Tag: pubmed

Psychol Rep. 2026 Aug 25:332941261480087. doi: 10.1177/00332941261480087. Online ahead of print.

ABSTRACT

This study examined how baseline autonomic tone (resting skin conductance level, SCL) relates to emotional over-control and bulimic tendencies (i.e., binge eating propensity), as well as their cross-sectional correlation with body mass index (BMI). The Eating Disorder Inventory-3 (EDI-3) was used to assess emotional over-control (EDI-3-OC) and bulimic tendencies/binge eating propensity (EDI-3-B). Baseline autonomic tone was evaluated by measuring the logarithmic value of resting SCL (log-SCL). Body mass index (BMI) was calculated as an anthropometric correlate. By controlling for gender and age, the Path Analysis showed that baseline log-SCL was negatively associated with emotional over-control (EDI-3-OC) (B = -3.08; p = .05), which, in turn, was positively associated with bulimic tendencies (EDI-3-B) (B = 0.26; p < .001). Additionally, emotional over-control (EDI-3-OC) statistically mediated the association between baseline log-SCL and EDI-3-B (Sobel Z = -1.90; p = .05) (F = 8.80, p < .001, R² = 0.40). Finally, EDI-3-B showed a positive cross-sectional association with BMI (B = 0.34; p < .001) (F = 13.63, p < .001, R² = 0.37). Our findings reveal statistical associations linking baseline autonomic hypoarousal, emotional over-control, and bulimic tendencies in university students. These cross-sectional patterns highlight the interplay between physiological baseline states and cognitive over-control, though longitudinal and experimental stress paradigms are required to establish temporal causality.

PMID:42638447 | DOI:10.1177/00332941261480087

Hand (N Y). 2026 Aug 24:15589447261465829. doi: 10.1177/15589447261465829. Online ahead of print.

ABSTRACT

BACKGROUND: Hand injuries are a major contributor to emergency department workload and work-related disability. Existing descriptive scoring systems, such as Hand Injury Severity Score (HISS) and Modified HISS, help grade injury severity but have notable limitations. We developed the Employees’ State Insurance Corporation Hand Injury Severity Score (ESICHISS), a simple, function-orientated scoring system. The aim was to determine whether this functionally orientated scoring system correlates with injury severity as measured by the descriptive HISS.

METHODS: All hand injury patients presenting to the hospital casualty were assessed at the time of their de novo presentation, and the objective information required to calculate both HISS and ESICHISS was recorded. The Spearman rank correlation test was used to evaluate the association between injury severity as determined by the prospectively assigned ESICHISS and the corresponding HISS scores at presentation. In addition, separate analyses were performed to assess the correlation between the 2 scoring systems specifically for amputational injuries and for integument-only injuries, which represent the 2 extremes of the hand injury spectrum.

RESULTS: The Spearman rank correlation showed a significant positive association between overall injury severity as assessed by HISS and ESICHISS (P = .024). No correlation was observed for amputational injuries (P = .264) or for integument-only injuries (P = .060). In contrast, a strong and statistically significant correlation was observed for all remaining hand injuries (P = .009).

CONCLUSION: Employees’ State Insurance Corporation Hand Injury Severity Score provides a more functionally meaningful assessment of hand injury severity compared with the pre-existing HISS. Its use may help patients make earlier and better-informed personal, financial, and retraining decisions following injury.

PMID:42638430 | DOI:10.1177/15589447261465829

J Appl Clin Med Phys. 2026 Sep;27(9):e70753. doi: 10.1002/acm2.70753.

ABSTRACT

PURPOSE: To evaluate the reproducibility and precision of CT beam width measurements using a pencil ionization chamber and radiopaque mask and to assess the robustness of the technique against clinically realistic setup errors in the superior-inferior (SI) and anterior-posterior (AP) directions.

METHODS: Beam width was measured on a GE Discovery RT590 CT scanner at three nominal collimations (10, 15, 20 mm), three tube potentials (80, 100, 120 kV), and three tube currents (50, 100, 150 mA). Three repeated exposures per setting were acquired using a Radcal Accu-Gold pencil ionization chamber with a radiopaque mask to calculate beam width. Coefficients of variation and Levene’s test were used to test precision. To assess the robustness to setup error, the chamber was offset from the isocenter at 0, 1, 3, and 5 mm in the SI direction at 20-mm collimation across all kV/mA combinations and at 0 and 5 mm in the AP direction at 10- and 20-mm collimation. A linear mixed-effects model was used to test the sensitivity of beam width to SI setup errors across kV/mA combinations. Slopes of the overall deviance from the global mean vs offset were obtained for each combination with 95% confidence intervals, and pairwise slope differences were evaluated using a Tukey-adjusted statistical test. Confidence intervals were used to assess AP setup errors at two different nominal collimations.

RESULTS: Across all kV/mA combinations, mean measured radiation beam width was 13.04, 16.90, and 20.60 mm for nominal 10-, 15-, and 20-mm collimations, with inter-protocol coefficients of variation of 0.57%, 0.48%, and 0.25%, respectively. Intra-protocol standard deviations across triplicate exposures were 0.04 to 0.09 mm. SI offset slopes from 0 – 3 mm ranged from -0.07 to -0.12 mm (per mm of offset) with overlapping 95% confidence intervals. There was no significant interaction with kV/mA (p > 0.05). AP offsets of 5 mm produced beam-width changes of 0.09 mm at 10 mm collimation and 0.15 mm at 20 mm collimation.

CONCLUSION: The pencil ionization chamber and radiopaque mask technique produced highly reproducible CT beam width estimates for potentials up to 120 kV and at or above 50 mA that were independent of tube potential, tube current, and robust to clinically plausible setup inconsistencies.

PMID:42638414 | DOI:10.1002/acm2.70753

Bone Jt Open. 2026 Aug 25;7(8):1118-1125. doi: 10.1302/2633-1462.78.BJO-2025-0343.R1.

ABSTRACT

AIMS: The aim of this investigation was to assess the effects of anterior cruciate ligament (ACL) resection on assessment of mediolateral laxity gaps during robotic-assisted total knee arthroplasty (TKA).

METHODS: We conducted a prospective study on 251 patients undergoing robotic-assisted primary TKA between January and June 2025. Patients with previous ACL or other knee ligament injury, and cases with missing data on outcomes of interest were excluded. Pre-resection mediolateral stressed laxity gaps in extension (10°) and flexion (90°) were measured in millimetres using optical navigation data before and after ACL resection. The primary outcome was paired mean difference in medial and lateral laxity gap measurements. The secondary outcome was prediction of factors associated with gap measurement differences. Paired t-tests with mean differences (MDs) compared pre- and post-resection measurements, with multivariate linear regression models examining independent predictors.

RESULTS: ACL resection did not alter medial extension gaps (MD 0.0 mm, p = 0.317) and lateral extension gaps (MD 0.1 mm, p = 0.172). Clinically negligible but statistically significant changes in medial flexion (MD 0.1 mm, p = 0.001) and lateral flexion gaps (MD 0.2 mm, p < 0.001) were noted, with all below the established minimum clinically important difference threshold of 0.3 mm. Multivariate regression identified mechanical hip-knee-ankle angle and medial posterior tibial slope as significant predictors for lateral extension gap differences (β 0.05, p < 0.001 and β -0.04, 95% CI 0.06 to -0.01, p = 0.006, respectively).

CONCLUSION: These findings indicate that routine ACL sacrifice is not necessary when evaluating extension and flexion gap measurements used for functional positioning in robotic-assisted TKA.

PMID:42638410 | DOI:10.1302/2633-1462.78.BJO-2025-0343.R1

Brain Behav. 2026 Aug;16(8):e71685. doi: 10.1002/brb3.71685.

ABSTRACT

BACKGROUND: Generalized anxiety disorder (GAD) is commonly accompanied by sleep disturbance in young adults. Whether clinically diagnosed GAD with self-reported habitual short sleep (HSS) is associated with altered resting-state large-scale functional connectivity remains unclear. We examined EEG functional connectivity in young adults with GAD + HSS and healthy controls using complementary connectivity measures and multilevel network analyses.

METHODS: Resting-state EEG data were analyzed from 74 college students, including 37 participants with clinically diagnosed GAD and self-reported HSS, defined as habitual weekday nocturnal sleep duration ≤ 6 h/night for at least 1 month, and 37 healthy controls. Functional connectivity was estimated using the weighted phase lag index (wPLI) and corrected amplitude envelope correlation (AEC-c) across delta, theta, alpha, and beta bands. Group differences were assessed using network-based statistics (NBS), node strength, and graph-theoretical analyses. Covariate-adjusted sensitivity analyses accounted for age and years of education, and graph metrics were tested across density thresholds of 10%-30%.

RESULTS: Significant group differences were confined to the alpha-band wPLI network. NBS identified one connected component comprising 434 suprathreshold edges (FWER-corrected p = 0.0002), predominantly showing stronger connectivity in the GAD + HSS group. All 30 scalp nodes showed higher node strength after FDR correction, including after covariate adjustment. The GAD + HSS group also showed higher global efficiency, lower characteristic path length, and higher weighted clustering coefficient, whereas transitivity did not differ. These findings were directionally stable across density thresholds.

CONCLUSIONS: Young adults with clinically diagnosed GAD and self-reported HSS showed distributed alterations in resting-state alpha-band phase-based connectivity. Convergent network-level, nodal, and graph-theoretical findings indicated stronger weighted integration and clustering. However, these results should not be interpreted as biomarkers of objectively verified sleep loss, and the independent contributions of anxiety and sleep status cannot be determined.

PMID:42638376 | DOI:10.1002/brb3.71685

Nurs Crit Care. 2026 Sep;31(5):e70649. doi: 10.1111/nicc.70649.

ABSTRACT

BACKGROUND: Intensive care units (ICUs) are high-technology environments where patient safety is monitored through various devices. However, the high frequency of alarms can lead to alarm fatigue, especially in neonatal and paediatric ICUs due to rapid physiological fluctuations. This condition may decrease nurses’ attention and lead to missed nursing care.

AIMS: The primary aim of this study was to determine the levels of alarm fatigue and missed nursing care, along with the underlying reasons for missed care, among neonatal and paediatric intensive care nurses. The secondary aim was to examine the relationship between alarm fatigue levels and missed nursing care.

STUDY DESIGN: This descriptive, cross-sectional correlational study was conducted in the neonatal and paediatric intensive care units of two public hospitals in Türkiye. Data were collected using self-administered instruments, including the Nurse Characteristics Form, Alarm Fatigue Questionnaire and MISSCARE Survey-Paediatric Version.

RESULTS: The sample consisted of 175 neonatal and paediatric intensive care nurses. The mean alarm fatigue score was 15.46 ± 5.88. Labour and communication resources factors were prominent reasons for missed nursing care. A positive and statistically significant relationship was found between alarm fatigue and the reasons for missed nursing care, including labour (r = 0.243, p = 0.001), communication (r = 0.208, p = 0.006) and material resource factors (r = 0.268, p < 0.001).

CONCLUSIONS: Effective alarm management strategies, adequate staffing and improved communication processes may help reduce missed nursing care and enhance patient safety in neonatal and paediatric intensive care units.

RELEVANCE TO CLINICAL PRACTICE: Reducing alarm fatigue in paediatric intensive care settings is essential. However, given the clinical vulnerability of paediatric patients, the life-saving nature of these alarms mandates the provision of in-service training on alarm management and the optimisation of patient-specific alarm settings. Furthermore, to enhance the quality of care and optimise patient safety, it is recommended that institutional resources be improved and effective inter-professional communication strategies be developed.

PMID:42638374 | DOI:10.1111/nicc.70649

J Clin Nurs. 2026 Aug 24. doi: 10.1111/jocn.70523. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: To compare and rank the effectiveness of various non-pharmacological interventions on depression for community-dwelling individuals with spinal cord injury (SCI).

BACKGROUND: Depression is a significant and persistent mental health problem among community-dwelling individuals with SCI. There is increasing evidence that non-pharmacological interventions are safe and effective for alleviating depression. However, the efficacy and comparative effectiveness of various non-pharmacological interventions for community-dwelling individuals with SCI remain unclear.

DESIGN: Systematic review and network meta-analysis (NMA) according to PRISMA-NMA guidance.

METHODS: We included randomized controlled trials (RCTs) of community-dwelling individuals with SCI comparing non-pharmacological interventions versus usual care/waiting list and reporting depressive symptoms using validated scales. China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Literature Database, China Science and Technology Journal Database, the Cochrane Library, PubMed, Web of Science, Embase, ProQuest and Scopus were systematically retrieved. Pairwise meta-analyses were performed using Review Manager 5.4.1, and the network meta-analysis was conducted using Stata 15.1.

RESULTS: Thirty-two RCTs involving 2200 participants were identified from database inception to May 2026. Compared with the control group, combination therapy (SMD = -0.86, 95% CI: -1.46 to -0.27), exercise therapy (SMD = -0.66, 95% CI: -1.16 to -0.15), psychological interventions (SMD = -0.41, 95% CI: -0.70 to -0.13) and self-management education (SMD = -0.33, 95% CI: -0.61 to -0.05) showed statistically significant effects, whereas vocational rehabilitation was not (SMD = -0.03, 95% CI: -1.00 to 0.95). Combination therapy had the highest SUCRA (89.1%, mean rank = 1.5), followed by exercise therapy (76.9%, mean rank = 2.2), psychological interventions (55.5%, mean rank = 3.2), self-management education (44.0%, mean rank = 3.8) and vocational rehabilitation (24.7%, mean rank = 4.8).

CONCLUSION: Combination therapy had the highest ranking probability. However, all comparisons were rated as very low certainty according to CINeMA. The findings should be interpreted with caution.

RELEVANCE TO CLINICAL PRACTICE: Community nurses may consider integrating exercise, self-management education and brief psychological support into individualized depression management for individuals with SCI. Support should be tailored according to depressive symptom severity, functional status, secondary complications, patient preferences, safety considerations and available community resources. Nurse-led or nurse-coordinated care may include depressive symptom screening, exercise planning, self-management coaching, motivational interviewing, scheduled follow-up and referral to mental health professionals when indicated.

TRIAL REGISTRATION: PROSPERO: CRD42022342155.

PMID:42638371 | DOI:10.1111/jocn.70523

Healthc Inform Res. 2026 Jul;32(3):251-261. doi: 10.4258/hir.2026.32.3.251. Epub 2026 Jul 31.

ABSTRACT

OBJECTIVES: The hospital standardised mortality ratio (HSMR) is the ratio of the observed number of hospital deaths to the expected number of deaths, with the latter estimated using statistical models that adjust for available case-mix factors. This study aimed to develop and validate in-hospital or 30-day post-discharge mortality prediction models for 40 diagnosis groups within the HSMR framework, using penalized logistic regression (pLR) and random forest (RF), and to compare the performance of these two approaches.

METHODS: We analysed 1,144,890 hospital admissions from 14 Malaysian state hospitals between 2012 and 2016. Separate models were developed for each diagnosis group using nine administrative features, including age, comorbidities, and admission category. Model performance was evaluated using mean Brier scores and Cstatistics across multiple bootstrapped datasets to obtain less biased performance estimates. Aggregate expected mortality counts were also compared with observed counts.

RESULTS: The overall observed mortality rate was 10.2%. The pLR models consistently showed better discrimination and calibration than the RF models, with lower Brier scores and higher C-statistics across the 40 diagnosis groups. On average, the C-statistic for pLR exceeded that for RF by 0.062. Although the RF model produced aggregate mortality predictions that were numerically closer to the observed counts, it showed high variance and poorer probabilistic calibration than pLR.

CONCLUSIONS: The pLR model tended to underestimate mortality more than RF but still demonstrated better calibration and discrimination, making it the preferable model for HSMR analysis in this dataset.

PMID:42638363 | DOI:10.4258/hir.2026.32.3.251

J Med Internet Res. 2026 Aug 21;28:e94788. doi: 10.2196/94788.

ABSTRACT

BACKGROUND: Digital health interventions (DHIs), including telemedicine and AI-enabled health tools, are increasingly integrated into health care systems worldwide. While these technologies have the potential to improve access and efficiency, unequal access to resources and health capabilities may create disparities in their use. Evidence remains limited on how social and structural determinants shape population-level entry into DHI use in rapidly digitalizing health systems such as China.

OBJECTIVE: This study aimed to examine social and structural determinants of broader DHI use among adults in China using the World Health Organization’s (WHO) Social Determinants of Health (SDoH) framework.

METHODS: This cross-sectional study analyzed data from a national survey conducted in China in 2024 among adults aged 18 years or older. The primary outcome was self-reported ever use of DHIs, including telemedicine, digital health apps, and AI-enabled health tools. Explanatory variables were categorized into 5 SDoH domains: economic stability, education and health-related capabilities, health care access and quality, neighborhood and built environment, and social and community context. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% CIs. Adjusted predicted probabilities and subgroup analyses by age and region were conducted as supplementary analyses.

RESULTS: Among 34,672 participants, 14,565 (42.0%) reported ever using a DHI. DHI use was higher among participants with greater socioeconomic resources and health-related capabilities, including higher income, higher educational attainment, and higher health and eHealth literacy (HL, eHL). For example, participants with a monthly income of 6001 CNY (approximately US $889) or higher had higher odds of DHI use than those with an income of 3000 CNY (approximately US $444) or less (aOR 1.370, 95% CI 1.285-1.462), and those with a bachelor’s degree or above had higher odds than those with junior high school education or below (aOR 1.487, 95% CI 1.377-1.607). Health system engagement also showed substantial differences: participants unaware of family doctor services had lower odds of DHI use than those enrolled in such services (aOR 0.502, 95% CI 0.465-0.542). Difficulty paying medical expenses was associated with higher DHI use (aOR 1.314, 95% CI 1.221-1.414). Adjusted predicted probabilities showed meaningful absolute differences for education, income, HL, eHL, difficulty paying medical expenses, and family doctor service status, whereas the adjusted urban-rural difference was small.

CONCLUSIONS: Broader self-reported DHI use in China is strongly associated with socioeconomic resources, health-related capabilities, and access to health care. Equitable digital health transformation requires more than technological expansion. Strategies to improve digital health equity should strengthen HL and eHL, integrate digital tools with accessible primary care and family doctor services, preserve nondigital support pathways, and incorporate equity-oriented design and governance as AI-enabled health tools become more widely implemented.

PMID:42638345 | DOI:10.2196/94788

Cancer Invest. 2026 Aug 24:1-11. doi: 10.1080/07357907.2026.2721530. Online ahead of print.

ABSTRACT

BACKGROUND: Although inflammation and lipid metabolism disorders have been confirmed to affect the risk of cardiovascular disease (CVD)-specific mortality and cancer-specific mortality in cancer survivors, the predictive value of the high-sensitivity C-reactive protein/high-density lipoprotein cholesterol ratio (CHR) for these outcomes remains unclear, with a paucity of relevant research evidence.

METHODS: Based on data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018, a total of 1,064 cancer survivors aged ≥20 years were enrolled and followed up for 61 months. Inverse probability of treatment weighting (IPTW)-weighted Fine-Gray competing risk models, restricted cubic splines, and subgroup analyses were used to systematically explore the association between CHR and CVD-specific mortality as well as cancer-specific mortality.

RESULTS: During the follow-up period, 127 deaths occurred, including 52 cancer-specific deaths and 27 CVD-specific deaths. The level of high-sensitivity C-reactive protein (hs-CRP) was significantly higher in the CVD-specific death group, while the level of high-density lipoprotein cholesterol (HDL-C) was significantly lower in the cancer-specific death group; CHR was significantly elevated in both death groups compared with their corresponding non-death groups. After IPTW-weighted Fine-Gray competing risk adjustment, each 1-unit increment in CHR was associated with a 5.0% higher subdistribution hazard of CVD-specific mortality among cancer survivors (adjusted SHR = 1.050, P < 0.05). A weak but statistically significant overall linear association was also observed between CHR and cancer-specific mortality (P < 0.05). Restricted cubic spline (RCS) competing risk models further revealed a distinct threshold-dependent nonlinear relationship for cancer-specific mortality, with an inflection point at 3.02 mg/mmol. The hazard of cancer death increased sharply with rising CHR below this cutoff and remained stable without additional risk elevation at higher CHR levels.

CONCLUSIONS: CHR independently predicts higher subdistribution hazard of CVD-specific mortality in cancer survivors, with a 5.0% risk increase per unit elevation. While CHR shows a weak overall linear association with cancer-specific mortality, their relationship exhibits a segmented nonlinear pattern with an exploratory inflection point at 3.02 mg/mmol; this value is not a validated clinical cutoff due to limited outcome events. With distinct predictive effects for the two competing fatal outcomes, CHR could act as a convenient auxiliary biomarker for long-term mortality risk evaluation and lay a foundation for future large-cohort validation of clinical thresholds.

PMID:42637674 | DOI:10.1080/07357907.2026.2721530