Tag: pubmed

JAMA Netw Open. 2025 Feb 3;8(2):e2459371. doi: 10.1001/jamanetworkopen.2024.59371.

ABSTRACT

IMPORTANCE: Over the past decade, the leadership of the National Institute of Mental Health (NIMH) has emphasized the importance of a transdiagnostic approach to psychiatric investigation using Research Domain Criteria (RDoC) mapping more closely to neurobiology.

OBJECTIVE: To investigate whether research support from the NIMH for individual RDoC domains and for transdiagnostic investigation has changed over time and has had differential impact in terms of publication, citations, or patent filings.

DESIGN, SETTING, AND PARTICIPANTS: In this longitudinal cohort study, all R01, R21, and R03 studies funded by the NIMH between January 2003 and December 2023 were identified via the National Institutes of Health RePORTER database. Their abstracts were characterized in terms of RDoC domains (negative valence, positive valence, cognition, social, arousal, and sensorimotor) using a large language model.

MAIN OUTCOMES AND MEASURES: Primary outcomes were publications, citation impact estimated at 5 years from the index year of funding, and patents, examined using regression models adjusted for other grant characteristics.

RESULTS: Among 8897 R01, R03, and R21 projects, reflecting $17.7 billion of investment, abstracts of 3141 (35.3%) reflected negative valence; 1344 (15.1%), positive valence; 2781 (31.3%), cognition; 1607 (18.1%), social; 343 (3.9%), arousal; and 571 (6.4%), sensorimotor domains. A total of 1793 (20.2%) incorporated a transdiagnostic perspective. Positive and social domains were associated with fewer publications (difference, -1.13 [95% CI, -2.11 to -0.15] and -2.23 [95% CI, -3.15 to -1.30], respectively) and lesser citation impact (difference, -0.47 [95% CI, -0.75 to -0.18] and -1.19 [95% CI, -1.46 to -0.91], respectively) at 5 years. Social (adjusted odds ratio [AOR], 0.11; 95% CI, 0.04-0.23) and cognitive (AOR, 0.66; 95% CI, 0.48-0.89) domains and transdiagnostic proposals (AOR, 0.37; 95% CI, 0.21-0.60) were associated with lower likelihood of patent filing.

CONCLUSIONS AND RELEVANCE: In this study of NIMH funding, grants reflecting different RDoC domains differed substantially in their scientific impact in terms of publications, citations, and patent generation. The findings suggest that large language models represent a promising approach to characterizing research proposals at scale, which may be useful in guiding resource allocation to maximize scientific return on investment.

PMID:39937475 | DOI:10.1001/jamanetworkopen.2024.59371

JAMA Netw Open. 2025 Feb 3;8(2):e2459554. doi: 10.1001/jamanetworkopen.2024.59554.

ABSTRACT

IMPORTANCE: The impact of Medicaid telehealth reimbursement policies on staffing and patient-centered care in the safety net are largely unknown but critical to successful and equitable access to telehealth.

OBJECTIVE: To identify and characterize federally qualified health center (FQHC) staff and leadership’s perceptions of the benefits and drawbacks of Medicaid telehealth reimbursement policies.

DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used semistructured interviews conducted from April 2022 to January 2024 with snowballed sampled participants consisting of FQHC leadership, clinicians, and administrative staff in 6 FQHCs representing the 5 boroughs in New York, New York.

MAIN OUTCOMES AND MEASURES: Participants described telehealth experiences, including factors impending or contributing to staff turnover, patient satisfaction, and financial sustainability within FQHCs. Thematic analysis was used to analyze the data.

RESULTS: Of 56 interviews, 26 participants (46.4%) were part of the leadership team, 18 (32.1%) were clinical staff, 8 (14.3%) were program support staff, 7 (12.5%) were enabling services staff, 3 (5.4%) were site directors, and 3 (5.4%) were another staff category. Three overarching themes characterized staff and leadership understanding of the impact of Medicaid telehealth reimbursement policies on FQHCs: (1) Medicaid telehealth policy design was perceived to exacerbate a workforce shortage, particularly among mental health care practitioners; (2) patients ranged in preferences and ability to access telehealth while FQHCs struggled to attain resources for telehealth; and (3) FQHC leadership envisioned a productive hybrid model where telehealth complements on-site care. FQHC staff and leadership reported opportunities to improve compliance, no-shows, and workflows through telehealth, but improvements in funding policy, such as payment parity and more grants that can be used to address telehealth infrastructure (eg, Internet access, equipment, and literacy), are urgently needed.

CONCLUSIONS AND RELEVANCE: In this qualitative study, staff at FQHCs perceived the current telehealth Medicaid reimbursement policies in New York State as a factor that exacerbated inequities to accessing care, particularly for mental health needs. These findings indicate that although telehealth brings new opportunities to advance patient-centered care, there are serious challenges on the path toward equitable care because telehealth is not yet integrated into payment in a sustainable way.

PMID:39937474 | DOI:10.1001/jamanetworkopen.2024.59554

JAMA Surg. 2025 Feb 12. doi: 10.1001/jamasurg.2024.6922. Online ahead of print.

ABSTRACT

IMPORTANCE: Transvaginal surgery is commonly performed to treat pelvic organ prolapse. Little research focuses on how sexual function relates to clitoral anatomy after vaginal surgery despite the clitoris’ role in the sexual response.

OBJECTIVE: To determine how postoperative sexual function after vaginal surgery is associated with clitoral features (size, position, shape).

DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional ancillary study of magnetic resonance imaging (MRI) data from the Defining Mechanisms of Anterior Vaginal Wall Descent (DEMAND) study. The setting comprised 8 clinical sites in the US Pelvic Floor Disorders Network and included the MRI data of 88 women with uterovaginal prolapse previously randomized to either vaginal mesh hysteropexy or vaginal hysterectomy with uterosacral ligament suspension between 2013 and 2015. Data were analyzed between September 2021 and June 2023.

EXPOSURES: Participants underwent postoperative pelvic MRI at 30 to 42 months (or earlier if reoperation was desired) between June 2014 and May 2018. Sexual activity and function at baseline (preoperatively) and 24- to 48-month follow-up (postoperatively) were assessed using the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, International Urogynecological Association Revised (PISQ-IR). Clitoral features were derived from postoperative MRI-based 3-dimensional models.

MAIN OUTCOMES AND MEASURES: Correlations between (1) PISQ-IR mean, subscale, and item scores and (2) clitoral size, position, and shape (principal component scores).

RESULTS: A total of 82 women (median [range] age, 65 [47-79] years) were analyzed (41 received hysteropexy and 41 received hysterectomy). Postoperatively, 37 were sexually active (SA), and 45 were not SA (NSA). Among SA women, better overall postoperative sexual function (higher PISQ-IR summary score) correlated with a larger clitoral glans width (Spearman ρ = 0.37; 95% CI, 0.05-0.62; P = .03) and thickness (Spearman ρ = 0.38; 95% CI, 0.06-0.63; P = .02). Among NSA women, sexual inactivity related to postoperative dyspareunia correlated with a more lateral clitoral position (Spearman ρ = 0.45; 95% CI, 0.18-0.66; P = .002), and sexual inactivity related to incontinence/prolapse correlated with a more posterior clitoral position (Spearman ρ = -0.36; 95% CI, -0.60 to -0.07; P = .02) (farther from the pubic symphysis). Shape analysis demonstrated that poorer postoperative sexual function outcomes in SA women and sexual inactivity in NSA women correlated with a more posteriorly positioned glans, anteriorly oriented clitoral body, medially positioned crura, and lateral vestibular bulbs.

CONCLUSIONS AND RELEVANCE: Results of this cross-sectional study suggest that postoperative sexual function after vaginal surgery was associated with clitoral glans size, position, and shape. Results warrant prospective studies on surgery-induced changes in clitoral anatomy and sexual function.

PMID:39937459 | DOI:10.1001/jamasurg.2024.6922

Int J Clin Oncol. 2025 Feb 12. doi: 10.1007/s10147-024-02658-1. Online ahead of print.

ABSTRACT

BACKGROUND: Human epidermal growth factor receptor 3 (HER3), a tyrosine kinase belonging to the HER family, is a known target for cancer therapy; recently, an anti-HER3 antibody-drug conjugate (ADC) is developing. To understand HER3 expression in epithelial ovarian cancer (EOC), this study was conducted.

METHODS: We investigated the expression of HER3 in 202 patients with EOC using immunohistochemistry (IHC), and the association between HER3 expression, clinicopathological features, prognosis, and treatment timing.

RESULTS: Of all the cases, 55.4% had a HER3 IHC score ≥ 1 + . In particular, 78.0% of the patients with clear cell carcinoma (CCC) and 87.9% of the patients with mucinous carcinoma (MC) had a HER3 IHC score ≥ 1 + . Regarding clinicopathological features, early disease stage, feasibility of primary debulking surgery, no residual tumor, and low CA125 levels were more frequently observed in patients with a HER3 IHC score ≥ 1 + . Furthermore, a HER3 no-expression showed a significant association with a relatively short progression-free survival (PFS). And, for patients with mucinous carcinoma, those with a HER3 IHC score ≥ 1 + had poorer PFS and overall survival than those with a HER3 no-expression (no statistically significant difference). In addition, we analyzed HER3 expression at primary tumor and recurrence tumor in same patients. Thus, we observed the HER3 IHC score tended to change from 0 to ≥ 1 + in recurrence cases compared with primary cases.

CONCLUSIONS: These observations suggested that patients with MC, CCC and recurrence of all histological type may potentially benefit from future clinical trials of HER3-directed therapies.

PMID:39937426 | DOI:10.1007/s10147-024-02658-1

J Epidemiol Glob Health. 2025 Feb 12;15(1):23. doi: 10.1007/s44197-025-00344-7.

ABSTRACT

BACKGROUND: Many of the studies in causal inference using propensity scores relied on binary treatments where it is estimated by logistic regression or machine learning algorithms. Since 2000s, attention has been given for multiple values (categorical) and continuous treatments and the propensity score associated with such treatments is called generalized propensity score (GPS). However, there is scant literature on the use of count treatments in causal inference. Besides, effective sample size, after weighting, along with other methods has not been practiced for GPS model performance measure. The study was done with the aim of using count treatments in causal inference; select appropriate GPS and outcome models for such treatment and ordinal outcome.

METHOD: A family of count models and a generalized boosted model (GBM) were used for GPS estimation. Their performance was measured in terms of covariate balancing power, effective sample size and the average treatment effect after GPS-based weighting. Marginal structural modeling (MSM) and covariate adjustment using GPS were used to estimate treatment effect on ordinal outcome. Stabilized inverse probability treatment weighting was used for covariate balancing assessment. Monte Carlo simulation study at various sample sizes with 1000 replication and household survey data were used in the study.

RESULT: GPS was trimmed at 1% and 99% which gave better results as compared to untrimmed results. The generalized boosted model performed well both in simulation and actual data producing a larger effective sample size and smaller metrics when estimating average treatment effect on the outcome. The MSM was found better than GPS as a covariate in the outcome model.

CONCLUSION: It is important to trim GPS when it approaches zero or one without loss of more information due to trimming. Effective sample size after weighting should be used along with other methods such as correlation and absolute standardized mean differences for GPS model selection. GBM should be used for GPS estimation for count treatments. MSM is important for the outcome model when weighting GPS method is used. Finally, the number of antenatal care services had an increasing effect on the probability of age-specific childhood vaccination.

PMID:39937387 | DOI:10.1007/s44197-025-00344-7

Discov Nano. 2025 Feb 12;20(1):32. doi: 10.1186/s11671-025-04190-1.

ABSTRACT

A highly efficient and nontoxic material methylammoniumtin(II) iodideperovskite solar cell is proposed. This proposed solar cell uses CH₃NH₃SnI₃ as the absorber layer, TiO₂ as an Electron transport layer (ETL), Indium tin oxide as a buffer layer, and Copper(I) oxide as the hole transport layer (HTL). The device is simulated using the SCAPS-1D simulation tool. This study details the optimization of a set of parameters, including the defect densities and the thickness of the absorber layer. The proposed structure is highly optimized result of 31.73% of enhanced power conversion efficiency (PCE), a J_SC of 24.526 mA/cm² (short-circuit current), FF of 81.40% (fill factor), and a V_OC of 1.56 V (open-circuit voltage) is obtained through simulation process. Compared to previously reported works, the performance of the device has improved significantly due to better optimization. Along with this electrical characteristic temperature analyses, conductance voltage, capacitance-voltage, and bandgap analyses have also been carried out to examine the device’s efficiency and performance.

PMID:39937384 | DOI:10.1186/s11671-025-04190-1

Brain Topogr. 2025 Feb 12;38(2):30. doi: 10.1007/s10548-025-01103-4.

ABSTRACT

The selection of an appropriate virtual reference schema is pivotal in determining the outcomes of event-related potential (ERP) studies, particularly within the widely utilized Talk/Listen ERP paradigm, which is employed to non-invasively explore the corollary discharge phenomenon in the speech-auditory system. This research centers on examining the effects of prevalent EEG reference schemas-linked mastoids (LM), common average reference (CAR), and reference electrode standardization technique (REST)-through statistical analysis, statistical parametric scalp mapping (SPSM), and source localization techniques. Our ANOVA findings indicate significant main effects for both the reference and the experimental condition on the amplitude of N1 ERPs. Depending on the reference used, the polarity and amplitude of the N1 ERPs demonstrate systematic variations: LM is associated with pronounced frontocentral activity, whereas both CAR and REST exhibit patterns of frontocentral and occipitotemporal activity. The significance of SPSM results is confined to regions exhibiting prominent N1 activity for each reference schema. Source analysis provides corroborative evidence more aligned with the SPSM results for CAR and REST than for LM, suggesting that results under CAR and REST are more objective and reliable. Therefore, the CAR and REST reference are recommended for future studies involving Talk/Listen ERP paradigms.

PMID:39937375 | DOI:10.1007/s10548-025-01103-4

Cancer Causes Control. 2025 Feb 12. doi: 10.1007/s10552-025-01968-7. Online ahead of print.

ABSTRACT

PURPOSE: Breast cancer (BC) incidence is increasing in US women under 40, with variation across racial and ethnic groups. It is not yet known if incidence trends also vary by geography within the USA, which may inform whether place-based exposures contribute to BC risk in younger women.

METHODS: Using the US Cancer Statistics database, we analyzed age-adjusted BC incidence rates from 2001 to 2020 in women aged 25-39. We calculated the average annual percent change (AAPC) using Joinpoint regression and performed age-period-cohort analyses.

RESULTS: From 2001 to 2020, BC incidence in women under 40 increased by more than 0.50% per year in 21 states, while remaining stable or decreasing in the other states. Incidence was 32% higher in the five states with the highest rates compared to the five states with the lowest rates. The Western region had the highest rate of increase (AAPC = 0.76, 95% CI 0.56-0.96), despite having the lowest absolute incidence rate from 2001 to 2020. The Northeast had the highest absolute rate of BC among women under 40 and experienced a significant increase over time (AAPC = 0.59, 95% CI 0.36-0.82). The South was the only region where BC under 40 did not increase from 2001 to 2020.

CONCLUSION: These findings support that BC incidence trends in US women under 40 vary by geography, and the range of state-specific risks was comparable in magnitude to other risk measures, such as polygenic risk scores. This suggest that incorporating place-based factors alongside established risk factors into risk prediction may improve our ability to identify groups of younger women at higher risk for early-onset BC.

PMID:39937364 | DOI:10.1007/s10552-025-01968-7

Clin Transl Oncol. 2025 Feb 12. doi: 10.1007/s12094-025-03862-9. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the prevalence and characteristics of burnout among Radiation Oncology residents in Spain, focusing on its associated risk factors and implications for residency training.

MATERIALS AND METHODS: A cross-sectional online survey was conducted from June to September 2024, using the Maslach Burnout Inventory (MBI) to evaluate emotional exhaustion, depersonalization, and self-fulfillment. Residents from various Spanish regions completed an anonymous questionnaire covering workload and burnout.

RESULTS: Fifty residents, predominantly in their third (38%) and fourth (42%) years of training, participated. High emotional exhaustion was reported by 58%, while 54% exhibited elevated depersonalization. Self-fulfillment scores were low in 32%. Overall, 70% experienced at least one burnout symptom, with 12% meeting criteria for full-burnout syndrome. An inverse correlation between self-fulfillment and emotional exhaustion was observed (p = 0.007). Trends suggested higher burnout risk in senior residents (R3-R4) compared to juniors (R1-R2), though these differences were not statistically significant (OR = 1.682; p = 0.086).

CONCLUSION: The findings reveal a high prevalence of at least one burnout symptom among Radiation Oncology residents in Spain, with emotional exhaustion and depersonalization notably elevated. However, full-burnout syndrome is not prevalent. These findings underscore the need for reforms in residency training programs, emphasizing workload management, well-being initiatives, and support for scientific and professional development.

PMID:39937361 | DOI:10.1007/s12094-025-03862-9

Environ Monit Assess. 2025 Feb 12;197(3):276. doi: 10.1007/s10661-025-13754-8.

ABSTRACT

Air pollution is a significant global issue that impacts public health, particularly in urban areas where pollution levels often exceed safe limits. The Air Quality Index (AQI) serves as a key metric to assess the concentration of harmful pollutants such as particulate matter (PM), ozone, and nitrogen oxides. This study conducts an extreme value analysis (EVA) of AQI data from five major Indian cities-Delhi, Mumbai, Kolkata, Chennai, and Hyderabad-and eight other metropolitan cities worldwide, including Dhaka, Chengdu, and Bogota. The goal is to evaluate the probability of extreme pollution events and compare the seasonal patterns of air quality in these cities. Our findings indicate that cities like New Delhi and Dhaka consistently experience AQI levels that exceed hazardous thresholds, particularly during the winter months and festival seasons. This study provides critical insights into the air quality crisis in India and other regions, emphasizing the need for targeted policy interventions, including stricter emission regulations, adoption of cleaner energy sources, and enhanced public awareness campaigns to mitigate the effects of extreme pollution events.

PMID:39937354 | DOI:10.1007/s10661-025-13754-8