuration manifold. Consequently, parity-inverting pathways are dynamically suppressed, and once a chiral sign becomes established, it tends to persist and amplify under irreversible evolution consistent with least-time free-energy dissipation. Our framework reframes biomolecular homochirality not as the consequence of a primordial energetic asymmetry but as an emergent, statistically stabilized standard arising from the interplay between nonequilibrium thermodynamics and the geometry of configuration space.

PMID:42204377 | DOI:10.1002/chir.70107

NPJ Digit Med. 2026 May 27. doi: 10.1038/s41746-026-02721-3. Online ahead of print.

ABSTRACT

Significant executive function deficits mark attention-deficit/hyperactivity disorder (ADHD). Digital therapeutics (DTx) targeting cognitive control offer promising non-pharmacological options but require rigorous validation. We evaluated the efficacy and safety of STAR RUCKUS, an adaptive multitasking DTx designed to strengthen cognitive control in children with ADHD. In this multicenter, randomized, single-blind, sham-controlled trial, 122 children aged 6-12 years with DSM-5/ICD-10-diagnosed ADHD were assigned 1:1 to STAR RUCKUS or a visually matched driving-only sham intervention and completed five daily sessions for 4 weeks. The primary outcome was the change in clinician-rated Korean ADHD rating scale (K-ARS) scores. Of 122 randomized children, 114 completed the trial. At Week 4, STAR RUCKUS produced greater symptom reduction than sham (-7.50 vs. -4.00; p = 0.009), with improvements in inattention (p = 0.024) and hyperactivity/impulsivity (p = 0.015). These findings suggest statistically significant improvements of small-to-moderate magnitude (ηp² = 0.05) in clinician-rated ADHD symptoms, along with favorable adherence and tolerability. Trial registration: ClinicalTrials.gov (NCT07173439).

PMID:42204362 | DOI:10.1038/s41746-026-02721-3

Sci Rep. 2026 May 27. doi: 10.1038/s41598-026-54614-w. Online ahead of print.

ABSTRACT

Hypertension is a chronic condition frequently requiring long-term pharmacotherapy, which may increase the risk of medication-related problems. Comprehensive Medication Management (CMM) has been associated with improvements in health outcomes in patients with hypertension; however, evidence from pragmatic randomized clinical trials in primary care settings remains limited. This study aimed to evaluate the association between pharmacist-led CMM on clinical, anthropometric, humanistic, and cardiovascular risk outcomes among patients with hypertension treated within the public health care network of Alegre, Espírito Santo, Brazil. A pragmatic, single-blind, randomized controlled clinical trial with a 12-month follow-up was conducted. A total of 128 adults with hypertension were randomized in a 1:1 ratio to the intervention group (CMM) or the control group (usual care). No statistically significant between-group differences were observed for clinical, anthropometric, or humanistic parameters; cardiovascular risk was the only outcome showing a statistically significant time × group interaction (p = 0.039; η²p = 0.026), indicating a trend toward a more favorable trajectory in the CMM group. Intention-to-treat analyses showed significant time effects for systolic blood pressure, lipid profile components, quality of life, hypertension-related knowledge, and cardiovascular risk in both groups. In exploratory intragroup analyses, the intervention group showed significant changes in systolic blood pressure (- 9.47 mmHg), total cholesterol, LDL cholesterol, non-HDL cholesterol, and cardiovascular risk, along with improvements in quality of life and hypertension-related knowledge, whereas the control group showed improvements limited to knowledge scores and self-rated quality of life. Per-protocol sensitivity analyses confirmed the consistency of these findings. Although between-group comparisons did not demonstrate clear statistical superiority of CMM over usual care for most outcomes, the results suggest that CMM may contribute to clinically relevant improvements in cardiovascular risk and patient-centered outcomes in real-world practice. These findings should be considered hypothesis-generating, and larger, adequately powered, multicenter pragmatic trials are warranted to confirm the effectiveness of CMM in hypertension management.

PMID:42204303 | DOI:10.1038/s41598-026-54614-w