Tag: pubmed

Neurol Sci. 2026 Jul 21;47(8):649. doi: 10.1007/s10072-026-09201-2.

ABSTRACT

BACKGROUND: This study validated the Italian version of the In-Person Telephone Interview for Cognitive Status (IP-TICS).

METHODS: 468 healthy Italian individuals (176 males; age: 57.5 ± 15.4, education: 13.2 ± 3.7) completed the TICS, IP-TICS, MMSE and MoCA. Correlational analyses explored the construct validity of the IP-TICS against the TICS, MMSE and MoCA. Hierarchical Confirmatory Factor Analyses tested the configural, metric and scalar invariance between the TICS and IP-TICS. Statistical equivalence was assessed via a two one-sided test (TOST) procedure. Equating norms were derived via log-linear smoothing equipercentile equating (LSEE) analyses, with TOST procedures assessing equivalence between empirical and LSEE-derived scores.

RESULTS: The IP-TICS converged with the TICS, MMSE and MoCA, showing configural and metric invariance and equivalence with the TICS. Empirical and LSEE-derived scores were statistically equivalent.

DISCUSSION: Findings support the convergence, equivalence and invariance between the TICS and the IP-TICS. The IP-TICS converges with established in-person screeners.

PMID:42479254 | DOI:10.1007/s10072-026-09201-2

J Patient Rep Outcomes. 2026 Jul 21. doi: 10.1186/s41687-026-01144-8. Online ahead of print.

ABSTRACT

BACKGROUND: Systematic collection of patient-reported outcomes via electronic health records can improve symptom assessment and supportive care delivery in oncology, yet implementation is often hindered by inadequate attention to end-user needs and organizational context. Guided by an implementation science framework, we conducted a formative evaluation to inform design and implementation planning of an electronic patient-reported outcome supportive care screening system in ambulatory oncology care, using head and neck cancer as a use case.

METHODS: A prospective mixed-methods observational study was conducted using semi-structured interviews as part of a pre-implementation formative evaluation. Eligible participants were target users of the proposed supportive care screening system, including (1) clinical staff and (2) patients with head and neck cancer from a single health care system. Using the Consolidated Framework for Implementation Research as a guiding framework, we elicited user feedback through interview and prototype engagement. Quantitative measures included patient symptom burden and validated pre-implementation measures of acceptability, appropriateness, feasibility, and usability. For data analyses, we used directed content analysis and matrix analysis for qualitative data, and descriptive and comparative statistics for quantitative assessments.

RESULTS: Forty-six target users (20 clinical staff, 26 patients) participated. Both groups expressed strong tension for change, recognizing many inadequacies of the current approach to symptom assessment. Clinical staff described current practices as “haphazard,” while patients recounted missed opportunities for support and preventable harm. Electronic health record integration enhanced perceived compatibility, though time constraints and alert fatigue emerged as potential barriers. Clinical staff emphasized the need for clear symptom thresholds and actionable referral criteria; patients emphasized that their sustained engagement depended on evidence of clinicians using the data in their care. Pre-implementation scores indicated strong readiness across both groups: acceptability (clinical staff 4.47/5, patients 4.21/5), appropriateness (4.46/5, 4.24/5), feasibility (4.41/5, 4.35/5), and usability (82.2/100, 85.6/100). Findings informed key design priorities and implementation strategies.

CONCLUSIONS: Systematic pre-implementation formative evaluation revealed important barriers, facilitators, and contextual insights that shaped both intervention design and implementation approach. High scores on leading indicators suggest strong organizational readiness and perceived value. This user-informed development process provides a replicable model for optimizing electronic patient-reported outcome systems before deployment.

PMID:42479244 | DOI:10.1186/s41687-026-01144-8

Eur J Trauma Emerg Surg. 2026 Jul 21;52(1):224. doi: 10.1007/s00068-026-03265-7.

ABSTRACT

PURPOSE: The aim of this exploratory pilot study was to describe First Person View drone (FPV) related, blast-mechanism thoracic trauma with no rib fractures in Ukrainian military patients sustained during the Russia-Ukraine Conflict, and report the prevalence of persistent neuropathic pain symptoms at three months among patients admitted to a rehabilitation and pain medicine service.

METHODS: A retrospective, single-centre observational, exploratory study design was used. Military patients (≥ 16 years old) with blast-mechanism thoracic injuries with no rib fractures, admitted to a hospital’s rehabilitation and pain medicine service in Ukraine for ≥ 24 h were included. The PainDETECT survey was completed at three months post-injury. Participant characteristics were summarised using descriptive statistics. Exploratory univariate and multivariate analyses were performed to explore possible associations between variables and the development of persistent neuropathic pain symptoms.

RESULTS: 217 patients were included in the final analysis. Median age was 39 years (IQR: 32-47.5). 131 (60.4%) patients were admitted to critical care with 91 (41.9%) patients requiring mechanical ventilation. The median hospital length of stay was 22 days (IQR: 16-25) and critical care length of stay was 4 days (IQR: 2-5). Persistent neuropathic pain symptoms were reported in 173 out of 217 patients (79.7% absolute event rate). Univariate analysis revealed a stark contrast in absolute rates based on the mechanism: 99.4% (172/173) of patients exposed to blasts developed persistent symptoms compared to just 0.6% (1/45) in the low-energy and bullet-like injury group, representing an absolute risk difference of 0.97 (95% CI: 0.93-0.99, p < 0.001).

CONCLUSIONS: The results of this pilot study demonstrate a very high rate of persistent neuropathic pain symptoms at three months in this cohort of military patients admitted to a rehabilitation and pain medicine service, highlighting significant implications for rehabilitation of long-term complications. We highlight that FPV-drone blasts can lead to significant soft tissue injuries to the thorax, in the absence of rib fractures.

PMID:42479227 | DOI:10.1007/s00068-026-03265-7

Eur J Nutr. 2026 Jul 21;65(5):218. doi: 10.1007/s00394-026-04069-6.

ABSTRACT

PURPOSE: To simulate realistic dietary scenarios aligned with the EAT-Lancet reference diet and evaluate their impact on diet-related greenhouse gas emissions (GHGE), land use (LU), and obesity status in paediatric age.

METHODS: Dietary intake of children (3-9 y) and adolescents (10-17 y) from the last National Food, Nutrition, and Physical Activity Survey, Portugal (n = 1153), was assessed using food diaries (children) and 24-h recalls (adolescents) and an automated multiple-pass method with portion size estimations. The World Index for Sustainability and Health (WISH) measured adherence to the EAT-Lancet reference diet, reflecting dietary quality aligned with planetary health principles. Diet-related environmental indicators (greenhouse gas emissions [GHGE] and land use [LU]) were estimated using the SHARP-Indicators database. BMI (measured) z-scores were classified according to WHO criteria. Dietary patterns (DP) were derived using latent class analysis. Simulations aligned current dietary intake with the EAT-Lancet reference diet. The potential to prevent obesity cases was estimated by Potential Impact Fractions (PIF).

RESULTS: Overall, current diets are not aligned with the Planetary Health Diet. Among children, reducing the consumption of eggs, meats, fish, and soft drinks improved WISH scores and decreased environmental indicators. For adolescents, the greatest reductions of these indicators were achieved by reducing dairy and red meat. The scenario that led to the largest significant reduction in obesity cases involved a shift towards a plant-based dietary pattern (PIF = 0.7% children, 0.2% adolescents), which also increased environmental impact (with mean GHGE increasing from 3.9 to 4.1 kg CO₂-eq), as it replaced diets already low in animal products with a plant-based pattern of greater overall food intake.

CONCLUSIONS: To effectively enhance adherence to the EAT-Lancet diet, promoting plant-based foods should be coupled with reductions in dairy, meat, soft drinks, and total dietary quantity.

PMID:42479223 | DOI:10.1007/s00394-026-04069-6

Eur J Pediatr. 2026 Jul 21;185(8):595. doi: 10.1007/s00431-026-07257-y.

ABSTRACT

The purpose of the study is to compare the efficacy and safety of available interventions for infantile hemangioma against oral propranolol and to evaluate the certainty of the comparative evidence. We conducted a Bayesian network meta-analysis in accordance with PRISMA-NMA guidelines and systematically searched PubMed, Embase, the Cochrane Library, and CNKI from January 2008 to June 2026. A random-effects consistency model was fitted using the BUGSnet package. Evidence certainty was assessed using the CINeMA framework, and risk of bias was evaluated using the revised Cochrane RoB 2 tool. Thirty randomized controlled trials (RCTs) including 2,639 patients across nine treatment nodes were included in the efficacy analysis, and 12 RCTs involving 1,143 patients across eight nodes were included in the safety analysis. Using oral propranolol as the reference treatment, no active intervention demonstrated statistically significant superiority in efficacy, whereas placebo was significantly inferior. Corticosteroids were the only intervention associated with substantially higher adverse event rates, whereas atenolol showed a trend toward fewer adverse events. By anchoring all comparisons to oral propranolol and integrating CINeMA certainty assessments with inconsistency testing, these findings are consistent with the continued role of oral propranolol as the reference systemic treatment for infantile hemangioma. For patients intolerant to propranolol, atenolol may represent a reasonable alternative.

CONCLUSIONS: By anchoring all comparisons to oral propranolol and integrating CINeMA certainty assessments with inconsistency testing, these findings are consistent with the continued role of oral propranolol as the reference systemic treatment for infantile hemangioma. For patients intolerant to propranolol, atenolol may represent a reasonable alternative.

WHAT IS KNOWN: • Oral propranolol is the established first-line systemic therapy for infantile hemangioma. • Previous network meta-analyses have reported treatment rankings, but the clinical meaning of these rankings relative to oral propranolol remains uncertain.

WHAT IS NEW: • Despite favorable point estimates for combination therapy and nadolol, this benchmark-anchored analysis found no included active intervention statistically superior to oral propranolol. • Certainty assessment showed that treatment rankings were limited by heterogeneity, inconsistency, risk of bias, and imprecision; atenolol had the largest body of direct comparative evidence among the alternatives.

PMID:42479211 | DOI:10.1007/s00431-026-07257-y

Eur J Clin Pharmacol. 2026 Jul 21;82(8):213. doi: 10.1007/s00228-026-04140-5.

ABSTRACT

INTRODUCTION: Venous thromboembolism (VTE) may be a significant complication in medical patients, and infectious disease has been highlighted as an additional risk factor. Pharmacological thromboprophylaxis can prevent VTE and is recommended in at-risk populations, but not routinely in patients with infectious diseases.

METHODS: We conducted a systematic review and meta-analysis of studies on the effectiveness of pharmacological thromboprophylaxis in patients with acute infections, excluding those involving COVID-19. The primary outcome was VTE events. Secondary outcomes were mortality and adverse events related to anticoagulant therapy.

RESULTS: Data from seven studies (four randomized controlled trials and three observational studies) involving 16,994 patients with infectious diseases were analyzed. Pharmacological thromboprophylaxis regimens consisted of unfractionated heparin, low-molecular-weight heparin (enoxaparin or dalteparin), and fondaparinux. The severity of the disease varied from acute infections to sepsis. Six studies reported fewer VTE events with thromboprophylaxis. The meta-analysis yielded a pooled odds ratio of 0.50 [95% CI: 0.37-0.69, I² = 47%]. Three studies reported bleeding or bruising outcomes: one observational study reported significantly more bleeding with thromboprophylaxis, while two randomized trials reported either no significant difference in severe bleeding or in mild bleeding-related adverse events. Two studies assessed mortality, but neither found a statistically significant difference with or without thromboprophylaxis. One study was at high risk of bias, and another was at critical risk of bias.

CONCLUSION: This analysis quantifies the effect of thromboprophylaxis in patients with acute infectious diseases. Although available results show that thromboprophylaxis is associated with fewer VTE events, limited data, sparse safety and mortality reporting, and heterogeneity among studies preclude reliable risk-benefit evaluation. Further prospective research is warranted.

PMID:42479201 | DOI:10.1007/s00228-026-04140-5

Neurol India. 2026 Jul 1;74(4):621-626. doi: 10.4103/neurol-india.Neurol-India-D-25-00926. Epub 2026 Jul 21.

ABSTRACT

BACKGROUND: Embolic Strokes of Undetermined Source (ESUS) accounts for about 9-25% of all ischemic strokes. Atrial cardiopathy (AC) is a recently described pathology of the left atrium and is found to be associated with embolic strokes. This study aimed to study the prevalence and outcomes of AC among patients with ESUS.

METHODS: This is a single-centre, prospective, observational study conducted over a period of 1 year. AC was diagnosed by the presence of any one of the following biomarker using electrocardiogram (P-wave duration ≥110 ms, prolonged PR interval ≥200 ms, P-wave terminal force V1 ≥5000 μV*ms), echocardiogram (left atrial diameter ≥39 mm in men and ≥37 mm in women, left atrial volume index ≥34 ml/m2) or serum (N-terminal-probrain natriuretic peptide [NT-proBNP] ≥250 pg/mL) at baseline among patients with ESUS. All the patients were followed up after 90 days. The study cohort was divided into two groups: ESUS with AC and ESUS without AC. Both groups were compared using the Mann-Whitney U test. Fisher’s exact test was used to identify the parameter associated with recurrent stroke. P <0.05 was considered statistically significant.

RESULTS: A total of 63 patients were included in the study with a mean age of 59.2 (5.6) years. A total of 48 patients (76%) were included in the ESUS with AC group, and 15 patients (24%) were included in the ESUS without AC group. NT-proBNP was the most common AC biomarker found in 24 (39%) patients, followed by elevated left atrial diameter found in 23 (37%) patients. Recurrent stroke was seen in 11 (18%) patients during 90-days follow-up. Abnormal P-wave terminal force V1 and P-wave duration ≥110 ms were significantly associated with stroke recurrence (P = 0.054).

CONCLUSION: There is a high prevalence of AC among patients with ESUS, and NT-proBNP >250 pg/mL is the most common biomarker. Abnormal P-wave terminal force in V1 and P-wave duration may be associated with stroke recurrence.

PMID:42478394 | DOI:10.4103/neurol-india.Neurol-India-D-25-00926

Neurol India. 2026 Jul 1;74(4):606-610. doi: 10.4103/neurol-india.Neurol-India-D-25-00971. Epub 2026 Jul 21.

ABSTRACT

BACKGROUND: Migraine is a prevalent primary headache disorder associated with substantial disability. Restless legs syndrome (RLS), a sensorimotor disorder linked to dopaminergic dysfunction, has been increasingly reported as a comorbidity in migraine, particularly in chronic forms and those with aura. Data on this association in the Indian population remain limited.

OBJECTIVE: To determine the prevalence of RLS in patients with migraine and assess clinical correlations including age, gender, aura status, disease duration, and disability.

METHODS: A cross-sectional observational study was conducted over 12 months at a tertiary care hospital in North India. Adults aged 18-65 years diagnosed with migraine (ICHD-3 criteria) were consecutively enrolled. RLS was diagnosed using IRLSSG criteria. Patients were stratified into two groups based on RLS presence. Disability was assessed using the Migraine Disability Assessment (MIDAS) questionnaire. Statistical analysis included independent t-tests and Chi-square tests; P < 0.05 was considered significant.

RESULTS: Of 150 migraine patients, 54 (36%) met diagnostic criteria for RLS. The RLS group had a higher mean age than the non-RLS group (45.2 ± 11.9 vs. 38.2 ± 12.2 years; P = 0.001). RLS prevalence was significantly higher in patients with aura (64.8%) than in those without (21.9%; P < 0.001). The mean migraine duration was longer in the RLS group (13.7 ± 7.3 vs. 9.6 ± 7.4 years; P = 0.001). MIDAS scores were also significantly higher in the RLS group (15.3 ± 6.7 vs. 9.8 ± 4.2; P < 0.001). Gender distribution did not differ significantly.

CONCLUSION: RLS is a frequent comorbidity in migraine, particularly among older patients and those with aura. Its presence is associated with longer migraine duration and greater disability. Routine screening for RLS in migraine patients may aid in comprehensive management and potentially reduce disease burden.

PMID:42478391 | DOI:10.4103/neurol-india.Neurol-India-D-25-00971

Neurol India. 2026 Jul 1;74(4):574-585. doi: 10.4103/neurol-india.Neurol-India-D-25-00766. Epub 2026 Jul 21.

ABSTRACT

Mild cognitive impairment (MCI) represents a transitional state between normal cognitive aging and dementia, with significant implications for public health. The objective of our study was to estimate the pooled prevalence of MCI among Indian elderly individuals (≥60 years). We conducted a systematic review and meta-analysis in accordance with PRISMA-2020 guidelines. Four databases (PubMed, Scopus, Embase, Web of Science) were searched up to January 2025. Twenty-six studies met the eligibility criteria. Random-effects models were used to calculate pooled prevalence with 95% confidence intervals (CIs), stratified by community- and hospital-based settings. Heterogeneity was assessed using I² and τ² statistics. Subgroup and meta-regression analyses examined potential sources of heterogeneity. Publication bias was evaluated using funnel plots, Egger’s regression test. The methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. The pooled prevalence of MCI was 21% (95% CI: 13%-29%) in community settings and 44% (95% CI: 31%-57%) in hospital-based populations. Higher prevalence was observed among individuals with type 2 diabetes (53%), hypertension (57%), and those undergoing hemodialysis (38%). Diagnostic tool choice significantly influenced prevalence, with MoCA-based assessments yielding higher estimates than MMSE or Petersen criteria. Substantial heterogeneity was present across studies (I² >96%). Publication bias was minimal. MCI is prevalent among India’s elderly population, particularly in individuals with chronic conditions. These findings underscore the need to integrate cognitive screening into national noncommunicable disease programs and to adopt standardized, context-appropriate diagnostic protocols for early identification and intervention.

PMID:42478385 | DOI:10.4103/neurol-india.Neurol-India-D-25-00766

Nucleic Acids Res. 2026 Jul 17;54(14):gkag514. doi: 10.1093/nar/gkag514.

ABSTRACT

Transcription factor (TF) binding is typically described in terms of short sequence motifs and their immediate flanking regions. However, increasing evidence suggests that broader genomic context may influence TF-DNA interactions. By a thorough analysis of the DNA sequence in the broad context ($pm$ 5000 bp) of in vivo binding sites (as identified in a ChIP-seq or a Cut&Tag experiment), we show that the average GC content is in most cases statistically significantly increased around the binding site in a patch spanning 1000-1500 bp. This increase was observed consistently in experiment targeting the same TF in different cell lines. The surrounding of binding sites of certain TFs like MYC display a directional alteration of dinucleotide frequencies. Using sequence-derived structural descriptors, we hypothesize that DNA shape reflects (and may partly explain) patterns in sequence composition. In addition, we observe differences in sequence affinity to various potential cooperating TFs between cell lines. Altogether, we interpret these observations as indicating that the observed feature distortion reflects a coarse scanning mechanism that facilitates TF target-site recognition in absence of clear sequence sequence consensus.

PMID:42478380 | DOI:10.1093/nar/gkag514