Tag: pubmed

Folia Morphol (Warsz). 2026;85:e01726086. doi: 10.5603/fm.111746.

ABSTRACT

BACKGROUND: Understanding anatomical variation in the sacral hiatus (SH) is important for improving the safety and technical success of caudal epidural block (CEB), particularly by reducing the risk of inadvertent dural puncture. However, data linking external sacral landmarks to internal volumetric capacity remain limited, especially in Southeast Asian skeletal populations. This study evaluated the relationships between external SH-related surface parameters and internal volumetric measures, particularly half-cone and caudal space volumes, in Thai dry sacra from Northeastern Thailand.

MATERIALS AND METHODS: Forty-five Thai dry sacra were analyzed using 20 parameters, including SH dimensions (SH1-SH4), external sacral surface landmarks (ES5-ES20), and volumetric measurements. Associations among SH parameters, ES parameters, and volumetric measures were assessed using Pearson correlation analysis. Intra- and inter-rater reliability were also evaluated.

RESULTS: The most prevalent SH morphologies were the inverted-U and irregular shapes, each accounting for 17.78% of specimens. The hiatal apex was most commonly located at the S4 vertebral level (64.44%), followed by S3 (26.67%). The mean SH length was 22.02 ± 9.59 mm. No statistically significant relationship was identified between SH morphology and either internal volumetric parameter. In contrast, several external sacral surface parameters demonstrated moderate-to-strong positive correlations with volumetric capacity.

CONCLUSIONS: SH morphology was not associated with internal volumetric capacity, whereas the external sacral surface framework appeared to be more informative than the hiatus aperture itself. These findings suggest that selected posterior sacral surface dimensions may provide anatomically relevant indicators of internal capacity in osteological assessment related to CEB. Further imaging-based and clinical studies are needed to validate these findings.

PMID:42117261 | DOI:10.5603/fm.111746

Pediatr Blood Cancer. 2026 May 12:e70390. doi: 10.1002/1545-5017.70390. Online ahead of print.

ABSTRACT

BACKGROUND: Osteosarcoma (OS) and Ewing sarcoma (EWS) are the most common primary bone cancers in children, but acute thrombosis is poorly characterized in this population. Our study evaluated the rates of venous thromboembolism (VTE) and associated risk factors in pediatric patients with bone sarcomas treated over a 10-year period encompassing the emergence of COVID-19.

PROCEDURE: Data were obtained via EMR review for patients diagnosed with OS and EWS at Texas Children’s Hospital from 2014 to 2023. Statistical analyses were performed using Fisher’s exact, chi-square, and Wilcoxon rank-sum tests. Change in VTE rate prior to and after 2020 was compared using interrupted time series analysis.

RESULTS: Among 137 eligible patients, the majority were diagnosed with OS (n = 85, 62%) compared to EWS (n = 52, 38%). Twelve patients (8.8%) developed VTEs during primary cancer therapy. Femoral tumor location was associated with increased VTE occurrence (p = 0.016), and there was a trend toward increased VTE in OS (p = 0.13) and obese patients (p = 0.2). VTE rates increased after the emergence of COVID-19, although only one affected patient tested positive. The incidence rate ratio pre- and post-COVID-19 emergence (2014-2019 vs. 2020-2023) was 8.7 (95% CI: 2.29-56.61; p = 0.005). This increase in VTEs after 2020 was sustained.

CONCLUSION: Our cohort represents the largest population of pediatric patients with bone sarcomas studied to date. In our 10-year analysis, we observed a sustained increase in VTE events following the emergence of COVID-19. Additionally, our data suggest that subsets of this patient population, specifically obese patients with OS and femoral tumors, should be closely monitored for thrombosis.

PMID:42117248 | DOI:10.1002/1545-5017.70390

Psychol Health. 2026 May 12:1-19. doi: 10.1080/08870446.2026.2668116. Online ahead of print.

ABSTRACT

Trait mindfulness refers to one’s natural tendency to be aware of and attentive to present experiences. Although the trait has been associated with physical health, most studies have been cross-sectional and failed to account for confounding variables. The present study tested the longitudinal relationship between trait mindfulness and physical health symptoms. Undergraduate student participants completed four surveys over a period of 3 months, in which they reported their trait mindfulness, physical symptoms (e.g. fatigue, stomachache), and cold symptoms (sore throat, congestion). Additionally, participants answered questions to assess general health, recent perceived stress, and trait neuroticism. Initial enrolment included 409 participants with 288 at Time 2, 218 at Time 3, and the final wave including 172 participants. Findings indicated that those higher in trait mindfulness reported fewer symptoms across all time points, regardless of general health, recent stress, or neuroticism, t(395) = -6.75, p < 0.001. By examining associations across time and covarying related variables, this study underscores the importance of trait mindfulness in predicting health outcomes. It is the largest longitudinal investigation of trait mindfulness and physical health symptoms in emerging adults. Future studies should explore pathways through which mindfulness influences symptoms.

PMID:42117223 | DOI:10.1080/08870446.2026.2668116

Inquiry. 2026 Jan-Dec;63:1. doi: 10.1177/00469580261450891. Epub 2026 May 12.

ABSTRACT

BackgroundSouth Korea’s Health Plan 2030 targets an increase in the proportion of adults with sufficient health literacy to 70% by 2030.MethodsThis scenario-based simulation study projected national outpatient healthcare expenditure from 2023 to 2030 using an ARIMA(1,1,1) model fitted to Korea National Health Accounts data (1970-2022). Two scenarios were compared: status quo (no change in health literacy distribution) and policy target (linear increase in sufficient health literacy from 49.3% in 2021 to 70% by 2030). An 8.6% expenditure differential between health literacy groups (95% CI: 1.3%-15.4%), estimated from the 2021 Korea Health Panel Survey, was applied with sensitivity analyses.ResultsNational outpatient expenditure was projected to reach KRW 91.2 trillion by 2030 under the status quo, compared with KRW 89.5 trillion under the policy target scenario, representing savings of KRW 1.70 trillion (1.9%). Sensitivity analyses yielded projected savings of KRW 0.25-3.15 trillion.ConclusionThese projections are conditional on modeling assumptions and do not imply causality, but suggest that achieving the national health literacy target may contribute to reducing outpatient expenditure and improving healthcare system efficiency.

PMID:42117221 | DOI:10.1177/00469580261450891

J Hand Surg Asian Pac Vol. 2026 May 12. doi: 10.1142/S2424835526500244. Online ahead of print.

ABSTRACT

Background: Although ultrasonography is useful for assessing soft-tissue injuries, its role in classifying tendinous mallet injuries remains underdefined. This study aimed to propose a modified ultrasonographic classification system that combines Wang’s classification with additional subtypes emphasising lateral band involvement to improve diagnostic accuracy and prognostic assessment. Methods: A retrospective cross-sectional study was performed on 36 patients with acute closed tendinous mallet injuries of the fingers. All patients underwent ultrasonographic evaluation. Based on the modified classification, Wang Type B was subdivided into Subtype B1 (complete terminal tendon rupture) and Subtype B2 (rupture of either the radial or ulnar slip of the lateral band). Clinical outcomes were recorded at a minimum of 4 months of follow-up. Data on pinch strength, pain, extension lag and functional scores were analysed to compare outcomes across the three injury types. Results: Fifteen Type B1, eight Type B2, and 13 Type C injuries were identified. In all types, as the length of the injured tendon increased, pinch strength relative to the contralateral side was significantly weaker. Additionally, the injured tendon was significantly longer in Type C injuries than in Type B1 and B2 injuries. As the length of the injured tendon increased, pinch strength relative to the contralateral side decreased across all injury types. Nevertheless, the pain score, functional score and initial extension lag did not show statistically significant variations amongst injury types. Crawford criteria showed that Types B2 and C injuries were mostly graded as ‘excellent’ or ‘fair’, whereas Type B1 injuries were more often classified as ‘poor’ or ‘fair’. Conclusions: The modified ultrasonographic classification provides a more detailed framework for assessing tendinous mallet injuries by integrating Wang’s classification and distinguishing partial lateral band ruptures. This approach enhances diagnostic precision and may improve functional prognostication. Level of Evidence: Level IV (Diagnostic).

PMID:42117206 | DOI:10.1142/S2424835526500244

Australas J Dermatol. 2026 May 12. doi: 10.1111/ajd.70138. Online ahead of print.

ABSTRACT

Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting over 200 million people globally. Emerging IL-4Rα-targeted monoclonal antibodies have demonstrated strong efficacy and safety in clinical trials, warranting comparison with dupilumab, the current systemic standard. This meta-analysis synthesises available evidence on their efficacy and safety. PubMed, Embase and Cochrane Library were systematically searched in April 2025 for randomised controlled trials (RCTs) comparing IL-4Rα-targeting monoclonal antibodies versus placebo in moderate-to-severe AD, with EASI-75 as the primary outcome. Non-RCTs and trials using concomitant corticosteroids were excluded. Risk of bias was assessed using the Cochrane RoB-2 tool. Analyses were performed in R (v4.5.0), with heterogeneity evaluated by Cochran Q and I² statistics. Nineteen RCTs comprising 4465 patients met inclusion criteria. At week 16, IL-4Rα inhibitors showed sustained efficacy across EASI-50/75/90, IGA 0/1 and pruritus reduction. Dupilumab remained the most validated agent, with durable effects, low heterogeneity and favourable safety. Among novel biologics, stapokibart and rademikibart demonstrated the most promising results, achieving superior EASI-90 and ≥ 4-point PP-NRS responses: stapokibart (OR 4.94; 95% CI 3.20-7.61) and rademikibart (OR 4.61; 95% CI 1.68-12.65), though the latter showed higher odds of adverse events. Other agents (MG-K10, GR1802, 611, AK120) provided encouraging but limited data. IL-4Rα inhibitors represent effective and safe therapies for moderate-to-severe AD. Dupilumab remains the reference standard, while stapokibart and rademikibart emerge as promising next-generation options. Further large, long-term, head-to-head RCTs are warranted to confirm their comparative performance. PROSPERO Registration: CRD420251129343.

PMID:42117199 | DOI:10.1111/ajd.70138

Psychometrika. 2026 May 12:1-22. doi: 10.1017/psy.2026.10109. Online ahead of print.

ABSTRACT

Large-scale assessment data typically include numerous variables, often affected by missing values. Motivated by the challenges arising in this framework, we extend the knockoffs method for selecting predictors to settings with missing values. Our proposal relies on a preliminary phase of multiple imputation (MI) of missing values. Each imputed dataset is then processed using a suitable knockoff filter. We evaluate the performance of the proposed method through simulation studies, showing satisfactory results consistent with a recently advocated cutting-edge method. We apply the method to large-scale assessment data collected by INVALSI on test scores of Italian students in grade 5, including many background variables. This case study is challenging, as most predictors have unordered categories, a setting not considered by traditional knockoff methods. In addition, some of the key predictors are affected by missing values. Our proposal to implement the knockoffs method within an MI framework is feasible, flexible, and effective.

PMID:42117181 | DOI:10.1017/psy.2026.10109

J Korean Med Sci. 2026 May 11;41(18):e81. doi: 10.3346/jkms.2026.41.e81.

ABSTRACT

BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) is a common but serious opportunistic infection after allogeneic hematopoietic cell transplantation (HCT). The preferred regimen for PJP prophylaxis is trimethoprim-sulfamethoxazole (TMP-SMX), but TMP-SMX can delay engraftment and has some toxicities. This study retrospectively analyzed the efficacy and safety of aerosolized pentamidine (AP) as an alternative to TMP-SMX for PJP prophylaxis after allogeneic HCT.

METHODS: One hundred and fifty-five patients received AP and 86 patients received TMP-SMX. Pentamidine isethionate 300 mg was nebulized every 4 weeks and double-strength TMP-SMX was administrated once-daily and 2 days per week.

RESULTS: Incidences of suspicious PJP and confirmed PJP were not statistically different between two groups (suspicious PJP, 4.5% vs. 3.5%, P = 1.000; confirmed PJP, 0.6% vs. 0.0%, P = 1.000). There were fewer adverse reaction in AP group than TMP-SMX group (10.3% vs. 26.7%, P < 0.001). Only 1 patient (0.6%) discontinued prophylaxis due to adverse reaction in AP group, while 17 patients (19.8%) in TMP-SMX group discontinued prophylaxis due to adverse reaction (P < 0.001). There was more incidence of graft failure in TMP-SMX group and the incidence of prolonged thrombocytopenia was significantly higher in TMP-SMX group. There was no deterioration of lung function in patients received AP prophylaxis.

CONCLUSION: In conclusion, AP is well tolerated without severe adverse events and effective in preventing PJP after allogeneic HCT.

PMID:42117147 | DOI:10.3346/jkms.2026.41.e81

J Multidiscip Healthc. 2026 May 5;19:578782. doi: 10.2147/JMDH.S578782. eCollection 2026.

ABSTRACT

OBJECTIVE: To assess the current level of knowledge, attitudes and practices (KAP) regarding Lewy Body dementia (LBD) among staff of all grades within long-term care (LTC) facilities.

METHODS: An anonymous online survey was developed, consisting of three sections assessing demographics, LBD knowledge, attitudes and practices. Questions were informed by analogous studies and were adapted following a trial phase. The survey was disseminated to all grades of staff members working in LTC facilities across the Republic of Ireland. Descriptive and inferential statistics are used to examine participant knowledge and attitudes, while a multivariable regression analysis is run to examine the drivers of knowledge.

RESULTS: 8.7% of people working in LTC facilities had never heard of LBD before. Staff in management positions and activity coordinator positions had a higher LBD knowledge score in comparison to non-clinical staff. Directors of nursing (DONs), assistant directors of nursing (ADONs) and clinical nurse managers (CNMs) were able to name more than one dementia subtype more frequently than other staff members. Vascular dementia was the most known dementia subtype outside of Alzheimer’s disease (AD). Activity coordinators and directors of nursing reported a higher level of comfort caring for residents with LBD, were more satisfied in their job role, and felt sufficiently trained to care for residents with different types of dementia. Over 75% of respondents were willing to undergo specialised LBD training.

CONCLUSIONS AND IMPLICATIONS: The findings support further role-specific, and practical LBD training for all LTC staff. Interdisciplinary training and knowledge-sharing across job roles may enhance team cohesion, and the willingness of staff to engage in training is promising.

PMID:42117116 | PMC:PMC13157695 | DOI:10.2147/JMDH.S578782

J Multidiscip Healthc. 2026 May 5;19:602533. doi: 10.2147/JMDH.S602533. eCollection 2026.

ABSTRACT

INTRODUCTION: Early identification of high-risk trauma patients in the prehospital setting is critical for optimizing emergency care and improving outcomes, particularly in resource-limited systems.

PURPOSE: To determine the 24-hour mortality rate and identify clinical predictors and resuscitative care indicators associated with early mortality among adult major trauma patients transported by emergency medical services (EMS) in Thailand.

METHODS: A retrospective registry-based cohort study included adult patients (≥18 years) with major trauma transported by EMS to a tertiary trauma center in Bangkok between January 2019 and December 2024. Eligible patients were classified under Thailand Emergency Medical Triage Protocol symptom groups 21-25 with red-level severity. Data were obtained from an EMS-based trauma registry integrating prehospital and early in-hospital variables. The primary outcome was all-cause mortality within 24 hours of hospital arrival. Survival was analyzed using Kaplan-Meier methods, and predictors were identified using multivariable flexible parametric survival models.

RESULTS: Among 197 patients, the 24-hour mortality rate was 25.9% (95% CI: 20.3-32.6). Severe neurological impairment (Glasgow Coma Scale 3-8) was independently associated with mortality (adjusted hazard ratio [aHR] 3.72, 95% CI: 1.56-8.87). Resuscitative care indicators, including chest tube insertion (aHR 6.82, 95% CI: 3.23-14.39) and central venous catheter placement (aHR 2.50, 95% CI: 1.21-5.17), were also associated with mortality and likely reflect underlying injury severity and physiological instability rather than direct causal effects. The model demonstrated good discrimination (C-statistic 0.848) and calibration.

CONCLUSION: One in four adult major trauma patients transported by EMS died within 24 hours of hospital arrival. Early mortality was associated with both clinical severity and resuscitative care indicators. These findings support the use of routinely available clinical variables to identify high-risk patients and inform early triage and escalation of care, while emphasizing cautious interpretation of care-related variables as markers of severity rather than modifiable risk factors.

PMID:42117115 | PMC:PMC13157350 | DOI:10.2147/JMDH.S602533