Tag: pubmed

Hum Reprod Update. 2026 Jan 13:dmaf030. doi: 10.1093/humupd/dmaf030. Online ahead of print.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) affects women globally, but its prevalence across World Health Organization (WHO) regions has not previously been reported.

OBJECTIVE AND RATIONALE: We aimed to synthesize evidence on the prevalence of PCOS by diagnostic criteria and by WHO geographic regions to inform the International Evidence-Based PCOS Guideline.

SEARCH METHODS: A systematic search of OVID MEDLINE, All EBM, PsycInfo, EMBASE, and Cumulative Index to Nursing and Allied Health Literature was conducted from 1990 to November 2024. Studies assessing PCOS prevalence in an unselected population were included. Non-primary studies or those with unclear diagnostic criteria were excluded. The primary outcome was PCOS prevalence among adult women. The secondary outcome was PCOS prevalence among women of all ages. Random effects meta-analysis using the DerSimonian and Laird method was applied for estimating the overall effect size. Two reviewers independently assessed risk-of-bias (RoB) and evidence certainty.

OUTCOMES: The search yielded 16 664 articles, of which 119 unique studies (in 137 articles) were eligible, and 92 (including 157 181 participants) were pooled in a meta-analysis. By diagnostic criteria, PCOS global prevalence among adult women only was 12.1% (95% CI: 9.8, 14.8; I2: 98.8%) using Rotterdam criteria, 7.9% (95% CI: 6.2, 9.9; I2: 96.2%) using the original National Institute of Health (NIH) criteria, 12.7% (95% CI: 8.2, 17.9; I2: 98.0%) using the Androgen Excess (AE)-PCOS criteria, and 7.8% (95% CI: 5.8, 10.0; I2: 99.4%) by self-report. By WHO regions, PCOS prevalence among adult women when using Rotterdam criteria was highest in the Eastern Mediterranean region (15.1%; 95% CI: 11.1, 19.7) and the South-East Asian region (14.3%; 95% CI: 5.8, 25.9), followed by the European region (11.7%; 95% CI: 5.1, 20.3), the region of the Americas (10.5%; 95% CI: 3.0, 21.7), and the Western Pacific region (9.1%; 95% CI: 6.2, 12.5), with no data from Africa. Subgroup analysis using Cochran’s Q test indicated a statistically significant difference in prevalence by WHO region (P = 0.022). Subgroup analyses including adolescents yielded a lower prevalence globally, with a global prevalence of 11.4% (95% CI: 9.5, 13.5) by Rotterdam criteria, 7.1% (95% CI: 5.7, 8.7) by NIH criteria, 11.2% (95% CI: 7.4, 15.5) by AE-PCOS criteria, and 7.6% (95% CI: 5.8, 9.6) on self-report. Of the 119 studies, 30 had low, 49 had moderate, and 40 had high RoB. Certainty of evidence ranged from very low to low.

WIDER IMPLICATIONS: This is the most comprehensive and contemporary review of PCOS prevalence and highlights past inconsistencies in diagnostic criteria and individual diagnostic features. Pooled PCOS prevalence was 12.1% by the Rotterdam criteria and was highest in the Eastern Mediterranean and the South-East Asian regions, with a potentially different health burden of PCOS across world regions. These findings directly inform International PCOS Guidelines, including updated guideline diagnostic criteria and refined individual features, emphasizing early, accurate diagnosis.

REGISTRATION NUMBER: PROSPERO CRD42022372029.

PMID:41528735 | DOI:10.1093/humupd/dmaf030

Drugs Aging. 2026 Jan 13. doi: 10.1007/s40266-025-01273-7. Online ahead of print.

ABSTRACT

BACKGROUND: The scientific literature, including systematic reviews and meta-analyses, has frequently described associations between aging, medication use, and frailty, without evaluation of their independent causation. The Bradford Hill Criteria, a framework consisting of nine principles for assessing epidemiological causation, is ideally suited to unconfound and assess the independent causal effect of aging versus medication use, in frailty progression.

METHODS: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, searched MEDLINE, EMBASE, and CENTRAL with no restrictions on date or study design. Studies were selected based on predefined inclusion criteria and assessed for quality using the Joanna Briggs Institute critical appraisal tool. Where appropriate, meta-analyses of collated data were performed in RStudio, including effect sizes accounting for minimum age and polypharmacy to reduce confounding bias. Causal relationships between aging, medication use, and frailty were then evaluated independently using the nine principles of the Bradford Hill Criteria.

RESULTS: Data from 105 moderate-to-high quality studies based on the Joanna Briggs Institute assessment were extracted, formatted, and compiled to allow evaluation via the Bradford Hill Criteria. Evidence supported a strong independent causal relationship between aging, medication use, and frailty progression across eight of the nine principles. Strength of association, consistency, and a clear biological gradient were observed, with frailty increasing alongside age and medication count, respectively. Temporality was addressed as aging and medication exposure often preceded frailty, while interventions reducing medication supported the experiment criterion. Biological plausibility, biological coherence, and analogy were reinforced by clear biological mechanism, scientific reasoning, and epidemiological patterns. However, specificity could not be fully met, as frailty is influenced by multiple factors beyond aging and medication use, making the relationship inherently non-specific.

CONCLUSIONS: An independent causal link between aging and frailty, as well as between medication use and frailty, is well supported by the framework of Bradford Hill Criteria. Given the limited availability of randomized controlled trials or interventional studies in older adults, these findings offer valuable insights where evidence has been lacking and serve as a strategic starting point for future investigations into factors driving frailty progression.

CLINICAL TRIAL REGISTRATION: PROSPERO Registration Number CRD42024614144.

PMID:41528721 | DOI:10.1007/s40266-025-01273-7

Phys Eng Sci Med. 2026 Jan 13. doi: 10.1007/s13246-025-01688-x. Online ahead of print.

ABSTRACT

Wrist pulse measurement offers significant insights into cardiovascular health. However, the application of various sensors, such as optical, pressure, image, and ultrasonic, is limited due to issues like bright environments, incompatibility with pressure adjustments, and system complexity. Recent studies suggest condenser microphones as promising alternatives, though the optimal type among various condenser microphones remains unclear. This study explores the application of three different condenser microphones using four regression-based machine learning models (Partial Least Square Regression, Ridge Regression, Principal Component Regression, and Nu-Support Vector Regression) for wrist pulse measurement based on pulse rate accuracy. One omnidirectional condenser microphone, previously used for wrist pulse measurement, and two commonly available unidirectional condenser microphones were evaluated. A mechanical system for pulse acquisition was developed, and data were collected from 27 healthy subjects using each microphone alternatingly. Extracted time-domain and statistical features were used as inputs to compare the predicted pulse rates with the ground truth pulse rate values. Results indicated that unidirectional condenser microphones were more accurate than the omnidirectional type. Among the unidirectional microphones, the one with a sensitivity range of – 50 to – 44 dB outperformed the microphone with a sensitivity range of – 40 to – 34 dB. The Nu-Support Vector Regression model exhibited the least errors, indicating superior predictive capabilities compared to the other models. In conclusion, this study provides valuable insights into selecting appropriate condenser microphones for wrist pulse measurement, offering a guiding framework for future research in this domain.

PMID:41528717 | DOI:10.1007/s13246-025-01688-x

J Behav Med. 2026 Jan 13. doi: 10.1007/s10865-025-00624-4. Online ahead of print.

ABSTRACT

Sleep health disparities are well documented, whereas racial differences in treatment response to sleep interventions, are not. This single arm sleep intervention study explored treatment-response differences in sleep behaviors, quality of life, well-being, depressive symptoms, and daytime sleepiness between White and Underrepresented racial groups, as well as racial differences in pre-treatment sleep-relevant characteristics. Middle-aged adults at risk for the metabolic syndrome with short sleep duration (N = 41; 49% Underrepresented racial group [n = 20], 51% White [n = 21]) participated in a virtually-delivered, 12-week personalized systematic sleep time extension informed by cognitive behavioral therapy for insomnia. Sleep behaviors were estimated using wrist actigraphy. Quality of life, emotional well-being, daytime sleepiness, chronotype preference, daytime sleepiness, depressive symptoms, quality of life, and well-being were assessed using validated surveys. Sleep environment, race, and socio-demographic characteristics were self-reported. Underrepresented participants had a greater increase in fragmentation indexes and a greater improvement in emotional well-being from pre to post-intervention compared to their White counterparts of medium and medium-to-large magnitude, respectively. Within each racial group, statistically and clinically significant improvements in sleep duration and daytime sleepiness were found. Within the Underrepresented group, the sleep regularity index increased and sleep onset times advanced significantly. These exploratory findings suggest that future studies with larger samples should investigate the modulating effects of chronotype on sleep intervention treatment response for Underrepresented racial groups and the upstream contextual and systemic factors impacting sleep.Trial registration numberTrial registration number ClincalTrials.gov NCT03596983.

PMID:41528656 | DOI:10.1007/s10865-025-00624-4

J Occup Rehabil. 2026 Jan 13. doi: 10.1007/s10926-025-10361-9. Online ahead of print.

ABSTRACT

PURPOSE: Firefighting is widely recognized as a physically demanding profession, in which working until the statutory retirement age is considered highly challenging. However, increasing societal pressure to extend working lives highlights the need to gain more insight into how sustainable employability (SE) can be supported in such occupations. This study aims to examine cross-sectional associations between overall and task-specific physical work demands and SE among Dutch career firefighters.

METHODS: Data from the SEmFire Cohort Study questionnaire for Dutch career firefighters (n = 1371) were used. SE was assessed using nine indicators across three domains: health (health status, work ability, need for recovery, prolonged fatigue), well-being (job satisfaction, motivation to work), and employability (employability, skill gap, job performance). Physical work demands-overall and task-specific-were used as independent variables. Multiple logistic regression models were applied, adjusting for personal, occupational, and health-related factors.

RESULTS: Dutch career firefighters reported high physical work demands and unfavorable outcomes across multiple SE indicators. Both overall and task-specific physical demands were cross-sectionally associated with adverse SE outcomes across all three domains. Statistically significant associations were observed in all three distinguished function groups-operational, hybrid, and non-operational-though patterns (i.e., which indicators and the strength of associations) varied between groups. The frequency of incident responses per month also influenced the strengths of these associations.

CONCLUSION: This study shows that physical work demands are associated with multiple indicators of SE among Dutch career firefighters. These findings provide an important first step toward identifying actionable areas to enhance SE among firefighters.

PMID:41528644 | DOI:10.1007/s10926-025-10361-9

Clin Rheumatol. 2026 Jan 13. doi: 10.1007/s10067-026-07929-y. Online ahead of print.

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation. Growing evidence suggests a link between insulin resistance (IR) and RA. However, the association of specific lipid-based IR indices, such as the Mffm/I index (Metabolic Score for Insulin Sensitivity), with RA prevalence remains underexplored. This study aimed to investigate the associations of the Mffm/I index and the Quantitative Insulin Sensitivity Check Index (QUICKI) with the prevalence of RA in a large, nationally representative population.

METHODS: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018. A total of 8,477 adult participants were included and categorized based on their RA status. The associations between Mffm/I, QUICKI (as both continuous variables and quartiles), and RA were evaluated using multivariable logistic regression models, adjusting for a comprehensive set of sociodemographic and clinical covariates. Results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses, interaction tests, and mediation analyses were conducted to explore the consistency of these associations and the potential mediating role of obesity.

RESULTS: Of the 8,477 participants, 549 (6.5%) reported a diagnosis of RA. After full adjustment for potential confounders, both the Mffm/I index and QUICKI demonstrated a significant inverse association with RA. In the fully adjusted model (Model 3), participants in the highest quartile (Q4) of Mffm/I had a 40% lower odds of RA (OR = 0.60, 95% CI: 0.45-0.79) compared to the lowest quartile (Q1). Similarly, the highest quartile of QUICKI was associated with a 28% lower odds of RA (OR = 0.72, 95% CI: 0.55-0.94). These negative associations were consistent across most predefined subgroups. Mediation analysis revealed that obesity significantly mediated the relationships, accounting for 43.87% of the total effect for Mffm/I and 51.04% for QUICKI.

CONCLUSION: This study establishes a stable and robust inverse association between both the Mffm/I index and QUICKI and the prevalence of rheumatoid arthritis in the U.S. adult population. These findings highlight the potential role of insulin sensitivity in the pathophysiology of RA and suggest that obesity is a critical mediator in this relationship. These easily accessible indices may serve as valuable tools for risk assessment in clinical practice. Key Points • High insulin sensitivity is strongly associated with lower rheumatoid arthritis prevalence. • The novel lipid-based Mffm/I index is a robust indicator of RA prevalence. • Obesity mediates over 40% of the link between insulin resistance and RA. • Accessible insulin sensitivity indices may aid in clinical RA risk assessment.

PMID:41528638 | DOI:10.1007/s10067-026-07929-y

Genet Med. 2026 Jan 9:101684. doi: 10.1016/j.gim.2026.101684. Online ahead of print.

ABSTRACT

PURPOSE: We characterized dimensions of clinical utility in a prospective, observational cohort of patients with rare diseases undergoing genome sequencing (GS).

METHODS: Clinical utility data (diagnostic, clinical management and research recommended, avoided, or pursued for index cases and relatives) were collected from medical records and summarized using descriptive statistics. A multivariable regression model characterized factors associated with each type of utility, reported as odds ratios with 95% confidence intervals.

RESULTS: Among 715 cases who underwent GS, results triggered diagnostic investigations in 17.5%, clinical management activities in 35.8%, research opportunities in 30.8%, and genetic counseling/testing for relatives in 19.0%. Results also limited diagnostic investigations in 87.9%. Regression analyses identified clinical, geographic, and ethnicity-related factors as significantly associated with utility. Diagnostic/potentially diagnostic results increased odds of changes in diagnostic investigations, management and genetic testing recommendations for relatives. Patients from larger sites had higher odds of management or research recommendations and patients of non-European ethnicity were less likely to pursue recommendations.

CONCLUSIONS: Our findings provide evidence that GS has clinical utility beyond diagnostic care, including management, research, as well as familial care and preventing unnecessary medical activity. To determine which factors are associated with utility, multiple dimensions of care and broad sociodemographic factors warrant consideration.

PMID:41527898 | DOI:10.1016/j.gim.2026.101684

Clin Gerontol. 2026 Jan 13:1-12. doi: 10.1080/07317115.2026.2615710. Online ahead of print.

ABSTRACT

OBJECTIVES: This study examined the association between self-critical rumination and attitudes toward aging in older adults.

METHODS: A cross-sectional descriptive design was employed between December 2024 and September 2025 with 391 older adults in Türkiye. Data were collected using the Self-Critical Rumination Scale (SCRS) and the European Attitudes to Aging Questionnaire (EAAQ). Analyses included descriptive statistics, Pearson correlation, and linear regression.

RESULTS: A moderately strong negative correlation was found between SCRS and EAAQ total scores (r = -.518, p < .001). Higher SCRS scores were positively correlated with the EAAQ psychosocial loss subscale (r = .507, p < .001) and negatively correlated with physical change and psychological growth subscales (p < .001). Self-critical rumination accounted for 26.9% of the variance in attitudes toward aging (B = -.896, R2 = .269, p < .001). Participants with higher income, better perceived health, no sleep problems, and regular eating habits reported lower rumination and more positive attitudes.

CONCLUSIONS: Elevated self-critical rumination was associated with more negative attitudes toward aging, particularly regarding psychosocial loss. Health-related factors significantly influenced both rumination and attitudes toward aging.

CLINICAL IMPLICATIONS: Targeted cognitive-behavioral interventions and health-promoting strategies, implemented by psychiatric nurses, may support positive aging attitudes and psychological well-being in older adults.

PMID:41527894 | DOI:10.1080/07317115.2026.2615710

J Patient Saf. 2026 Jan 13. doi: 10.1097/PTS.0000000000001459. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to determine the frequency of opening of operating room doors during cardiovascular surgery operations, the number of personnel entering and exiting, and the reasons for these entries.

MATERIALS AND METHODS: This descriptive observational study was carried out in the cardiovascular surgery operating rooms of a university hospital. Using purposive sampling, 22 consecutive surgeries were observed, and data were collected with an “Intraoperative Observation Form.” Descriptive statistics were used for analysis.

RESULTS: The mean number of door openings per procedure was 74.18±41.54, corresponding to 16.92±7.33 openings per hour. Individuals opening the doors were support staff (27.8%), nurses (24.7%), perfusionists/others (18.9%), surgeons (15.6%), and anesthesiologists/anesthesia technicians (13.1%). The leading reason for entry was equipment retrieval (27.2%). Notably, 20.3% of entries were unrelated to the ongoing surgery.

CONCLUSION: Operating-room traffic is characterized by frequent door openings and substantial personnel movement, conditions that may degrade air quality and heighten the risk of surgical-site infection. Educational initiatives, improved equipment planning, and institutional policy development are recommended to reduce unnecessary traffic.

PMID:41527873 | DOI:10.1097/PTS.0000000000001459

Subst Use Misuse. 2026 Jan 13:1-22. doi: 10.1080/10826084.2025.2606861. Online ahead of print.

ABSTRACT

BACKGROUND: Substance use disorders (SUDs) are a major global health burden, and third-wave therapies that target transdiagnostic processes such as psychological flexibility and mindfulness have emerged as promising options. This systematic review synthesized evidence on third-wave interventions for adults with diagnostic and statistical manual of mental disorder (DSM)-defined SUDs.

METHODS: A comprehensive search of seven databases (2014-2025) identified randomized and non-randomized studies of acceptance and commitment therapy (ACT), related mindfulness-based programs, and dialectical behavioral therapy skills training. Two reviewers screened records, extracted data, assessed risk of bias with Risk of Bias 2 (RoB 2) and risk of bias in non-randomized studies of interventions (ROBINS-I), and synthesized findings using SWiM-consistent narrative methods. The review was prospectively registered in PROSPERO (CRD420251028610).

RESULTS: Forty-seven studies (35 randomized, 12 non-randomized) met inclusion criteria. Across modalities, third-wave interventions yielded small-to-moderate benefits on abstinence, craving, and substance use outcomes compared with control conditions, with larger and more consistent gains in psychological flexibility, emotion regulation, and mindfulness. Effect sizes varied and most trials showed some concerns or serious risk of bias, resulting in generally low-to-moderate certainty of evidence.

CONCLUSIONS: Third-wave interventions may serve as adjunctive or alternative SUD treatments by engaging targeted mechanisms, enhancing psychological functioning, and producing modest but clinically relevant substance-use benefits. More rigorous, adequately powered mechanism-focused trials are needed to clarify comparative efficacy and guide process-based personalization and implementation in routine addiction services.

PMID:41527866 | DOI:10.1080/10826084.2025.2606861