Tag: pubmed

J Clin Monit Comput. 2026 Aug 29. doi: 10.1007/s10877-026-01486-0. Online ahead of print.

ABSTRACT

The purpose was to describe patient monitor alarm burden in a cardiac surgical intensive care unit and explore whether routinely available patient characteristics are associated with alarm frequency, type, and duration. Secondary objectives were to assess indirect signs of alarm fatigue and compare alarm rates with two previous studies using identical monitors in different clinical units. We retrospectively collected patient-monitor alarm data and patient characteristics over four consecutive weeks in the cardiac surgical intensive care unit of Helsinki University Hospital. The study population comprised 81 patients. Alarm data were analysed descriptively and modelled using negative-binomial regression. Patients produced 45,044 alarms, with a median alarm rate of 6.8 [4.8 to 10.8] alarms per patient per hour. Older age was associated with fewer alarms (IRR = 0.90, 95% CI 0.83 to 0.98, P < 0.05). ASA 5 classification was associated with more low- ETCO2 alarms (IRR = 9.05, 95% CI 3.37 to 27.88, P < 0.05). Smoking was associated with more low invasive blood pressure alarms (IRR = 1.94, 95% CI 1.05 to 3.90, P < 0.05). Alarm load was high, clinician interaction with alarms was limited, and many alarms were momentary. Alarm rates were similar across three clinically different units using identical monitors. Routinely available patient characteristics were associated with selected alarm patterns, but the findings are hypothesis-generating. Similar alarm rates across different units suggest that default settings may not reflect unit- or patient-specific monitoring needs. The results suggest low positive predictive value and possible alarm fatigue, supporting unit-level alarm review that incorporates patient-level alarm patterns and signal-quality improvement, with prospective validation before patient-specific alarm-management changes.

PMID:42667580 | DOI:10.1007/s10877-026-01486-0

Obes Surg. 2026 Aug 29. doi: 10.1007/s11695-026-08918-5. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether documented preoperative mental health (MH) conditions were associated with early postoperative psychiatric events and metabolic outcomes after primary metabolic-bariatric surgery (MBS).

METHODS: A retrospective cohort study of adults who underwent primary MBS at a tertiary UK bariatric centre between April 2021 and March 2024 was conducted. Preoperative MH conditions and postoperative outcomes were identified via review of electronic health records. Comparisons between groups were analysed using Fisher’s exact test and regression models adjusted for age, sex, preoperative BMI, and surgery type.

RESULTS: Among 482 patients, 217 (45.0%) had at least one documented preoperative MH condition. During 2-year follow-up, suicidal ideation was recorded in 6/217 (2.8%) in the MH group versus 1/265 (0.4%) in the non-MH group and self-harm (including suicide attempt) in 5/217 (2.3%) versus 1/265 (0.4%), respectively. Preoperative MH conditions were associated with higher odds of postoperative suicidal ideation (OR 6.75, 95% CI 1.09-41.86; p = 0.0420), while the association with self-harm was directionally similar but not statistically significant (OR 5.10, 95% CI 0.80-32.72; p = 0.0860). Weight-loss and metabolic outcomes did not differ materially by baseline MH status.

CONCLUSIONS: In this single-centre cohort, patients with documented preoperative MH conditions achieved comparable metabolic benefit after surgery but had higher recorded early suicidality-related events. Although causality cannot be inferred, these findings support structured postoperative MH follow-up.

PMID:42667565 | DOI:10.1007/s11695-026-08918-5

HEC Forum. 2026 Aug 29. doi: 10.1007/s10730-026-09609-5. Online ahead of print.

ABSTRACT

Patients with serious illness hospitalized in the pediatric setting can receive support from Pediatric Palliative Care (PPC) and Ethics Consultation (EC). However, empirical data on dual PPC-EC involvement in pediatrics is limited. Therefore, we characterized ethical issues, contextual features, palliative care domains, and consultation timing for inpatients with dual PPC-EC involvement. We reviewed 135 EC from 2016 to 2023 at an academic children’s hospital to identify cases with PPC involvement. PPC notes, demographics, and admission, consultation and discharge dates were extracted from the medical record. Ethical issues, contextual features, and palliative domains were deductively coded using established frameworks. Analyses used descriptive statistics and compared EC-first, PPC-first, and combined cases. Sixty-two inpatients had dual PPC-EC involvement: of these, 33 (53%) were infants < 1 year, 52 (84%) in the Intensive Care Unit (ICU), and 21 (34%) were discharged alive. The primary ethical issue was Beneficence/Best-Interest Concerns (14; 23%), and the most common contextual feature was Communication Dispute/Conflict (25; 40%). Most PPC consultations addressed Communication of Treatment Goals/Plans (47; 76%). PPC was consulted first in 50 patients (81%). Median EC-to-PPC interval was six days, while PPC-to-EC was fifteen days. Dual PPC-EC involvement represents a distinct patient population, primarily infants in the ICU with high mortality, facing medical and ethical challenges with communication support from both services. PPC was usually consulted first, possibly from more familiarity of PPC and PPC’s role in proactive ethics. Later EC involvement indicates an area for further study for when EC is most beneficial in collaborative care.

PMID:42667532 | DOI:10.1007/s10730-026-09609-5

Qual Life Res. 2026 Aug 29;35(10):269. doi: 10.1007/s11136-026-04361-2.

ABSTRACT

PURPOSE: To develop and validate mapping algorithms that estimate EQ-5D health state utility values (HSUVs) from two diabetes-specific patient-reported outcome measures, the Problem Areas in Diabetes (PAID) and Diabetes Distress Scale (DDS), to support economic evaluations when EQ-5D data are unavailable.

METHODS: Data from 662 adults with diabetes in Germany included PAID-20, DDS-17, and EQ-5D-5L responses. Direct mapping models predicted EQ-5D utilities using Tobit and censored least absolute deviation (CLAD) regressions, while indirect mapping models used proportional and partial proportional odds regressions to predict EQ-5D dimensions. Six model specifications were tested, incorporating PAID and DDS items with covariates (age, sex, diabetes type), with selection of predictors guided by item correlations and backward stepwise procedure to retain statistically relevant variables. Model performance was assessed using a selection of performance metrics including root mean square error (RMSE) and mean absolute error (MAE). Internal validation of the models employed 10-fold cross-validation.

RESULTS: The strongest-performing direct mapping models consisted of a model with a selection of PAID-20 items and covariates (Tobit regression; RMSE: 0.159; MAE: 0.117) and a model that incorporated PAID-20, DDS-17, and covariates (CLAD regression; RMSE: 0.146; MAE: 0.09), and a model based on DDS-17 items and covariates (Tobit regression; RMSE: 0.164; MAE: 0.121). Indirect mapping models demonstrated higher prediction errors overall (RMSE: 0.187-0.21; MAE: 0.124-0.141) than their counterparts.

CONCLUSIONS: We present novel algorithms that enable estimation of EQ-5D utilities from PAID and DDS scores, facilitating economic evaluation in diabetes. Preferred models demonstrated predictive accuracy comparable to published mapping studies.

PMID:42667522 | DOI:10.1007/s11136-026-04361-2

Curr Psychiatry Rep. 2026 Aug 29;28(1):66. doi: 10.1007/s11920-026-01714-z.

ABSTRACT

PURPOSE OF REVIEW: Growing evidence suggests that adverse childhood experiences (ACE) increase the risk for reproductive mood disorders (RMD), i.e. premenstrual syndrome, premenstrual dysphoric disorder, postpartum and perimenopausal depression, and might be associated with symptom severity in these disorders. However, evidence for the specific impact of ACE subtypes remains scarce. This review investigates whether certain ACE subtypes are more prevalent among women with RMDs, whether women exposed to ACE have a higher risk to develop such disorders and if the degree of exposure is associated with the symptom severity.

RECENT FINDINGS: We conducted a literature search across electronic data bases and reviewed a final selection of 16 studies that differentiated between ACE subtypes.

RESULTS: The findings indicate that emotional abuse tends to be the subtype most clearly associated with these disorders. While emotional abuse was consistently linked to adverse outcomes, the complexities of ACE co-occurrence and the potential differing impacts of other subtypes such as different forms of abuse and neglect are underscored. The review highlights the variability in study populations, methodologies, and assessment tools. The interplay between hormonal fluctuations and emotional dysregulation is discussed as potential mediators in the development of RMDs, suggesting that emotional abuse may exacerbate sensitivity to hormonal changes. Future research is called for to clarify subtype-specific mechanisms, age-related effects, and genetic predispositions to hormonal sensitivity following ACE. Overall, this article contributes to the understanding of how ACE subtypes intersect with the etiology of RMDs in women, emphasizing the need for tailored approaches in research and clinical interventions.

PMID:42667511 | DOI:10.1007/s11920-026-01714-z

Qual Life Res. 2026 Aug 29;35(10):274. doi: 10.1007/s11136-026-04379-6.

ABSTRACT

PURPOSE: We examined whether cognitive function statistically accounted for associations between stroke and quality of life (QOL).

METHODS: A cross-sectional survey included adults aged ≥ 60 years in Segamat, Malaysia. Cognition was assessed using the Identification and Intervention for Dementia in Elderly Africans instrument, and QOL was assessed using the WHOQOL-BREF. Stroke survivors were matched 1:3 with non-stroke participants by propensity scores based on age, sex, and education. Stroke status was the exposure, cognition the proposed statistical mediator, and four QOL domains, overall QOL, and overall health the outcomes. Models were adjusted for sociodemographic and vascular factors, accounted for matching and multiple testing, and p < 0.05 was considered statistically significant.

RESULTS: Among 596 participants, 149 reported stroke; the mean age was 70.36 years (SD 6.81); 41.6% female; 58.4% male. An indirect association between stroke and physical QOL via cognition was observed (β = -0.67, 95% CI – 1.30 to – 0.18; BH-adjusted p = 0.018). A residual correlation of ρ = 0.16 between cognition and physical-QOL models would attenuate this association to the null. The indirect association did not differ by sex (index β = -0.49, 95% bootstrap CI – 1.48 to 0.18; p = 0.164). Item-level physical-QOL analysis identified an indirect association with greater pain interference through lower cognition (β = -0.051, 95% CI – 0.113 to – 0.009; BH-adjusted p = 0.028).

CONCLUSION: Reduced cognition partly accounted for associations of stroke with reduced physical QOL and greater pain interference. Findings were sensitive to modest unmeasured confounding but require confirmation from longitudinal studies.

PMID:42667483 | DOI:10.1007/s11136-026-04379-6

J Robot Surg. 2026 Aug 29;20(1):902. doi: 10.1007/s11701-026-03776-w.

ABSTRACT

Robotic-assisted total hip arthroplasty (ra-THA) has received increasing academic attention. This bibliometric study aimed to identify the 100 most-cited English-language articles related to ra-THA indexed in the Web of Science Core Collection (WOSCC) and to characterize their citation patterns, evidence levels, research themes, and collaboration networks. The WOSCC was searched for English-language articles and reviews related to ra-THA. The retrieved records were ranked by total citation count, screened according to predefined eligibility criteria, and the 100 most-cited articles were included for analysis. Data on publication year, citation count, journal, authorship, country, institution, keywords, document type, and level of evidence were extracted. Citation density, year-normalized citation indicators, Mann-Kendall trend analysis, Spearman correlation analysis, and bibliometric visualizations were used to evaluate citation patterns, temporal trends, research themes, and collaboration networks. The 100 included articles were published between 2008 and 2025. Publication output and citation frequency showed increasing tendencies within this highly cited cohort. The United States contributed the largest number of articles and citations, followed by China and the United Kingdom. The Journal of Arthroplasty, Clinical Orthopaedics and Related Research, and The Bone & Joint Journal were major publication sources. Keyword analysis indicated that surgical accuracy, navigation, clinical outcomes, and procedure-related risks were frequent research themes. No statistically significant association was observed between level of evidence and citation count within the selected cohort. Among the 100 most-cited English-language WOSCC-indexed articles retrieved using the specified search strategy, ra-THA research showed increasing citation attention over time. The most frequently represented themes were surgical accuracy, navigation, clinical outcomes, and procedure-related risks. These findings provide a bibliometric overview of the influential citation landscape and thematic development of ra-THA research.

PMID:42667481 | DOI:10.1007/s11701-026-03776-w

Brain Imaging Behav. 2026 Aug 29;20(5):125. doi: 10.1007/s11682-026-01186-y.

ABSTRACT

Developmental stuttering is a neurodevelopmental speech disorder characterized by speech disfluency and variable persistence into adolescence. While white matter and functional connectivity abnormalities have been widely reported, the topological organization of gray matter (GM) networks in affected children remains unclear. This study investigated GM morphological network alterations in children with persistent developmental stuttering (CWS) and examined their relationships with stuttering severity. Thirty-three CWS and thirty age- and sex-matched healthy controls underwent T1-weighted MRI. Individual GM morphological networks were constructed using Kullback-Leibler divergence of voxel-based morphometry data across 90 brain regions. Graph-theoretical analyses quantified global and local topological properties, and network-based statistics (NBS) were used to identify alterations in morphological connectivity. Both groups exhibited small-world topology; however, CWS showed significantly higher clustering coefficient(Cp), local efficiency (E_loc), and modularity (Q) (P < 0.05), indicating a hyper-segregated GM organization. NBS revealed reduced morphological connectivity within a subnetwork encompassing the default mode, sensorimotor, basal ganglia-thalamic, and visual regions. Greater network segregation (Cp, E_loc, Q) was positively correlated with stuttering severity, whereas reduced subnetwork connectivity was negatively correlated with stuttering severity (FDR-corrected P < 0.05). These findings suggest that children with persistent stuttering exhibit excessive local specialization and decreased interregional integration, reflecting a network-level imbalance that may underlie the persistence and severity of stuttering. Altered GM network topology may represent a potential neurostructural biomarker for early identification and targeted intervention.

PMID:42667480 | DOI:10.1007/s11682-026-01186-y

J Comput Aided Mol Des. 2026 Aug 29;40(1):219. doi: 10.1007/s10822-026-00929-9.

ABSTRACT

Molecular docking is one of the most established methods in computational drug discovery, due to its balance of speed and accuracy. However, the accuracy of docking results depends on a number of different parameters, and systematic reference data for comparisons to more advanced methods for binding affinity prediction are still scarce. This study assesses the impact of key parameters on the accuracy of binding free energy estimates from docking, using nine benchmark systems with 278 high-affinity ligands. Using the Molecular Operating Environment (MOE), we evaluated combinations of three receptor structures (two crystal structures, one AlphaFold2 model), two force fields, two scoring functions, two receptor flexibility settings, and two statistical evaluation schemes. The performance of the docking approaches is measured based on the squared Pearson’s correlation coefficient (R²), the root mean square error (RMSE) with respect to the experimental binding affinities, as well as the mean signed error (MSE) and Kendall’s tau for individual targets and the full dataset. The results show that the scoring function and the protein structure are the most important factors for binding affinity accuracy in rigid docking with the MOE software. Amber10:EHT and MMFF94x force fields had the same average R_mean² value, but Amber10:EHT had a lower average RMSE_mean. AlphaFold2 protein models yielded lower binding affinity accuracy and higher errors compared to experimental crystal structures, although induced fit docking improved results. Using the original benchmark, we also compared several docking programs. DOCK6 and MOE performed best, with mean R² values of about 0.49 and 0.40, respectively. The remaining docking programs did not outperform a molecular weight regression baseline. For a subset of four targets (CDK2, JNK1, P38, TYK2) evaluated in previous work, the performance of the optimized DOCK6 and MOE protocols produced correlation coefficients similar to those reported for certain MM/PBSA, FMO, and Boltz2 implementations evaluated on the same target subset. This raises questions about potential dataset biases, the structural preparation, or the implementation of those methods. Docking therefore should be considered as an important and computationally inexpensive reference baseline for binding affinity prediction.

PMID:42667474 | DOI:10.1007/s10822-026-00929-9

Sleep Breath. 2026 Aug 29;30(5):245. doi: 10.1007/s11325-026-03789-7.

ABSTRACT

OBJECTIVE: While the high prevalence and health impacts of sleep in hemodialysis patients are well-documented, there has been limited exploration of multidimensional sleep health in Chinese cohorts. This study aimed to investigate the association between multidimensional sleep health and fatigue among patients undergoing hemodialysis in China.

METHODS: A cross-sectional study was conducted in patients undergoing hemodialysis at a hospital in Nanjing, China. The Fatigue Scale-14 and RU_SATED 2.0 were administered to measure fatigue and sleep health, respectively. Sociodemographic and lifestyle characteristics and disease-related laboratory indices were concurrently collected. Multivariable linear regression was employed to examine the relationship between multidimensional sleep health and fatigue, with an interaction term included to assess the moderating effects of age.

RESULTS: A total of 249 patients (69.1% male, 56.5 years old on average) completed the survey. Participants scored 7.15 ± 3.27 and 7.53 ± 2.57 on fatigue and sleep health, respectively. After adjusting for sociodemographic and lifestyle characteristics and disease-related indices, multidimensional sleep health demonstrated a statistically significant association with fatigue (B = – 0.36, 95% CI: -0.50, – 0.21, P < 0.001), physical fatigue (B = – 0.22, 95% CI: -0.34, – 0.11, P < 0.001) and mental fatigue (B = – 0.13, 95% CI: -0.20, – 0.06, P < 0.001). Moreover, age exhibited a significant moderation effect on the relationship between sleep health and fatigue (B = 0.02, 95%CI: 0.01, 0.03, P = 0.017) and mental fatigue (B = 0.01, 95%CI: 0.00, 0.01, P < 0.001).

CONCLUSIONS: Better composite sleep health was associated with lower levels of fatigue, highlighting the potential clinical relevance of sleep health in relation to fatigue.

PMID:42667469 | DOI:10.1007/s11325-026-03789-7