Tag: pubmed

Int J Prosthodont. 2026 Mar 19;0(0):1-19. doi: 10.11607/ijp.9690. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate enamel composition in teeth with high wear (HW) and no wear (NW).

MATERIALS AND METHODS: One hundred and eighty-four teeth embedded in polymerized blocks, were assessed using the MolWear system. Specimens were imaged with a Zeiss Gemini 300 field emission SEM and analyzed via energy dispersive X-ray spectrometry. Weight percentages of calcium (Ca), phosphorus (P), sodium (Na), carbon (C), and oxygen (O) were measured. Measurements were taken on lateral enamel to avoid occlusal wear interference.

RESULTS: Eight molars with composite score zero (NW) and 12 molars with composite score >20 (HW) were analyzed. Means and standard deviations for Ca, P, O, C, and Na were calculated for outer, middle, and inner enamel layers. Two-way ANOVA with Tukey-adjusted post hoc tests showed the Ca in the outer region was greater than in the inner region for both the HW and LW cohorts. It also showed that the Na increased from the outer to the inner layer of the enamel in both cohorts. The statistical difference in the Ca and Na cohorts was between the inner and outer range not between the HW and LW. One sample in the NW cohort showed evidence of demineralization.

CONCLUSION: In the teeth evaluated there were no significant differences between the HW cohort and the NW cohort with respect to calcium, phosphorus, carbon, oxygen, and sodium content. Only one sample showed evidence of demineralization, and it was in the no wear cohort.

PMID:41854720 | DOI:10.11607/ijp.9690

Fam Med. 2025 Nov;57(10):732-736. doi: 10.22454/FamMed.2025.195277.

ABSTRACT

BACKGROUND AND OBJECTIVES: This study explored the influence of adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) on coping mechanisms among medical students. It aimed to determine the association between ACE and BCE scores and their impact on coping behaviors, recognizing the potential for interventions to promote healthier coping strategies.

METHODS: We used data collected from the Texas Tech University Health Sciences Center School of Medicine P3-1 Honors Project Omnibus Survey among preclinical medical students. Participants self-reported ACE and BCE scores, along with the frequency and perceived effectiveness of both healthy and unhealthy coping mechanisms.

RESULTS: The analysis showed a significant negative correlation between ACE and BCE scores, indicating that higher ACE scores corresponded to lower BCE scores. Social support emerged as the most common healthy coping mechanism, while self-blame stood out as the predominant unhealthy coping strategy. Additionally, we found statistically significant associations between BCE scores and the use of coping strategies such as spiritual support, self-blame, and isolation.

CONCLUSIONS: Findings imply that high ACE scores correlate with impulsive behaviors. Conversely, high BCE scores are associated with lower tendencies for self-blame, isolation, and impulsive activities, suggesting protective factors. The study underscores the need for interventions to foster healthy coping mechanisms, particularly for individuals with high ACE scores.

PMID:41854707 | DOI:10.22454/FamMed.2025.195277

Fam Med. 2025 Nov;57(10):727-731. doi: 10.22454/FamMed.2025.954255.

ABSTRACT

BACKGROUND AND OBJECTIVES: Artificial intelligence (AI) tools have potential utility in multiple domains, including medical education. However, educators have yet to evaluate AI’s assessment of medical students’ clinical reasoning as evidenced in note-writing. This study compares ChatGPT with a human proctor’s grading of medical students’ notes.

METHODS: A total of 127 subjective, objective, assessment, and plan notes, derived from an objective structured clinical examination, were previously graded by a physician proctor across four categories: history, physical exam, differential diagnosis/thought process, and treatment plan. ChatGPT-4, using the same rubric, was tasked with evaluating these 127 notes. We compared AI-generated scores with proctors’ scores using t tests and χ2 analysis.

RESULTS: The grades assigned by ChatGPT were significantly different than those assigned by proctors in history (P<.001), differential diagnosis/thought process (P<.001), and treatment plan (P<.001). Cohen’s d was the largest for treatment plan at 1.25. The differences led to a significant difference in students’ mean cumulative grade (proctor 23.13 [SD=2.84], ChatGPT 24.11 [SD 1.27], P<.001), affecting final grade distribution (P<.001). With proctor grading, 81 of the 127 (63.8%) notes were honors and 46 of the 127 (36.2%) were pass. ChatGPT gave significantly more honors (118/127 [92.9%]) than pass (9/127 [7.1%]).

CONCLUSIONS: When compared to a human proctor, ChatGPT-4 assigned statistically different grades to students’ SOAP notes, although the practical difference was small. The most substantial grading discrepancy occurred in the treatment plan. Despite the slight numerical difference, ChatGPT assigned significantly more honors grades. Medical educators should therefore investigate a large language model’s performance characteristics in their local grading framework before using AI to augment grading of summative, written assessments.

PMID:41854706 | DOI:10.22454/FamMed.2025.954255

J Exp Psychol Learn Mem Cogn. 2026 Mar 19. doi: 10.1037/xlm0001589. Online ahead of print.

ABSTRACT

Statistical learning is the process of extracting regularities from the environment. Although sequential cross-modal regularities are ubiquitous (e.g., the sight of a falling ball followed by the sound of impact), previous research has failed to demonstrate that such learning occurs between sensory modalities. This has led to the view that sequential statistical learning is modality specific. The present study investigates factors that may determine statistical learning of cross-modal sequences. In the first experiment, participants viewed a stream of meaningless visual fractals and synthetic auditory stimuli. The sequence of stimuli could be grouped into either unimodal or cross-modal pairs based on their transitional probabilities. Using implicit and explicit measures of learning, we found that participants learned only the unimodal pairs. In the second experiment, pairs were presented in separate unimodal and cross-modal blocks. The cross-modal blocks alternated between visual and auditory modalities, allowing participants to anticipate the upcoming modality. This manipulation enabled significant implicit statistical learning for the cross-modal pairs. This suggests that the predictability of modality transitions facilitates appropriate deployment of attention across sensory modalities, which is crucial for learning cross-modal sequential contingencies. In the third experiment, we used audiovisual stimuli with semantic content. Here, participants were able to implicitly learn and explicitly recognize statistical regularities between cross-modal pairs even when the upcoming modality was unpredictable. Together, these findings challenge the view that sequential statistical learning is strictly modality specific, showing that it occurs when sensory-level limitations are bypassed by attentional cues or when learning engages higher level semantic representations shared across modalities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41854691 | DOI:10.1037/xlm0001589

Res Q Exerc Sport. 2026 Mar 19:1-11. doi: 10.1080/02701367.2026.2619085. Online ahead of print.

ABSTRACT

This cross-sectional study involved secondary data analysis to: (1) examine relationships between psychosocial factors (autonomous motivation for physical activity [PA], PA self-efficacy, social support for PA) and various levels of PA intensity (light PA [LPA], moderate PA [MPA], vigorous PA [VPA]), and moderate-to-vigorous PA [MVPA]) in adolescents aged 10-14 years in the U.S.; and (2) investigate the influence of demographic, physiological, and activity-related characteristics (age, sex, race/ethnicity, body mass index [BMI], annual family income, cardiorespiratory fitness [CRF; estimated maximal oxygen uptake: VO2 max], current sports or cheerleading team participation, and non-sport PA program participation) on various PA intensities. In 2022-2024, adolescents completed demographic and psychosocial surveys and wore accelerometers to assess PA. Of 935 adolescents enrolled, 623 (66.6%) provided valid accelerometer data (≥4 days). Structural equation modeling was used. MPA, VPA, and MVPA were positively associated with male sex, higher CRF, and sports or cheerleading team participation. Age and BMI z-score were negative predictors of MVPA and VPA. MPA was negatively associated with age, and LPA was negatively associated with annual family income. Social support for PA predicted autonomous motivation for PA and PA self-efficacy. Indirect effects of social support on the various levels of PA intensity via autonomous motivation or PA self-efficacy were not significant. Strengthening social support for PA may enhance adolescents’ autonomous motivation for PA and PA self-efficacy to help them increase PA. However, indirect effects on the PA levels were not statistically significant. Findings underscore the promise and limitations of psychosocial pathways.ClinicalTrials.gov Identifier NCT04213014.

PMID:41854685 | DOI:10.1080/02701367.2026.2619085

Clin Psychol Psychother. 2026 Mar-Apr;33(2):e70260. doi: 10.1002/cpp.70260.

ABSTRACT

OBJECTIVE: This study conducted a preliminary naturalistic effectiveness evaluation of Individualised Metacognitive Therapy (MCT+) delivered via videoconferencing for individuals with bipolar I disorder (BD-I) in a real-world clinical setting in Chile. It also explored how therapist characteristics-specifically mentalisation capacity-influence the therapeutic alliance in digital psychotherapy.

METHODS: A longitudinal quantitative case series design was implemented across 14 therapist-patient dyads. Patients received 12 weekly sessions of MCT+ online. Standardised measures assessed anxiety (GAD-7), depression (PHQ-9), metacognitive beliefs (MCQ-30), psychological distress (CORE-10) and quality of life (WHOQOL-BREF). Therapeutic alliance was tracked session-by-session (WAI-S). Therapist mentalisation and attachment were evaluated at baseline (MASC-SP, RFQ-8, ECR-12). Changes in outcome measures were analysed using paired t-tests, effect sizes (Cohen’s d), correlations, reliable change indices (RCI) and hierarchical linear modelling (HLM).

RESULTS: Across the intervention, there were significant decreases in anxiety (d = 0.64) and improvements in metacognitive beliefs (d = 0.37). Depression showed a modest improvement (d = 0.34), while changes in quality of life were negligible (d = -0.21). Hierarchical modelling indicated a significant interaction between automatic and controlled mentalisation (b = -0.45, p = 0.008), suggesting that flexible adjustment supported therapeutic alliance development. Attachment style showed no significant associations with the alliance (largest unadjusted effect: ρ = -0.54, p = 0.073; all adjusted ps > 0.99).

CONCLUSIONS: Digital MCT+ showed preliminary effectiveness in reducing anxiety and maladaptive metacognitive beliefs among individuals with BD-I, with more limited effects on depression and quality of life. Importantly, therapist mentalisation flexibility-the capacity to shift between automatic and controlled modes, or the mentalisation switch-emerged as a central mechanism for alliance building and engagement in digital contexts, highlighting a key target for clinical training and future research.

PMID:41854642 | DOI:10.1002/cpp.70260

Q J Nucl Med Mol Imaging. 2026 Mar 19. doi: 10.23736/S1824-4785.26.03673-3. Online ahead of print.

ABSTRACT

BACKGROUND: Fibroblast activation protein (FAP) is highly expressed in the stroma of various cancers, making it a promising target for positron emission tomography (PET) imaging. This study aimed to evaluate the clinical performance of ⁶⁸Ga-labeled fibroblast activation protein inhibitor (FAPI)-46 PET/CT across multiple cancer types.

METHODS: In this single-center, retrospective study, we included 22 patients (mean age 43 years, range 10-69) with histopathologically confirmed primary or metastatic cancers in whom ¹⁸F-FDG PET/CT or conventional imaging yielded inconclusive results. All patients underwent ⁶⁸Ga-FAPI-46 PET/CT. Scan positivity was determined by two experienced nuclear medicine physicians based on non-physiologic tracer uptake. Malignancy was confirmed by histopathology (the reference standard) or correlative imaging follow-up. Analysis was performed on both a per-patient and per-lesion basis. Tumor uptake was quantified using maximum standardized uptake value (SUV<inf>max</inf>) and tumor-to-background ratio (TBR). Statistical comparisons of SUV<inf>max</inf> and TBR between different groups were performed using Student’s t-tests.

RESULTS: A total of 115 lesions were identified and evaluated across 12 different cancer types. The highest ⁶⁸Ga-FAPI-46 avidity (SUV<inf>max</inf>>12) was observed in sarcoma, breast cancer, and cholangiocarcinoma, while the lowest uptake (SUV<inf>max</inf><6) was found in renal cell, differentiated thyroid, and gastric cancers. Intermediate uptake (SUV<inf>max</inf> 6-12) was seen in hepatocellular, colorectal, and ovarian cancers. Due to minimal background activity (muscle and blood pool SUV<inf>max</inf><2), TBRs were high, exceeding 3-fold for intermediate and 6-fold for high-uptake tumors.

CONCLUSIONS: ⁶⁸Ga-FAPI-46 PET/CT provides high-contrast imaging across a wide spectrum of malignancies, demonstrating particularly strong potential for visualizing tumors with prominent stromal components. These findings suggest a significant clinical role for this modality in improving tumor staging, restaging, and therapy assessment, especially in cases where ¹⁸F-FDG PET/CT is suboptimal.

PMID:41854637 | DOI:10.23736/S1824-4785.26.03673-3

Epilepsia. 2026 Mar 19. doi: 10.1002/epi.70204. Online ahead of print.

ABSTRACT

OBJECTIVE: Polymicrogyria (PMG) presents a complex challenge in epilepsy surgery. The optimal surgical strategy and extent of resection, from hemispheric to more limited approaches, remain debated. We aimed to summarize subject-level surgical outcomes and identify factors informing procedure selection.

METHODS: We conducted a subject-level pooled analysis of 161 patients across 20 retrospective studies, evaluating surgical outcomes (Engel classification), in relation to anatomic extent, surgical procedure, use of intracranial electroencephalography (ICEEG), and other decision-influencing factors.

RESULTS: At ≥12 months follow-up, ~70% of patients achieved seizure freedom (Engel Class I). In our univariate analysis Engel Class I outcomes were associated with shorter epilepsy duration (8.05 vs 11.92 years, p = 0.009). Hemispheric PMG was linked to earlier seizure onset (p = 0.02) and a higher incidence of epileptic encephalopathy with spike-wave activation in sleep (p < 0.0005). Among unilateral non-hemispheric and bilateral PMG cases, seizure-freedom rates were similar between hemispheric and more limited resections, but the latter were associated with a lower incidence of new or worsened motor deficits. Mixed-effects logistic regression (n = 160) showed that hemispheric surgery increased the odds of seizure freedom but without statistical significance (odds ratio [OR] = 3.52, p = 0.055). ICEEG did not significantly influence seizure outcomes but may play a key role in identifying eloquent cortex and guiding safer, tailored resections.

SIGNIFICANCE: In PMG-related epilepsy, surgical strategy must balance seizure control with preservation of function. ICEEG (especially stereo-EEG [SEEG]) remains a valuable tool for functional mapping and tailored resections.

PMID:41854623 | DOI:10.1002/epi.70204

JAMA Netw Open. 2026 Mar 2;9(3):e261532. doi: 10.1001/jamanetworkopen.2026.1532.

ABSTRACT

IMPORTANCE: Early warning scores (EWSs) are widely used tools to support triage and risk stratification in the emergency department (ED). However, data on their performance in identifying clinical deterioration among acutely ill adults aged 80 years or older are scarce.

OBJECTIVE: To evaluate and compare the performance of 5 EWSs for predicting short-term clinical deterioration in ED patients aged 80 years or older.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective prognostic study included all consecutive nontrauma ED visits by patients aged 80 years or older between January 2015 and December 2024 at a large urban teaching hospital in Rome, Italy.

EXPOSURES: Physiologic parameters recorded at ED admission were used to calculate 5 EWSs: National Early Warning Score (NEWS), National Early Warning Score 2 (NEWS2), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and International Early Warning Score (IEWS).

MAIN OUTCOMES AND MEASURES: The primary outcome was clinical deterioration, defined as death or intensive care unit (ICU) admission within 24 hours of ED arrival. Discrimination was assessed by area under the receiver operating characteristic curve (AUROC), calibration by the Brier score, and age-related performance by spline regression. Comparative contributions of variables were analyzed using Shapley additive explanations (SHAP) values.

RESULTS: Among 50 645 patients (median age, 85 years [IQR, 82-88 years]; 54.6% females), 1233 (2.4%) experienced clinical deterioration. All EWSs demonstrated fair discrimination (AUROC range, 0.747 [IQR, 0.731-0.763] for MEWS to 0.782 [IQR, 0.767-0.798] for NEWS). Whereas NEWS achieved the highest AUROC, REMS had the best calibration (Brier score, 0.0220; 95% CI, 0.0208-0.0232). Discriminatory performance declined with increasing age beyond 90 years except for REMS, whose predictive accuracy improved among patients older than 94 years. For patients aged 87 years or older vs 80 to 86 years, oxygen supplementation (SHAP difference, 0.59), systolic blood pressure (SHAP difference, 0.32), and Glasgow Coma Scale score (SHAP difference, 0.40) were the strongest predictors of clinical deterioration.

CONCLUSIONS AND RELEVANCE: In this prognostic study of EWSs conducted among ED patients aged 80 years or older, all scores provided acceptable short-term prognostic accuracy. REMS demonstrated the most consistent performance in patients aged 94 years or older, supporting its use for targeted risk stratification in this population.

PMID:41854615 | DOI:10.1001/jamanetworkopen.2026.1532

JAMA Netw Open. 2026 Mar 2;9(3):e262404. doi: 10.1001/jamanetworkopen.2026.2404.

ABSTRACT

IMPORTANCE: Population-based colorectal cancer (CRC) screening programs are implemented globally. When determining screening intervals, variations in the risk of subsequent CRC by colonoscopy outcome should be considered.

OBJECTIVE: To evaluate the incidence of CRC after a negative screening colonoscopy result or nonadherence to colonoscopy in individuals with a positive fecal occult blood test (FOBT) result.

DESIGN, SETTING, AND PARTICIPANTS: This was a prospective cohort study conducted between January 1, 2008, and December 31, 2021. It was conducted within a population-based CRC screening program in the Stockholm-Gotland region, Sweden, using biennial FOBT as the primary screening test in the target population aged 60 to 69 years. The study cohort included all men and women born between 1938 and 1954 residing in the Stockholm-Gotland region between 2008 and 2012 who were invited to a CRC screening. All participants with a positive FOBT result were identified. Data provided by national registers were analyzed from October 2024 through January 2026.

EXPOSURES: Individuals with a positive FOBT result were categorized as (1) having a negative result on recommended follow-up colonoscopy or (2) nonadherence to recommended follow-up colonoscopy.

MAIN OUTCOMES AND MEASURES: The primary outcome was CRC incidence compared with the general population (defined as all individuals in the cohort who were invited to screening, excluding those with negative colonoscopy or nonadherence following positive FOBT). This was measured by standardized incidence ratio (SIR).

RESULTS: Of 318 096 individuals invited to CRC screening with FOBT, 14 873 had a positive FOBT result (7799 male [52.4%]; median [IQR] age, 65 [63-67] years). Of these individuals, 11 473 (87.3%) underwent a colonoscopy, and 8433 of those colonoscopies (73.5%) were negative. Individuals with a negative screening colonoscopy result had a significantly lower observed CRC incidence (SIR, 0.52; 95% CI, 0.39-0.68) relative to the general population, with a lower SIR in men (0.37; 95% CI, 0.25-0.56) than women (0.71; 95% CI, 0.49-1.03). In contrast, individuals with a positive FOBT who did not adhere to follow-up colonoscopy had a markedly increased CRC incidence (SIR, 4.21; 95% CI, 3.24-5.48) compared with the general population.

CONCLUSIONS AND RELEVANCE: In this study, a decrease in CRC incidence was observed among individuals with negative results in screening colonoscopies, with a greater decrease in men, supporting risk-based, individualized follow-up strategies. A high-risk group for CRC was identified among individuals who did not adhere to follow-up colonoscopy, enabling targeted interventions to improve early CRC detection.

PMID:41854612 | DOI:10.1001/jamanetworkopen.2026.2404