Tag: pubmed

Neurosurgery. 2026 Aug 5. doi: 10.1227/neu.0000000000004183. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Chronic subdural hematomas (cSDH) are among the most common neurosurgical pathologies. Older adults also often have comorbidities treated with anticoagulant and antiplatelet (ACAP) medications. Managing clinicians frequently must weigh the benefits and risks of stopping and reinitiating such drugs in cSDH. The aim of this retrospective study was to analyze outcomes associated with ACAP use and cSDH, focusing on the need for reoperation, mortality, and neurological function.

METHODS: Between 2011 and 2023, patients requiring surgical management of a cSDH across 5 UK neurosurgical units were identified. Collected variables included patient comorbidities, preoperative and postoperative neurological function, ACAP termination and reinitiation, need for reoperation, and mortality. Statistical analysis included multivariable logistic regression for predictors of key outcomes; reoperation, functional status, and mortality including a Kaplan-Meier analysis for reoperation rates based on different ACAP treatments.

RESULTS: One thousand three hundred fifty-five patients underwent analysis, of which 245 were on anticoagulants, 277 were on antiplatelets, 35 were on dual ACAP medications, and 798 were not on any previous ACAP therapy. The median age was 75 years (IQR = 66-83), and the overall reoperation rate was 10.2% (n = 68 on ACAP and n = 70 on no ACAP treatment). Patients on ACAP had higher crude reoperation rates (12.2% vs 8.8%, P = .049), though this difference was not significant after multivariable adjustment (odds ratio = 1.41, 95% CI, 0.77-2.55, P = .272). Discontinuing ACAP treatment for longer preoperatively and later reinitiation did not significantly affect reoperation rates. ACAP patients were generally more comorbid and had significantly worse functional outcomes (modified Rankin Scale 0-2: 52.4% vs 66.4%, adjusted odds ratio = 0.69, 95% CI, 0.53-0.91, P = .007).

CONCLUSION: Preoperative ACAP use and longer preoperative discontinuation are not independently associated with increased reoperation risk in patients with cSDH. Earlier postoperative ACAP reinitiation is also not significantly associated with reoperation risk. However, more extensive large scale prospective studies are required to support these findings and form clinical recommendations.

PMID:42554463 | DOI:10.1227/neu.0000000000004183

J Clin Ultrasound. 2026 Aug 5. doi: 10.1002/jcu.70363. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate whether maternal dietary calcium intake during early pregnancy is associated with fetal cardiac function at mid-gestation, given the heghtened dependence of the fetal myocardium on extracellular calcium and the lack of previous studies addressing this relationship.

METHODS: This prospective observational study was conducted at Kastamonu Training and Research Hospital between August and November 2025. Pregnant individuals undergoing routine fetal anomaly screening were recruited. Maternal calcium intake over the preceding 3 months was quantified through a calcium-specific food frequency questionnaire. Fetal echocardiography was performed between 18 and 22 weeks of gestation by a single experienced operator. Left and right ventricular myocardial performance indices (MPI), isovolumic intervals, ejection times, E/A ratios, and cardiac morphometrics were measured. Continuous variables were analyzed using Spearman correlation and Mann-Whitney U tests, with significance defined as p < 0.05.

RESULTS: A total of 147 participants were analyzed. Maternal calcium intake showed no significant correlations with any fetal cardiac functional parameter, including LV-IVRT (r = -0.035), LV-IVCT (r = -0.058), LV-ET (r = 0.087), MV-TEI (r = -0.102), RV-TEI (r = 0.000), or ventricular filling indices. Categorization by intake < 800 mg/day versus ≥ 800 mg/day similarly revealed no differences in systolic, diastolic, or global cardiac function (all p > 0.13). Dairy products constituted 68.6% of total calcium intake.

CONCLUSION: No statistically significant association was identified between maternal total calcium intake and fetal cardiac function at mid-gestation in this cohort. However, the study may not have been sufficiently powered to exclude small differences in myocardial performance indices. In addition, the absence of an observed association may reflect physiological placental buffering of maternal calcium homeostasis or a temporal mismatch between the period of calcium exposure assessment and fetal functional evaluation. Future studies involving populations with low habitual calcium intake and incorporating biochemical markers are warranted.

PMID:42554437 | DOI:10.1002/jcu.70363

J Clin Periodontol. 2026 Aug 5. doi: 10.1111/jcpe.70164. Online ahead of print.

ABSTRACT

AIMS: To evaluate wound-healing progression among platelet-rich fibrin (PRF), plasma rich in growth factors (PRGF), a collagen-based wound dressing (CS = collagen substitute) and spontaneous healing (control), assessed by percentage of remaining open wound area and patient-reported pain.

MATERIALS AND METHODS: Twenty participants each received four standardised palatal wounds (6 mm × 3 mm) and were randomly assigned to PRF, PRGF, a collagen substitute or spontaneous healing as control. All dressings were secured with criss-cross sutures. Standardised clinical photographs and pain assessments were obtained at baseline and on postoperative days 2,5,7,9, 12 and 14. Parametric and nonparametric models for longitudinal data were used to compare outcomes, accounting for within-subject correlation of repeated measurements.

RESULTS: Open wound area decreased across all groups throughout the 14-day period. Some defects enlarged transiently at Day 2, and the greatest differences between the groups were observed on Day 7 (35.7%-47.0% of wound remaining). Pain scores decreased significantly over time in all groups, with no statistically significant differences between treatments (p > 0.05). Anterior defects tended to be perceived as more painful than posterior defects.

CONCLUSIONS: Spontaneous healing resulted in slightly faster reduction of remaining open wound area than PRF, PRGF or the collagen substitute, with comparable postoperative pain levels. In standardised defects in healthy individuals, PRF, PRGF and collagen substitutes demonstrate minimal additional benefit for soft-tissue healing. Further studies are warranted to determine whether benefits emerge in larger wounds or in patients with compromised healing.

PMID:42554427 | DOI:10.1111/jcpe.70164

Transl Vis Sci Technol. 2026 Aug 3;15(8):3. doi: 10.1167/tvst.15.8.3.

ABSTRACT

PURPOSE: To assess the within and between-session repeatability of foveal sensitivity measurements using adaptive optics (AO) microperimetry.

METHODS: Five normal-sighted participants underwent AO microperimetry testing (550-nm circular stimulus) at the preferred retinal locus across two sessions (2 months ± 2 weeks). Two psychophysical paradigms were used: quick estimation of threshold (QUEST) and method of constant stimuli (MOCS). Each paradigm employed both 1.05-arcmin2 and 30.4-arcmin2 stimulus sizes; stimuli were not stabilized in real time. Trial-by-trial responses were fit with a logistic psychometric function to obtain thresholds at a criterion of 78% seen. Thresholds were converted to sensitivity. Statistical comparisons were performed using paired-sample t-tests.

RESULTS: Sensitivities measured from QUEST and MOCS procedures were not significantly different (QUEST: 1.05 arcmin2, P = 0.36 for session 1 and P = 0.41 for session 2; MOCS: 30.4 arcmin2, P = 0.14 for session 1 and P = 0.12 for session 2). Data were thus combined across paradigms for tests of repeatability. Sensitivities for data split into two groups within session 1 and separately within session 2 were not significantly different (QUEST: 1.05 arcmin2, P = 0.34 for session 1 and P = 0.51 for session 2; MOCS: 30.4 arcmin2, P = 0.31 for session 1 and P = 0.27 for session 2). Overall, sensitivities across the two sessions were not significantly different (QUEST: 1.05 arcmin2, P = 0.06; MOCS: 30.4 arcmin2, P = 0.81). The coefficients of repeatability across sessions were 1.5 decibels (dB) and 0.4 dB for 1.05 arcmin2 and 30.4 arcmin2, respectively.

CONCLUSIONS: Sensitivity measurements from AO microperimetry were repeatable within and across sessions.

TRANSLATIONAL RELEVANCE: Results of the present study will guide future longitudinal studies of disease progression in detecting sensitivity changes using AO microperimetry.

PMID:42554416 | DOI:10.1167/tvst.15.8.3

Disabil Rehabil. 2026 Aug 5:1-11. doi: 10.1080/09638288.2026.2706363. Online ahead of print.

ABSTRACT

PURPOSE: To test psychometric properties to support the validity of the Arabic language version of the Modified Falls Efficacy Scale (A-MFES) for use with older adults in rehabilitation settings.

MATERIALS AND METHODS: A cross-sectional study included the response of A-MFES for 207 older adults (66.6 ± 5.8) from Saudi Arabia. Rasch analysis was used to investigate psychometric properties like unidimensionality with reliability, targeting, rating scale functioning and Differential Item Functioning (DIF).

RESULTS: The main dimension was explained by 78.8% of the variance, which confirmed the unidimensionality of the A-MFES. The reliability coefficient was 0.95, indicating high internal consistency. Targeting showed that item difficulty covered 96% of the participants’ ability. No statistically significant DIFs were observed between males and females or between age groups. Rating scale functioning of the original 11-category scale indicated overlap between the adjacent categories. Collapsing adjacent categories suggested a six-category scale, which indicated better functioning.

CONCLUSION: Five of six validity evidence supported the validity of the A-MFES for use in rehabilitation settings to evaluate fall-related self-efficacy among older adults. The A-MFES indicated promising use for identifying older adults at fall risk and planning interventions accordingly. However, revision of rating scale structure is recommended, and further investigation is needed.

PMID:42554356 | DOI:10.1080/09638288.2026.2706363

Curr Cancer Drug Targets. 2024;24(1):46-58. doi: 10.2174/1568009623666230503094327.

ABSTRACT

AIM: The study aimed to explore the effect of metabolism on lung cancer.

BACKGROUND: The tumor microenvironment is largely influenced by metabolism, tightly involved in tumor progression.

OBJECTIVE: We try to investigate the effect of tumor metabolism terms on non-small cell lung cancer (NSCLC) prognosis, drug and immunotherapy sensitivity, as well as its underlying mechanisms.

METHODS: All the data was obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases. R software was used to perform all statistical analyses and plots.

RESULTS: This study conducted 21 metabolism statuses in NSCLC to identify their underlying roles. We found that alpha-linolenic acid metabolism, sphingolipid metabolism, glycerophospholipid metabolism, fatty acid degradation, linoleic acid metabolism, primary bile acid biosynthesis, and fatty acid metabolism were protective factors for NSCLC. Next, we constructed a prognosis model based on primary bile acid biosynthesis, glycerophospholipid, and sphingolipid metabolism. Results in the present study showed that our model could effectively predict patients’ prognosis in both training and validation cohorts. A clinical correlation revealed that patients at high-risk exhibited more progressive clinical characteristics. Biological enrichment indicated that MYC targets, E2F targets, mTORC1 signaling, G2/M checkpoint, and epithelial-mesenchymal transition were activated in the high-risk group. Immune relation analysis showed that risk score positively correlated with Th2 cells, yet a negative correlation with CD56 bright NK, Th17, mast and CD8⁺ T cells. Moreover, our model was related to NSCLC patients’ sensitivity to immunotherapy and chemotherapy. Ultimately, eight characteristic genes were identified to distinguish the patients’ risk group in the real application.

CONCLUSIONS: The model we developed is a useful tool to predict NSCLC patients’ prognosis and is associated with the sensitivity of immunotherapy and chemotherapy. Meanwhile, our results can guide the following metabolism-related studies in NSCLC.

PMID:42554341 | DOI:10.2174/1568009623666230503094327

Psychol Health Med. 2026 Aug 5:1-20. doi: 10.1080/13548506.2026.2714468. Online ahead of print.

ABSTRACT

The aim of this study is to determine the effect of Cognitive Behavioural Therapy (CBT)-Based Psychoeducation given to children diagnosed with ADHD on internalized stigma and hope. This is a randomized controlled experimental study. The study was conducted with children diagnosed with attention-deficit/hyperactivity disorder who were followed up in a Paediatric Psychiatry outpatient clinic between May 2020 and January 2022. The study was completed with 145 children (75 in the control group, 70 in the experimental group). Data were collected using the descriptive characteristics form, the internalized stigma scale for children and adolescents, and the children’s hope scale (CHS). The experimental group received an 8-session, nurse-administered CBT-Based Psychoeducation program delivered in a closed-group format twice a week for 4 weeks, focusing on ADHD awareness, impulsivity, attention, hyperactivity, stigma, and hopeful thinking. No intervention was made to the control group during the study period; however, to meet ethical standards, the same CBT-Based Psychoeducation program was administered to the control group after all post-test measurements were completed. In addition to descriptive statistics, chi-square, dependent samples t-test, and independent samples t-test were used in the analysis of data. As a result of the measurements made before and after the CBT-based psychoeducation applied to the experimental group, internalized stigma decreased in children with ADHD, while the level of hope increased statistically significantly (p < 0.05). This change in the experimental group also showed a significant change compared to the control group. It was concluded that the nurse-led CBT-Based Psychoeducation program reduced internalized stigma and increased hope in children with ADHD.

PMID:42554334 | DOI:10.1080/13548506.2026.2714468

Oncologist. 2026 Aug 5:oyag314. doi: 10.1093/oncolo/oyag314. Online ahead of print.

ABSTRACT

INTRODUCTION: The rising incidence of early-onset GI cancer has made the impact of treatment-related gonadal toxicity increasingly significant. While there is ample evidence on oncofertility outcomes in breast cancer and hematological malignancies, data in GI cancers remain limited. We sought to evaluate oncofertility perspectives from the viewpoint of young GI cancer survivors across Europe.

METHODS: A cross-sectional 60-item electronic survey regarding oncofertility practices was distributed via patient digital platforms. The target population was survivors treated for GI cancers before the age of 45 or 50 years (women/men). Statistical analysis was performed on country, gender, and tumor type.

RESULTS: One hundred and forty survivors from 19 countries completed the survey (78F/62M), median age at diagnosis was 36.9y/35.6y (F/M), the majority had colorectal cancer, treated with chemotherapy (88%/89%) and radiotherapy (34%/48%). Fertility impact was discussed in 66% of women and 71% of men, but fewer were referred for fertility preservation (43%/57%), and fewer underwent preservation (18%/61%), with variability between countries. The main reason for not preserving fertility was lack of desire of future offspring (women) or lack of referral (men). Sexual health counseling was conducted in less than 50% of patients. Among women, 46% reported persistent amenorrhea and 64% menopausal symptoms. Significant sexual dysfunction was indicated by 69% of women and 83% of men.

CONCLUSION: Anti-cancer treatment has substantial impact on fertility and sexual function in young GI cancer survivors. Counseling, referral, and uptake vary across countries. Gonadal-related issues remain an unmet need in GI oncology, requiring improved counseling and clinical practice.

PMID:42554320 | DOI:10.1093/oncolo/oyag314

Scand J Clin Lab Invest. 2026 Aug 5:1-7. doi: 10.1080/00365513.2026.2713141. Online ahead of print.

ABSTRACT

The blood urea nitrogen (BUN)-to-plasma creatinine ratio is a conventional method for diagnosing dehydration. We examined the relationship between this method and the more recently promoted urine biomarkers of dehydration. Blood and urine sampling was performed in 921 patients who were fasting before surgery. The blood was analyzed for the BUN-to-plasma creatinine ratio which was divided into three ranges: low (<50), normal (50-100), and high (>100 mmol/L). The fractions of the cohort that belonged to these ranges were 8.9%, 76.7%, and 14.4%, respectively. The urine was analyzed for color, specific gravity, osmolality, and creatinine, and the results summarized in the Fluid Retention Index, which is a robust measure of renal water conservation. The analysis shows that none of the four urine biomarkers differed statistically between these three groups. The Fluid Retention Index was 2.3, 2.0, and 1.7, respectively (p = 0.17), which means that the degree of urine concentration varied in the opposite direction to that expected. Moreover, no linear correlations were found when individual blood and urine measurements were compared. Patients who were classified as being dehydrated according to the Fluid Retention Index had a mean BUN to creatinine ratio of 77 while the others had 76 mmol/L (p = 0.94). In conclusion, the BUN-to-ratio did not correlate with urine biomarkers of dehydration in fasting pre-surgical patients. This result suggests that the BUN-to-creatinine ratio may not reliably reflect hydration status and motivates a repeat study where the body volume deficit is known or the water consumption is monitored over time.

PMID:42554314 | DOI:10.1080/00365513.2026.2713141

JMIR Res Protoc. 2026 Aug 4;15:e74202. doi: 10.2196/74202.

ABSTRACT

BACKGROUND: The current landscape of emergency care (EC) is marked by high demand, leading to issues such as emergency department boarding, overcrowding, and subsequent delays that impact the quality and safety of patient care. Integrating data science into EC can enhance decision-making with predictive, preventative, personalized, and participatory approaches. However, gaps in adherence to fairness, accountability, interpretability, and responsibility are evident, particularly due to barriers to data-sharing, which often result in a lack of transparency and robust oversight in these applications.

OBJECTIVE: The FAIR-EC (Fair, Accountable, Interpretable, and Responsible-Emergency Care) collaboration adapts the existing Fair, Accountable, Interpretable, and Responsible principles to address emerging challenges as data science integrates with EC. This initiative aims to transform EC by establishing ethical artificial intelligence standards specifically tailored for this integration. By bridging the gap between EC professionals, data scientists, and other stakeholders, the collaboration promotes international cooperation that leverages advanced data science techniques to enhance EC outcomes across different care settings.

METHODS: We propose a federated research design to analyze extensive datasets from various global institutions without compromising patient privacy. This approach transforms epidemiological research with advanced data science techniques, emphasizing the harmonization of data for comprehensive analyses across different health care systems.

RESULTS: The FAIR-EC initiative has facilitated the identification and harmonization of datasets from diverse geographical regions, enabling the examination of regional variations in EC practices. As of paper submission, participating sites have identified retrospective EC datasets totaling >2 million records (eg, Duke Health >400,000 and Singapore General Hospital >1.7 million records). Initial projects have demonstrated feasibility and operational readiness, including implementation of federated workflows and ongoing development of a federated scoring system, cross-site evaluation, and adaptation of association studies and predictive models across various regions. Cross-site harmonization and pilot analyses are underway (with local ethics approvals in progress), and first multisite results are expected to be submitted in mid-late 2026, with additional project-level publications anticipated in 2027. These efforts highlight the feasibility of leveraging advanced data science techniques to address the complexities of EC while preserving patient privacy without centralizing individual-level data. This project was funded from September 1, 2022, to August 31, 2023.

CONCLUSIONS: FAIR-EC integrates data science ethically and effectively into EC, addressing challenges such as fragmented data, real-time handoffs, and public health crises. Its federated design harmonizes diverse data streams while preserving privacy, and its emphasis on ethical artificial intelligence aligns with the dynamic nature of EC. Despite challenges in data variability and system complexity, FAIR-EC establishes a strong foundation for innovation in global EC.

PMID:42554297 | DOI:10.2196/74202