Tag: pubmed

J Burn Care Res. 2026 Aug 4:irag130. doi: 10.1093/jbcr/irag130. Online ahead of print.

ABSTRACT

INTRODUCTION: Preoperative communication checklists are used to improve surgical safety and team coordination. We evaluated whether introduction of a preoperative communication checklist was associated with reduced operative duration in a burn operating room.

METHODS: We conducted a quality improvement study comparing operative outcomes before and after introduction of a preoperative communication checklist in a burn unit. Cases from August 19, 2020, to August 20, 2022, were included, with checklist introduction occurring in August 20, 2021. Adult patients undergoing excisional debridement procedures were analyzed. The primary outcome was operative duration. Mixed-effects models were used to assess the association between checklist use and operative duration while adjusting for surgeon, procedure type, and square area excised.

RESULTS: A total of 139 patients undergoing 281 operations were included (143 pre-checklist, 138 post-checklist). Mean operative duration decreased from 107.8 minutes pre-checklist to 96.0 minutes post-checklist. In adjusted analysis, checklist use was associated with a 17.99-minute reduction in operative duration (p<0.001). Procedures involving autograft, ReCell, and biodegradable temporizing matrix were associated with increased operative time, as was greater square area excised. In interaction models, the overall reduction was not statistically significant; however, ReCell procedures demonstrated a significant reduction of 30.49 minutes (p=0.003) following checklist introduction.

CONCLUSION: Introduction of a preoperative communication checklist was associated with decreased operative duration. The greatest effect was observed in ReCell procedures, suggesting that improved preoperative coordination may enhance efficiency in complex workflows. Preoperative checklists represent a scalable quality improvement strategy to optimize operative efficiency and resource utilization in burn care.

PMID:42550498 | DOI:10.1093/jbcr/irag130

Pain Med. 2026 Aug 4:pnag100. doi: 10.1093/pm/pnag100. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the incidence and risk factors of chronic opioid use following head and neck adenoid cystic carcinoma (HNACC) surgery and explore the association between postoperative opioid use and survival outcomes.

DESIGN: Observational retrospective cohort study.

SETTINGS: Perioperative care of cancer patients at the UT – MD Anderson Cancer Center.

SUBJECTS: Adults (≥18 years) who underwent HNACC surgery with curative intent were included; while those with recurrent or metastatic disease at the time of surgery or who received palliative treatment were excluded.

METHODS: Multivariable logistics and Cox regression analyses were performed to identify predictors of chronic opioid use and explore associations with recurrence-free survival (RFS) and overall survival (OS). Chronic opioid use was defined as an active opioid prescription documented and reconciled by a clinician on postoperative day 90 (POD90).

RESULTS: Among 102 subjects included in the study, 47.1% were taking opioids chronically after surgery. Preoperative opioid use was associated with more than double the odds of chronic postoperative opioid use, whereas older age and ASA class 1-2 were associated with reduced odds. Positive surgical margins, bone graft procedures, and neck dissection were independently associated with poorer prognosis. No statistically significant association between opioid use an RFS and OS was observed.

CONCLUSIONS: These findings suggest that patients with HNACC exhibit several risk factors for chronic opioid use, underscoring the importance of careful opioid prescribing and monitoring in this population.

PMID:42550492 | DOI:10.1093/pm/pnag100

J Natl Cancer Inst. 2026 Aug 4:djag268. doi: 10.1093/jnci/djag268. Online ahead of print.

ABSTRACT

BACKGROUND: Clonal hematopoiesis of indeterminate potential (CHIP) and biological aging have been individually associated with increased cancer risks. However, their joint effect on cancer risks remains unknown.

METHODS: We analyzed data from 332,911 participants at baseline in the UK Biobank. We defined CHIP as a pathogenic variant with variant allele fractions ≥2%. Biological aging was assessed by the phenotypic age acceleration (PhenoAgeAccel) and categorized as biologically younger and older. Associations of CHIP and biological aging with 25 cancers were assessed by Cox proportional hazard models. Interactions between CHIP and biological aging were tested on additive and multiplicative scales.

RESULTS: CHIP was associated with higher risks of myeloid malignancies (HR 9.56, 95%CI 8.28-11.03), lung cancer (HR 1.61, 95%CI 1.42-1.82) and oesophageal cancer (HR 1.54, 95%CI 1.18-2.01). Biologically older participants had higher risks of hematologic neoplasms (HR 1.42, 95%CI 1.30-1.55) and various solid tumors compared with biologically younger participants. CHIP carriers who were biologically older had increased risks of hematologic neoplasms (HR 6.56, 95%CI 5.67-7.59) and various solid tumors compared with biologically younger participants without CHIP. The proportion of excess risk attributable to additive interaction was 40% for hematologic neoplasms and 27% for lung cancer. A significant multiplicative interaction was also observed for hematologic neoplasms (P interaction<0.001).

CONCLUSION: CHIP confers substantial cancer risk, amplified when participants are biologically older. Assessing CHIP and biological aging may serve as an effective strategy for early screening and risk stratification for hematologic neoplasms and lung cancer.

PMID:42550479 | DOI:10.1093/jnci/djag268

J Natl Cancer Inst. 2026 Aug 4:djag265. doi: 10.1093/jnci/djag265. Online ahead of print.

ABSTRACT

BACKGROUND: Acute chemotherapy-related gastrointestinal symptoms can limit colorectal cancer treatment. We evaluated electroacupuncture as adjunctive care for acute gastrointestinal symptom burden during chemotherapy.

METHODS: This multicenter, randomized, patient- and assessor-blinded, sham-controlled trial was conducted at 6 tertiary hospitals in China from July 2022 to August 2025. Adults with colorectal cancer and chemotherapy-related gastrointestinal symptoms were randomly assigned 1 1:1 to electroacupuncture, nonpenetrating sham acupuncture, or usual care. Treatments were given once daily for 3 days during chemotherapy. The primary outcome was change in Gastrointestinal Symptom Rating Scale (GSRS) total score from baseline to day 3. Secondary outcomes included rescue medication use and adverse events.

RESULTS: Among 230 randomized patients (mean age, 60.1 years; 54.3% men), 211 (91.7%) completed the 3-day intervention. At day 3, electroacupuncture reduced GSRS total scores more than sham acupuncture (mean difference [MD], -1.54; 95% CI, -2.35 to -0.74; P < .001) and usual care (MD, -1.30; 95% CI, -2.09 to -0.50; P = .001). These differences did not exceed the prespecified minimal clinically important difference of 2.15 points. Electroacupuncture was associated with higher odds of remaining rescue-free than sham acupuncture (adjusted OR, 2.86; 95% CI, 1.23 to 6.63; P = .015) and usual care (adjusted OR, 2.64; 95% CI, 1.16 to 6.01; P = .021). No serious adverse events occurred.

CONCLUSIONS: Electroacupuncture was associated with statistically significant but modest short-term reductions in acute gastrointestinal symptom burden. The between-group differences did not exceed the prespecified clinical-importance threshold and should be interpreted cautiously.

TRIAL REGISTRATION: Chinese Clinical Trials Register identifier ChiCTR2200062317.

PMID:42550476 | DOI:10.1093/jnci/djag265

Drugs Aging. 2026 Aug 4. doi: 10.1007/s40266-026-01326-5. Online ahead of print.

ABSTRACT

BACKGROUND: Polypharmacy is a known risk factor for adverse outcomes during stroke rehabilitation; however, evidence is limited on whether nutritional status modifies this association. This study investigated whether the association between polypharmacy and functional recovery in patients after stroke differed according to body mass index (BMI), an anthropometric indicator related to nutritional status.

METHODS: This retrospective cohort study included patients with stroke admitted to a convalescent rehabilitation ward in Japan between January 2015 and December 2024. Patients with cerebral infarction, intracerebral hemorrhage, or subarachnoid hemorrhage were eligible. Polypharmacy was defined as the prescription of five or more medications at admission. Patients were classified by BMI according to the criteria of the Japan Society for the Study of Obesity: underweight (< 18.5 kg/m²), normal weight (18.5 to < 25.0 kg/m²), and obese (≥ 25.0 kg/m²). The primary outcome was the functional independence measure (FIM)-motor score at discharge, and secondary outcomes were the FIM-cognitive score at discharge and home discharge. Multivariable regression analyses were used to evaluate whether BMI category modified the association between polypharmacy and each outcome.

RESULTS: Among 1245 patients (median age, 75 years; 54.3% men), a significant negative interaction between polypharmacy and underweight status was observed for the FIM-motor score at discharge (B = – 4.396, 95% CI – 8.693 to – 0.100). In the underweight group, patients with polypharmacy had significantly lower adjusted FIM-motor scores than those without (65.3 versus 69.8; p = 0.020). No significant association between polypharmacy and functional recovery was found in the normal-weight or obese groups. Polypharmacy was not associated with FIM-cognitive scores or home discharge rates in any BMI category.

CONCLUSIONS: Polypharmacy was associated with modestly poorer activities of daily living at discharge primarily among underweight patients after stroke. These findings suggest that BMI category may help identify patients who could benefit from closer medication assessment, although the clinical magnitude of the association was limited.

PMID:42550458 | DOI:10.1007/s40266-026-01326-5

Sante Ment Que. 2026 Spring-Summer;51(2):31-51.

ABSTRACT

Objective Several factors can contribute to the recovery of people living with schizophrenia. According to service users living with schizophrenia, spirituality would be an important element in their recovery journey. Spirituality could serve as a coping mechanism to manage psychological stress. The objective of this exploratory study was to examine the relationship between spirituality and cortisol, a stress biomarker, among people living with schizophrenia compared to the general population. Method Participants were drawn from the Signature Project of the Institut universitaire en santé mentale de Montréal (IUSMM). The sample included 94 people living with schizophrenia and 95 control participants. Linear regressions were performed to examine the association between spirituality and cortisol. Results Individuals with schizophrenia accorded greater importance to spirituality than control participants, with a medium to large effect size. Spirituality was more important for women than men, regardless of the group. No significant differences were observed in cortisol concentrations. Lastly, spirituality had no effect on cortisol levels in either group. Bayesian analyses confirmed that the absence of effect was real and not due to a lack of statistical power. Conclusion This study highlights the clinical relevance and importance of integrating the perspective of those directly involved by confirming that people living with schizophrenia place great importance on spirituality. Furthermore, the findings suggest that the role played by spirituality in the recovery of people living with schizophrenia does not rely on a physiological mechanism. Therefore, it would be pertinent to explore the relationship between spirituality and other dimensions of recovery, such as psychological, social or cognitive aspects. A better understanding of the role of spirituality in the recovery of people living with schizophrenia would provide a better comprehension of how to mobilize it to support service users in their ongoing journey.

PMID:42550433

Dokl Biol Sci. 2026 Aug 3. doi: 10.1134/S0012496626600314. Online ahead of print.

ABSTRACT

Circadian rhythm disruption is a risk factor for metabolic and age-associated diseases. The liver is a key target of such desynchronosis. The effect of chronic continuous light exposure and the corrective effect of melatonin on the liver status were investigated in rats. Desynchronosis mediated by melatonin deficiency was shown to induce the formation of a pro-senescent and metabolically dysfunctional liver phenotype. Melatonin administration significantly reduced the severity of the identified disorders and prevented statistically significant deviations in most of the parameters under study. The results, together with previous data on ultrastructural damage to hepatocytes and a negative impact of desynchronosis on lifespan, indicate that chronic continuous light exposure is a significant pro-gerontological factor and that melatonin is an effective agent for correcting the associated disturbances of liver homeostasis.

PMID:42550425 | DOI:10.1134/S0012496626600314

Dokl Biol Sci. 2026 Aug 3. doi: 10.1134/S001249662660034X. Online ahead of print.

ABSTRACT

The contents of total lipids (TL) and individual lipid classes were studied in the mantle, foot, and hepatopancreas of the freshwater pearl mussel Margaritifera margaritifera from eight northwestern Russian rivers belonging to the White and Barents Sea basins. Tissue specificity of the lipid composition was observed in the studied tissues; i.e., the hepatopancreas had several times higher contents of TL and dominant lipid classes. A predominance of triacylglycerols among energetic lipids in the hepatopancreas was a distinctive feature of pearl mussels from the Lotta, Sredniy Verman, Mashjoki, and Nautsiyoki rivers, whereas cholesterol esters predominated in mussels from the rivers of the Pyaozero water system, which is further south. Furthermore, the cholesterol/phospholipid ratio (an indicator of the structural and functional state of membranes and a marker of temperature adaptation) was the highest in pearl mussels from the Lotta, Sredniy Verman, Mashjoki, and Nautsiyoki rivers. This may be related to corresponding adaptive changes associated with preparation for the winter period, given a more northern location of the rivers. The results of lipid status analysis in pearl mussels from different habitats may be useful for monitoring studies aimed at preserving and restoring populations of the species in the wild.

PMID:42550423 | DOI:10.1134/S001249662660034X

Ophthalmic Physiol Opt. 2026 Aug 4. doi: 10.1007/s44402-026-00161-w. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate accommodative amplitude (AA), accommodative lag (LAG) and defocus curve (DC) metrics in phakic adults aged 45-65 years, and investigate their relationships.

METHODS: Observational cross-sectional study including 77 subjects stratified into four age groups (G1-G4: 45-50, 51-55, 56-60 and 61-65 years, respectively). AA was measured using the push-up method and LAG at 40 cm and 66 cm using an open-field autorefractometer. Monocular DC were obtained and two summary metrics derived: area under the curve (AUC) and defocus cut-off at 0.20 logMAR. Differences among age groups were analysed using appropriate statistical tests, and regression models evaluated the predictive value of age and defocus cut-off for AA.

RESULTS: AA decreased significantly with age (G1-G4: 2.41 ± 0.53, 2.13 ± 0.63, 1.61 ± 0.44 and 1.75 ± 0.73 D; p < 0.001), with higher values in younger (45-55 years) compared with older subjects (56-65 years) and no significant differences within each age cluster. LAG remained stable at both 40 cm (p = 0.27) and 66 cm (p = 0.50). DC metrics showed significant age-related changes, with reduced AUC and less defocus cut-off values in older groups (p < 0.001). AUC differed significantly between G1 and G4 and between G2 and G4, whereas defocus cut-off differed only between G2 and G4. Age (R² = 0.22) and defocus cut-off (R² = 0.09) had limited predictive value for AA.

CONCLUSION: AA and DC metrics decline with age, whereas LAG remains stable. Their weak association suggests that they reflect partially distinct aspects of visual function. DC analysis captures aspects of functional near visual performance that are not fully reflected by accommodative measurements alone, which may be useful for a more comprehensive characterisation of presbyopic visual function and for the evaluation of presbyopia-correcting interventions.

PMID:42550417 | DOI:10.1007/s44402-026-00161-w

Clin Exp Nephrol. 2026 Aug 4. doi: 10.1007/s10157-026-02908-8. Online ahead of print.

ABSTRACT

BACKGROUND: Although depression is common among patients with chronic kidney disease (CKD), its impact on the incidence of end-stage kidney disease (ESKD) and all-cause mortality remains unclear.

METHODS: This retrospective cohort study used Cox proportional hazards (CPH) models and CPH models with penalized splines to assess the association between depression severity and the incidence of ESKD and mortality in patients with CKD, drawing on data from the Chronic Kidney Disease Japan Cohort (CKD-JAC) Study.

RESULTS: This study included 1,694 patients with CKD (median age 61 years; mean eGFR 29.0 ± 12.2 mL/min/1.73 m²; median Beck Depression Inventory-II (BDI-II) score 8). Depression severity was classified into four categories: normal (0-13), mild (14-19), moderate (20-28), and severe (≥ 29). In Multivariable CPH models, ESKD risk showed a stepwise elevation in hazard ratios (HRs) without reaching statistical significance, whereas, mortality risk increased significantly in the moderate and severe group: HR 3.11 (95%CI 1.61-6.03) and 3.51 (1.40-8.80). Additionally, CPH models demonstrated a dose-dependent association between BDI-II categories and the incidence of both ESKD and mortality. CPH Models with penalized splines further revealed a gradual increase in ESKD risk, and a J-shaped association in mortality risk.

CONCLUSION: Depression severity showed dose-dependent associations with increased the incidence of ESKD and mortality in patients with CKD. Although mortality risk was significantly higher in the moderate and severe groups (BDI-II score ≥ 20), the stepwise elevation in ESKD risk did not reach statistical significance, and an optimal threshold for ESKD risk could not be identified.

PMID:42550412 | DOI:10.1007/s10157-026-02908-8