Tag: pubmed

Br J Radiol. 2026 May 21:tqag075. doi: 10.1093/bjr/tqag075. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare virtual straight and bending rods Spatially Fractionated Radiation Therapy (SFRT) for cervical cancer brachytherapy delivery.

METHODS: CT scan datasets from ten patients with locally advanced cervical cancer who received brachytherapy were included. For each patient, two distinct plans were generated: one using straight virtual rods and the other using bending virtual rods. The total prescribed dose was 30 Gy in 5 fractions. All plans were created with 10XFFF beam. Dosimetric parameters, including D90, V100, V150, and V200 for high risk-clinical target volume (HRCTV), were evaluated. Additionally, dose constraints for OARs (bladder, rectum, sigmoid, and bowel D2cc) were compared. Plan delivery quality assurance was performed for using Mobius verification phantom, and gamma passing rate was analyzed.

RESULTS: Comparable CTV coverage was observed between the two configurations. D90 values showing no statistically significant difference (p > 0.05). In both plans, the D2cc ofbladder, rectum, sigmoid, and bowel were observed to be ≤ 23.75 Gy, ≤ 17.00 Gy, ≤ 19.50 Gy, and ≤ 17.00 Gy, respectively. The average hotspot in HRCTV was evaluated at 18.4% (±10.4) and 20.8% (±7.8) for V200%, respectively. The gamma passing rate was found to be greater than 90% for the 2%/2 mm criteria.

CONCLUSION: This in-silico study concludes that both virtual rod configurations provide comparable target coverage while effectively minimizing OAR exposure. Further clinical validation is recommended to confirm these findings.

ADVANCES IN KNOWLEDGE: This study demonstrates the feasibility of SFRT and the potential for future testing in patients who are unable to undergo brachytherapy.

PMID:42179164 | DOI:10.1093/bjr/tqag075

J Endourol. 2026 May 25:8927790261454506. doi: 10.1177/08927790261454506. Online ahead of print.

ABSTRACT

AIM OF THE STUDY: Epidemiological studies have shown that female patients are at higher risk of developing stone-related infectious complications and urosepsis than their male counterparts. However, this gender-based difference in outcomes has not been specifically explored in the context of obstructive uropathy. This study aimed to investigate gender-related predictors of sepsis in patients treated for obstructive uropathy for ureteral stones.

MATERIALS AND METHODS: We retrospectively analyzed clinical, laboratory, and radiological data from 291 consecutive patients presenting to the emergency department for obstructive uropathy because of ureteral stones and submitted to stent or nephrostomy tube decompression between 01/2016 and 10/2024. Comorbidities were assessed using the Charlson Comorbidity Index. Sepsis was defined as an acute increase in ≥2 sequenctial organ failure assesment points and documented blood or urine cultures. All patients underwent preoperative computed tomography. Clinical and stone characteristics were collected in each case. Descriptive statistics and logistic regression models were used to identify gender-specific factors associated with sepsis.

RESULTS: In males, sepsis is linked to older age, larger stones, higher white blood cells, and C-reactive protein (CRP). In females, sepsis is linked to older age, higher Charlson Index, creatinine, and CRP. Septic females had smaller stones and lower CRP and creatinine than males. CRP and age were strongest sepsis predictors, with lower thresholds in females. Limitations include single-center, retrospective design, missing data (e.g., antibiotic timing, hormonal status), and reduced power for sex-specific analyses. Larger, prospective studies needed.

CONCLUSIONS: Female patients with obstructive uropathy had a higher risk of sepsis than men. Clinical and laboratory predictors of sepsis are different according to gender. Female developed sepsis at lower inflammatory scores and smaller stone diameter than males, highlighting that a gender-based management strategy should be performed in patients with obstructive uropathy.

PMID:42179155 | DOI:10.1177/08927790261454506

Disabil Rehabil Assist Technol. 2026 May 25:1-13. doi: 10.1080/17483107.2026.2678549. Online ahead of print.

ABSTRACT

PURPOSE: Wheelchair users represent a population with significant and often permanent mobility impairment. Despite well-established links between disability and socioeconomic deprivation, the geographic relationship between wheelchair user concentration and area-level deprivation has not previously been examined at national scale. This study aimed to identify spatial clusters of wheelchair users across Wales and characterise their association with socioeconomic deprivation across domains of the Welsh Index of Multiple Deprivation (WIMD).

METHODS: This cross-sectional ecological study used 43,790 NHS-registered wheelchair users across all 1,917 Lower Layer Super Output Areas (LSOAs) in Wales. Local Moran’s I identified statistically significant High-High (HH) spatial clusters of wheelchair user counts. Chi-square goodness of fit tests, chi-square tests of association, and binary logistic regression quantified the association between WIMD deprivation quintile (Q1-5) and HH clustering across WIMD domain, with Benjamini-Hochberg false discovery rate correction applied throughout.

RESULTS: One-hundred-and-ten HH clusters were identified, with 41% in the most deprived WIMD Overall quintile. Significant deprivation gradients were observed across six domains; Health and Employment showed the strongest associations, with Q1:Q5 wheelchair user ratios of 1.747 and 1.738 and up to 20-fold greater odds of HH cluster membership in the most deprived quintile. Housing and Access to Services showed divergent patterns, with clusters concentrated in areas of moderate rather than extreme deprivation.

CONCLUSIONS: Wheelchair user spatial clustering in Wales is strongly associated with socioeconomic deprivation, but the association varies by WIMD domain. These findings provide actionable spatial evidence to support equitable NHS wheelchair service commissioning aligned with true geographic need.

PMID:42179143 | DOI:10.1080/17483107.2026.2678549

Pain Res Manag. 2026;2026(1):e5531157. doi: 10.1155/prm/5531157.

ABSTRACT

BACKGROUND: Patient-controlled analgesia (PCA) pumps have emerged as the prevalent modality for managing postoperative pain. Opioids, although widely utilized as analgesic agents in these pumps, are often accompanied by undesirable side effects that can compromise patient comfort and hinder the widespread adoption of PCA therapy.

METHODS: We conducted a retrospective study involving 392 patients undergoing lumbar spine surgery who were prescribed PCA pumps for pain relief. Over the initial 1-3 days postsurgery, comprehensive data encompassing resting and activity-related pain levels, Ramsay sedation scores, activity status, and flatus passage were carefully recorded and analyzed.

RESULTS: Interestingly, patients who received a supplemental dose of nalmefene in their PCA pumps exhibited a notable increase in resting pain intensity on the second postoperative day. However, the incidence of postoperative nausea and vomiting (PONV) was notably reduced (15.5% in the sufentanil + nalmefene group vs 25.5% in the sufentanil group). Notably, no statistically significant variations were discerned between the two groups in Ramsay sedation scores, postoperative activity capabilities, flatus passage, or inflammatory biomarker levels.

CONCLUSION: The integration of nalmefene into PCA pumps presents a promising strategy for mitigating the occurrence of PONV, albeit with the caveat of potentially compromising opioid-mediated analgesia, necessitating further research and exploration. The delicate balance between enhancing patient comfort and preserving effective pain control remains a critical area of investigation in the field of postoperative pain management.

PMID:42179138 | DOI:10.1155/prm/5531157

Mediators Inflamm. 2026;2026(1):e3674573. doi: 10.1155/mi/3674573.

ABSTRACT

BACKGROUND: Despite extensive evidence supporting the American Heart Association (AHA)’s life’s essential 8 (LE8) framework for cardiovascular health (CVH) assessment, the underlying biological mechanisms linking LE8 to mortality outcomes in high-risk populations remain unexplored. This study aimed to investigate the association between LE8 scores and mortality risk among individuals with diabetes, hypertension, and their coexistence, and explored whether inflammation and biological aging statistically mediate these relationships.

METHODS: We conducted a large-scale longitudinal analysis using National Health and Nutrition Examination Survey (NHANES) data (2005-2018), including 4939 individuals with diabetes, 13,298 with hypertension, and 3303 with both conditions. LE8 scores were calculated from eight CVH metrics, with mortality ascertained through the National Death Index (NDI). Mediation analyses examined the roles of inflammation markers (neutrophil-to-lymphocyte ratio [NLR] and pan-immune-inflammation value [PIV]) and phenotypic age acceleration (PhenoAgeAccel).

RESULTS: Higher LE8 scores were significantly associated with reduced all-cause mortality and heart disease mortality across all groups (p < 0.001). Stratified analyses showed stronger associations among younger individuals (≤60 years) and those with higher socioeconomic status. In mediation analyses, inflammatory markers and PhenoAgeAccel statistically explained a meaningful proportion of the LE8-mortality associations, with different patterns across disease groups. For all-cause mortality, in diabetes, NLR and PIV accounted for larger proportions of the association (NLR: 31.6%; PIV: 26.9%), whereas in hypertension, PhenoAgeAccel accounted for a larger proportion (56.3%). Among individuals with both conditions, PhenoAgeAccel (26.1%) and NLR (5.3%) contributed to the association. Similar patterns were observed for heart disease mortality.

CONCLUSION: Higher LE8 scores are associated with reduced mortality risk in individuals with diabetes and/or hypertension, with inflammation and biological aging statistically mediating these associations in an exploratory manner. These findings suggest potential statistical mediators that may inform future mechanistic research and therapeutic targets, but causal interpretation requires further longitudinal studies.

PMID:42179110 | DOI:10.1155/mi/3674573

Public Health Nurs. 2026 May 25. doi: 10.1111/phn.70135. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the Disaster Safe Educational Unit (SPAB), internationally known as the Comprehensive School Safety (CSS) program, in DKI Jakarta, Indonesia focusing on disaster preparedness across different types of educational units.

METHODS: This study employed an evaluative mixed-methods design combining quantitative and qualitative approaches. Quantitative data were analyzed using cross-tabulation and Chi-Square tests in IBM SPSS Statistics version 22. Semi-structured qualitative interviews with experts were conducted to support data triangulation.

SAMPLE: The study included 3672 schools in DKI Jakarta Province, Indonesia surveyed using an online instrument adapted from the National Disaster Management Agency (BNPB) monitoring framework, covering three implementation pillars: disaster-safe facilities, disaster management in schools, and disaster risk reduction education.

RESULTS: The findings indicate that while progress has been made in providing disaster-safe facilities, preparedness in disaster management and disaster risk reduction education remains limited. Notably, preschools were identified as a high-priority risk group due to regulatory exclusions and resource constraints. Key challenges include a lack of teaching materials, limited resources, and insufficient expertise.

CONCLUSION: Although institutional support for the SPAB is high, implementation capacity across schools remains insufficient. This study highlights the need for inclusive regulatory reinforcement, targeted capacity building for early childhood education, and the formal integration of SPAB into school budgeting to ensure resilient learning environments.

PMID:42179070 | DOI:10.1111/phn.70135

Stress Health. 2026 Jun;42(3):e70184. doi: 10.1002/smi.70184.

ABSTRACT

Dermatological conditions are a major contributor to global nonfatal disease burden. Evidence suggests that psychological stress and trauma, including adverse childhood experiences (ACEs), stressful life events (SLEs), and post-traumatic stress disorder (PTSD), may affect the onset and severity of inflammatory and stress-responsive skin diseases, though findings remain fragmented. This systematic review aimed to synthesise evidence on associations between stress- and trauma-related exposures and dermatological conditions across the lifespan, focusing on timing, chronicity, and cumulative stress. The review followed PRISMA 2020 guidelines. Searches were conducted in Scopus, PubMed, and PsycINFO (from January 2000 to November 2025). Eligible studies were peer-reviewed empirical investigations of stress- or trauma-related exposures and dermatological outcomes in children or adults. Risk of bias was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklists; only low- and moderate-risk studies were included. Thirty studies met inclusion criteria. Stress- and trauma-related exposures were associated with increased risk, earlier onset, or greater severity of conditions, particularly psoriasis, atopic dermatitis, alopecia areata, and chronic urticaria. Associations were strongest for early-life adversity and cumulative stress. Results support an association between trauma-related exposures and dermatological outcomes. Longitudinal studies are needed to clarify temporal relationships and inform psychosocial assessment.

PMID:42179055 | DOI:10.1002/smi.70184

Cancer Control. 2026 Jan-Dec;33:10732748261455722. doi: 10.1177/10732748261455722. Epub 2026 May 25.

ABSTRACT

IntroductionEvidence indicates that being married may influence prognosis in various malignancies; however, whether this association extends to small intestinal stromal tumors (SISTs) remains unclear. To address this gap, we analyzed population-based data to determine the prognostic significance of marital status for SIST patients.MethodsThis population-based, retrospective cohort study leveraged data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2019. We classified patients as either married or unmarried according to their recorded marital status. To minimize bias from confounders, we performed 1:1 propensity score matching (PSM). Survival outcomes, including overall survival (OS) and cancer-specific survival (CSS), were estimated via the Kaplan-Meier method and Cox proportional hazards models.ResultsOur analysis included 3315 SIST patients, of whom 2132 were married and 1183 were unmarried. Compared with unmarried individuals, married patients experienced significantly better OS and CSS (both P<0.05). Multivariable analysis identified marital status as an independent predictor for both endpoints, with adjusted HRs of 1.35 (95% CI: 1.20-1.52) for OS and 1.27 (95% CI: 1.10-1.48) for CSS. Following PSM, the survival advantage for married patients persisted (P<0.05 for both OS and CSS). Notably, the 5-year OS and CSS rates favored the married cohort over the unmarried cohort (75.2% vs. 64.0%, P <0.001; 83.7% vs. 76.1%, P = 0.001, respectively). Subgroup analyses further revealed that the survival benefit associated with marriage was particularly evident among elderly, female, Caucasian, and surgically treated patients.ConclusionsMarital status independently predicts prognosis in small intestinal stromal tumors (SISTs), with married patients exhibiting superior outcomes.

PMID:42179050 | DOI:10.1177/10732748261455722

Behav Sleep Med. 2026 May 25:1-10. doi: 10.1080/15402002.2026.2679677. Online ahead of print.

ABSTRACT

OBJECTIVE: In recent times, Fear of Missing Out (FoMO) has emerged as a significant psychological construct adversely impacting the well-being and emotional health of social media users. Among the many psychological and physiological impacts of FoMO, its relation with sleep is frequently examined, considering its influence on disruption of sleep. This study intended to explore the association between FoMO, Psychological Capital (PsyCap), and sleep quality among college students and to determine whether PsyCap moderates the relationship between FoMO and sleep quality.

METHOD: A total of 110 college students aged between 18 and 25 participated in the study. Standardized self-report measures, including the Fear of Missing Out Scale (FoMOs), Psychological Capital Questionnaire (PCQ-24), and Pittsburgh Sleep Quality Index (PSQI), were employed to assess FoMO, PsyCap, and sleep quality. Descriptive statistics, Pearson correlations, independent sample t-tests, and moderation analysis using the Hayes PROCESS macro (Model 1) were executed.

RESULTS: Findings demonstrated that FoMO was positively correlated with poor sleep quality. PsyCap, on the other hand, was negatively correlated to FoMO and poor sleep quality. Further, it was observed that FoMO significantly correlates with poorer sleep in those students with low PsyCap levels.

CONCLUSION: PsyCap appears to play a moderating role against the effects of FoMO on sleep. The study highlights the need to conduct PsyCap-based interventions for enhancing the sleep quality and overall well-being among young adults.

PMID:42179046 | DOI:10.1080/15402002.2026.2679677

Int J Urol. 2026 May;33(5):e70527. doi: 10.1111/iju.70527.

ABSTRACT

OBJECTIVES: Desmopressin is an established treatment for nocturia due to nocturnal polyuria. In Japan, low-dose formulations (25 and 50 μg) were approved only for men in 2019. However, age- and dose-specific prescribing patterns in real-world practice remain unclear. Using nationwide aggregated claims data, we analyzed age-stratified prescribing trends and dose selection patterns.

METHODS: Publicly available NDB Open Data (fiscal years 2020-2023) were used. Outpatient prescriptions for desmopressin orally disintegrating tablets (25 and 50 μg) were extracted by sex and 5-year age categories. Population-adjusted prescription rates per 1000 persons and 95% confidence intervals (CIs) were calculated. Temporal trends were evaluated using Poisson regression models with log-population offset.

RESULTS: In men, the population-adjusted prescription rate increased from 21.5 per 1000 persons in 2020 to 84.6 in 2023 (p for trend < 0.001). More than 90% of prescriptions were issued to individuals aged ≥ 65 years. Overall, use of the 25 and 50 μg formulations was balanced; however, the proportion of the 25 μg formulation increased with advancing age, and the 25 μg/50 μg ratio reached 1.37 among those aged ≥ 90 years. Prescriptions in women also increased, with predominance of the 25 μg formulation.

CONCLUSIONS: Desmopressin prescribing has increased nationwide in Japan, particularly among older men. Increased selection of the lower-dose formulation in older patients may reflect safety considerations. Off-label use in women is increasing, indicating the need for further safety evaluation and appropriate prescribing guidelines.

PMID:42179007 | DOI:10.1111/iju.70527