Tag: pubmed

Int J Nurs Stud. 2026 Jun 15;182:105620. doi: 10.1016/j.ijnurstu.2026.105620. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative thirst in the post-anesthesia care unit is a common symptom that can have adverse physiological and psychological effects. Although various cooling and moisturizing interventions have been shown to alleviate postoperative thirst, their relative effectiveness remains unclear.

OBJECTIVE: To compare the effects of cooling and moisturizing interventions on postoperative thirst relief in patients in the post-anesthesia care unit.

DESIGN: A systematic review and network meta-analysis.

INFORMATION SOURCES: PubMed, Web of Science, CINAHL, EMBASE, and Scopus were systematically searched from inception to January 16, 2026.

METHODS: Two reviewers independently conducted study screening, quality assessment, and data extraction. A random-effects network meta-analysis was undertaken to compare the relative effects of oral cooling and moisturizing interventions on postoperative thirst.

RESULTS: A total of eleven RCTs involving 3098 participants and eight oral interventions were included. The network meta-analysis showed that, compared with the nil by mouth (NPO) control group (i.e., no oral intake or oral intervention), the interventions showing the largest reductions in postoperative thirst intensity were menthol ice (MD = -4.84; 95% CI, -6.42 to -3.26), followed by ice (MD = -4.17; 95% CI, -5.82 to -2.51) and water (MD = -4.07; 95% CI, -5.36 to -2.78). In contrast, citric acid spray, aromatic solution spray, water spray, wet gauze, and wet cotton swab did not show statistically significant reductions in postoperative thirst intensity.

CONCLUSIONS: Menthol ice, ice, and water emerged as the most promising options for reducing postoperative thirst intensity. However, the current evidence remains limited, and further high-quality studies with standardized protocols are needed to confirm these findings.

REGISTRATION: https://www.crd.york.ac.uk/prospero/ CRD42024610113, registered 4/11/2024.

PMID:42365725 | DOI:10.1016/j.ijnurstu.2026.105620

Gen Hosp Psychiatry. 2026 Jun 22;101:159-165. doi: 10.1016/j.genhosppsych.2026.06.005. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the comparative efficacy and safety of quetiapine versus haloperidol for delirium treatment in hospitalized adults.

DATA SOURCES: Systematic search in MEDLINE (via PubMed), Embase, and Cochrane Central Register of Controlled Trials from inception through February 19, 2026.

STUDY SELECTION: RCTs directly comparing quetiapine and haloperidol for delirium treatment in adult inpatients.

DATA EXTRACTION: Two reviewers independently extracted data and assessed risk of bias using the Cochrane RoB 2 tool. Primary outcome was change in delirium severity (DRS-R-98). Secondary outcomes included ICU and hospital length of stay (LOS), mortality, sleep duration, and extrapyramidal symptoms (EPS).

DATA SYNTHESIS: Four RCTs comprising 292 patients were included. No significant difference was found in delirium severity reduction (MD, -1.99; 95% CI, -4.70 to 0.72; p = 0.15; I² = 73.6%), ICU LOS (MD, -0.84 days; 95% CI, -2.30 to 0.62), hospital LOS (MD, -0.06 days; 95% CI, -2.32 to 2.19), or mortality (RR, 0.68; 95% CI, 0.35 to 1.34). Quetiapine showed non-significant trends toward fewer EPS (RR, 0.14; 95% CI, 0.02 to 1.06) and increased sleep duration (MD, 1.59 h; 95% CI, -0.45 to 3.63). TSA indicated the required information size was not reached.

CONCLUSIONS: Quetiapine and haloperidol show no statistically significant differences in efficacy or safety for delirium management. GRADE certainty was very low for all outcomes, and TSA confirmed the evidence is inconclusive due to sparse data and imprecision. The absence of statistical significance should not be interpreted as equivalence. Selection should be individualized based on individual patient risk profiles and adverse-effect susceptibility until adequately powered trials are available.

PMID:42365709 | DOI:10.1016/j.genhosppsych.2026.06.005

Comput Methods Programs Biomed. 2026 Jun 9;285:109508. doi: 10.1016/j.cmpb.2026.109508. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Early identification of carotid atherosclerosis (CAS) is critical for preventing cardio-cerebrovascular diseases. Mainstream screening methods (e.g. ultrasound, CTA) are operator-dependent and high cost. This study aimed to propose a novel non-contact facial imaging photoplethysmography (iPPG) approach for CAS risk assessment.

METHODS: A total of 95 middle-aged and elderly participants were enrolled, with synchronous facial iPPG signals and carotid/lower-extremity ultrasound data collected. A deep learning-based Period-aware Autoencoder (PA-AE) with bidirectional cross-modal attention was developed to reconstruct high-fidelity iPPG signals with periodic peak constraint and full-face reference signal fusion for robust noise suppression. Facial hemodynamic heatmaps were generated via signal-to-spatial mapping, interquartile range-based outlier removal, and spatial proximity repair. We analyzed the association between heatmap patterns and atherosclerosis using Pearson chi-square tests and Odds Ratios (OR).

RESULTS: The PA-AE outperformed traditional wavelet and LSTM-AE methods in signal periodicity preservation and noise reduction. The Type 3 facial iPPG heatmap (characterized by ≤ 20% red area distributed in the facial periphery) was significantly associated with carotid atherosclerosis (P=0.048), whereas no association was observed for lower extremity atherosclerosis (P=0.674). After adjusting for age, BMI, and hypertension in multivariable logistic regression, heatmap Type 3 still showed a positive trend with CAS (adjusted OR=2.29, 95%CI: 0.56-9.41), and robust statistical analyses including stratified analyses (age < 65 and non-hypertensive subgroups), ridge regression, and continuous red-area ratio quantification consistently confirmed this significant association.

CONCLUSIONS: Facial iPPG heatmaps, enhanced by the PA-AE, demonstrate significant potential as a non-invasive tool for identifying CAS risk, offering a promising avenue for accessible community healthcare screening.

PMID:42365708 | DOI:10.1016/j.cmpb.2026.109508

Midwifery. 2026 Jun 23;161:104901. doi: 10.1016/j.midw.2026.104901. Online ahead of print.

ABSTRACT

PROBLEM: Many midwives experience emotional distress, low morale and job dissatisfaction, and are making the decision to leave the profession as a result.

BACKGROUND: There is limited evidence on how resilience shapes midwives’ career experiences, choices, and trajectories, particularly during early exposure to workplace stress and dissatisfaction.

AIM: To conduct a UK based study to explore midwives’ and student midwives’ perceptions, attitudes, and experiences of the influence of resilience in relation to any decisions they make about their careers.

METHODS: A constructivist grounded theory design was used to explore the influence of resilience on midwives’ and student midwives’ career-related decisions. Thirty-six participants recruited from three NHS Trusts in the North of England took part. A purposive and theoretical sampling approach using individual semi-structured interviews between 2019 and 2021 was adopted.

FINDINGS: The influence of resilience in relation to any career-related decisions participants’ made, resulted in the substantive grounded theory (GT), ‘Time to change’. ‘Time to Change’ developed comprising four core concepts: ‘Fitting in’, ‘Being valued,’ ‘Feeling in control’ and ‘Getting the balance right’. Central to the theory was the importance of confidence, experience, and perceived support on fluctuating levels of resilience, and midwives’ subsequent ability to make career-related decisions.

DISCUSSION: Participants’ perceived resilience, alongside a number of other influences, has a significant role in midwives’ career-related decisions.

CONCLUSION: The findings provide novel insight into the influence of resilience in midwifery that has relevance for the profession and the potential to inform midwifery policy, practice, and education for the future.

PMID:42365685 | DOI:10.1016/j.midw.2026.104901

Midwifery. 2026 Jun 19;161:104900. doi: 10.1016/j.midw.2026.104900. Online ahead of print.

ABSTRACT

BACKGROUND: Low paternal self-efficacy in essential newborn care has been associated with reduced father involvement in caregiving and weaker father-infant attachment.

OBJECTIVE: This study aimed to evaluate the effects of essential newborn care training, delivered through different instructional methods, on paternal self-efficacy and father-infant attachment.

DESIGN: A prospective, three-arm randomized controlled trial with a pre-test-post-test design was conducted using a 1:1:1 allocation ratio.

PARTICIPANTS: First-time fathers residing in [xxx Province] were recruited through the obstetrics and gynecology department during the early postnatal (neonatal) period and randomly assigned to one of three groups (n = 25 per group): web-based, face-to-face, or control.

METHODS: This randomized controlled trial included three groups: web-based, face-to-face, and control. Fathers in the intervention groups received essential newborn care training either via an online platform or through in-person sessions, while the control group received routine care. Data were collected at baseline and after the intervention using validated measurement tools assessing paternal self-efficacy and father-infant attachment. Descriptive statistics summarized the data: categorical variables were presented as frequencies and percentages, while continuous variables were expressed as means, standard deviations, and minimum-maximum values. Group homogeneity was evaluated using the Pearson chi-square test or Fisher’s exact test for categorical variables, and one-way ANOVA for continuous variables. The Shapiro-Wilk test assessed normality. Intergroup differences were analyzed using one-way ANOVA. Intragroup changes over time were assessed with repeated measures one-way ANOVA. A two-way repeated measures ANOVA assessed the interaction effects of group and time.

RESULTS: The mean age of the fathers ranged from 30.45 ± 4.80 to 32.04 ± 5.02 years across the groups, with no significant difference between groups (p > 0.05). Data from 73 participants were included in the final analysis. Following the newborn care training, paternal self-efficacy, and father-infant attachment levels significantly increased in both the web-based (p < 0.05) and face-to-face (p < 0.05) intervention groups compared to the control group. Paternal self-efficacy levels in the web-based group were significantly higher than in both the face-to-face and control groups.

CONCLUSION: Web-based newborn care education programs appear to be effective in increasing paternal self-efficacy and father-infant bonding.

PMID:42365684 | DOI:10.1016/j.midw.2026.104900

Environ Int. 2026 Jun 25;214:110383. doi: 10.1016/j.envint.2026.110383. Online ahead of print.

ABSTRACT

BACKGROUND: Gestational exposure to environmental chemicals contributes to adverse neurodevelopmental outcomes in children. We aim to evaluate the joint associations between gestational chemical biomarkers and behavioral functioning in preschool-aged children.

METHODS: We pooled data from 695 mother-child dyads (female, n = 353; male, n = 342) enrolled in the Health Outcomes and Measures of the Environment (HOME) & Maternal-Infant Research on Environmental Chemicals (MIREC) Studies. We assessed concentrations of 29 EDC biomarkers at gestation and assessed the child’s behavior and executive functioning at 3 years using the Behavioral Assessment System for Children (BASC-2) and Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Higher scores on these instruments indicate adverse behavioral outcomes. We applied quantile g-computation to estimate joint associations, adjusting for covariates.

FINDINGS: Every quartile increase in chemical biomarker mixture was associated with a 0.84-point higher behavior symptom index score (95% CI: -0.89, 2.57), 1.38-point higher externalizing behavior score (95% CI: -0.65, 3.41), and 1.34-point higher internalizing behavior score (95%CI: -0.97, 3.65); these associations were imprecise with confidence intervals including null. Although the interaction by child sex remained null (p = 0.69) for internalizing behavior scores, gestational chemical mixture was associated with higher internalizing behavior scores in males (Ψ: 3.59; 95%CI: 0.42, 6.75), but not in females. We found evidence of sex-specific trends for working memory scores (interaction p = 0.02), with an imprecise positive trend in males (Ψ: 3.04; 95%CI: -0.46, 6.55) and a negative trend in females.

INTERPRETATION: Gestational exposure to a mixture of environmental chemicals showed suggestive but imprecise associations with internalizing problems and poorer working memory among preschool-age males, but not females. Associations were more pronounced in the HOME Study, which includes participants with higher concentrations for many chemical biomarkers, than in MIREC, raising the possibility that pooled estimates reflect cohort-specific exposure contexts. Sex-specific patterns, particularly for working memory, need further investigation, and our findings should be interpreted cautiously given the imprecision of subgroup estimates.

PMID:42365676 | DOI:10.1016/j.envint.2026.110383

J Gastrointestin Liver Dis. 2026 Jun 27;35(2):181-188. doi: 10.15403/jgld-6740.

ABSTRACT

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) case reports provide rich longitudinal insights but have rarely been analyzed using quantitative text-mining approaches. This study applied unsupervised machine learning to PubMed-indexed IBD case reports to identify long-term thematic structures spanning 60 years and evaluate whether major historical milestones in IBD care can be reconstructed from biomedical texts.

METHODS: Case reports indexed under the keyword “inflammatory bowel disease” were retrieved from PubMed (1960-2025). Titles, key words, and abstracts were concatenated and preprocessed before TF-IDF vectorization. Non-negative matrix factorization (NMF) was applied to extract latent topics, followed by KMeans clustering using the optimal topic number selected by silhouette evaluation (2-15 topics). Cluster characteristics were summarized using report counts and term frequency-inverse document frequency (TF-IDF) statistics. Top discriminative key words were used to assign data-driven topic labels. All analyses were performed in Python 3.10.5 (PyCharm 2022.1.3) using pandas, numpy, scikit-learn, matplotlib, and seaborn.

RESULTS: A total of 18,458 case reports were analyzed. Across all time periods, two highly stable clusters consistently emerged, corresponding to Crohn’s disease and ulcerative colitis. Early decades (1960-1989) emphasized pathology and complication-focused descriptions. Reports from the 1990s showed increasing terminology related to diagnosis and emerging therapies. From 2000 onward, infliximab-related and treatment focused terms predominated, paralleling the rise of biology. After 2010, clusters reflected diversified therapeutic strategies, including attention to extraintestinal manifestations and biologic or small-molecule therapies.

CONCLUSIONS: Unsupervised machine learning successfully reconstructed important historical changes in IBD management, demonstrating that a large case report text corpus captures the evolution of clinical concepts and treatment paradigms over 60 years.

PMID:42365648 | DOI:10.15403/jgld-6740

J Gastrointestin Liver Dis. 2026 Jun 27;35(2):229-236. doi: 10.15403/jgld-6786.

ABSTRACT

BACKGROUND AND AIMS: Publications influence selection into competitive gastroenterology fellowships, yet drivers of research productivity among current trainees are not well characterized. We evaluated whether training stage, institutional pedigree, and degree pathway are associated with research output among United States of America gastroenterology fellows.

METHODS: We performed a cross-sectional study of fellows listed on publicly available rosters from Accreditation Council for Graduate Medical Education (ACGME)-accredited adult gastroenterology fellowship programs (October-November 2025). PubMed-indexed publications were identified and categorized by training stage (medical school, residency, fellowship) and gastroenterology (GI)-specificity. Group comparisons used Mann-Whitney U tests. Poisson generalized estimating equation models clustered by program estimated adjusted incidence rate ratios (IRRs) for total publication counts.

RESULTS: Among 776 fellows from 125 programs, PGY6 fellows had more GI-specific publications than PGY4 fellows (median 3 vs 2) and greater fellowship-period output. Training in top-ranked environments was associated with higher total and GI-specific publication counts, with the largest differences observed for top 20 fellowship environments. In adjusted analyses, top-ranked training affiliations remained independently associated with higher total publication output. Women had approximately 15% lower total publication output than men (adjusted IRR ≈0.85). International medical graduates had higher publication counts than non-IMGs, whereas U.S. DO graduates had lower counts.

CONCLUSIONS: Research productivity among United States of America gastroenterology fellows varies by training stage, training environment, and degree pathway, likely reflecting opportunity and infrastructure as well as individual aptitude.

PMID:42365644 | DOI:10.15403/jgld-6786

J Gastrointestin Liver Dis. 2026 Jun 27;35(2):222-228. doi: 10.15403/jgld-6794.

ABSTRACT

BACKGROUND AND AIMS: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) may have favorable hepatic effects, but long-term outcomes in cirrhosis are uncertain. We investigated the relationship between SGLT2i exposure and 5-year outcomes among adults with cirrhosis.

METHODS: We performed a retrospective cohort study in the TriNetX US Collaborative Network (March 2013- January 2025). Adults (≥18 years) with cirrhosis were classified as SGLT2i users (first exposure on/after cirrhosis diagnosis) or non-users (no SGLT2i exposure) and propensity score matched 1:1. Outcomes were assessed over 5 years beginning 1 day after index. Primary outcomes were all-cause mortality and hospitalization burden (inpatient encounters per patient). Secondary outcomes included hepatic decompensation complications and prespecified adverse events; tertiary outcomes were the most recent liver- and kidney-related laboratory values during follow-up.

RESULTS: After matching, 24,559 patients were included per cohort. SGLT2i use was associated with lower all-cause mortality (11.8% vs 26.0%; OR=0.381, 95%CI: 0.363-0.399; p<0.001) and fewer hospitalizations (mean 3.6±10.7 vs 5.4±13.4; p<0.001). Composite hepatic decompensation was less frequent (OR=0.617, 95%CI: 0.580-0.656; p<0.001), including lower odds of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome; hepatic encephalopathy did not differ. Acute kidney failure and urinary tract infection were less frequent, while diabetic ketoacidosis did not differ. Laboratory profiles favored SGLT2i use (lower aspartate aminotransferase and bilirubin, higher albumin, lower international normalized ratio, and improved renal indices).

CONCLUSIONS: In this matched real-world cohort, SGLT2i exposure after cirrhosis diagnosis was associated with an improved 5-year survival, fewer hospitalizations, and fewer decompensation events.

PMID:42365643 | DOI:10.15403/jgld-6794

J Gastrointestin Liver Dis. 2026 Jun 27;35(2):173-180. doi: 10.15403/jgld-7121.

ABSTRACT

BACKGROUND AND AIMS: Inflammatory bowel diseases (IBD), including Crohn’s disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U), are increasingly recognized across Eastern Europe, including Romania, where historical data indicated low incidence. Contemporary real-time epidemiological data for our country are scarce. This study evaluated the short-term frequency and epidemiological characteristics of IBD patients presenting to major Romanian gastroenterology centers.

METHODS: We conducted a prospective, cross-sectional observational study over a 14-day period in November 2024 across 18 university-affiliated tertiary gastroenterology clinical sites in Romania. All consecutive adult patients with confirmed IBD were enrolled using a centralized online platform. Demographics, disease type and phenotype, severity, and treatment were recorded and analyzed descriptively.

RESULTS: A total of 1,045 patients were registered: 52.4% CD, 46.9% UC, and 0.7% IBD-U. Geographical distribution revealed a statistically significant variation, with Crohn’s disease being more frequent in Southern Romania, while UC predominated in the Eastern and Central-western regions (p=0.0009). Most patients resided in urban areas, and the majority were in clinical remission at presentation. Phenotypic analysis revealed ileocolonic CD (L3) and left-sided/pancolitis UC (E2/E3) as most frequent. Severe disease history was more common in CD, and prior surgery was significantly higher in CD than UC. Smoking and appendectomy were more frequently associated with CD as previously reported. Therapeutic patterns reflected disease type: anti-TNF use predominated in CD, while other biologics and small molecules were more common in UC. Regional differences in therapy were observed, with southern centers showing higher use of novel therapies, likely reflecting a more mature IBD population, with a higher CD prevalence. Notably, the number of IBD diagnoses increased over time, correlating with Romania’s GDP growth (R² = 0.89, p < 0.001), suggesting that socioeconomic factors may influence disease recognition and diagnosis.

CONCLUSIONS: This study offers the most recent snapshot of IBD epidemiology in Romania, highlighting a transition toward medium-incidence patterns and growing clinical complexity. These findings provide evidence for the need to establish nationwide population-based surveillance systems and healthcare planning initiatives aimed at mitigating the rising burden of IBD.

PMID:42365638 | DOI:10.15403/jgld-7121