Tag: pubmed

Harefuah. 2026 Jan;166(1):8-13.

ABSTRACT

INTRODUCTION: In recent decades, a gender revolution has transformed the medical profession, with women becoming the majority in the workforce and increasingly dominating obstetrics and gynecology (Ob&Gyn), particularly in residency selection.

AIMS: No prior research has explored the determinants behind women’s preference for this residency in Israel or its anticipated impact.

METHODS: Qualitative research was conducted using unstructured, in-depth, interviews with 64 medical students randomly selected from Ben-Gurion University and the Technion, alongside 24 senior doctors and residents from the gynecology divisions at Soroka University Medical Center and Rambam Health Care Campus. The data subsequently underwent comprehensive thematic, focused, and interpretive analysis.

RESULTS: Among female medical students, obstetrics and gynecology is highly favored (41.4%). The primary motivation was professional interest (97%). Yet, many express concerns regarding work conditions that impact both personal and family life (42% and 37%, respectively). The clerkship exerts a crucial influence on residency decisions, as cited by 86% of students. Conversely, senior physicians worry that the increasing feminization will diminish its prestige and lower salaries. However, among students, such concerns are secondary; 62% believe that the shift towards predominantly female physicians will substantially shape the future trajectory of the field.

CONCLUSIONS: Within a decade, obstetrics and gynecology will evolve into a field predominantly led by female physicians. This gender shift will transform work routines and reshape healthcare systems with significant impact in Israel and across the western world confronting comparable trends.

PMID:41582791

J Clin Psychopharmacol. 2026 Jan 26. doi: 10.1097/JCP.0000000000002132. Online ahead of print.

ABSTRACT

PURPOSE/BACKGROUND: Cognitive impairment severely disrupts functioning and recovery in schizophrenia. Methylphenidate extended-release (ER) shows promise for cognition in attention-deficit/hyperactivity disorder but has limited, inconsistent evidence in schizophrenia. This study investigates low-dose methylphenidate ER’s effects on cognitive and functional outcomes in schizophrenia, addressing a critical therapeutic gap.

METHODS/PROCEDURES: In an 8-week, open-label, randomized crossover trial, 24 stable adults with Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnosis of schizophrenia spectrum disorder received 4 weeks of methylphenidate ER or treatment-as-usual (TAU), with crossover at week 4, and follow-up at week 12. The primary outcome was improvement in functional capacity, measured by the Virtual Reality Functional Capacity Assessment Tool (VRFCAT), while secondary outcomes included cognitive performance, assessed by the Brief Assessment of Cognition in Schizophrenia (BACS), and symptom severity evaluated by Positive and Negative Symptoms Scale (PANSS).

FINDINGS/RESULTS: VRFCAT scores improved significantly over time; in the first period (baseline to week 4), the medication-first arm showed improvement versus the TAU-first arm, with overall gains from baseline to week 8 of 303.47 seconds and 159.91 seconds , respectively, sustained post medication. BACS showed significant improvements in the TAU-first arm during the medication phase for Symbol Coding and Tower of London. PANSS-6 improved significantly while on study medication, notably in delusions and social withdrawal, without psychosis exacerbation. At 2-month follow-up, 75% resumed methylphenidate ER.

IMPLICATIONS/CONCLUSIONS: While results are interpreted cautiously due to the open-label design and small sample size, this trial suggests low-dose methylphenidate ER may enhance functional capacity, specific cognitive domains, and symptoms in schizophrenia without exacerbating psychosis.

PMID:41582768 | DOI:10.1097/JCP.0000000000002132

Ecol Appl. 2026 Jan;36(1):e70183. doi: 10.1002/eap.70183.

ABSTRACT

Large old trees are widely recognized as ecologically important across forest landscapes and concern regarding the decline of these trees is well documented because of their role in maintaining biodiversity for a broad range of organisms. In response to a growing need to inventory such trees, we developed and present the methodology to map and quantify the occurrence of large trees based on height and dbh thresholds using airborne LiDAR data and associated canopy height models. The innovative, succinct, and flexible solution we offer is based on the integration and augmentation of several existing packages within the open-source statistical software R. We use local tree-height and crown diameter data to calibrate an algorithm to count individual trees above specified height thresholds, including supercanopy trees. To satisfy large-tree definitions based on dbh, we used individual-tree height and dbh data available from existing forest inventory plots to define height-dbh curves for dominant forest community types, which then allowed height thresholds to be used as a surrogate for specified dbh thresholds. We illustrate the use of these methods to efficiently map and quantify large tree distributions within 8 forest communities across a study area consisting of 1.65 million ha of productive, industrially managed forest in New Brunswick, Canada. Spatial maps are presented, along with large-tree frequency statistics for specific communities, according to the definitions outlined in New Brunswick’s provincial forest management guidelines. In excess of 37 million large trees are estimated to be broadly distributed across the study area. The methods developed identify patterns in the distribution of large trees across extensive areas (e.g., in millions of hectares) as one metric for maintenance of biodiversity at the landscape level. The methodology may be readily adapted to alternative forest-specific definitions of large trees based on tree height or dbh.

PMID:41582766 | DOI:10.1002/eap.70183

Zhongguo Dang Dai Er Ke Za Zhi. 2026 Jan 15;28(1):30-41. doi: 10.7499/j.issn.1008-8830.2503068.

ABSTRACT

OBJECTIVES: To systematically evaluate neurodevelopmental differences between children with congenital heart disease (CHD) and healthy controls.

METHODS: A comprehensive search was conducted in Web of Science, PubMed, Embase, Wanfang Data, China National Knowledge Infrastructure, Chinese Biomedical Literature Service System, and VIP Database to identify studies published from database inception to February 2025 that assessed the neurodevelopment of children with CHD (CHD group) and healthy controls (control group) using the Bayley Scales of Infant Development (BSID) and the Wechsler Intelligence Scale. In total, 33 studies involving 3 316 children were included. Hedges’ g was used as the effect size. Meta analysis, subgroup analysis, sensitivity analysis, and publication bias analysis were performed using STATA/SE 17.0.

RESULTS: Based on BSID-II, compared with the control group, the CHD group had significantly lower mental development index (Hedges’ g=-1.09) and psychomotor development index (Hedges’ g=-1.22) scores (both P<0.001). Based on BSID-III, compared with the control group, the CHD group had markedly lower scores in cognition (Hedges’ g=-0.78), language (Hedges’ g=-0.65), and motor (Hedges’ g=-0.98) (all P<0.001). The Wechsler Intelligence Scale indicated that, compared with the control group, the CHD group had significantly lower full-scale intelligence quotient (Hedges’ g=-0.74), verbal intelligence quotient (Hedges’ g=-0.86), and performance intelligence quotient (Hedges’ g=-0.67) (all P<0.001).

CONCLUSIONS: Children with CHD exhibit developmental delays in cognition, language, motor function, and intelligence.

PMID:41582746 | DOI:10.7499/j.issn.1008-8830.2503068

J Community Psychol. 2026 Jan;54(1):e70084. doi: 10.1002/jcop.70084.

ABSTRACT

AIM: We explored the negative impact of the COVID-19 pandemic on self-reported mental health and perceived social and economic challenges in very-low- to low- to middle-income households in four urban typologies in South Africa: formal township dwellings, backyard dwellings, inner-city high-density apartments, and informal settlement dwellings. The purpose was to inform urban policy and crisis-response planning.

METHODS: Structured interviews were conducted with 1330 adults from a stratified random sample from each urban typology during the third SARS-CoV-2 wave.

RESULTS: Respondents reported increases in anxiety (28.5%), depression (23.9%), and decreased social connectedness (20.0%). Conversely, some respondents reported improved mental health, with decreases in anxiety (16.3%), depression (18.4%), and increased social connectedness (17.5%). Anxiety and depression were more prevalent in formal township dwellings and high-density apartments than in informal settlements. Financial concerns, worries about isolation, crime, and community violence, and fear of COVID-19 infection and stigma were mostly associated with decreased mental health.

CONCLUSIONS: Our findings suggest that residents from different urban typologies were affected differently by the COVID-19 pandemic. This research demonstrates the impact of environmental disasters on mental health in urban communities, which is mediated by social and economic problems.

PMID:41582737 | DOI:10.1002/jcop.70084

J Am Geriatr Soc. 2026 Jan 26. doi: 10.1111/jgs.70317. Online ahead of print.

ABSTRACT

BACKGROUND: Reports of neuropsychiatric symptoms (NPS) from informants, often patients’ caregivers and families, and from clinicians are both important for accurate detection of symptoms. However, informant/caregiver report and clinician assessments of NPS often differ.

METHODS: We examined agreement between informant/caregiver and clinician report of NPS in the National Alzheimer’s Coordinating Center Uniform Data Set. Participants were age ≥ 50 at baseline with mild cognitive impairment (MCI) or dementia (N = 27,225). At each visit, informants reported NPS using the Neuropsychiatric Inventory questionnaire (NPI-Q). Study clinicians provided clinical assessment per study protocol. Agreement between informant report and clinician judgment was assessed using Cohen’s kappa statistic. Associations between agreement in reporting for each NPS and participant/informant characteristics were examined using random-effects logistic regressions.

RESULTS: At baseline, participants were on average 72.9 ± 9.4 years old, 49% male, 76% non-Hispanic White, with 14.8 ± 3.6 years of schooling. Average follow-up was 4.0 ± 2.5 years. Informants were 63.7 ± 13.2 years old, 31% male, with 15.4 ± 2.8 years of schooling. 60% of informants were spouse/partner of the participant. Informants were more likely than clinicians to report the presence of all symptoms except for hallucinations. Agreement between informant and clinician reports of all symptoms was lower in patients with more severe dementia. Over time, agreement between informant and clinician reports of apathy increased. Agreement between informant and clinician reporting of NPS differed by participant’s sex and race/ethnicity. Informants who had lower frequency of contact and more distant relationships with the participant were more likely to agree with clinicians’ reporting.

CONCLUSIONS: Understanding differences between informant and clinician reports of NPS in dementia is essential in obtaining a more complete, accurate picture of behavioral challenges patients face. Considering patient and informant characteristics and dynamics between them would help clinicians better understand potential biases that may affect the accuracy of reported NPS and better manage and treat the symptoms.

PMID:41582731 | DOI:10.1111/jgs.70317

Otolaryngol Head Neck Surg. 2026 Jan 26. doi: 10.1002/ohn.70115. Online ahead of print.

ABSTRACT

OBJECTIVE: Characterize the somatic mutations in Oncocytic Carcinoma of the Thyroid (OCA) using a large, multi-institutional database to identify potential therapeutic targets and gain insights into tumor biology.

STUDY DESIGN: Cross-sectional study.

SETTING: Retrospective nationwide database review.

METHODS: Genomic data from 130 OCA samples, representing 124 adult patients, were retrieved from the American Association for Cancer Research (AACR) Project Genomics, Evidence, and Neoplasia Information Exchange (GENIE) database (v17.0-public). Analysis focused on nonsynonymous somatic mutations identified via whole-genome, whole-exome, or targeted panel sequencing after standardized filtering. Mutation frequencies, enrichment based on gender and metastatic status (primary vs. metastatic), and patterns of co-occurrence or mutual exclusivity were statistically evaluated.

RESULTS: The most frequently mutated genes were TERT (33.1%, predominantly promoter mutations), TP53 (20.0%), DAXX (16.2%), KMT2D (13.1%), NF1 (12.3%), and PTEN (10.0%). Significant gender-specific enrichment was identified, notably MST1R mutations exclusive to females (10.7%) and PRKDC mutations exclusive to males (16.7%). Mutations in PC, PCLO, MEN1, and TSC2 were significantly enriched in metastatic samples. DAXX and CDKN1A mutations exhibited significant co-occurrence, whereas TERT mutations were mutually exclusive with DAXX alterations.

CONCLUSION: The genomic landscape of OCA is marked by frequent TERT promoter mutations and distinct mutational patterns associated with patient gender and tumor metastatic status. These findings highlight potential molecular subtypes, reveal pathways potentially driving metastasis (eg, involving MEN1/TSC2), and identify novel sex-specific alterations (MST1R, PRKDC), offering avenues for improved development of targeted therapeutic strategies for OCA.

PMID:41582704 | DOI:10.1002/ohn.70115

Int J Gynaecol Obstet. 2026 Jan;172 Suppl 1:9-19. doi: 10.1002/ijgo.70761.

ABSTRACT

BACKGROUND: Female sexual dysfunction (FSD), characterized by persistent problems with desire, arousal, orgasm, or pain, can occur in women with any type of female genital mutilation (FGM) as a result of anatomical changes, pain, or psychological trauma.

OBJECTIVES: To systematically review the evidence on the effects of non-surgical interventions, including sexual counseling, mechanical devices, and lubricants, on the sexual function in women living with FGM.

SEARCH STRATEGY: A comprehensive search was conducted in CINAHL Plus, IRIS, MEDLINE (Ovid), PsycINFO (EBSCOhost), SCOPUS, and Web of Science from inception to November 2025. Reference lists were hand-searched and study authors contacted for additional data.

SELECTION CRITERIA: Studies were eligible if they involved women with any type of FGM who received non-surgical interventions for FSD.

DATA COLLECTION AND ANALYSIS: One controlled trial met the inclusion criteria. Data were extracted independently by two reviewers, and the certainty of the evidence was assessed using the GRADE approach.

MAIN RESULTS: In women with Type I FGM, use of the FDA-approved Eros-Clitoral Therapy Device (CTD) combined with psychotherapy led to statistically significant improvements across all domains of the Female Sexual Function Index compared with psychotherapy alone. In the control group, only orgasm scores improved.

CONCLUSIONS: Evidence on non-surgical interventions for FSD in women with FGM is extremely limited and based solely on a small single trial in women with Type I FGM. Although Eros-CTD shows promise, findings cannot be generalized to other FGM types, and data on safety and contraindications are lacking. Further research is needed across diverse populations and FGM types to inform practice and policy.

PMID:41582691 | DOI:10.1002/ijgo.70761

Diabetes Obes Metab. 2026 Jan 26. doi: 10.1111/dom.70485. Online ahead of print.

ABSTRACT

AIMS: The precise mechanism of sodium glucose co-transporter 2 (SGLT2) inhibitor on reno-protective effect has been still unclear. In this study, we hypothesised that SGLT2 inhibitor prevents diabetic kidney disease via reduction of hypoxia-induced factors.

MATERIALS AND METHODS: In this multicenter, prospective, randomised, double blinded clinical trial, people with type 2 diabetes and microalbuminuria were randomised equally to empagliflozin (10 mg/day) (n = 40) and placebo (n = 39) and followed 24 weeks. The primary endpoint was change in urinary albumin creatinine ratio (ACR) and urinary liver type fatty acid binding protein (L-FABP) excretion from baseline to 24 weeks. Major secondary outcome was change in serum vascular endothelial growth factor (VEGF), angiopoietin-like proteins 2 (ANGPTL2), angiopoietin-like proteins 4 (ANGPTL4), and adrenomedullin (AM) levels.

RESULTS: Although the reduction of ACR was significantly greater in the empagliflozin group than the placebo group at 4 and 12 weeks, the difference of change at 24 weeks between the two groups was not statistically significant (Empagliflozin group-Placebo group: -0.3643, 95% CI: -0.7571 to 0.0285, p = 0.0686). There was no difference in urinary L-FABP excretion between the empagliflozin and placebo groups. Serum VEGF and ANGPTL2 decreased significantly more in the empagliflozin group, whereas there were no significant differences in AM and ANGPTL4.

CONCLUSIONS: These results demonstrated that empagliflozin partially suppressed the hypoxia-induced angiogenic factors overproduction in addition to a declining trend in ACR in the early stage of diabetic kidney disease, which might contribute to the mechanisms of reno-protective effects of this agent (jRCTs051200147).

PMID:41582689 | DOI:10.1111/dom.70485

Int J Gynaecol Obstet. 2026 Jan;172 Suppl 1:31-47. doi: 10.1002/ijgo.70759.

ABSTRACT

BACKGROUND: Type III female genital mutilation (FGM) is corrected by the scar tissue removal of the vaginal opening, known as deinfibulation.

OBJECTIVES: To determine the current evidence on whether deinfibulation leads to improved obstetric, neonatal, gynecologic, and sexual health outcomes.

SEARCH STRATEGY: The following databases were searched from inception to May 18, 2023: CINAHL Plus (EBSCOhost), MEDLINE (Ovid), PsycINFO (EBSCOhost), SCOPUS, and Web of Science.

SELECTION CRITERIA: Two review authors independently screened the titles and abstracts, extracted data, and performed the risk of bias assessment.

DATA COLLECTION AND ANALYSIS: Meta-analysis was conducted with RevMan, and the quality of evidence was assessed using the GRADE approach.

MAIN RESULTS: Eight studies with serious risk of bias involving 3166 women were included. Very low-certainty evidence indicates that deinfibulation for women with type III FGM reduced the odds of an emergency cesarean birth (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.06-0.42) and genital tract lacerations (OR 0.48, 95% CI 0.29-0.79) when compared to women with type III FGM without deinfibulation. Reduced odds of an emergency cesarean birth apply when compared to women without FGM (OR 0.59, 95% CI 0.37-0.93). Antepartum deinfibulation, compared to intrapartum deinfibulation, may lead to a reduction in the duration of labor, with little or no difference in the risk of prolonged labor (low-certainty evidence). Antepartum deinfibulation may increase the likelihood of postpartum hemorrhage and cesarean births in pregnant women with type III FGM (low-certainty evidence). We found no studies for inclusion on gynecologic, urologic, and sexual health outcomes for this update.

CONCLUSIONS: The evidence of deinfibulation for women with type III FGM is available only for obstetrics outcomes. Larger observational studies in settings where type III FGM is predominantly practiced are required to improve the certainty of the evidence in these findings.

PMID:41582683 | DOI:10.1002/ijgo.70759