Tag: pubmed

Soins Gerontol. 2026 Jul-Aug;31(180):10-14. doi: 10.1016/j.sger.2026.06.003. Epub 2026 Jul 20.

ABSTRACT

Residents of long-term care facilities for the elderly have complex medical needs. They are at particularly high risk of being admitted to the emergency room. However, some of these admissions could be prevented. Establishing a clear definition of what constitutes an avoidable admission for this population-and identifying the reasons behind it-allows us to focus our efforts on opportunities for improvement in the five areas listed below.

PMID:42542353 | DOI:10.1016/j.sger.2026.06.003

Enferm Infecc Microbiol Clin (Engl Ed). 2026 Aug-Sep;44(7):503215. doi: 10.1016/j.eimce.2026.503215.

ABSTRACT

INTRODUCTION: Quantitative hepatitis B surface antigen (qHBsAg) is increasingly recognized as a key biomarker for chronic hepatitis B (CHB) management. This study aimed to assess the adoption, practices, and barriers to qHBsAg testing in Spanish clinical microbiology laboratories.

METHODS: A cross-sectional survey was distributed through the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) Viral Hepatitis Study Group (GEHEP). Clinical microbiology laboratory professionals across Spain were invited to complete an anonymous online questionnaire. The survey collected information on qHBsAg implementation, technical practices, barriers, and patient-related data. Descriptive statistics were applied.

RESULTS: Of 118 laboratories invited, 91 responded (77.1%); only 37.4% performed qHBsAg. Among non-performing centers, 86% did not refer samples, mainly due to perceived low clinical demand (57.1%), plus lack of equipment/resources. Implementation correlated with hospital size (p=0.041): 0% (<200 beds), 23.3% (200-500), 44.9% (500-1000), 62.5% (≥1000). Among performing labs, 57.6% quantified after a positive qualitative test, 27.3% on request, and 15.2% as initial screening. Proactive reporting was 69.7%, and 81.8% diluted samples above limits. In the last year, 40.7% of results were <100IU/mL and 27.1% >3000IU/mL; over five years (≈14,500 tests), 29.5% >3000IU/mL and 27.3% <100IU/mL, supporting the clinical relevance of these thresholds.

CONCLUSIONS: qHBsAg testing is not uniformly implemented across Spanish clinical microbiology laboratories and workflows and reporting practices are heterogeneous. Given the descriptive design and potential selection bias, these results should be interpreted as a baseline assessment to inform harmonization efforts and future evaluations linking testing availability to clinical decision-making.

PMID:42542350 | DOI:10.1016/j.eimce.2026.503215

Aerosp Med Hum Perform. 2026 Aug;97(8):618-626. doi: 10.3357/AMHP.6799.2026.

ABSTRACT

INTRODUCTION: The objective of this study was to establish a quantitative relationship between the occurrence of certain auditory impairments in Chinese military pilots and their flight hours. The investigation will determine whether the prevalence of left-ear vulnerability necessitates the implementation of cockpit noise control measures.

METHODS: Cross-sectional pure-tone audiometry (0.125-8 kHz) was performed in 155 active-duty aviators with an average time of 2241 h in 2024. Hearing loss (HL) was defined as pure tone average (4, 6, 8 kHz) ≥25 dB. Asymmetry was tested with paired t-tests.

RESULTS: Prevalence of high-frequency HL rate was 14.2% unilateral and 12.9% bilateral. Aircraft type correlated with threshold differences at 0.125, 2, and 6 kHz in the left ear and at 8 kHz in the right ear. Flight hours showed strong associations with elevated thresholds at 4, 6, and 8 kHz in both ears. A two-way analysis of variance indicated no significant interaction between flight hours and aircraft type on hearing thresholds. An asymmetry existed between the two ears, with left-ear thresholds exceeding the right by 2.9 ± 0.73 dB at 0.25-4 kHz.

DISCUSSION: This study found that age and flight time were statistically significant risk factors for noise-induced HL in military pilots. Early detection strategies are of critical importance for hearing protection. The consistent inferiority of the left ear indicates the necessity of optimizing active noise reduction for the left helmet cup. Hao M, Zheng X, Chen D, Ma X, Yu W, Liu L, Bai Y. A cross-sectional audiometric analysis of noise-induced hearing loss in military aviators. Aerosp Med Hum Perform. 2026; 97(8):618-626.

PMID:42542331 | DOI:10.3357/AMHP.6799.2026

Neurotrauma Rep. 2026 Jul 10;7:2689288X261463039. doi: 10.1177/2689288X261463039. eCollection 2026 Jan-Dec.

ABSTRACT

Females of reproductive age with concussion often report greater symptom severity and duration than age-matched males; the mechanisms underlying female symptomology remain unclear. This study investigated the association between hormone profiles and time to return to learn/work (RTL/W) following concussion. A secondary aim was to explore differences in symptom severity and salivary miR-27a-5p/miR-30a-3p expression between hormone profile groups. Based on an a priori power calculation, 36 females aged 28.8 ± 7.5 (17-44 years) presenting to an emergency department within 72 h of a confirmed concussion were recruited. Participants were classified into three hormone profile groups: n = 20 natural menstrual cycle (NMC); n = 8 progestin-only hormonal contraception (PROG); and n = 8 oral contraception (Oral Contraceptive Pill; OCP). Saliva samples were collected for measurement of miR-27a-5p/miR-30a-3p, and participants completed weekly online surveys reporting symptom scores until achieving RTL/W. The mean initial symptom score was 47.0 ± 23.7 (8-100), and mean time to RTL/W was 27.3 ± 33.1 (2-179 days). Cox hazard regression revealed a statistically significant association of hormone profile with time to RTL/W. PROG (hazard ratio [HR]: 2.5, 95% confidence interval [CI]: 1.0-6.1, p = 0.048) and OCP (HR: 2.7, 95% CI: 1.1-6.4, p = 0.027) were significantly associated with increased likelihood of RTL/W compared with NMC. Initial symptom score was not significantly associated with time to RTL/W (p = 0.628). Exploratory analysis showed no statistically significant mean differences between groups for initial symptom score [F_{(2, 33)} = 1.755, p = 0.189]. Fourteen saliva samples provided complete miR-27a-5p/miR-30a-3p data; mean miR-27a-5p/miR-30a-3p was 0.84 ± 0.06 (0.75-0.92). No statistically significant mean differences in miR-27/miR-30 expression were observed between hormone profile groups (F 2, 11 = 0.519, p = 0.609). Females using PROG or OCP were between 1.0 and 6.7 times more likely to achieve RTL/W than NMC at any given time. Hormone profile, but not initial symptom score, was predictive of time to RTL/W. Salivary miR-27a-5p/miR-30a-3p may be a useful biomarker in females with concussion and warrants further research.

PMID:42539337 | PMC:PMC13422596 | DOI:10.1177/2689288X261463039

Womens Health Rep (New Rochelle). 2026 Jul 1;7:26884844261465278. doi: 10.1177/26884844261465278. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: Although atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in men and women, there are sex differences in its prevalence and burden. There is limited time to address preventive counseling during in-person office visits. We propose an innovative health care delivery strategy with telehealth group counseling to improve care for women with ASCVD.

METHODS: After institutional review board approval, physicians screened our cardiology practice, and eligible patients were contacted. Women of ≥18 years of age were included, and 13 consented. Group counseling was performed via Zoom in one to five sessions over 12 weeks. Each 60-minute session discussed a secondary prevention topic. Surveys were administered before and after each session. Effectiveness was assessed using unpaired t-tests and qualitative feedback.

RESULTS: The average participant age was 64.5 years. 69.2% of patients were White, while 30.8% were non-White. Hypertension and hyperlipidemia were present in 53.8% and 100% of participants, respectively. 53.8% had Medicare, 7.7% had Medicaid, and 38.5% had commercial insurance. Sessions averaged 7 participants per session, with an average attendance of 2.7 sessions per person. Pre- and postintervention comparisons showed improvement in ease of receiving answers to questions, feeling rushed, and understanding of cardiac problems, though results did not reach statistical significance. Feedback noted satisfaction with format, quality of information, and accessible communication of topics.

CONCLUSION: Telemedicine group health counseling enhanced patient understanding of cardiac problems. However, significance was limited by size. Telemedicine provides an opportunity to optimize preventive care, highlighting the need for larger studies and correlation with clinical outcomes.

PMID:42539330 | PMC:PMC13421926 | DOI:10.1177/26884844261465278

Palliat Med Rep. 2026 Jul 12;7:26892820261463086. doi: 10.1177/26892820261463086. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: We sought to analyze the effect of a palliative care intervention on quality of life (QoL) in patients with fibrotic interstitial lung disease (fILD).

DESIGN: This was a prospective observational study including 14 patients with fILD treated with a bundle of care provided by multidisciplinary specialists in pain and palliative care, a psychologist, physical therapists, and a nutritionist, with all patients initiating 10 mg of morphine sulfate. Measurements at baseline, 30 days, and 90 days included cough, dyspnea, pain, tiredness, nausea, depression, anxiety, sleepiness, appetite, and difficulty sleeping. QoL was recorded using the modified St. George’s Respiratory Questionnaire (SGRQ-1). Change over time in each endpoint was analyzed.

RESULTS: Baseline assessment reflected an impaired QoL (median SGRQ-1, 91 points). All symptom scores improved at 90 days, with a statistically significant and clinically meaningful 20-point decrease in the SGRQ-1 (p = 0.001).

CONCLUSION: Palliative care intervention improves symptom and QoL in fILD.

PMID:42539329 | PMC:PMC13422728 | DOI:10.1177/26892820261463086

Neurotrauma Rep. 2026 Jul 22;7:2689288X261469045. doi: 10.1177/2689288X261469045. eCollection 2026 Jan-Dec.

ABSTRACT

No pharmacologic agent has demonstrated long-term neurological recovery following acute traumatic spinal cord injury (ATSCI). Thus, consideration of alternative outcome indicators is reasonable. A new and novel outcome variable, time to recovery, is introduced and compared to long-term recovery, examining nine variables for a two-grade improvement (Marked Recovery [MR]). The updated historical US FDA IND SYGEN ATSCI database (n = 760 patients) was used, as it is unique in having sufficient neurological examinations (4, 8, 16, 26, and 52 weeks) to allow the analysis. The time to MR was defined as the geometric mean between the time to first MR and the preceding examination with no MR. The SYGEN group exhibited the maximum fractional MR disparity at 8 weeks (p = 0.0248), coinciding with the discontinuation of the SYGEN study drug treatment. In the model fit analysis using long-term MR outcomes (26-52 weeks), significant variables were ASIA Injury Score (AIS) baseline grade (p < 0.0001), cervical versus thoracic injury (p = 0.0334), and direct admission versus transfer to spinal cord injury center (p = 0.0269). In the model fit analysis using time to MR, significant variables were AIS baseline grade (p < 0.0001), SYGEN versus placebo (p = 0.0227), age <30 years old (p = 0.0248), and early surgery ≤72 h (p = 0.0350). For time to MR, the combined effects of SYGEN and early surgery were additive, with a total decrease of 40.87 days (p = 0.0041) compared with placebo and late surgery. The time to MR is a new and novel metric for evaluating differences in recovery, as demonstrated by finding significant statistical relationships in several variables. The mechanism of action of a shortening of time to MR between groups after ATSCI is an augmentation of the body’s inherent neurological healing process. Clinically, this results in shorter rehabilitation time.

PMID:42539301 | PMC:PMC13422613 | DOI:10.1177/2689288X261469045

bioRxiv [Preprint]. 2026 Jul 21:2026.07.16.738889. doi: 10.64898/2026.07.16.738889.

ABSTRACT

BACKGROUND: Ductal carcinoma in situ (DCIS) is a noninvasive breast lesion with variable risk of progression to invasive breast cancer (IBC). Current transcription and cell marker investigations suggest ECM decreases in later events but are limited in details of ECM proteomic composition, including post-translational modifications. We investigated whether the extracellular matrix (ECM) proteome alters with later breast events of DCIS or IBC.

METHODS: ECM-targeted mass spectrometry imaging and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were applied to ten tissue microarrays from the Resource of Archival Human Breast Tissue cohort (RAHBT). Primary DCIS specimens (n=136) were analyzed in relation to later events of DCIS (n=40) or IBC(n=30), with a mean follow-up of 192.1 months 95% CI [179.1,205.1]. Statistical modeling, survival analyses, and exploratory machine learning approaches were used to identify ECM peptide signatures associated with later events.

RESULTS: Distinct ECM peptide profiles were associated with later events of DCIS or IBC. Fifteen peptides derived from fibrillar collagens (COL1A1, COL1A2, COL3A1) and elastin, showed significantly reduced abundance in patients who developed IBC. Lower expression of specific collagen peptides associated with overall 19.9% 95% CI [17.92, 21.81] decreased disease-free survival for IBC. Lower expression of these peptides was significantly associated with reduced disease-free survival (age-adjusted hazard ratio [HR] = 2.45, 95% CI: 2.33-2.57; P < 0.05). Patient-matched samples of primary DCIS, later DCIS, and later invasive breast cancer further demonstrated reduction in ECM peptide detection. Exploratory predictive modeling from patient-matched samples achieved high performance (AUROC >0.98, accuracy >93%) in distinguishing primary from later events. Following prior work in the RAHBT cohort, reduction of certain collagen peptides was also observed in primary DCIS samples from higher risk patient groups.

CONCLUSIONS: ECM proteomic remodeling, particularly decreases of specific collagen domains, is strongly associated with later events of DCIS and IBC. These findings highlight ECM proteome as a critical regulator of breast cancer emergence with potential as a prognosticator of risk stratification to guide clinical management of DCIS.

PMID:42539300 | PMC:PMC13420415 | DOI:10.64898/2026.07.16.738889

Neurotrauma Rep. 2026 Apr 30;7:2689288X261446234. doi: 10.1177/2689288X261446234. eCollection 2026 Jan-Dec.

ABSTRACT

The International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) in traumatic brain injury (TBI) only includes data from hospital admission as predictors. Including updated physiological data after hospital admission would likely improve prognostic ability above the IMPACT model alone. We sought to evaluate differences in the daily trajectory of clinical metabolic panels (e.g., glucose, sodium, platelets, hemoglobin) for the first 7 days post-severe TBI (sTBI). This is a prospective cohort study of patients with sTBI with Glasgow Coma Scale (GCS) ≤8. Intake GCS was conducted by a neurosurgeon or neurosurgical resident to ensure GCS at presentation was related to the brain injury and not other factors. We compared daily metabolic panel trajectories between survivors to 6 months and nonsurvivors to 6 months using ordinal mixed-effects models. Dichotomizing trajectories as “high” or “low” was set to 4+ of the first 7 days postinjury to represent a majority of the first postinjury week. We then examined the added prognostic value of these trajectories compared with the IMPACT-extended model for 6-month mortality. Included patients (n = 572) were 40.4 ± 17.1 years of age, 79.4% male, and 38.4% had died by 6 months postinjury. The likelihood ratio tests (LRT) comparing the ordinal trajectories of sodium and platelets were statistically significant after false discovery correction (sodium: likelihood ratio = 51.0; adj. p < 0.001; platelets: likelihood ratio = 16.0; adj. p = 0.003), indicating that the overall trajectory over 7 days differs between groups. The LRT comparing the trajectories of glucose and hemoglobin were not statistically significant (p = 0.21-0.98). The models identified a divergence in platelet values on days 6 and 7, where nonsurvivors to 6 months had lower odds (OR = 0.27-0.41) of being in higher platelet categories than survivors to 6 months on those days. The IMPACT-only model had an area under the curve (AUC) for 6-month mortality of 0.85 and a Hosmer-Lemeshow p value = 0.68. The IMPACT-biomarker trajectory model had an AUC for 6-month mortality of 0.87 (DeLong’s test p value of 0.005) and a Hosmer-Lemeshow p value of 0.16. Trajectory of metabolic panel labs in the first week postinjury yields meaningful improvements in prognostic ability for the individual patient.

PMID:42539293 | PMC:PMC13422602 | DOI:10.1177/2689288X261446234

Womens Health Rep (New Rochelle). 2026 Jul 3;7:26884844261465224. doi: 10.1177/26884844261465224. eCollection 2026 Jan-Dec.

ABSTRACT

BACKGROUND: This study examined the associations between specific adverse childhood experiences (ACEs) and hysterectomy among adult women and assesses the dose-response relationship with cumulative ACE exposure. It extends prior work by evaluating individual ACE categories while adjusting for gynecological cancers, diabetes, obesity, and selected health-risk behaviors.

METHODS: Data were drawn from the 2020, 2021, 2022, and 2024 Behavioral Risk Factor Surveillance System (BRFSS), including 119,165 women across 26 U.S. areas with available data on ACEs and hysterectomy. Multivariable logistic regression estimated associations between ACEs and hysterectomy, adjusting for covariates.

RESULTS: Approximately 24.2% of participants reported a history of hysterectomy, and 65.8% reported at least one ACE. All but one of the 11 ACE items were independently associated with higher odds of hysterectomy after adjustment for age, race/ethnicity, marital status, education, annual income, survey year, area, gynecological cancers, diabetes, obesity, physical activity, smoking, and alcohol consumption. The strongest associations were observed for childhood sexual abuse, including unwanted sexual touching and forced sexual intercourse. The ACE distribution was 34.2% for 0 ACEs, 33.5% for 1-2 ACEs, 15.5% for 3-4 ACEs, and 16.9% for ≥5 ACEs. The odds of hysterectomy increased in a dose-response manner with higher ACE exposure, becoming statistically significant at ≥3 ACEs after adjustment. The association between ACE count and hysterectomy did not differ significantly by age (p = 0.2464).

CONCLUSIONS: ACEs, particularly childhood sexual abuse, were associated with higher odds of hysterectomy. These associations persisted after adjustment for demographic, clinical, and behavioral factors, suggesting long-term gynecological consequences of early-life adversity.

PMID:42539250 | PMC:PMC13420389 | DOI:10.1177/26884844261465224