Tag: pubmed

Community Ment Health J. 2025 May 6. doi: 10.1007/s10597-025-01471-y. Online ahead of print.

ABSTRACT

Young adults experiencing psychosis are at high risk for disengagement from their daily lives. Occupational therapy (OT) services play an important role in fostering participation, yet their intervention efficacy in Early Intervention in Psychosis (EIP) remains poorly understood. To determine the commonly utilized OT interventions and measurement tools that require further research to determine their efficacy and effectiveness. Cross-sectional, mixed-methods survey study. Quantitative descriptive statistics were completed on Microsoft Excel and qualitative thematic analysis was completed by two researchers using Dedoose. Online survey. Occupational therapy practitioners (OTPs) working on EIP programs in the United States were recruited through purposive and snowball sampling. The survey consisted of 24 closed and open-ended questions assessing use of interventions, outcomes tracked, and measurement tools. Study had 21 respondents. The most frequent interventions were self-regulation and activities of daily living (ADL). Self-regulation interventions were overwhelmingly sensory-based. Most commonly reported outcome measure was observation of participation in occupations. This study confirms the use of sensory and ADL-based interventions by OTPs in EIP programs. Findings suggest a strong sense of the role of OT within EIP as intervention use is relatively consistent across programs and focuses on client-centered, occupation-based interventions. Outcome tracking and quality improvement were gaps as most OTPs are not using standardized methods or not performing this. Additional study is required to determine the efficacy of commonly used interventions and to improve outcome measurement methods in EIP programs. Occupational therapy is an undervalued profession on teams that provide services to young adults dealing with the onset of a psychotic illness. This study is the first of many needed to demonstrate the impact OT services can have on the outcomes of the young adults who receive care for their psychotic illness. This study identifies what OT interventions are common, and what outcomes OT professionals track to determine their services’ impact on these mental health care teams. These results will help to build the needed research on how helpful these common interventions are for young adults facing psychotic illnesses.

PMID:40327230 | DOI:10.1007/s10597-025-01471-y

J Patient Rep Outcomes. 2025 May 6;9(1):47. doi: 10.1186/s41687-025-00885-2.

ABSTRACT

BACKGROUND: Assessment of patient readiness for hospital discharge has been advocated as an important component of discharge preparation. However, no measures focused on hospital-to-home transitions for patients receiving a palliative approach to care, or the associated difficulties in coping at home after hospital discharge, have been developed to date. Using a co-design approach, the purpose of this study was to (1) adapt two scales to a palliative care population, one of which was developed to assess readiness for the hospital-to-home transition and another developed to assess difficulty in coping post-transition and to (2) test the content validity of both scales from the perspectives of patients, family caregivers, and healthcare providers. The scales chosen for adaptation were the Readiness for Hospital Discharge Scale and Post-Discharge Coping Difficulty Scale.

METHODOLOGY: The research team made initial adaptations to scale language prior to developing three parallel versions of each scale to be patient-, family caregiver-, and healthcare provider-facing. We conducted content validity testing of the items on both scales by asking each participant group to rate scale items on their usefulness, and to provide suggestions on ways items could be improved. We calculated the Item Content Validity Index and a modified Kappa statistic for each scale item, and calculated the Scale Content Validity Index for each of the three versions of the scales. Refinements were informed by qualitative feedback provided by participants during the content validity process. Final refinements were informed by members of a Patient and Family Advisory Council, and healthcare provider research team members.

RESULTS: Moderate modifications were required to the three versions of both scales. Modifications included adding items, modifying item language, and adding examples in parentheses to enhance item context. Patients, family caregivers, and healthcare providers deemed the research team’s initial modifications to the scales useful, as evidenced by each scale yielding a Scale Content Validity Index of higher than 0.5.

CONCLUSION: The methodology provided can be used as an example of ways to engage and leverage the experiences of healthcare system users and healthcare providers throughout the outcome measures development process. The next steps will be to utilize the adapted scales as intervention outcome measures in a subsequent implementation study.

PMID:40327215 | DOI:10.1186/s41687-025-00885-2

Cancer Causes Control. 2025 May 6. doi: 10.1007/s10552-025-02006-2. Online ahead of print.

ABSTRACT

PURPOSE: To estimate the number of screenings received, life-years (LYs) saved, and number of screenings per LY saved per woman who participated in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) (Program) compared with those who did not participate (no Program).

METHODS: We developed a time-to-event simulation model to compare the outcomes of women participating in the Program vs. no Program, categorized by race/ethnicity. Model input parameters included data from the Program’s minimum data elements, United States Cancer Statistics, National Health Interview Survey, and published literature. The Program’s impact was calculated as the difference in LYs between the Program and no Program using data from 2010 to 2019.

RESULTS: Among 1 million women of all races/ethnicities who participated in the NBCCEDP in the last 10 years, 457,152 (standard deviation [SD]: 848) received more screenings than those who did not participate. These participants saved an average of 0.027 LYs per woman screened. In addition, we estimated that about 17 screenings would be required to save an additional 1 LY per woman screened in the Program compared with no Program. Per woman screened by race/ethnicity, non-Hispanic Black women had the highest estimated 0.075 LYs saved, followed by Hispanic women with 0.025 LYs, non-Hispanic White with 0.014 LYs, and non-Hispanic American Indian/Alaska Native and Asian/Pacific Islander had the least health outcome with 0.011 LYs.

CONCLUSION: The reported findings underscore the importance of providing preventive health services to populations that might not otherwise have access to these services.

PMID:40327212 | DOI:10.1007/s10552-025-02006-2

Med Biol Eng Comput. 2025 May 6. doi: 10.1007/s11517-025-03367-1. Online ahead of print.

ABSTRACT

The threads of dental implants are critical components that transfer occlusal loads to the surrounding bone. The appropriate size of thread parameters can influence the stability of the implant after implantation. Despite several research studies on the effectiveness of implant thread parameters, there is limited structured information available. This study aims to conduct a systematic review to evaluate the biomechanical effects of thread parameters, namely, thread depth, thread width, thread pitch, and thread angle on implant stability. A comprehensive literature review was conducted in PubMed/MEDLINE, Scopus, ScienceDirect, and Web of Science for research published in English in the last two decades according to the PRISMA protocols. The extracted data were organized in the following order: area, bone layers, bone type, implant design, implant material, failure criteria/unit, loading type, statistical analysis/optimization, experimental validation, convergence analysis, boundary conditions, parts of the Finite Element Model, studied variables, and main findings. The search yielded 580 records, with 39 studies meeting the selection criteria and being chosen for the review. All four thread parameters were found to affect the stress and strain distribution in cancellous and cortical bones. Thread pitch and depth are more important for implant primary stability as they are directly correlated with the functional surface area between the implant and bone. Moreover, thread pitch, depth, and width can increase the insertion torque, which is favorable for implant primary stability, especially in low-quality bones. The thread angle can also direct occlusal forces to the bone more smoothly to prevent bone overloading and destructive shear stresses, which cause bone resorption. This structured review provides valuable insights into the biomechanical effects of thread parameters on implant stability.

PMID:40327205 | DOI:10.1007/s11517-025-03367-1

Blood Res. 2025 May 6;60(1):29. doi: 10.1007/s44313-025-00078-2.

ABSTRACT

BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune condition characterized by low platelet count and increased risk of bleeding. Several pathophysiological processes contribute to the disease, including complement activation by autoantibodies bound to platelet surfaces. This study aimed to assess complement levels in ITP patients and determine their correlation with clinical presentation and disease severity.

PATIENTS AND METHODS: This case-control study enrolled 40 patients (both sexes, aged 18-40 years) with primary ITP and 40 healthy controls. All participants underwent a comprehensive health assessment, thorough physical examination, laboratory investigations, and abdominal ultrasound. These included a complete blood count (CBC) with blood film, renal and hepatic function tests, hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (HCV-Abs), human immunodeficiency virus (HIV) antibodies, hepatitis B core antibody (HBcAb), C-reactive protein (CRP), antinuclear antibody (ANA), thyroid-stimulating hormone (TSH), erythrocyte sedimentation rate (ESR), serum complement levels (C3 and C4), and Helicobacter pylori antigen in stool.

RESULTS: Mean C3 and C4 levels were significantly lower in patients with ITP than in healthy controls. A statistical significant negative correlation was found between CRP and C4 levels in ITP patients. However, no statistically significant relationship was observed between C3 and C4 levels and platelet count in ITP patients, regardless of the presence of bleeding complications.

CONCLUSION: Complement levels were significantly lower in patients with ITP than in healthy controls. Complement levels were also significantly lower in treatment-naïve patients than in patients who received treatment. Therefore, complement levels could serve as a valuable laboratory test for disease activity.

PMID:40327196 | DOI:10.1007/s44313-025-00078-2

Emerg Radiol. 2025 May 6. doi: 10.1007/s10140-025-02346-1. Online ahead of print.

ABSTRACT

PURPOSE: Diagnosing adnexal torsion is challenging due to non-specific presentation and ultrasound findings. MRI may provide alternative assessment of adnexal torsion. We evaluated an MRI appendicitis protocol for torsion identification.

METHODS: Retrospective chart and image review was performed for girls with appendicitis MRI exams from 2013 to 2019. Ovarian volumes, stromal T2 signal, and apparent diffusion coefficient (ADC) ratios were tabulated. Ovarian and paratubal cysts’ size and location were recorded as well as presence or absence of torsion. Statistical analysis was performed.

RESULTS: Six hundred-fifty cases were included, eight with torsion. Higher ovarian volumes and volume ratios were found with torsion (p < 0.0001 and p < 0.0001, respectively). Ovarian volume ratio less than 4:1 had 99.7% negative predictive value (NPV). Ovarian volume less than 20 mL had 99.8% NPV. Five of six cases with 7 cm or larger adnexal cysts were torsed. T2 signal and ADC ratios overlapped between torsed and untorsed groups. No torsed adnexa appeared normal on MRI.

CONCLUSION: Torsed cases tended to have larger ovaries and higher volume ratios. Adnexal cysts greater than 7 cm diameter were likely to be torsed. No torsion cases had normal adnexae on MRI. Normal appearing adnexae on MRI are very unlikely to be torsed.

PMID:40327188 | DOI:10.1007/s10140-025-02346-1

Hernia. 2025 May 6;29(1):159. doi: 10.1007/s10029-025-03342-7.

ABSTRACT

PURPOSE: We sought to evaluate the risks for reoperation, recurrence, and groin pain following open inguinal hernia repair with a plug versus flat mesh.

METHODS: We conducted a cohort study including 90,319 patients ≥ 18 years who underwent first elective open inguinal hernia repair with polyester/polypropylene mesh within a US integrated healthcare system (1/2010-6/2023). Plug versus flat mesh were the treatment groups. Reoperation related to the index hernia repair, as well as other reoperation reasons, and recurrence during follow-up were primary outcomes, while 5-year postoperative groin pain (excluding first 6-month postoperative acute recovery period) was a secondary outcome. Multiple Cox regression was used to evaluate risk of longitudinal outcomes, while multiple logistic regression was used to evaluate groin pain, with covariate adjustment.

RESULTS: Plugs were used in 37,490 (41.5%) repairs; plug use declined from 53.0% in 2010 to 13.9% in the first six months of 2023. No difference in risk for reoperation (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 0.92-1.16) or recurrence (HR = 0.93, 95% CI = 0.83-1.04) was found for plug compared to flat mesh. A higher risk of reoperation for device infection was observed with plug use compared to flat mesh (HR = 2.71, 95% CI = 1.09-6.77). In adjusted analysis, no difference in the likelihood of groin pain was observed (odds ratio = 1.08, 95% CI = 1.00-1.17).

CONCLUSION: Plug mesh for open inguinal hernia repairs were not found to have improved outcomes compared to flat mesh but a higher risk of reoperation for infection. These findings align with the current literature, which generally advises against the use of mesh plugs due to associated risks and complications.

PMID:40327184 | DOI:10.1007/s10029-025-03342-7

J Gerontol A Biol Sci Med Sci. 2025 May 4:glaf096. doi: 10.1093/gerona/glaf096. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying effective risk assessment strategies and prediction models for frail populations is crucial for precise mortality risk identification and improved patient management. This study aimed to evaluate whether prediction models incorporating survey data combined with biomarkers, physical measurements, or both could enhance mortality risk prediction in frail individuals than survey-only models.

METHODS: 15,754 frail participants aged 40-72 from the UK Biobank were included. We used Cox models to assess all-cause mortality risk and Light Gradient Boosting Machines for variable selection by sex. Performance was evaluated through discrimination, calibration, and reclassification.

RESULTS: In the survey-only models, we selected 24 predictors for males and 19 for females; age, and number of treatments were the top predictors for both sexes. In the biomarker models, we selected 15 predictors for males and 24 for females. In the physical measurement models, we retained 24 predictors for males and 23 for females. The base models showed good discrimination: C-statistic was 0.73 (95% CI, 0.72-0.75) for males and 0.74 (95% CI, 0.72-0.76) for females in development, and 0.70 (95% CI, 0.65-0.75) for males and 0.78 (95% CI, 0.73-0.83) for females in validation. Although incorporating additional predictors led to some improvement in model performance, the overall enhancement was not substantial.

CONCLUSIONS: Survey-based models predicted mortality in frail individuals effectively, with only minor improvements from adding biomarkers or physical measurements. These findings highlighted the value of surveys in forecasting outcomes and informed personalized management strategies to improve health for the frail.

PMID:40326431 | DOI:10.1093/gerona/glaf096

Pharmacotherapy. 2025 May 6. doi: 10.1002/phar.70022. Online ahead of print.

ABSTRACT

OBJECTIVE: The Anticholinergic Drug Scale (ADS) is a commonly used measure of anticholinergic exposure. This study describes an expanded and revised version of the ADS (rADS) and its relationship with cultured cell-based serum anticholinergic activity (cSAA) and cognitive measures.

STUDY PARTICIPANTS: Adults aged 60 years and older with mild cognitive impairment (MCI), remitted major depressive disorder (rMDD), or both, participate in the Prevention of Alzheimer’s Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study.

STUDY DESIGN: Cross-sectional investigation of data from the PACt-MD study.

MEASURES: The rADS includes ratings for 1047 distinct products, about twice as many as the originally published scale; previously published ratings were revised for 40 drugs. Total rADS scores were calculated as sums of ratings of all drugs taken by participants; cSAA was measured in the participants’ sera; cognitive performance included measures of executive function, language, processing speed, verbal memory, visuospatial memory, working memory, and an overall composite score.

STATISTICAL ANALYSIS: The relationship between rADS total scores and cSAA was examined using a Spearman rank correlation coefficient. Relationships between rADS total scores and cognitive performance measures were explored in multivariable linear regression models.

RESULTS: The sample included 310 participants (mean [standard deviation] age: 72 (6) years; 61.6% were women, and 81.6% had MCI [with or without rMDD]). Total rADS scores were positively correlated with cSAA (Spearman’s correlation coefficient: 0.178, p = 0.0016). Total rADS scores were not significantly associated with cognitive performance.

CONCLUSIONS: The revised scale is recommended as a replacement for the original ADS since it includes ratings for more drugs and was significantly, albeit weakly, associated with cSAA, similar to previous findings using the original ADS.

PMID:40326412 | DOI:10.1002/phar.70022

Eur J Psychotraumatol. 2025 Dec;16(1):2490329. doi: 10.1080/20008066.2025.2490329. Epub 2025 May 6.

ABSTRACT

Background: Psychological safety plays a vital role in rest, recovery, and fostering social connections. However, a history of trauma can predispose individuals to perceive heightened levels of threat and danger. Research suggests that a lack of psychological safety may be a defining biopsychosocial characteristic of posttraumatic stress disorder (PTSD). Persistent feelings of threat and danger are associated with a lack of psychological safety and may be predictive of PTSD. Our pioneering work reported on the development of the neuroception of psychological safety (NPSS), rooted in polyvagal theory, and consists of social engagement, compassion, and body sensations dimensions. Understanding more about the dimensionality of the NPSS and further establishing its psychometric properties was our priority.Objective: Our current research aimed to validate and test the reliability and dimensionality of the NPSS, using a large community sample (n = 2035) of adult residents in the UKMethod: We examined the internal and test-retest reliability, convergent, discriminant, and concurrent validity as well as dimensionality of the NPSS.Results: The 3-factor structure of the NPSS was replicated with regard to the absolute fit indices. Internal consistencies ranged from acceptable to excellent across the NPSS’s subscales. Providing support for the validity of the NPSS, scores were predictably related to team psychological safety, wellbeing, post-traumatic stress, burnout, body awareness, and personality, with effect sizes typically in the high to medium range. Scores on the NPSS were found to show good test-retest reliability.Conclusions: This study demonstrates the validity, reliability and dimensionality of the NPSS with an adult sample. Further work is underway to support and enhance understandings of psychological safety with diverse clinical populations impacted by trauma. The NPSS has applicability across a range of health and social care contexts, such as shaping new approaches to evaluating trauma treatments and enhancing trauma informed care.

PMID:40326393 | DOI:10.1080/20008066.2025.2490329