Tag: pubmed

JAMA Psychiatry. 2026 Jan 14. doi: 10.1001/jamapsychiatry.2025.4106. Online ahead of print.

ABSTRACT

IMPORTANCE: Grief-focused cognitive behavioral therapies (GF-CBTs) are found effective in treating prolonged grief disorder (PGD), but the relative efficacy of different delivery formats is unknown. While evidence for individual GF-CBT (GF-CBT individual) is well established, evidence for group GF-CBT (GF-CBT group) is scarce. However, the group format holds possible advantages in a bereavement context.

OBJECTIVE: To examine whether GF-CBT group is noninferior to GF-CBT individual in reducing PGD symptoms in older adults.

DESIGN, SETTING, AND PARTICIPANTS: Enrollment and data collection for this noninferiority randomized clinical trial took place from April 2021 to May 2025. Participants were randomized 1:1 to GF-CBT group and GF-CBT individual and followed up with until 6 months posttreatment. Recruitment and treatment were done in a naturalistic clinical practice. Participants included older bereaved adults (65 years or older) with clinically relevant levels of PGD, posttraumatic stress disorder (PTSD), depression, and/or anxiety based on established cutoffs on self-report questionnaires. These data were analyzed from June 2025 through August 2025.

INTERVENTIONS: GF-CBT group and GF-CBT individual consisted of 12 weekly sessions (duration: 2 hours vs 1 hour), including the same intervention techniques in the same order (exposure, cognitive restructuring, and behavioral activation).

MAIN OUTCOMES AND MEASURES: Outcomes were measured at pretreatment, posttreatment, 3-month follow-up, and 6-month follow-up as the primary end point. The primary outcome was PGD symptoms measured with the Prolonged Grief-13 questionnaire. Secondary outcomes included symptoms of PTSD, depression, anxiety, loneliness, social support, functional impairment, quality of life, and well-being.

RESULTS: Participants (N = 113; mean [SD] age, 71.58 [5.86] years; 92 female [81.4%], 20 male [17.7%], and 1 person [.09%] had missing information on gender) were randomized to GF-CBT group (n = 56) or GF-CBT individual (n = 57). Mixed linear models on the intention-to-treat sample showed that both formats yielded statistically significant large reductions in PGD symptoms over time (GF-CBT group: d = 1.74; GF-CBT individual: d = 1.46). GF-CBT group was noninferior compared with GF-CBT individual (d = 0.09; 95% CI, -0.06 to 0.25) at 6-month follow-up. The noninferiority of GF-CBT group was evidenced for all secondary outcomes. Dropout rates were 23% (GF-CBT group) vs 19% (GF-CBT individual).

CONCLUSIONS AND RELEVANCE: In this study, GF-CBT group was noninferior to GF-CBT individual at 6-month follow-up in reducing PGD symptoms, but also symptoms of PTSD, depression, and anxiety. Both formats had large effects on symptoms over time and appear to be relevant treatment formats for older adults with symptoms of PGD and other disorders post loss.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04694807.

PMID:41533372 | DOI:10.1001/jamapsychiatry.2025.4106

Int J Environ Health Res. 2026 Jan 14:1-9. doi: 10.1080/09603123.2026.2614976. Online ahead of print.

ABSTRACT

CVS prevalence was found to be 76.9%. Females had higher odds of CVS (OR = 1.834, p = 0.028). Each one-unit increase in screen time was associated with higher odds of CVS (OR = 1.340, p = 0.030). Each one-unit increase in screen distance was associated with higher odds of CVS (OR = 2.153, p = 0.004). Each one-unit increase in room illumination was associated with lower odds of CVS (OR = 0.555, p = 0.015). Those who used at least one protective measure had lower odds of CVS (OR = 0.403, p = 0.006). There was no statistically significant relationship between CVS and academic year, screen brightness, or posture.

These findings highlight the need for spreading awareness and promoting targeted interventions to improve eye health.

PMID:41533339 | DOI:10.1080/09603123.2026.2614976

Am J Physiol Cell Physiol. 2026 Jan 14. doi: 10.1152/ajpcell.00845.2025. Online ahead of print.

ABSTRACT

Prostate cancer progression and metastasis is a complex step that is controlled by various molecular and cellular mechanisms. Here, the process of osteomimicry has a vital role in the context of bone metastasis. Osteomimicry phenomenon refers to the ability of cancer cells to acquire bone-like properties, thus enabling them to adapt to and survive in their bone microenvironment. This phenomenon promotes cancer cell and bone microenvironment interactions and contributes directly to tumor survival, growth, and the development of bone metastatic lesions. In this review we discuss the role of different osteomimicry factors in prostate cancer progression and metastasis, highlighting their involvement in each stage of the metastatic cascade. Key factors involved in osteomimicry – such as bone matrix proteins, signaling pathways, and transcriptional regulators – play important roles throughout the various stages of cancer progression. These include the initial development of the tumor, its local invasion into surrounding tissues, entry into the bloodstream (intravasation), spread to other more distant areas (extravasation), and ultimately, colonization and growth in the bone. Gaining a better understanding of how these factors are regulated, interact, and function can shed light on new treatment strategies aimed at targeting osteomimicry to slow down or prevent the progression of prostate cancer and its spread to the bones.

PMID:41533336 | DOI:10.1152/ajpcell.00845.2025

Tissue Eng Regen Med. 2026 Jan 14. doi: 10.1007/s13770-025-00782-1. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD) presents significant unmet medical needs with no effective therapeutic options. Current pharmacological treatments provide only symptomatic relief and do not prevent the ongoing neurodegeneration. Cell therapies using mesenchymal stem cells (MSCs) are being widely investigated for its potential in treating AD but remain unverified. This review aimed to evaluate therapeutic effects of MSCs on AD patients through a review of clinical trial literatures.

METHODS: Publications and registered clinical trials from January 2011 to June 2025 were collected from the international databases (ClinicalTrials.gov, PubMed, Web of Science, SCOPUS) using the keywords of “Alzheimer’s disease”, “mesenchymal stem cells”, and “clinical trials”. After initial screening and sorting, 17 clinical trials and 4 related papers were finally selected for in-depth analysis.

RESULTS: The 17 clinical trials were mostly early stages with 4 phase 1 (23.5%), 9 phases 1/2 (52.9%), 3 phase 2 (17.7%), and 1 pilot phase (5.9%). The source of MSCs included allogeneic umbilical cord blood (UCB) in 5 trials (29.4%), autologous adipose tissue in 4 (23.5%), allogeneic umbilical cord (UC) in 3 (17.6%), allogeneic bone marrow (BM) in 3 (17.6%), allogeneic placenta in 1 (5.9%) and 1 unknown (5.9%). Administration routes were primarily intravenous (IV) infusion in 12 trials (70.6%), intracerebroventricular (ICV) infusion via Ommaya reservoir in 3 (17.6%), and stereotactic brain injection (SBI) in 2 (11.8%). Among the 17 clinical trials, outcome data of 7 trials have been reported in 4 clinical papers and 1 clinical results posted in ClincalTrials.gov: 4 trials using UCB MSCs (NEUROSTEM-AD) in 2 papers, 2 trials using BM MSCs (Lomecel-B) in 2 papers and 1 trial using adipose MSCs (AstroStem) in ClinicalTrials.gov. All 5 reports using different cell types, administration routes or dosages claimed the safety of MSCs administration. As for the therapeutic efficacy, 2 reports using Lomecel-B reported meaningful improvement in AD pathophysiology or cognitive functions, while the other 3 reports using NEUROSTEM-AD or AstroStem failed to show statistically significant efficacy.

CONCLUSION: The analysis of 17 clinical trials and 5 relevant clinical outcomes showed that MSCs therapy if feasible and generally safe in AD patients. There are indications of potential therapeutic benefits such as improved cognitive function or quality of life measures in some AD patients. However, its therapeutic efficacy has not been proven definitely due to small size of subjects, variations in dosage, MSCs source, and administration scheme (route, timing, and frequency). Larger subject sizes and well-controlled trials are needed to provide more conclusive evidence.

PMID:41533329 | DOI:10.1007/s13770-025-00782-1

Spine Deform. 2026 Jan 14. doi: 10.1007/s43390-026-01278-1. Online ahead of print.

ABSTRACT

PURPOSE: Osteogenesis Imperfecta (OI) is a rare connective tissue disorder often associated with severe, brace-resistant scoliosis. Posterior spinal fusion (PSF) with pedicle screws can achieve up to 60% coronal correction, while preoperative halo-gravity traction (HGT) may provide additional benefits but carries potential risks. This study evaluated whether HGT offers perioperative or radiographic advantages compared with PSF alone in pediatric OI patients.

METHODS: Thirty-six patients treated between 2002 and 2020 with ≥ 2 years’ follow-up were retrospectively analyzed. Patients were divided into HGT + PSF (N = 19) and PSF-only (N = 17) groups, comparable in baseline characteristics. The primary outcome was coronal correction rate (CR); secondary outcomes included operative time, blood loss, length of stay (LOS), complications (Modified Clavien-Dindo-Sink Classification, MCDS), and loss of correction at follow-up. Statistical comparisons used Mann-Whitney U and Chi-Squared tests (p < 0.05).

RESULTS: Postoperative major and minor curve CR were 60.2% and 66.5% in the HGT + PSF group vs. 55.1% and 37.7% in PSF (p = 0.337 and p = 0.003). At last follow-up, CR was 51.1% and 38.8% for HGT + PSF vs. 44.9% and 25.2% for PSF (p = 0.298 and p = 0.238). Mean blood loss (1235 vs. 1368 mL, p = 0.972), operative time (443 vs. 410 min, p = 0.490), and LOS (12.6 vs. 9.5 days, p = 0.186) were not significantly different. Complications occurred in 57.9% of HGT + PSF vs. 29.4% of PSF patients (p = 0.367), with more major complications in the HGT + PSF group.

CONCLUSIONS: In this cohort, HGT provided only modest additional coronal correction without clear perioperative advantages compared with PSF alone. Given these limited and partly transient effects, its routine use should be considered cautiously and in the context of individual patient characteristics. Larger prospective multicenter studies are needed to clarify the specific clinical scenarios in which preoperative HGT may offer meaningful benefit in the surgical management of OI-related scoliosis.

PMID:41533302 | DOI:10.1007/s43390-026-01278-1

Qual Life Res. 2026 Jan 14;35(2):43. doi: 10.1007/s11136-025-04157-w.

ABSTRACT

PURPOSE: To examine sex differences in health-related quality of life (HRQoL) among patients surgically treated for renal cell carcinoma (RCC) in Sweden, utilizing data from the National Swedish Kidney Cancer Register (NSKCR).

METHODS: In this study of 4658 surgically treated RCC patients, data on HRQoL, clinical, demographic, and socioeconomic characteristics were retrieved from the NSKCR for patients undergoing surgical treatment between January 2016, and April 2024. HRQoL was measured using the 14- and 19-item versions of the Functional Assessment of Cancer Therapy – Kidney Symptom Index (FKSI-14/19) instrument six months after surgery. The association between sex and HRQoL was estimated using linear regression. Separate analyses were performed for the FKSI-14 and FKSI-19 total scores and underlying domains.

RESULTS: In total, 3086 (66.3%) men and 1572 (33.7%) women were included. After adjusting for clinical, demographic, and socioeconomic characteristics, male sex was significantly associated with higher HRQoL. Specifically, men had higher scores, indicating fewer symptoms, for physical and mental symptoms according to FKSI-14 (P < 0.001), and for physical (P < 0.001) and emotional (P < 0.001) disease-related symptoms, as well as treatment side effects (P < 0.022), according to FKSI-19. Total HRQoL was significantly higher in men, according to both the FKSI-14 (P < 0.001) and the FKSI-19 (P < 0.001).

CONCLUSIONS: HRQoL differed significantly between men and women six months after surgery, with men reporting higher HRQoL, even after accounting for clinical, demographic, and socioeconomic factors. Healthcare professionals should be aware of the risk of lower HRQoL among female patients.

PMID:41533299 | DOI:10.1007/s11136-025-04157-w

Clin Transl Oncol. 2026 Jan 14. doi: 10.1007/s12094-025-04198-0. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate how the implementation of intensity-modulated/image-guided RT (IMRT/IGRT) with intraprostatic seeds can impact the risk of late gastrointestinal (LGI) and genitourinary (LGU) toxicity in prostate cancer (PCa) patients treated with dose-escalation RT.

MATERIALS /METHODS: Retrospective analysis of a prospective cohort of 1,010 men treated within a risk-adapted, intensification program with a minimum follow-up (FU) of 5 years. The median radiation dose to prostate was 79.5 Gy (IQR: 75.0, 80.3). Short-term ADT (STADT, n = 165) and long-term ADT (LTADT, n = 385) were administered to intermediate- and high-risk patients, respectively. Late toxicities were assessed using the EORTC/RTOG criteria. Kaplan-Meier analysis: to calculate the cumulative incidence of late toxicities; Cox proportional regression model: to estimate hazard ratios (HRs).

RESULTS: Median FU was 116 months (IQR: 88-133). The median RT dose for IMRT/IGRT was 80.0 Gy (IQR 79.1, 81.2) and 78.0 Gy (IQR 73.1, 79.6), (p = 0.001) for those treated with 3DCRT. The 10-year Kaplan-Meier grade ≥ 2 LGI and LGU toxicities were 10% (95% confidence interval [CI] 8-12) and 16% (95% CI 14-18), respectively. The multivariate analysis (MVA) showed that the use of IMRT/IGRT with intraprostatic seeds was a significant protective factor for grade ≥ 2 LGI toxicity (HR: 0.66, 95%CI: 0.46-0.95, p = 0.021), despite the higher radiation dose in the IMRT/IGRT group. However, its impact on decreasing grade ≥ 2 LGU toxicity did not achieve statistically significance (13% vs 18%; p = 0.053, HR 0.88). A prior transurethral resection of the prostate (TURP) (HR 1.98, 95% CI: 1.30-2.59, p = 0.002) and the presence of acute grade ≥ 2 GU complications (HR:1.76, 95% CI: 1.20-2.9, p = 0.003) were associated with a higher incidence of grade ≥ 2 LGU toxicity, while LTADT was significantly associated with a lower risk of GU complications (HR:0.66, 95% CI: 0.46-0.95, p = 0.021).

CONCLUSION: The study confirms that IMRT/IGRT with intraprostatic fiducial markers significantly reduces grade ≥ 2 late GI toxicity, and appears to prevent an increase in GU toxicity rates despite dose escalation.

PMID:41533295 | DOI:10.1007/s12094-025-04198-0

Int J Comput Assist Radiol Surg. 2026 Jan 14. doi: 10.1007/s11548-025-03564-1. Online ahead of print.

ABSTRACT

Purpose Surgical gestures are fundamental components of surgical procedures, encompassing actions such as cutting, suturing, and knot-tying. Gesture recognition plays a pivotal role in the automatic analysis of surgical data. Although recent advancements have improved surgical gesture recognition, much of the existing research relies on simulations or minimally invasive surgery data, failing to capture the complexities of open surgery. In this study, we introduce and employ a new open surgery dataset focused on closing incisions after saphenous vein harvesting. Methods Our goal is to improve gesture recognition accuracy by incorporating tool pose estimation and 3D hand pose predictions of surgeons. We employ MS-TCN++ and LTContext for gesture recognition, and further enhance performance through an ensemble of models using different modalities-video, tool pose, and hand pose data.Results The results reveal that using an ensemble model combining all three modalities provides a substantial improvement over video-only approaches, leading to statistically significant gains across multiple evaluation metrics. We further demonstrate that the model can rely solely on hand and tool poses, completely discarding the video input, while still achieving comparable performance. Additionally, we show that an ensemble model using only hand and tool poses produces results that are either: statistically significantly better than using video alone, or not statistically significantly different.Conclusion This study highlights the effectiveness of integrating multimodal data for surgical gesture recognition. By combining video, hand pose, and tool pose information, our approach achieves higher accuracy and robustness compared to video-only methods. Moreover, the comparable performance of pose-only models suggests a promising, privacy-preserving alternative for surgical data analysis.

PMID:41533294 | DOI:10.1007/s11548-025-03564-1

Clin Transplant. 2026 Jan;40(1):e70441. doi: 10.1111/ctr.70441.

ABSTRACT

BACKGROUND: Efforts to identify barriers and improve access to kidney transplantation in the United States are limited by a lack of population-level data on early steps in the transplant evaluation process.

METHODS: We used a rule-based natural language processing (NLP) approach with clinical notes in the US Veterans Affairs Healthcare System (VA) electronic health record (EHR) and linkage with the United States Renal Data System registry to characterize sequential steps in the kidney transplant evaluation process. Adults with advanced kidney disease (estimated glomerular filtration rate ≤20 mL/min/1.73m²) from 1/1/2012-12/31/2019 who were receiving care within the VA were followed through 12/31/2021.

RESULTS: Among 45,174 cohort members, the median age was 71 (IQR 64, 80) years, and 97.2% were men. There was documentation of kidney transplant being mentioned as a treatment option for 46.3% of cohort members, 28.2% engaged in some type of evaluation for transplant, and 8.4% were referred to and 5.4% evaluated at a VA kidney transplant center. 6.9% of cohort members were added to the national deceased donor waitlist and 3.1% received a kidney transplant. Compared with events identified through EHR chart search and manual review by two clinicians, NLP identified events within 90 days with a precision of 0.82-0.94 and recall of 0.56-0.89.

CONCLUSION: These results illuminate the substantial proportion of patients who engage in early steps in the kidney transplant evaluation process. The work also demonstrates that NLP can accurately identify these key steps in the process as documented in patients’ EHRs.

PMID:41533291 | DOI:10.1111/ctr.70441

Int Urol Nephrol. 2026 Jan 14. doi: 10.1007/s11255-026-05015-5. Online ahead of print.

ABSTRACT

BACKGROUND: Vascular complications following percutaneous nephrolithotomy (PCNL), although uncommon, may result in significant morbidity. This systematic review and meta-analysis evaluated the incidence, distribution, and management outcomes of vascular complications after PCNL in contemporary practice.

METHODS: A systematic search of PubMed/MEDLINE, EMBASE, BIOSIS, Google Scholar, and the Cochrane Library identified observational studies reporting vascular complications after PCNL published between 2015 and 2025. Pooled proportions were calculated using a DerSimonian-Laird random-effects model. Statistical heterogeneity was assessed using the I² statistic, and methodological quality was evaluated using the Newcastle-Ottawa Scale. This review was not prospectively registered.

RESULTS: Ten studies met the inclusion criteria. Four studies reporting denominator-level data (10,440 PCNL procedures) were included in the pooled incidence analysis, yielding a vascular complication incidence of 3% (95% CI 2-4%). Among 625 reported vascular complications, pseudoaneurysms were the most frequent lesion (57%), followed by arteriovenous fistulas (29%), arterial lacerations (25%), and arteriocaliceal fistulas (11%); lesion categories were not mutually exclusive. Nine studies reported outcomes following angioembolization (703 cases) and two studies reported conservative management outcomes (204 cases). The pooled success rate was 92% (95% CI 84-98%) for angioembolization and 67% (95% CI 52-80%) for conservative management (p = 0.0013). No procedure-related mortality was reported.

CONCLUSIONS: Vascular complications after PCNL remain infrequent in contemporary practice but may be clinically significant when they occur. Pseudoaneurysm is the most reported lesion. Angioembolization is associated with high success rates in appropriately selected patients, while conservative management remains effective in selected cases. Interpretation of these findings should consider the observational nature of the evidence and substantial heterogeneity across studies.

PMID:41533282 | DOI:10.1007/s11255-026-05015-5