Tag: pubmed

JMIR Hum Factors. 2026 Mar 3;13:e75263. doi: 10.2196/75263.

ABSTRACT

BACKGROUND: The rising number of refugees and migrants has created growing mental health needs that health care systems struggle to address. Providing assessment and treatment for mental health problems in a digital format could help increase access to care and facilitate the provision of adapted interventions. Psychologists are key stakeholders in the delivery and influence of clinical services within routine care settings, but there are limited data on their perspectives regarding the use of digital solutions to assess and treat common mental health problems in refugees and migrants.

OBJECTIVE: This study aimed to examine psychologists’ usage, knowledge, and attitudes toward digital mental health solutions for assessing and treating common mental health problems in refugees and migrants within the Swedish health care system.

METHODS: A cross-sectional online survey was conducted among psychologists in Sweden between December 2023 and February 2024. Responses included Likert-scale items and categorical variables, which were analyzed using descriptive statistics, independent samples t tests, and Fisher exact test to explore differences between subgroups.

RESULTS: A total of 81 psychologists responded to the survey. Among them, 58 (72%) were women, and nearly half (40/81, 49%) worked in a public health care region. Respondents showed the highest acceptance for guided internet-based cognitive behavioral therapy (ICBT), blended treatment, and videoconferencing therapy. Only 20% (16/81) reported using digital solutions for refugees or migrants with mental health problems. Most respondents had low or very low knowledge of digital assessment and screening (61/81, 75%) and digital treatment (58/81, 72%) for these groups. Those using digital formats for refugees and migrants, or working in a setting that did so, had significantly higher ratings on all 5 knowledge items compared to those that did not (P<.001 to P=.01). Respondents emphasized the importance of digital solutions being provided in refugees’ and migrants’ native languages (70/81, 86%) and being culturally adapted (56/81, 69%). Those using digital formats for refugees and migrants considered cultural adaptation less necessary (P=.05). The preferred implementation approach was through specialized or decentralized units in primary care (66/81, 81%).

CONCLUSIONS: While psychologists recognize the potential of digital mental health solutions, significant barriers remain, including limited knowledge and experience with using digital formats for refugees and migrants. Psychologists prefer digital solutions in the native language of refugees and migrants that are implemented at the primary care level. The need for cultural adaptation should be further explored. Addressing psychologists’ preferences could facilitate the future integration and implementation of digital formats for refugees and migrants in routine care settings.

PMID:41774913 | DOI:10.2196/75263

Ecol Evol Physiol. 2026 Jan-Feb;99(1):33-42. doi: 10.1086/739792. Epub 2026 Jan 20.

ABSTRACT

AbstractFitness of interspecific hybrids can be higher or lower than that of their parental genotypes, with major ramifications for evolution and conservation. A recent study found that hybrid tiger salamanders had higher metabolic rates than their parental forms. Specifically, the ratio of resting metabolic rate to water loss, which was used as a measure of performance, was greater in hybrids. Recent genetic research showed that over half of the experimental subjects in that study were genetically pure California tiger salamanders (Ambystoma californiense) misclassified as hybrids. We reanalyzed the data using the corrected identification of hybrids and parentals. As expected, updating the classification revealed even stronger evidence for differences between hybrids and parentals. Hybrids had higher resting metabolic rates and greater water loss than parentals. The ratio of resting metabolic rate to water loss was also higher in hybrids. However, we suggest that this ratio might not be a positive measure of salamander performance. Higher metabolic rate means higher energy expenditure, and higher water loss suggests increased risk of desiccation. Both are major challenges for terrestrial amphibians, especially salamanders, which are hypothesized to be low-energy, low-water-loss specialists. Under this hypothesis, the ratio of energy expenditure to water loss is a ratio of two costs rather than a ratio of benefit to cost. While our analyses corroborate and strengthen the previous statistical results, we suggest that high resting metabolic rate is better interpreted as hybrid dysfunction, not vigor. Both hypotheses are speculative, and specific research on the fitness effects of these physiological differences is needed to resolve this important ecological question.

PMID:41774889 | DOI:10.1086/739792

JCO Clin Cancer Inform. 2026 Mar;10:e2500173. doi: 10.1200/CCI-25-00173. Epub 2026 Mar 3.

ABSTRACT

PURPOSE: Early-stage breast cancer (ESBC) in women younger than 50 years often presents with tumor features, including grade and hormone receptor and human epidermal growth factor receptor 2 (HER2) status different from older women. Machine learning clustering techniques can reveal underlying patterns in the inter-relationships of these features and provide novel insights to inform and guide decision making by patients and providers.

METHODS: Partitioning around medoids (PAM) was applied to SEER data from 67,746 women age 18-49 years diagnosed with ESBC. PAM clustering based on tumor size (T), nodal status (N), grade, and receptor status identified 10 distinct clusters. The PAM clusters and American Joint Committee on Cancer (AJCC) anatomic and prognostic stages were compared in terms of their tumor features and their association with chemotherapy and survival.

RESULTS: AJCC anatomic and prognostic stages are primarily defined by T and N. PAM clusters were primarily defined by receptor status and grade. PAM clusters align closely with luminal A, luminal B, triple-negative, or HER2-overexpressing treatment-related subtypes. PAM clusters better discriminated chemotherapy treatment, with C-statistic 0.839 (95% CI, 0.836 to 0.842), than either anatomic, with C-statistic 0.770 (95% CI, 0.767 to 0.773), or prognostic staging, with C-statistic 0.796 (95% CI, 0.794 to 0.800). PAM clusters were better predictors of 5-year overall survival, with C-statistic 0.733 (95% CI, 0.727 to 0.739), than anatomic stages, with C-statistic 0.721 (95% CI, 0.715 to 728), but not as predictive as prognostic stages, with C-statistic 0.759 (95% CI, 0.753 to 0.764).

CONCLUSION: Data-driven PAM clusters provide novel insights into the inter-relationship of tumor features and their association with hormonal, targeted, and chemotherapy treatment and with survival outcomes in women younger than 50 years with ESBC. An online application was created so that the PAM clusters could be used as alternatives or in addition to traditional AJCC staging to inform and guide patients and providers.

PMID:41774882 | DOI:10.1200/CCI-25-00173

Rev Med Inst Mex Seguro Soc. 2026 Mar 3;64(2):e6878. doi: 10.5281/zenodo.17537296.

ABSTRACT

Delaying the measurement of a complete blood count (CBC) for 6 to 24 hours after red blood cell transfusion remains a common practice in hospitals worldwide, despite the absence of strong physiological or empirical justification. This narrative review summarizes the available clinical evidence comparing early versus delayed post-transfusion evaluation of hemoglobin (Hb) and hematocrit (Hct) levels in adult patients. Studies conducted in the United States, Spain, Colombia, and Thailand, including more than 290 hemodynamically stable, non-bleeding adults, assessed Hb and Hct levels at different intervals ranging from 15 minutes to 24 hours after transfusion. Across all studies, early post-transfusion measurements showed no statistically significant differences when compared with delayed testing, demonstrating that Hb and Hct values stabilize rapidly within 15 to 60 minutes following transfusion. These findings refute the traditional assumption that several hours are required for equilibration. Implementing early CBC testing provides accurate results, enables prompt assessment of transfusion efficacy, reduces unnecessary delays in clinical decision-making, and improves hospital workflow efficiency. Therefore, early measurement of Hb and Hct is safe, reliable, and cost-effective in stable adult patients.

PMID:41774859 | DOI:10.5281/zenodo.17537296

Rev Med Inst Mex Seguro Soc. 2026 Mar 3;64(2):e6801. doi: 10.5281/zenodo.17537340.

ABSTRACT

Graphs used in scientific articles help improve the understanding of results. One of the most widely used graphs in recent scientific literature is the forest plot. Its growing popularity is related to its versatility. Although it was initially employed to present results of meta-analyses, it is now used to display findings from individual studies, for both qualitative and quantitative variables, as long as a confidence interval -most commonly the 95% CI- can be calculated. This graph not only allows the presentation of results from univariate analyses but also from multivariable analyses, making it applicable to diverse fields of scientific knowledge. In this article, we present, in addition to the history of the forest plot, a description of its components -its anatomy- and a tutorial on how to create one using statistical software.

PMID:41774848 | DOI:10.5281/zenodo.17537340

Rev Med Inst Mex Seguro Soc. 2026 Mar 3;64(2):e6877. doi: 10.5281/zenodo.17537377.

ABSTRACT

BACKGROUND: Occupational hazards represent high costs as they have negative consequences not only on the worker who suffers an injury, but also on his or her environment and the employer.

OBJECTIVE: To carry out an analysis on the characterization of occupational accidents associated with the activity or workplace, commuting accidents and occupational diseases, suffered by beneficiaries of the Mexican Social Security Institute registered during the year 2024.

MATERIAL AND METHODS: Descriptive design, cross-sectional with a quantitative approach. The data were obtained through the consultation of the 2024 statistical report generated by the Mexican Social Security Institute.

RESULTS: Of the occupational risks that occurred in 2024, 69% were work accidents, 28% commuting accidents and 3% occupational diseases. Of these, 61% of the risks occurred in men and 39% in women. The age group with the highest frequency of occupational risks was 25 to 29 years old. The most frequent injuries resulting from these accidents were superficial trauma (114,606) and the most frequent occupational diseases were dorsopathies (2940).

CONCLUSIONS: Knowing the characteristics of occupational risks in Mexican workers will facilitate the appropriate focus of efforts for their prevention and therefore the reduction of costs derived from these risks.

PMID:41774846 | DOI:10.5281/zenodo.17537377

J Spec Oper Med. 2026 Mar 3:J.Spec.Oper.Med.2026.1SDN-NWTW. doi: 10.55460/J.Spec.Oper.Med.2026.1SDN-NWTW. Online ahead of print.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) has the potential to address training limitations and inter-operator variability that constrain the use of lung ultrasound (LUS) in austere and prehospital settings. This pilot study evaluated whether AI-based decision support could improve the diagnostic accuracy and confidence of United States Marine Corps Corpsmen in identifying absent lung sliding, a key indicator of pneumothorax, during LUS interpretation.

METHODS: This pilot-prospective multi-reader, multi-case study involved five military medics, all novices in point-of-care ultrasound, each interpreting 50 de-identified LUS video clips twice, once without AI assistance (control) and once with AI assistance (ATLAS, Deep Breathe Inc., London, Canada), in randomized order with at least a 2-hour washout between sessions. Expert consensus served as a reference standard. Diagnostic performance was assessed using area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and accuracy. Differences were analyzed using the Random-Reader Random-Case method. Per-clip reader confidence ratings were compared using the Stuart-Maxwell test.

RESULTS: AI assistance significantly improved diagnostic performance across all measured outcomes. The mean AUROC increased from 0.72 (SD 0.16) without AI to 0.93 (SD 0.04) with AI (P=.03). Sensitivity rose from 0.63 (SD 0.14) to 0.90 (SD 0.09), specificity from 0.70 (SD 0.15) to 0.86 (SD 0.10), and overall accuracy from 0.67 (SD 0.10) to 0.88 (0.06) (McNemar’s test, P<.001). Reader confidence also improved, with high-confidence ratings nearly doubling from 20% to 37%, and low-confidence ratings decreasing from 38% to 33%. These distributional changes were statistically significant (Stuart-Maxwell χ², P<.001).

CONCLUSION: AI support markedly improved the diagnostic accuracy and confidence of novice LUS interpretation for detecting absent lung sliding. These findings suggest that real-time AI-based decision support may help improve access to high-quality LUS in military and other resource-limited care settings.

PMID:41774835 | DOI:10.55460/J.Spec.Oper.Med.2026.1SDN-NWTW

Proc Natl Acad Sci U S A. 2026 Mar 10;123(10):e2514297123. doi: 10.1073/pnas.2514297123. Epub 2026 Mar 3.

ABSTRACT

Liquid crystal mesophases of achiral molecules are normally achiral, yet in a few materials they spontaneously segregate and form right- and left-handed chiral domains. One mechanism that drives chiral segregation is molecular shape fluctuations between axial chiral conformations, where molecular interactions favor matching chirality and promote helical twist. Cooperative chiral ordering may also play a role in chirality amplification, as when a tiny fraction of chiral dopant drives a nematic phase to become cholesteric. We present a model of cooperative chiral ordering in liquid crystals using Maier-Saupe theory, and predict a phase diagram with a segregated cholesteric phase with alternating domains of left- and right-handed chiral twist, with opposite enantiomeric excess, in addition to racemic nematic and isotropic phases. Our model also demonstrates how chiral molecular fluctuations influence the helical twisting power of dopants in the nematic phase, which may be observed even in materials where the segregated cholesteric phase is preempted by a transition to another phase. We compare these results with Monte Carlo simulation studies of the switchable chiral Lebwohl-Lasher model, where each spin switches between right- and left-handed chiral states. Simulation results validate the predicted phase diagram, demonstrate chiral amplification in the racemic nematic phase, and reveal complex coarsening dynamics in the segregated cholesteric phase. These results suggest that molecular fluctuations between degenerate chiral configurations may be a common mechanism to produce cooperative chiral order in achiral liquid crystals.

PMID:41774802 | DOI:10.1073/pnas.2514297123

PLoS One. 2026 Mar 3;21(3):e0343981. doi: 10.1371/journal.pone.0343981. eCollection 2026.

ABSTRACT

BACKGROUND: The National Institute for Health and Care Research accepts applications for pilot and feasibility studies to their Research for Patient Benefit (RfPB) programme. There has been limited work describing the design practices of these applications and funding status. Knowing some of the qualities which may contribute towards a pilot or feasibility study application successfully gaining funding could help researchers improve the quality of their applications. Therefore, this study describes the protocol for a review looking at the characteristics of funded and non-funded external pilot trial applications. In particular, the primary objective is to describe the planned sample size and sample size justifications.

METHODS: The study will be conducted on 100 applications from Competition 31-37 with a randomised feasibility design, identified and given access to us by RfPB where the lead applicant has consented. We will screen these applications to identify the external pilot trials, first looking through the titles and then the full text. Following this, we will extract data on information such as medical area, study design, objective(s), sample size, sample size justification, and funding outcome stage one and two. Validation will be performed on 20% of the data extracted; discrepancies will be resolved by discussion or a third reviewer will decide if there is no consensus. We will use descriptive statistics to summarise quantitative data, and will analyse qualitative data using thematic analysis. Findings will be summarised through discussion with the project contributors to produce a reader-friendly guidance document.

DISCUSSION: This work will provide a more complete picture of RfPB external randomised pilot and feasibility trials. The findings will assist researchers when planning their pilot trials, and could help improve the quality of submitted applications.

PROTOCOL REGISTRATION: Open Science Framework protocol registration DOI: https://doi.org/10.17605/OSF.IO/PYKVG.

PMID:41774693 | DOI:10.1371/journal.pone.0343981

J Nephrol. 2026 Feb 3:aajaf013. doi: 10.1093/joneph/aajaf013. Online ahead of print.

ABSTRACT

BACKGROUND: Symptom burden in chronic kidney disease (CKD) patients has a negative impact on functional status and quality of life. Despite the high prevalence among hemodialysis (HD) patients, symptoms are often underestimated. We investigated the determinants of symptoms and their impact on mortality in a large cohort of HD patients.

METHODS: We analyzed 1825 HD patients for whom at least one questionnaire about symptoms was available. Machine learning-based algorithms were used to identify longitudinal variables associated with symptoms. Univariate and multivariate Cox regression analyses were used to investigate the association between symptoms and mortality. The additional prognostic value of symptoms was explored by using C-statistics and machine learning classification analyses.

RESULTS: Appetite Rating, Non-vascular Nervous System Score and Difficulty Following Diet were the variables most associated with symptoms, both at baseline and in longitudinal analyses. Survival analyses showed an independent association between symptoms and all the considered outcomes (Death, Hazard Ratio [HR]fper 10-unit increase: 0.91, 95% confidence interval [CI] 0.87-0.96, P < 0.001; Cardiovascular hospitalizations, HRper 10-unit increase: 0.89, 95% CI 0.84-0.94, P < 0.001; infectious hospitalizations, HRper 10-unit increase: 0.91, 95% CI 0.87-0.96, P < 0.001). However, classification analyses performed by machine learning showed that adding a symptom score to a base model did not significantly improve the performance of the models. Similarly, the improvement in R2, in discrimination power, and in reclassification capability was almost null.

DISCUSSION: In the large dataset of the Hemodialysis (HEMO) trial, we found that, among the analyzed variables, those related to eating habits and previous comorbidities were the most closely associated with the symptoms score, both at baseline and during follow-up. Although symptoms were associated with severe clinical outcomes, their prognostic power was limited. However, considering symptom burden in dialysis patients, strict monitoring of eating habits may help improve quality of life in these patients.

PMID:41774670 | DOI:10.1093/joneph/aajaf013