Tag: pubmed

Ann Otol Rhinol Laryngol. 2026 Aug 10:34894261476823. doi: 10.1177/00034894261476823. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study is to assess sociodemographic and medical factors associated with repeat bilateral myringotomy with tympanostomy tube placement (rBMT) in the diverse patient population at our academic medical center.

STUDY DESIGN: Retrospective chart review.

SETTING: Tertiary academic medical center.

METHODS: A retrospective chart review of pediatric patients seen at a quaternary medical center who underwent BMT was conducted. Demographic, medical, and socioeconomic information was collected. Fisher’s exact test was used to estimate the association between rBMT with all nominal responses. Logistic regression was used to estimate the association between patient variables and rBMT.

RESULTS: There were 216 (69% male) patients who underwent rBMT. The mean number of BMT surgeries in those requiring rBMT was 3.09. Black & Hispanic individuals were less likely to undergo rBMT (P < .05). There were no statistically significant association between social vulnerability index (SVI), type of insurance or distance from the medical center and rBMT (P > .05).

CONCLUSION: When looking at sociodemographic disparities in those who underwent rBMT, our study demonstrates race and ethnicity were statistically significant factors for decreased likelihood of repeat BMT. SVI, insurance type, and distance from the medical center were not statistically significant in terms of likelihood of rBMT.

PMID:42572846 | DOI:10.1177/00034894261476823

J Helminthol. 2026 Aug 10;100:e85. doi: 10.1017/S0022149X26102119.

ABSTRACT

This study was conducted to determine the in vivo anthelmintic efficacy and clinical safety of crude ethanolic extract (CEE) obtained from Artemisia absinthium in naturally infected Awassi breed sheep with gastrointestinal nematodes (GIN). A total of 18 non-pregnant sheep were divided into 3 groups of 6 animals each: CEE (1.0 g/kg), albendazole (5 mg/kg), and negative control (untreated). Changes in egg counts (EPG) were quantitatively monitored in faecal samples collected before treatment (day 0) and after treatment (days 7 and 15). The research findings showed that A. absinthium CEE significantly reduced the parasite load over time, with the highest efficacy achieved on day 15 (p < 0.001), demonstrating statistically significant efficacy in suppressing the fecundity of GIN agents. According to the faecal egg count reduction test (FECRT), therapeutic success was observed in 76.77% of the CEE group and 100% of the albendazole group. The performance demonstrated by CEE confirmed the potential of plant secondary metabolites to reduce dependence on synthetic drugs, and the absence of any adverse effects during the trial period demonstrated the plant’s high biosafety profile. Consequently, A. absinthium offers a powerful, economical, and residue-free biotherapeutic alternative to synthetic anthelmintics in sustainable and organic livestock models, countering global anthelmintic resistance. To the best of our knowledge, this study represents the first investigation in Türkiye evaluating the anthelmintic efficacy of A. absinthium CEE in Awassi breed sheep naturally infected with GIN, providing the first regional efficacy data from Şanlıurfa.

PMID:42572844 | DOI:10.1017/S0022149X26102119

J Res Adolesc. 2026 Sep;36(3):e70247. doi: 10.1111/jora.70247.

ABSTRACT

Latine lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth in the United States (U.S.) experience compounded forms of oppression that increase vulnerability to both school-based and cyberbullying. Guided by the Minority Stress Theory (MST) and the Temporal Intersectional Minority Stress Model (TIMSM), this study examined how intersectional bullying relates to future outlook among Latine LGBTQ+ youth, and whether internalized stigma, depression, and caregiver acceptance mediate or moderate these associations. Data were drawn from a national U.S. sample of 1772 Latine LGBTQ+ adolescents aged 13-18. Participants completed validated measures assessing intersectional school and cyberbullying, LGBTQ+ internalized stigma, depression-anxiety, caregiver acceptance, and beliefs about the future. Serial indirect-effects and moderation analyses were conducted. Both school-based bullying and cyberbullying were indirectly associated with more negative beliefs about the future through increased LGBTQ+ internalized stigma and depressive/anxiety symptoms. Cyberbullying demonstrated slightly stronger links to internalized stigma, whereas school bullying was more closely tied to depressive/anxiety outcomes. LGBTQ+ caregiver acceptance at high levels significantly buffered the effects of both forms of bullying on internalized stigma and depression. Findings underscore the cumulative impact of intersectional bullying on Latine LGBTQ+ youths’ mental health and future outlook within the U.S. sociocultural context. Culturally responsive interventions that strengthen caregiver acceptance, promote affirming school climates, and address digital victimization are essential for fostering resilience and hope among Latine LGBTQ+ youth in the U.S.

PMID:42572836 | DOI:10.1111/jora.70247

J Rehabil Med. 2026 Aug 10;58:jrm45736. doi: 10.2340/jrm.v58.45736.

ABSTRACT

IMPORTANCE: Multimodal prehabilitation improves outcomes in colorectal surgery, but its effectiveness and cost-effectiveness before metabolic and bariatric surgery are unknown.

OBJECTIVE: To evaluate the effectiveness and cost-effectiveness of a 6-week multimodal prehabilitation programme compared with standard preintervention education in patients undergoing bariatric surgery.

DESIGN, SETTING, AND PARTICIPANTS: Propensity score matched cohort observational study at Shanghai Tenth People’s Hospital, China, January 2022 to January 2025. Sixty prehabilitation patients were matched 1:1 to 60 controls from 254 standard care candidates using nearest-neighbour matching on the logit of the propensity score. Follow-up was 12 months.

INTERVENTIONS: A 6-week programme of supervised exercise, nutritional counselling, and psychological support vs 2 standard preoperative counselling sessions. All patients underwent Roux-en-Y gastric bypass or sleeve gastrectomy.

MAIN OUTCOMES AND MEASURES: Total weight loss at 12 months. Secondary outcomes included body composition, metabolic parameters, functional capacity, patient-reported outcomes, safety, and healthcare costs.

RESULTS: Among 120 matched patients (mean [SD] age, 32.6 [5.2] years; 65.8% male; mean body mass index [BMI], 38.2 [3.2] kg/m2), total weight loss at 12 months did not differ between groups (23.7 [5.1] vs 23.4 [2.7] kg; difference, 0.3 kg; 95% CI, -1.3 to 1.8; p = 0.75). At 3 months, prehabilitation showed significantly greater weight loss (adjusted β = 2.85 kg; 95% CI, 1.77 to 3.93; p < 0.001), lower body fat, lower diastolic blood pressure, and higher Short Form-36 (SF-36) mental scores. All differences were attenuated by 6 months. No serious adverse events occurred. Total costs were modestly higher in the prehabilitation group (mean, ¥84 843 vs ¥78 051), a difference attributable almost entirely to the prehabilitation programme itself; because the incremental effect on weight loss at 12 months was not statistically significant, a meaningful incremental cost-effectiveness ratio could not be estimated.

CONCLUSIONS AND RELEVANCE: A 6-week multimodal prehabilitation programme accelerated early postoperative weight loss and improved short-term functional outcomes but did not improve total weight loss at 12 months. Because prehabilitation added cost without a demonstrable difference in 12-month weight loss, a cost-effectiveness advantage could not be established. The dominant metabolic effects of bariatric surgery appear to override the incremental gains of preoperative conditioning over time.

PMID:42572833 | DOI:10.2340/jrm.v58.45736

J Child Psychol Psychiatry. 2026 Aug 10. doi: 10.1111/jcpp.70216. Online ahead of print.

ABSTRACT

BACKGROUND: Negative outcomes of psychological treatments for pediatric posttraumatic stress disorder (PTSD) have been underresearched. Although reporting has increased over the years, a comprehensive systematic review and meta-analysis is lacking.

METHODS: We conducted a preregistered systematic review and meta-analysis (PROSPERO ID: CRD42020206290) and followed PRISMA guidelines. MEDLINE, PsycInfo, Web of Science, and PTSDpubs were systematically searched from inception to May 13, 2025. Eligible studies were randomized controlled trials (RCTs) of psychotherapies for pediatric PTSD with ≥10 participants per arm. Two independent coders extracted data and assessed risk of bias.

RESULTS: Seventy-two RCTs (N = 5,677) met inclusion criteria. Of these, 69, 6, and 19 reported the incidence of all-cause dropout, deterioration of PTSD, and adverse events, respectively. Most trials (74%) investigated trauma-focused cognitive behavioral therapy (TF-CBT). Random effects meta-analysis showed that 7.87% of patients (95% CI, 4.07-12.55; I² = 82%) dropped out, with no significant difference relative to passive controls (RR = 1.04, 95% CI, 0.64-1.69; I² = 53%). Less than 0.01% (95% CI, 0.00-2.39; I² = 0%) of patients reported deterioration after TF-CBT, compared to 1.26% (95% CI, 0.00-8.13; I² = 40%) of passive controls. Limited data prohibited isolated review of other treatments. The incidence of adverse events during psychological treatments was also uncommon (0.29%, 95% CI, 0.00-2.67; I² = 34%) and similar to passive controls (1.14%, 95% CI, 0.00-8.02; I² = 84%).

CONCLUSIONS: Psychological treatments for pediatric PTSD-with most accumulated evidence for TF-CBT-appear safe and acceptable for the vast majority of children and adolescents with PTSD, which is encouraging for clinical practice. Reporting on deterioration and adverse events was scarce, limiting statistical power. Negative outcomes should be routinely assessed in clinical practice and future research, using validated measures and clearly defined constructs. Future work should distinguish serious adverse events and adverse events.

PMID:42572827 | DOI:10.1111/jcpp.70216

J Rural Health. 2026 Jun;42(3):e70203. doi: 10.1111/jrh.70203.

ABSTRACT

PURPOSE: Mailed fecal immunochemical test (FIT) and patient navigation for follow-up colonoscopy have been shown to increase colorectal cancer (CRC) screening rates, but implementation barriers exist in rural settings. Partnerships between clinics and Medicaid health plans may address these barriers. In a large pragmatic randomized trial, we conducted a qualitative analysis to identify ways in which practice facilitation supported the implementation of a partnered health plan-clinic intervention of mailed FIT and patient navigation to improve CRC screening among rural Medicaid enrollees.

METHODS: In the SMARTER CRC pragmatic trial, study team practice facilitators supported rural clinics and Medicaid health plans in implementing mailed FIT and patient navigation for follow-up colonoscopy. Qualitative data collected during the first year of implementation included clinic and health plan interviews, clinic contact logs, and monthly periodic reflections with the facilitator team.

FINDINGS: Practice facilitation was needed to support both clinics and health plans in the study. Facilitators supported continued engagement of clinics and health plans, used workflow mapping to align implementation between clinics and health plans, provided technical support for sharing of patient data, and facilitated communication between clinics and health plans. Prior study team experience implementing CRC screening interventions enabled successful facilitation.

CONCLUSIONS: Practice facilitation can successfully support partnered health plan-clinic implementation of mailed FIT and patient navigation in rural clinics. Our findings highlight the importance of assessing support needs across all partnering organizations when implementing multilevel preventive care interventions and underscore the importance of subject matter expertise in practice facilitation.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04890054.

PMID:42572815 | DOI:10.1111/jrh.70203

Aliment Pharmacol Ther. 2026 Aug 10. doi: 10.1111/apt.70906. Online ahead of print.

ABSTRACT

BACKGROUND: Non-Helicobacter pylori (H. pylori), non-nonsteroidal anti-inflammatory drug (NSAID) peptic ulcer disease (PUD) is increasingly recognized as a distinct subgroup, but its proportion across clinical presentations remains unclear.

AIM: We aimed to estimate this proportion.

METHODS: We searched MEDLINE, Embase and CENTRAL from their inception to March 2026 for observational studies. The primary outcome was the proportion of non-H. pylori, non-NSAID PUD among adults with overall, bleeding and perforated PUD. Random-effects meta-analysis of logit-transformed proportions was performed using restricted maximum likelihood. Meta-regression assessed associations with study year, country-level H. pylori prevalence and region. Protocol registered in PROSPERO (CRD420251174202).

RESULTS: Overall, 92 studies (60,816 patients) from 32 countries were included. The pooled proportions of non-H. pylori, non-NSAID PUD cases were 13.0% (95% confidence interval [CI], 10.4-16.2) in overall PUD, 11.3% (95% CI, 8.8-14.4) in bleeding PUD, and 22.0% (95% CI, 13.1%-34.7%) in perforated PUD. In univariable meta-regression, a more recent study year was associated with a higher proportion of bleeding PUD (β = 0.076; 95% CI, 0.031-0.120). This association remained statistically significant after adjustment for country-level H. pylori prevalence (β = 0.070; 95% CI, 0.026-0.113). Lower H. pylori prevalence was also associated with a higher proportion after further adjustment for region (β = -0.025; 95% CI, -0.046 to -0.005).

CONCLUSION: Non-H. pylori, non-NSAID PUD represents a non-negligible but heterogeneous component of PUD. In bleeding PUD, exploratory ecological analyses suggest a temporal increase, potentially reflecting evolving etiologic patterns beyond H. pylori infection and NSAID exposure.

PMID:42572812 | DOI:10.1111/apt.70906

Prehosp Disaster Med. 2026 Aug 10;41(1):e20. doi: 10.1017/S1049023X26109030.

ABSTRACT

INTRODUCTION: Conflict brings excess and changing demands to local civilian health care resources. While conflict-related needs are often easily identifiable, in the aftermath of disaster or conflict, health care systems may struggle to identify changing needs, and humanitarian actors may initiate responses targeted to traumatic injuries while facing different operational realities.

AIM: This study aims to quantify the immediate changes in, and short-term trends of, Emergency Department (ED) patient profiles following a break in conflict, informing humanitarian intervention and the prioritization of local health care resources in future contexts.

METHODS: A single center, retrospective Interrupted Time Series (ITS) analysis was undertaken comprising of every patient attendance to the Nasser Medical Complex (Gaza Strip) ED from September 1, 2025 through November 30, 2025, inclusive, to evaluate the impact of the ceasefire on October 10, 2025. Binomial and negative binomial regression was used, adjusting for day-of-week confounding, with Newey-West robust standard errors. Coefficients were exponentiated to Incidence Rate Ratios for interpretation as the percentage change in the relevant presentations numbers or trend and were presented with 95% Confidence Intervals (95%CI).

RESULTS: There were 107,631 presentations over the study period, a median of 1,217 (IQR 1,120-1,291) per day prior to, and 1,202 per day (IQR 1,083-1,356) following, the ceasefire. There was no significant step-change in total presentation to the ED following ceasefire, but thereafter, relative to the pre-ceasefire trajectory, attendances experienced a sustained decrease of two percent per day (95%CI, 1.0% to 2.0% reduction; P < 0.001).There were observed changes to the profile of attendances by diagnostic group, with step-change reductions in trauma admissions, gastrointestinal, and pediatric presentations. There were daily trend reductions for multiple diagnostic groups, including traumatic injuries discharged from the ED, respiratory infections, gastrointestinal presentations, and other medical emergencies.

DISCUSSION: This study demonstrates that the implementation of a ceasefire has the potential to change presentation patterns to a civilian ED in a conflict area. While there was no step-change following the ceasefire, there was a reversal of the previous trend of rising daily presentations. It should be noted that most presentations both before and after the ceasefire were for non-traumatic events. These findings highlight the need to continue support and resource for the non-traumatic workload of emergency care during crises, a pattern described in other contexts.

PMID:42572806 | DOI:10.1017/S1049023X26109030

Int J Nephrol Renovasc Dis. 2026 Aug 5;19:602592. doi: 10.2147/IJNRD.S602592. eCollection 2026.

ABSTRACT

PURPOSE: Chronic kidney disease (CKD) is a major public health concern in the United States, with persistently rising incidence and mortality. This study aimed to quantify geographic and demographic disparities in CKD mortality across the United States and to examine the association between CKD mortality and ambient temperature variation.

PATIENTS AND METHODS: CKD deaths and age-adjusted mortality rates (AAMRs) for 1999-2023 were obtained from CDC WONDER and stratified by census region, state, sex, race, age group, and urbanization level. Mortality trends were quantified using joinpoint regression. Primary temperature-mortality analyses used CDC WONDER-linked NLDAS temperature data for 1999-2011, while supplementary descriptive analyses used independently retrieved NLDAS temperature estimates for 2012-2023. Temperature-mortality associations were evaluated using Spearman rank correlations, quasi-Poisson regression models, and distributed lag nonlinear models (DLNMs).

RESULTS: From 1999 to 2023, 628,937 CKD deaths occurred, with national AAMR increasing steadily. Mortality rates were consistently higher in men and nonmetropolitan areas. AAPC rose fastest in the West and Midwest, though recent AAMR declines were noted in the Northeast and South. Winter mortality exceeded summer across regions. In the primary DLNM analysis, cold exposure at the region-specific 5th percentile was associated with higher cumulative CKD mortality risk, with risk ration (RR) ranging from 1.065 in the Northeast to 1.505 in the Midwest; the association reached statistical significance only in the Midwest (RR 1.505, 95% CI: 1.091-2.075), while hot-exposure estimates at the 95th percentile were generally imprecise and not statistically significant.

CONCLUSION: CKD mortality in the United States increased from 1999 to 2023 with marked geographic and demographic disparities. Cold air temperature was associated with higher short-term mortality risk.

PMID:42572783 | PMC:PMC13453418 | DOI:10.2147/IJNRD.S602592

Nat Sci Sleep. 2026 Aug 5;18:604964. doi: 10.2147/NSS.S604964. eCollection 2026.

ABSTRACT

PURPOSE: Post-chemotherapy insomnia is a prevalent complication among breast cancer patients. No relevant sham-controlled studies have employed polysomnography to objectively verify acupuncture treatment effects. This single-blind randomized controlled trial assessed the short-term therapeutic effect and safety of acupuncture for insomnia occurring after breast cancer chemotherapy.

PATIENTS AND METHODS: This single-center study recruited 76 patients diagnosed with stage I-III breast cancer. All participants completed chemotherapy treatment, fulfilled ICSD-3 chronic insomnia diagnostic standards, and conformed to the TCM syndrome of Yin deficiency with excessive fire. Subjects were allocated into acupuncture group and sham acupuncture group at a 1:1 ratio with sealed opaque envelope randomization. The research spanned 9 months, including 5 weeks of biweekly intervention with 10 treatment sessions, alongside follow-up visits conducted at one week and one month after treatment termination. Clinical assessments were carried out at baseline, treatment completion, 1-week and 1-month follow-up. The primary outcome was Insomnia Severity Index score. Secondary outcomes contained PSQI, polysomnographic parameters, BAI, BDI, BFI-C and TCMSRS. All 76 randomized participants (38 cases per group) were analyzed based on intention-to-treat approach via MMRM statistical model.

RESULTS: Baseline clinical features showed no statistical difference between two groups (all p > 0.05). Significant group-time interaction was detected in ISI assessment (F = 2.80, p = 0.047). The acupuncture group exhibited more favorable symptom improvement compared with sham group. Between-group mean differences reached -1.61 (95% CI: -2.71 to -0.50, p = 0.005) after treatment, -1.75 (95% CI: -3.15 to -0.35, p = 0.015) at 1-week follow-up, and -1.77 (95% CI: -3.22 to -0.32, p = 0.017) at 1-month follow-up. Remarkable group-time interaction was also observed in PSQI (F = 4.67, p = 0.005), with acupuncture group presenting better sleep improvement at post-treatment, with mean difference of -1.18 (95% CI: -2.01 to -0.36, p = 0.006). Statistically significant interactive results were obtained in BFI-C (F = 4.07, p = 0.010), and acupuncture brought obvious fatigue relief with mean difference of -1.95 (95% CI: -3.22 to -0.68, p = 0.003). TCMSRS also showed notable interaction effect (F = 5.85, p = 0.001), and intergroup difference stood at -1.47 (95% CI: -2.34 to -0.60, p = 0.001) at 1-month follow-up. BDI scores presented significant group-time interaction (F = 3.00, p = 0.039), yet no evident pairwise difference was found in post-hoc comparison. No interactive variation existed in BAI evaluation (F = 1.69, p = 0.176). Polysomnography results demonstrated distinct advantages of acupuncture intervention. Between-group comparisons showed the treatment group obtained elevated sleep efficiency by 10.54% (95% CI: 0.75 to 20.33, p = 0.036) and increased N3 sleep proportion by 8.26% (95% CI: 3.09 to 13.43, p = 0.003). Wake after sleep onset time decreased by 32.00 minutes (95% CI: -57.50 to -0.50, p = 0.046). No severe adverse events emerged throughout the study.

CONCLUSION: Acupuncture improved insomnia severity, sleep quality, PSG-measured sleep architecture (increased sleep efficiency and N3, reduced WASO), fatigue, and TCM pattern symptoms in breast cancer patients with post-chemotherapy insomnia and the Yin deficiency with excessive fire syndrome; however, the between-group difference for the primary outcome did not reach the minimal clinically important difference; therefore, a clinically meaningful advantage over sham cannot be concluded from the current data.

CLINICAL TRIAL REGISTRATION: China Clinical Trial Registry, https://www.chictr.org.cn/; registration number: ChiCTR2400082110.

PMID:42572762 | PMC:PMC13453411 | DOI:10.2147/NSS.S604964