Tag: pubmed

Atten Percept Psychophys. 2026 Aug 2;88(6):170. doi: 10.3758/s13414-026-03313-9.

ABSTRACT

Previous research has shown that people are sensitive to statistical regularities and will implicitly learn to bias attention toward locations and features frequently associated with search targets. However, most prior work has involved a single biasing contingency. In Experiment 1, we investigate whether individuals can simultaneously learn and implement two distinct contingencies: one based on location and another based on color. The results suggest that both contingencies are learned implicitly and exert independent effects on attentional allocation. Experiments 2 and 3 examine whether shifting one feature to the volitional system via endogenous cues affects the implicit learning and implementation of contingencies for the other feature. The findings indicate that endogenous cues for one feature do not block implicit learning of contingencies in the other. However, the influence of implicit contingencies on attentional allocation depends on the validity of the volitional cues: they are effective when cues are neutral or valid, but not when invalid. This pattern suggests that the implicit and volitional systems operate hierarchically, with the volitional system taking precedence. SIGNIFICANCE STATEMENT: Efficient attentional guidance is key to effective visual search. While both volitional control and statistical learning can guide attention, little is known about how attention is influenced when multiple guidance mechanisms compete. Using a task with competing statistical regularities, one for target location and one for color, we show that both statistical learning biases independently influence attention. Shifting a feature to the volitional control system does not disrupt the statistical learning of the other, but invalid volitional cues eliminate statistical learning effects, suggesting a hierarchical relationship. These findings offer new insight into how multiple guidance systems shape attentional allocation. OPEN PRACTICES STATEMENT: Subject level data and SPSS analysis syntax available on the Open Science Framework at: https://osf.io/5vt74/overview . The experiments were not preregistered, but the data, and analysis syntax are publicly available at https://osf.io/5vt74/overview .

PMID:42543466 | DOI:10.3758/s13414-026-03313-9

Environ Monit Assess. 2026 Aug 3;198(8):902. doi: 10.1007/s10661-026-15753-9.

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs) are persistent organic pollutants widely distributed in the environment and linked to adverse health effects. Yet integrated assessments across multiple media, exposure pathways, and environmental scenarios remain limited. Here, we applied a multi-media, multi-pathway framework to estimate population exposure to PAHs and associated carcinogenic risks in China. PAH concentrations in air, water, soil, dust, and food were compiled from studies published between 2010 and 2024. Average daily doses (ADDs) were calculated for dietary intake, inhalation, oral ingestion, and dermal contact pathways, while carcinogenic risks were quantified using benzo[a]pyrene equivalents (BaP_eq) and incremental lifetime cancer risk (ILCR). PAH levels differed markedly by medium and scenario: industrial areas showed higher concentrations in air and water, while urban areas were characterized by elevated dust and soil burdens; rural areas were generally lower. In the primary assessment, dietary intake contributed substantially to both total PAH exposure and carcinogenic risk. A percentile-based dietary scenario analysis showed that the industrial-urban-rural risk ranking remained stable within each age group, although absolute total ILCR values and some age-group comparisons were sensitive to dietary-pathway uncertainty. Monte Carlo and sensitivity analyses further indicated that pathway-specific ILCR variability was most strongly associated with medium-specific BaPeq concentrations.

PMID:42543456 | DOI:10.1007/s10661-026-15753-9

Geroscience. 2026 Aug 3. doi: 10.1007/s11357-026-02456-9. Online ahead of print.

ABSTRACT

Global population aging challenges acute, disease-centric healthcare models and highlights the need for functional markers of aging. The World Health Organization’s intrinsic capacity (IC) framework, encompassing cognition, vitality, locomotion, psychological well-being, and sensory function, provides a multidimensional measure of functional reserve. However, most longitudinal studies have collapsed IC into a single score, limiting insight into domain-specific trajectories and interrelationships. In this longitudinal cohort study, we examined 7-year changes in composite and domain-specific IC scores, stratified by age and sex, and assessed associations between changes across domains among community-dwelling adults aged 50 years and older participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). The analytic sample included 27,107 participants (56.5% women; mean age 65.1 ± 8.2 years) with complete IC data at baseline (Wave 6, 2015) and follow-up (Wave 9, 2022). IC was operationalized as a 0-50 composite score derived from five domains, each standardized to a 0-10 scale using SHARE-specific measures. Over 7 years, composite IC declined statistically significantly (mean difference – 1.57 points; 95% CI – 1.63 to – 1.50; p < 0.001), with greater decline in men than women (- 1.71 vs – 1.46; p < 0.001). Locomotion domain contributed most to overall decline across age groups. Changes in vitality were moderately correlated with changes in locomotion (r≈0.30) and psychological well-being (r≈0.25), suggesting that vitality may function as a physiological node linking physical and psychological domains. These findings demonstrate that IC declines progressively from midlife, with steeper trajectories in men, and support domain-specific monitoring to better characterize age-related functional decline.

PMID:42543444 | DOI:10.1007/s11357-026-02456-9

Eur Arch Otorhinolaryngol. 2026 Aug 3. doi: 10.1007/s00405-026-10524-1. Online ahead of print.

ABSTRACT

PURPOSE: To examine the association between human immunodeficiency virus (HIV) infection and thyroid cancer (TC) risk.

METHODS: A systematic search of PubMed, Embase, Web of Science, and Cochrane Library from inception to September 1, 2025 for population-based registry studies that reported standardized incidence ratios (SIRs) of TC in people living with HIV (PLHIV) compared with the general population was conducted. A random-effects model was used to pool SIRs, with subgroup analyses by national income level, highly active antiretroviral therapy (HAART) era and geographical region. Sensitivity analyses and publication bias tests were also performed.

RESULTS: Fourteen population-based registry studies involving 2,419,564 PLHIV and 1,088 incident TC cases were included. The pooled analysis showed that PLHIV had a lower risk of TC than the general population (SIR = 0.63, 95% CI 0.52-0.75). Subgroup analyses revealed a decreased risk in high-income countries (SIR = 0.59, 95% CI 0.51-0.68), while the risk estimate for low- and middle-income countries was based on only one study (SIR = 7.17, 95% CI 2.35-21.92). A lower risk was observed in the HAART era (SIR = 0.59, 95% CI 0.49-0.71), whereas no statistically significant difference in TC risk was detected in the pre-HAART era (SIR = 2.64, 95% CI 0.30-23.42). By region, risk was reduced in both North America (SIR = 0.61, 95% CI 0.54-0.70) and Europe (SIR = 0.50, 95% CI 0.29-0.85), while no statistically significant difference was observed in the Asian subgroup.

CONCLUSION: A reduced risk of TC was observed among PLHIV, but this association was modified by country income level, geographical region and treatment era.

PMID:42543426 | DOI:10.1007/s00405-026-10524-1

Eur Arch Otorhinolaryngol. 2026 Aug 3. doi: 10.1007/s00405-026-10468-6. Online ahead of print.

ABSTRACT

PURPOSE: To compare real-world initial treatment strategies for pediatric head and neck lymphatic malformations using a multidimensional outcome framework that distinguishes complete radiological response, objective lesion response, progression control, and treatment burden, and to examine how lesion complexity influences treatment selection and outcomes.

METHODS: We conducted a retrospective cohort study of pediatric patients with head and neck lymphatic malformations treated at a tertiary referral center between January 2016 and December 2025. Patients were categorized into surgery alone, interventional therapy alone, medical therapy alone, or combined therapy according to the initial treatment strategy. Radiological outcomes were classified as complete response, partial response, stable disease, or progression/recurrence. Primary outcomes included complete response, objective response rate, progression/recurrence, and progression-free survival. Lesion complexity was classified using an exploratory, literature-informed framework based on De Serres stage, cystic subtype, number of involved anatomical regions, and critical structure involvement. Multivariable logistic regression, generalized propensity score-based overlap weighting, propensity score matching, event-density analysis, and follow-up sensitivity analyses were used to address confounding by indication and unequal follow-up.

RESULTS: Among 210 patients, 40 received surgery alone, 110 interventional therapy alone, 23 medical therapy alone, and 37 combined therapy. Surgery alone achieved the highest complete response rate (75.0%). Interventional therapy alone showed the highest objective response rate (87.3%), highest disease control rate (95.5%), lowest progression/recurrence rate (4.5%), and lowest additional-treatment rate (4.5%). Medical therapy alone had the highest progression/recurrence rate (39.1%), a pattern that may at least partly reflect the selection of systemic therapy for more complex disease, although a contribution from limited treatment effect in this heterogeneous group cannot be excluded. High-complexity lesions were less likely to achieve complete response and had numerically higher progression/recurrence. The main outcome patterns remained directionally consistent after multivariable adjustment, overlap weighting, propensity score-matched sensitivity analysis, and follow-up sensitivity analyses.

CONCLUSION: Initial treatment strategies for pediatric head and neck lymphatic malformations demonstrated distinct outcome profiles rather than a simple hierarchy of effectiveness. Surgery alone was most strongly associated with complete radiological response, whereas interventional therapy alone showed a favorable objective-response and progression-control profile. A multidimensional framework integrating eradication, objective response, lesion complexity, treatment burden, and progression control may better support individualized treatment selection.

PMID:42543425 | DOI:10.1007/s00405-026-10468-6

Eur Arch Otorhinolaryngol. 2026 Aug 3. doi: 10.1007/s00405-026-10519-y. Online ahead of print.

ABSTRACT

PURPOSE: Osteoporosis and osteopenia, characterized by reduced bone mineral density (BMD), particularly affect women during menopause. While research has explored the link between low BMD and hearing loss (HL) in postmenopausal women, understanding this connection in premenopausal women requires further investigation. This study aimed to investigate the association between low BMD and HL in premenopausal women.

METHODS: Sixty premenopausal women, ages 20 to 54, exhibiting diverse BMD levels, underwent dual-energy x-ray absorptiometry (DXA) for BMD assessment alongside comprehensive audiological assessments. BMD was stratified into two categories: “Healthy” and “Low.”

RESULTS: Mild-to-moderate sensorineural HL was identified in the right ear of 26.7% of participants and in the left ear of 36.7% of participants following audiometric evaluation. Chi-square analysis did not establish a statistically significant connection between BMD groups. Comparison of means analysis demonstrated an association between self-perceived hearing difficulty and BMD of the lumbar spine (p < .05).

CONCLUSIONS: Findings suggest that reduced BMD may not be associated with objective hearing sensitivity in premenopausal women. Longitudinal studies are needed to determine whether bone health contributes to auditory changes across the menopausal transition.

PMID:42543423 | DOI:10.1007/s00405-026-10519-y

Eur Arch Otorhinolaryngol. 2026 Aug 3. doi: 10.1007/s00405-026-10504-5. Online ahead of print.

ABSTRACT

INTRODUCTION: Total thyroidectomy, a procedure for various thyroid pathologies, is traditionally performed using conventional clamp-and-tie hemostasis (CH). Advanced high-energy devices (HEDs), including the Harmonic Scalpel (HS) and LigaSure (LS), offer energy-based vessel sealing with potential efficiency gains, but safety concerns and cost implications remain. This systematic review and Bayesian network meta-analysis of randomized controlled trials (RCTs) was conducted to compare the efficacy and safety of energy-based hemostasis devices versus CH in total thyroidectomy.

METHODS: This Systematic review included 22 prospective RCTs, published between 2005 and 2022, enrolling 3,824 patients. The primary outcomes included operative time (OT), intraoperative blood loss (IOBL), and transient recurrent laryngeal nerve (RLN) injury and hypocalcemia. Secondary outcomes were postoperative hematoma (POH), postoperative drain output (POD), and length of hospital stay (LOS). Intervention rankings were determined using the Surface Under the Cumulative Ranking Curve (SUCRA), SUCRA values reflect the probability that an intervention ranks higher relative to others for a given outcome and do not indicate a clinical or statistical superiority; therefore, they should be interpreted alongside effect estimates and credible intervals.

RESULTS: In comparison with CH, both HS and LS were statistically significantly superior, reducing OT by approximately 22 min (HS: SUCRA 0.76, LS: SUCRA 0.73). HS demonstrated further significant superiority over CH, reducing LOS by -0.37 days (SUCRA 0.93) and POD output by -24 mL (SUCRA 0.87). While HS showed a numerical reduction in IOBL, this difference did not reach statistical significance, yet HS ranked highest for this outcome (SUCRA 0.91). Importantly, no significant differences were detected among HS, LS, and CH for key safety outcomes, including transient RLN palsy, transient hypocalcemia, and POH.

CONCLUSION: Energy-based hemostasis devices, particularly HS, were associated with shorter operative time and reduced postoperative fluid output and hospital stay compared with conventional clamp-and-tie hemostasis. However, the certainty of evidence for most outcomes was moderate to low, the analysis was underpowered to establish equivalence for rare safety events, and the modest clinical gains should be weighed against device costs and local operating-room efficiency. These findings support conditional, context-dependent use of HEDs rather than routine preference for any single device.

PMID:42543419 | DOI:10.1007/s00405-026-10504-5

Eur Arch Otorhinolaryngol. 2026 Aug 3. doi: 10.1007/s00405-026-10483-7. Online ahead of print.

ABSTRACT

PURPOSE: To describe real-world hearing outcomes after salvage intratympanic corticosteroid (ITC) therapy in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and incomplete recovery after systemic corticosteroids, emphasizing clinically meaningful recovery.

METHODS: Prospective observational study at a single tertiary center. Patients met ISSNHL diagnostic criteria (≥ 30 dB loss in ≥ 3 consecutive frequencies within 72 h) and received salvage ITC (methylprednisolone 40 mg/mL, weekly for 3 weeks) after absent or incomplete recovery on follow-up audiometry (day 10-15). Primary outcome was PTA4 change from pre-salvage audiogram to last available audiogram (minimum follow-up 1 month). Recovery was categorized using Siegel criteria. Non-parametric methods and Hodges-Lehmann estimators were used.

RESULTS: Of 83 ISSNHL patients, 41 received salvage ITC and were analyzed. In the salvage cohort, 63.4% were women; mean age was 53.3 years (95% CI 46.7-59.9); median follow-up was 11 months (IQR 3-15). Median PTA gain attributed to ITC rescue was 5.0 dB (IQR – 3.8 to 18.8; padj = 0.043). After salvage ITC, 71% showed ≤ 15 dB improvement; 29% achieved ≥ 15 dB. By Siegel criteria, normal hearing was achieved in 7%, mild-to-moderate loss in 34%, and severe loss in 59%.

CONCLUSION: Salvage ITC was associated with a statistically significant but clinically modest hearing gain and a low proportion of complete recovery. Standardized, patient-relevant outcome definitions are needed to support realistic counseling.

PMID:42543417 | DOI:10.1007/s00405-026-10483-7

Eur Arch Otorhinolaryngol. 2026 Aug 3. doi: 10.1007/s00405-026-10485-5. Online ahead of print.

ABSTRACT

PURPOSE: To examine intraoperative and postoperative practices (antibiotic and antithrombotic prophylaxis, ear packing, behavioural recommendations, follow-up strategies) in exclusive endoscopic ear surgery management, based on a global survey of experienced surgeons.

METHODS: The setting is an international survey distributed via personal mailing lists and the International Working Group on endoscopic ear surgery. Anonymous responses were collected through Google Forms and analyzed using descriptive statistics, logistic regression models, and Kruskal-Wallis tests with post-hoc analyses to explore associations between geographic origin, surgical practices, and postoperative protocols. The result is a cross-sectional descriptive study.

RESULTS: We collected responses from 44 surgeons across 21 different countries. Significant variability in surgical management practices was observed, often diverging from the current literature. Geographic origin and surgeon experience showed a limited association with specific practices. Notably, North American surgeons reported longer follow-up durations and more consistent use of cefazolin, whereas European surgeons demonstrated greater variability in antibiotic regimens.

CONCLUSION: The survey reveals wide variability in the intraoperative and postoperative management of exclusive endoscopic ear surgery, driven more by individual preferences than by scientific evidence. The absence of consistent patterns based on geography or expertise highlights the lack of standardized, evidence-based protocols.

PMID:42543412 | DOI:10.1007/s00405-026-10485-5

Support Care Cancer. 2026 Aug 3;34(8):821. doi: 10.1007/s00520-026-11050-w.

ABSTRACT

BACKGROUND: Informal caregivers of patients enrolled in early-phase clinical trials (EP-CTs) devote an average of fifty or more hours per week to providing care, but qualitative studies suggest they perceive receiving limited instruction about their role. However, no work has evaluated what formal guidance EP-CT caregivers might receive during enrollment. This study characterized the type and granularity of information provided to EP-CT caregivers in study documents.

METHODS: We manually reviewed informed consent and study protocol documents for adult EPCTs registered on ClinicalTrials.gov completed 1990-2025 with both documents available. Using a structured codebook from prior work [26], we identified whether trials delineated expectations for caregivers regarding: (1) participation in informed consent processes and learning about the study, (2) structured education in trial tasks (i.e., medication administration), (3) attendance at trial visits, (4) monitoring trial adherence, (5) symptom surveillance/management, (6) communicating with the study team, and (7) available supportive care resources. Descriptive statistics summarized provided caregiver content.

RESULTS: Overall, 145 EP-CT trials (66.9% solid only, 26.2% hematologic only, 6.9% mixed) were evaluated. Regarding EP-CT learning, only 8/145 (5.5%) of studies delineated study team commitment to explicitly discussing study details with caregivers if desired. Only 14/145 (9.7%) of studies referenced structured education in trial tasks. Less than 5% of studies outlined potential caregiver roles in supporting trial attendance, trial adherence, symptom surveillance/management, or study team communication. No trials referenced available supportive care resources for either patients or caregivers.

CONCLUSION: Overall, despite the demands that EP-CTs place on caregivers and their pivotal role in patient participation, formal trial documents provide limited delineation of caregiver roles and responsibilities. Future work should assess the supplemental role of informal caregiver resources and whether further caregiver consideration can enhance preparedness or care delivery.

PMID:42543409 | DOI:10.1007/s00520-026-11050-w