Tag: pubmed

Alcohol Clin Exp Res (Hoboken). 2026 Feb;50(2):e70254. doi: 10.1111/acer.70254.

ABSTRACT

BACKGROUND: Clinical and preclinical alcohol use disorder (AUD) research demonstrates that males and females differ in motivations behind drinking, patterns of drinking behaviors, and alcohol-related physiological responses and health consequences. Nonhuman primate (NHP) models of AUD have the potential to enhance our understanding of such sex differences. In NHP models, schedule-induced polydipsia is a common method to initiate ethanol drinking. In males, characteristics of drinking during the final stage of induction, when monkeys consume 1.5 g/kg/day, predict subsequent drinking patterns when monkeys have unlimited access to ethanol. The present study assessed sex differences in those predictive behaviors during induction and characterized patterns and intakes during 6 months of ethanol drinking.

METHODS: Eleven singly housed adult cynomolgus monkeys (six male, five female) were induced to consume water, then increasing doses of ethanol for 4 weeks per dose (0.5, 1.0, and 1.5 g/kg) using a 300-s fixed-time schedule of food pellet delivery. Following induction, monkeys switched to an “open-access” regimen wherein water and ethanol were available 22 h/day, 5 days/week.

RESULTS: Predictive relationships between drinking characteristics during the final phase of induction and subsequent open-access drinking were replicated, with no evidence of sex differences. Although weekly and total ethanol intakes were higher in males over 6 months of open access, the difference did not reach statistical significance. However, there were sex differences in the distribution of ethanol intake across the day. Males drank significantly more when meals were available, whereas females spread their drinking throughout the first half of the session; these differences were exacerbated in Month 2 and remained for the duration of the study.

CONCLUSIONS: These results replicate previous findings of a predictive relationship between drinking variables during induction and later open-access drinking and reveal sex differences in daily patterns of ethanol intake that may inform treatment approaches.

PMID:41731324 | DOI:10.1111/acer.70254

Psychol Psychother. 2026 Feb 23. doi: 10.1111/papt.70047. Online ahead of print.

ABSTRACT

INTRODUCTION: Emotional Disorders (EDs) are highly prevalent among university students, with only a small percentage (16.4%) receiving treatment. This study examines the feasibility and acceptability of delivering the Unified Protocol (UP) in two scalable formats and explores preliminary clinical outcomes in a university student population.

METHODS: Thirty-five university students (80% women, mean age = 21.29 years, SD = 1.87) with primary diagnoses of EDs were randomly assigned to either the blended-UP condition (n = 18) or the synchronous online UP condition (n = 17). The intervention involved 8 UP modules, delivered as either 9 weekly 2-h synchronous online group sessions or a blended format (4 synchronous online group sessions for modules 1, 4, 6 and 7+ autonomous work via the UP-APP). Depression, anxiety, transdiagnostic variables, difficulties in emotion regulation, maladjustment and quality of life were assessed at baseline, post-treatment and at 3- and 6-month followups. Satisfaction with the intervention received was also measured.

RESULTS: Statistically significant changes were observed over time (main effect of time) for all evaluated variables (except in quality of life and positive temperament), with no ‘Time × Condition’ interaction, meaning that the scores evolved similarly in both conditions. Participants reported high satisfaction scores (8.91/10 in the blended condition and 9.38/10 in the synchronous online UP condition) and rated highly how the intervention had helped them to properly regulate their emotions (8.83/10 in the blended condition and 9.00/10 in the synchronous online UP condition).

CONCLUSIONS: This study demonstrates that both the blended and synchronous online group formats of the UP are feasible and well accepted by university students, with associated improvements in emotional symptoms, and that the UP in these formats could be an efficient alternative to address the high demand for mental health support among university students.

PMID:41731322 | DOI:10.1111/papt.70047

Am J Sports Med. 2026 Feb 23:3635465251408855. doi: 10.1177/03635465251408855. Online ahead of print.

ABSTRACT

BACKGROUND: Shoulder stiffness after rotator cuff repair (RCR) represents a primary determinant of patient-reported quality of life. The implementation of predictive strategies for the early identification of risk factors is critical for mitigating this complication.

PURPOSE: To evaluate the incidence of shoulder stiffness after RCR and to identify associated risk factors.

STUDY DESIGN: Systematic review and meta-analysis; Level of evidence, 4.

METHODS: A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from database inception to February 28, 2025. Factors reported in ≥2 studies with extractable data underwent meta-analysis; otherwise, a qualitative synthesis was performed. Sensitivity analyses were executed for risk factors exhibiting substantial heterogeneity or potential reporting bias. Effect sizes for risk factors were calculated using odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs).

RESULTS: This meta-analysis incorporated 20 studies comprising 34,565 patients undergoing RCR. The pooled incidence of postoperative stiffness was 12.9% (95% CI, 8.5%-18.0%), with significant variations based on diagnostic criteria (15.8% for range of motion vs 2.2% for intervention-based definitions; P < .001) and follow-up duration (18.9% at <6 months vs 9.2% at ≥6 months; P < .05). Overall, 33 potential risk factors for stiffness after RCR were identified, with 11 amenable to meta-analysis. Significant associations emerged for diabetes mellitus (OR, 1.51 [95% CI, 1.07-2.14]), fatty infiltration (OR, 1.58 [95% CI, 1.08-2.31]), concomitant subacromial decompression (OR, 3.26 [95% CI, 1.88-5.65]), and older age (MD, 1.33 [95% CI, 0.39-2.27]) (all P < .05). No statistically significant correlations were observed for sex, body mass index, symptom duration, dyslipidemia, hypothyroidism, tear size, or surgical approach (all P > .05).

CONCLUSION: This study revealed a pooled incidence of 12.9% for stiffness after RCR, with notable variations observed across diagnostic criteria and follow-up durations. Additionally, older age, diabetes, fatty infiltration, and concomitant subacromial decompression were identified as significant risk factors for postoperative stiffness. Clinicians should prioritize recognizing these risk factors and implementing evidence-based preventive strategies to reduce the incidence of stiffness after RCR.

PMID:41731320 | DOI:10.1177/03635465251408855

Acad Emerg Med. 2026 Feb;33(2):e70248. doi: 10.1111/acem.70248.

ABSTRACT

BACKGROUND: Iatrogenic medication errors are a preventable source of harm in older adults. Yet their prevalence, types, and outcomes remain poorly characterized. This study aims to describe healthcare-associated iatrogenic medication errors in older adults, including those occurring in the emergency department (ED) and prehospital settings.

METHODS: An Institutional Review Board-approved retrospective cohort study was conducted among patients aged 65 years and older who had an iatrogenic medication exposure reported to a regional poison center network between January 1, 2020, and May 23, 2025. Cases were extracted from the poison center network’s electronic health record and manually reviewed for inclusion as healthcare-associated medication errors. Error severity was assessed using the National Poison Data System (NPDS) medical outcome scale and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index. Clinical effects, implicated medications, and treatment data were collected and analyzed using descriptive statistics.

RESULTS: Out of 192 potential cases, 182 met inclusion criteria. Most errors occurred in a healthcare setting (nursing facility 32%, non-critical care unit 14%, or ED 12%) and were managed in an ED (60%, 110). Cardiovascular (32%, 129) agents were most often implicated. Most errors occurred during the administration phase (77%, 138), primarily due to medication given to the wrong patient (24%, 43) or at the wrong dose (20%, 36). More than half of cases were classified as NCC MERP Category E or higher, indicating patient harm.

CONCLUSIONS: Iatrogenic medication errors in older adults occur across care settings and are most often managed in the ED. While many cause minor harm, a subset results in serious outcomes, with ED-based errors posing higher risk. These findings underscore the need for targeted interventions, particularly during administration and for cardiovascular agents, and provide data to guide strategies and future research to protect this vulnerable population.

PMID:41731318 | DOI:10.1111/acem.70248

J Paediatr Child Health. 2026 Feb 23. doi: 10.1111/jpc.70334. Online ahead of print.

ABSTRACT

AIM: Use of social media platforms such as TikTok within the adolescent population is widespread. Harnessing its accessibility and prevalence provides health professionals an opportunity to disseminate positive, evidence-based health information. However, infiltrating this domain brings challenges such as countering abundant misinformation and understanding the target audience. Creating successful short-form videos for social media is a nuanced skill. University health students produced videos focusing on common adolescent issues for a health-promoting TikTok channel. The aim of this study was to explore secondary school student perceptions of these videos.

METHODS: A mixed methods evaluation was undertaken using surveys and focus group interviews. Teachers from participating secondary schools recruited parents and students via the school online communication system. Descriptive statistics from survey responses were used to analyse demographics and scale responses. A uses and gratification lens was used for inductive content analysis of qualitative data.

RESULTS: Participant students were predominantly from Year 9 (age 14-15 years), 161/212 (76%). The median score for enjoyment and positive learnings from videos was 5/10 and for likelihood of sharing videos was 3/10. Three themes emerged from the qualitative data: (1) mixed perceptions of video content with a preference for health not disease, (2) engagement driven by entertainment and 3) social media platforms for enjoyment versus education.

CONCLUSIONS: Social media platforms are an accessible source of health information for adolescents. Health professionals have an opportunity to provide evidence-based health information and combat misinformation. Creating effective and targeted video content can increase the positive impact on adolescent audiences.

PMID:41731313 | DOI:10.1111/jpc.70334

Int J Stroke. 2026 Feb 23:17474930261430342. doi: 10.1177/17474930261430342. Online ahead of print.

ABSTRACT

BACKGROUND: Outcome prediction after endovascular thrombectomy (EVT) for ischemic stroke is important for patient counseling and rehabilitation planning. MR PREDICTS @24H, a nine-predictor model, showed excellent performance in predicting functional outcome at 90 days of patients with acute ischemic stroke. With the expanding treatment indications, we validated the model for patients receiving EVT within 24 hours after stroke onset and simplified it for easier clinical implementation.

METHODS: We used individual patient data from the Dutch MR CLEAN-Registry (2014-2018), a prospective observational cohort enrolling patients treated with EVT, and three randomized controlled trials MR CLEAN-MED, MR CLEAN-NOIV, and MR CLEAN-LATE (2018-2022). We included patients with an intracranial large vessel occlusion in the anterior circulation treated with EVT within 24 hours of symptom onset or last seen well. We assessed the effect of predictors on functional outcome (modified Rankin Scale [mRS]) at 90 days with ordinal logistic regression. Predicted probabilities of functional independence (mRS 0-2) and survival (mRS 0-5) were derived from the model formula. We evaluated predictive performance with discrimination (C-statistic) and calibration (intercept, slope). The model was simplified by excluding predictors based on the Akaike information criterion (AIC). We applied leave-one-study-out cross validation to evaluate heterogeneity in model performance between the cohorts.

RESULTS: The validation cohort included 6154 patients: 4737 from the Registry and 1417 from the trials. External validation of the original model showed excellent discrimination in predicting functional independence (C statistic 0.91, 95% CI 0.90-0.92) and survival (C statistic 0.90, 95% CI 0.89-0.91). The simplified model, comprising four predictors – NIHSS at 24 hours after EVT, age, pre-stroke mRS, and symptomatic intracranial hemorrhage – performed comparably (functional independence C statistic 0.91, 95% CI 0.90-0.92; and survival 0.89, 95% CI 0.88-0.90). Cross validation revealed heterogeneity between LATE and the other cohorts, with the model overestimating the probability of functional independence in LATE (observed 39.1% vs predicted 44.2%), whereas the observed and predicted probability of survival was similar (75.5% vs 75.7%).

CONCLUSIONS: A simplified version of MR PREDICTS @24H including only four predictors performed as good as the full model, providing a practical tool that can be applied one day after EVT for reliable outcome estimation. Further validation and updating of the model are needed for patients treated in the late time window (6-24h).

PMID:41731306 | DOI:10.1177/17474930261430342

Cytometry A. 2026 Feb 23. doi: 10.1002/cyto.a.70016. Online ahead of print.

ABSTRACT

In flow cytometry, raw detector values do not directly represent fluorochrome abundances and must be mathematically unmixed using coefficients derived from single-stained reference controls. Inaccuracies in these controls, referred to as reference errors, can distort the estimated fluorochrome abundances, leading to skewed population distributions. However, as panel complexity and dataset sizes increase, manually inspecting all marker combinations for such artifacts becomes impractical. To address this challenge, we developed CompensAID, an open-source R-based tool that automatically flags marker combinations potentially affected by reference errors, thereby supporting quality control workflows in flow cytometry. Preprocessed data from both conventional and spectral flow cytometry were used to develop and validate the tool. CompensAID applies a density-based cutoff detection to automatically gate the negative and positive populations. The positive population is then divided into equally sized segments, after which the Secondary Stain Index (SSI) is computed for each segment. Marker combinations are flagged if the last segment yields an SSI value below -1. The tool’s performance was evaluated against the consensus of five flow cytometry specialists. For the conventional dataset, 1761 out of 2240 marker combinations (79%) were unanimously classified as free of reference errors, while 24 marker combinations received a consensus score of three or higher, indicating that most flow cytometry specialists suspected reference errors. CompensAID successfully identified 23 out of these 24 marker combinations, achieving a sensitivity of 0.96. The single missed case involved a spillover spread error. In the spectral dataset, 1505 out of 1656 marker combinations (90%) were deemed free of reference errors. Of the 28 marker combinations suspected of reference errors, CompensAID flagged 21 marker combinations (sensitivity, 0.74). Five out of the seven missed marker combinations had SSI values close to the threshold. In both datasets, false positive findings were observed, often attributable to suboptimal gating or low event counts within the segments contributing to negative SSI values. CompensAID offers a robust approach for detecting marker combinations exhibiting signs of reference errors. While some false positives occur, the tool significantly reduces the burden of manual inspection. Its integration into quality control pipelines can enhance the reliability of flow cytometry data analysis. The R package is available at https://github.com/Olsman/CompensAID and will be made available through the Bioconductor platform.

PMID:41731288 | DOI:10.1002/cyto.a.70016

Mol Imaging Biol. 2026 Feb 23. doi: 10.1007/s11307-026-02084-x. Online ahead of print.

ABSTRACT

PURPOSE: To assess hypoxia-associated host-tumour vascular adaptations and glycolytic metabolism in the chick chorioallantoic membrane (CAM) glioblastoma model.

PROCEDURES: U251 GBM cells were conditioned under normoxia (21% O₂) or hypoxia (1% O₂) for 72 h before implantation onto the CAM on embryonic day 7 (E7). Imaging was performed on E13 using MRI (control-CAM n = 8, normoxic-tumour n = 7, hypoxic-tumour n = 6) and brightfield microscopy (control-CAM n = 7, normoxic-tumour n = 8, hypoxic-tumour n = 7). Tumours were harvested on E14 for histology and gene expression analyses. In a separate cohort of 25 GBM-CAM tumours grown under normoxic conditioning, the correlation of glucose metabolism was assessed using [¹⁸F]FDG-PET on E12 followed by lactate MRS on E13 (n = 8).

RESULTS: Normoxia- and hypoxia-conditioned tumour-bearing CAMs exhibited vascular remodelling and significant upregulation of VEGFA and ADM compared to cultured cells. αSMA staining confirmed vessel infiltration in normoxia-conditioned tumours. CAIX staining revealed a hypoxic core in these tumours while hypoxia-conditioned tumours displayed heterogeneous staining. In both conditions, GLUT1 staining colocalised with CAIX staining, indicating hypoxia-associated glycolysis. GLUT1, PDK1 and LDHA expression was elevated in CAM tumours relative to tumour cells in vitro. In the metabolic imaging cohort, most tumours exhibited [¹⁸F]FDG uptake and lactate signal. However, no statistically significant relationship was observed between the two methods.

CONCLUSIONS: The CAM model provides a versatile platform for investigating GBM vascularisation and metabolism. Hypoxic conditioning amplifies transcriptional and vascular changes to the CAM. Although both [¹⁸F]FDG uptake and lactate were measurable, no significant correlation between the two was observed, potentially reflecting variability in tumour engraftment, vascular delivery of [¹⁸F]FDG, and microenvironmental influences on lactate accumulation.

PMID:41731278 | DOI:10.1007/s11307-026-02084-x

Sports Med. 2026 Feb 23. doi: 10.1007/s40279-026-02395-7. Online ahead of print.

ABSTRACT

BACKGROUND: The literature is equivocal on whether complex training (i.e., combining traditional resistance and ballistic exercises within a single session) is superior to ballistic training in improving physical fitness qualities. This systematic review with meta-analysis aims to compare the effects of complex and ballistic training on physical fitness outcomes.

METHODS: A systematic search using the PRISMA 2020 guidelines was conducted in electronic databases (i.e., PubMed, Scopus, Web of Science). From the included studies, data were extracted for linear sprint, vertical jump (i.e., countermovement jump, squat jump), change of direction speed, and maximal strength. The risk of bias of the included studies was assessed using RoB-2 and ROBINS-I tools for randomized and nonrandomized studies, respectively. The meta-analyses were computed using a DerSimonian and Laird random effects model, reporting Hedges’ g effect size (ES) with 95% confidence and prediction intervals. Statistical significance was set at p ≤ 0.05. In addition, the certainty of evidence was assessed using the GRADE approach.

RESULTS: A total of 20 studies were initially eligible. However, one study was excluded owing to critical concerns at risk of bias assessment stage. Thereafter, 19 studies involving 537 participants ranging from “tier 0” (i.e., sedentary) to “tier 3” (i.e., highly trained) level were included. Randomized studies presented low (k = 2), some (k = 10), and high concerns (k = 5) regarding the risk of bias, while nonrandomized studies presented moderate concerns (k = 2). Compared with ballistic training, significantly greater improvements were reported after complex training for one-repetition maximum (ES = 1.12, p = 0.010), squat jump (ES = 0.37, p = 0.004), 10 m (ES = 0.67, p = 0.033), and 40 m (ES = 0.72, p = 0.005) linear sprint. Furthermore, a significant moderating effect of training duration was observed for complex training, favoring longer (> 7.5 weeks) interventions. The certainty of the evidence was low for the squat jump and very low for all other outcomes.

CONCLUSIONS: Our findings suggest complex training to be superior in improving one-repetition maximum squat, squat jump, 10 m, and 40 m linear sprint compared with ballistic training alone. However, 5 m, 20 m, change of direction speed, countermovement jump, and jump power were similarly improved after both training methods. In addition, a longer intervention duration (> 7.5 weeks) may optimize complex training effects. However, the certainty of the evidence was low for the squat jump and very low for all other outcomes. To increase confidence in the certainty of the current evidence, and therefore to provide robust recommendations favoring (or not) the use of complex training (and its prescription factors) over ballistic training to improve participants’ physical fitness, more robust studies would be required (e.g., larger samples).

PROTOCOL REGISTRATION: The protocol was published in the Open Science Framework (OSF) platform on 13/04/2024 (DOI: https://doi.org/10.17605/OSF.IO/STUZ7 ; Archive link: https://archive.org/details/osf-registrations-stuz7-v1 ).

PMID:41731268 | DOI:10.1007/s40279-026-02395-7

Ann Biomed Eng. 2026 Feb 23. doi: 10.1007/s10439-026-04040-w. Online ahead of print.

ABSTRACT

PURPOSE: Traditional hypertonia diagnosis relies on the Modified Ashworth Scale (MAS), which is subjective and dependent on doctors’ experience. Although previous studies have explored the use of force sensors and surface electromyography (sEMG), finding a reliable and valid detection method remains a challenge. This study aims to develop a simple yet effective platform that integrates biomechanical and sEMG data for upper-limb muscle tone assessment, providing a more objective and quantitative evaluation approach.

METHODS: A detection platform was developed to collect biomechanical and sEMG data from 59 subjects, including 49 patients (MAS Ⅰ = 21, MAS Ⅰ + = 16, MAS Ⅱ = 12) and 10 healthy individuals, at different movement speeds (15°/s, 20°/s, and 25°/s). The acquired data underwent feature extraction, including signal processing and statistical analysis. Dimensionality reduction was applied to optimize the extracted features, and these features were then integrated into a classification algorithm for further analysis.

RESULTS: The extracted features effectively distinguished patients from healthy individuals, with statistically significant differences (p < 0.01). Furthermore, the strong correlation between the extracted features and MAS scores (p < 0.01) confirmed the reliability of the proposed method. Finally, the classification algorithm demonstrated high consistency with clinical evaluations, validating its potential for clinical application in muscle tone assessment.

CONCLUSION: This study introduces an objective and quantitative method for assessing muscle tone, shifting away from the traditional subjective MAS evaluation. By enhancing diagnostic accuracy, the proposed approach provides a more reliable basis for hypertonia diagnosis and treatment. The findings hold significant promise for optimizing clinical decision-making, ultimately improving patient management and therapeutic strategies.

PMID:41731265 | DOI:10.1007/s10439-026-04040-w