Tag: pubmed

BMC Nurs. 2026 May 8. doi: 10.1186/s12912-026-04728-3. Online ahead of print.

ABSTRACT

BACKGROUND: Operating room nurses (ORNs) are at high risk for compassion fatigue (CF), which significantly impairs individuals’ well-being, undermines the stability of the nursing workforce, and jeopardizes patients’ safety. The study aimed to analyze the prevalence and symptom characteristics of CF among ORNs, construct and compare predictive models using machine learning, and determine the relative contribution of distinct features to the models.

METHODS: This is a multi-center cross-sectional study. The questionnaires used in the study included a sociodemographic questionnaire, the Professional Quality of Life Scale (ProQoL), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Pittsburgh Sleep Quality Index (PSQI). LASSO regression was used to select critical variables, and predictive models such as decision tree, logistic regression, random forest, SVM, and XGBoost were constructed and compared. SHapley Additive exPlanation (SHAP) were drawn to show the contribution of each feature to the models. SPSS version 26.0 and R software version 4.4.0 were used for statistical analyses.

RESULTS: In this study, a total of 1024 ORNs from 20 cities across China were recruited. According to ProQoL, 326 (31.8%) reported severe CF, 311 (30.4%) moderate CF, and the remaining 387 (37.8%) no or mild CF. Among the three dimensions, the incidence of secondary traumatic stress was most common (95.4%), followed by low compassion satisfaction (61.3%) and burnout (35.0%). In five machine learning-based predictive models, the RF model stood out with the highest AUC at 0.851 (95%CI: 0.795-0.907) in testing set. Following closely, the XGBoost model showed favorable efficacy with the AUC at 0.824 (95%CI: 0.769-0.879) in testing set, outperforming the remaining algorithms. The results of the two SHAP plots (RF and XGBoost) were consistent: depression, anxiety, self-mental health training, sleep quality, and length of service emerged as the five most significant contributors to the models.

CONCLUSION: This study identified severe CF among ORNs, and the most serious symptom was secondary traumatic stress. The RF model exhibited the best performance in identifying high-level CF among ORNs, and SHAP improved the interpretability of the model. The findings of this study could help medical managers and researchers better understand CF and provide timely interventions for ORNs.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:42104411 | DOI:10.1186/s12912-026-04728-3

Health Qual Life Outcomes. 2026 May 8. doi: 10.1186/s12955-026-02549-1. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to perform a cultural adaptation of the Child Health Utility 9D (CHU-9D), a health-related quality of life (HRQoL) instrument, into Traditional Chinese specifically for use in Hong Kong, and evaluating its psychometric properties among a sample of local adolescents.

METHODS: A cross-sectional survey design was employed for data collection. Adolescents aged 13 to 17 years were recruited from diverse local community settings to complete a self-administered questionnaire that included the adapted CHU-9D and relevant demographic items. Psychometric evaluations encompassed assessments of ceiling and floor effects, factorial validity through confirmatory factor analysis, convergent validity via correlation analysis, and known-group validity to examine differences across predefined risk groups.

RESULTS: A total of 627 adolescents successfully completed the survey, providing a robust dataset for analysis. The unidimensionality of the CHU-9D was confirmed, demonstrating excellent model fit indices. A ceiling effect was observed, with 27% of participants reporting full health status on the CHU-9D descriptive system, indicating potential limitations in capturing variations at the upper end of health. Convergent validity was supported by significant correlations between CHU-9D and conceptually relevant items and subscales from another HRQoL instrument. The instrument exhibited strong known-group validity, effectively discriminating HRQoL differences across various risk groups with statistically significant results.

CONCLUSION: The culturally adapted Traditional Chinese version of the CHU-9D demonstrates sound psychometric properties in Hong Kong adolescents, supporting it as a valid tool for measuring and valuing HRQoL in this population and cultural context.

PMID:42104409 | DOI:10.1186/s12955-026-02549-1

Parasit Vectors. 2026 May 9. doi: 10.1186/s13071-026-07376-3. Online ahead of print.

ABSTRACT

BACKGROUND: Cutaneous leishmaniasis (CL) is a neglected tropical skin disease. In Ethiopia, CL is a public health concern; about 29 million people are at risk, with an estimated incidence of up to 50,000 new cases annually. In endemic communities, access to diagnosis, treatment, and prevention is crucial but often limited. Understanding the prevalence and access to care, as well as exploring its relationship to agroecological factors, is crucial to inform control strategies.

OBJECTIVES: The aim of this work is to estimate the pooled prevalence, access to care service facilities, and spatial distribution and relationship to agroecological factors.

METHODS: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) framework. The metafor and metadata packages from R Studio were used to obtain pooled prevalence and odds ratio using a random-effects model with a double arcsine transformation. The CL endemicity at the woreda level was overlaid with the locations of CL treatment centers and agroecological zones using ArcGIS.

RESULTS: The pooled prevalence of CL was 6.75% (95% confidence interval (CI) 3.37-11.17). Sociodemographic factors (male gender, rural living) and environmental factors (muddy walls, outdoor sleeping, proximity to rocky habitats, and hyrax populations) were significantly associated with CL. CL cases were reported from 85 woredas with a broad spatial distribution; a higher proportion of them were from the Weyna Dega, Dega, and Upper Kola agroecological zones. Access to care is generally poor, with service centers for CL often centralized at the zone level.

CONCLUSIONS: The estimated pooled prevalence likely underrepresents the true burden of CL. The identified risk factors are more related to rural livelihoods and living conditions, and most of the endemic woredas are in the most productive agrarian agroecological zones, which underlines the health and socioeconomic significance of CL in Ethiopia. Thus, decentralizing healthcare services and improving surveillance for CL are crucial steps in breaking the vicious cycle of poverty.

PMID:42104399 | DOI:10.1186/s13071-026-07376-3

BMC Nurs. 2026 May 8. doi: 10.1186/s12912-026-04736-3. Online ahead of print.

ABSTRACT

BACKGROUND: Compassion fatigue is an occupational hazard among nurses that arises from prolonged exposure to patient suffering and to work-related stress. In resource-limited healthcare settings, such as public district hospitals in Bangladesh, high patient loads, staffing shortages, and limited organizational support may increase nurses’ vulnerability to CF. However, evidence from district-level hospitals in low- and middle-income countries is limited.

METHODS: A cross-sectional study was conducted between January and June 2025 among nurses working at a 250-bedded district hospital in Bangladesh. Using stratified random sampling, 380 nurses from the medicine, surgery, pediatrics, and intensive care/emergency units were recruited. Compassion fatigue was assessed using the Professional Quality of Life Scale (ProQOL-5). Descriptive statistics were used to estimate the prevalence. Chi-square tests and multivariate logistic regression were performed to identify the demographic and occupational predictors of high compassion fatigue.

RESULTS: Overall, 44.2% of nurses reported high compassion fatigue, and 37.6% reported moderate levels. The highest prevalence was observed among nurses working in intensive care/emergency units (52%). Multivariate analysis identified lack of organizational support (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.6-4.1), more than 10 years of service (OR 2.3, 95% CI 1.4-3.8), and intensive care/emergency assignment (OR 1.9, 95% CI 1.2-2.9) as significant predictors of high compassion fatigue scores. Subscale analyses indicated higher burnout and secondary traumatic stress among nurses working in high-acuity departments.

CONCLUSIONS: Compassion fatigue is highly prevalent among nurses in a resource-limited district hospital in Bangladesh, particularly among those working in high-acuity settings and those reporting insufficient organizational support. These findings highlight the need for targeted organizational strategies, including improved support systems, workload management, and mental health interventions, to promote nurses’ well-being and sustain quality patient care in similar healthcare contexts.

PMID:42104394 | DOI:10.1186/s12912-026-04736-3

Phys Med. 2026 May 7;146:105812. doi: 10.1016/j.ejmp.2026.105812. Online ahead of print.

ABSTRACT

PURPOSE: To develop an automated class-solution treatment-planning workflow for biologically guided dose-painting based on combined FDG- and FMISO-PET in head and neck cancer (HNC), and to compare its performance with manual planning.

MATERIAL AND METHODS: The workflow incorporating image-processing and treatment planning via a class-solution template was implemented in RayStation-10B-R and applied to patients imaged with FDG- and FMISO-PET/CT. The workflow converted FMISO- and FDG-PET uptake into oxygen partial pressure and clonogenic cell-density distributions, respectively. Accordingly, simultaneous integrated boost plans aiming at 95% tumour control probability (TCP) and using a dose-painting-by-contours approach for TV1, TV2, the GTV, and the hypoxic target volume (HTV), were created. For nine patients, automated and manual plans were compared using equivalent dose in 2-Gy fractions (EQD2)-based target metrics, organ-at-risk (OAR) doses, plan-complexity parameters, planning time, TCP and normal tissue complication probability (NTCP).

RESULTS: The automated workflow generated plans achieving target coverage; however not all plans met mandatory OAR constraints. In the nine-patient comparison, no statistically significant differences were found in OAR metrics or TCP/NTCP, except for the right parotid EQD2_mean, which favoured manual plans. Target results were mixed: template plans performed better for inner volumes, whereas manual plans showed higher EQD2_mean in the TV1-TV2 and HTV. Manual planning required ∼ 1 h, whereas automated planning required ∼ 5 h with no user interaction.

CONCLUSIONS: A scripting-based, biologically guided class-solution for dose-painting in HNC is feasible and achieves plan quality and radiobiological outcomes comparable to manual planning, providing a platform for standardised and adaptive radiotherapy workflows.

PMID:42102428 | DOI:10.1016/j.ejmp.2026.105812

Cortex. 2026 Apr 23;201:10-39. doi: 10.1016/j.cortex.2026.04.006. Online ahead of print.

ABSTRACT

The contralateral delay activity (CDA) is a widely used electrophysiological marker of visual working memory (VWM), yet recent work has questioned whether typical sample sizes in CDA studies are sufficient to robustly detect set size effects and brain-behavior correlations. As part of the #EEGManyLabs initiative, the present multi-site replication study aimed to rigorously test replicability of the key findings of Vogel and Machizawa (2004)using a large sample of 304 participants across 10 laboratories and a preregistered analysis plan. We replicated the expected contralateral-ipsilateral asymmetry and observed increases in CDA amplitude from set size 2 to 4 and from set size 2 to 6. In contrast, the hypothesized positive correlation between the CDA increase from set size 2 to 4 and individual VWM capacity was not replicated in the preregistered meta-analytic correlation. Across different pipelines and statistical analyses, the meta-analytic correlation estimate was small (r = .15) and substantially attenuated relative to the original effect size in Vogel and Machizawa (2004)study (r = .78). To contextualize these findings, we applied a funnel-plot diagnostic combining published effects with the #EEGManyLabs data, indicating small-study inflation and publication bias. Taken together, our results indicate that reports of strong correlations between CDA amplitude and VWM capacity may have been overestimated, in part because statistically significant findings were selectively reported. Our results highlight the importance of open science practices, including well-powered, preregistered studies with transparent data and analysis pipelines, in order to characterize the magnitude and robustness of individual-difference associations in psychophysiology.

PMID:42102425 | DOI:10.1016/j.cortex.2026.04.006

J Neurosurg Spine. 2026 May 8:1-8. doi: 10.3171/2025.10.SPINE241562. Online ahead of print.

ABSTRACT

OBJECTIVE: Interventional pain management physicians (IPMPs) and spine surgeons are allies in treating spinal disorders. In addition to medical management, IPMPs can perform procedures such as epidural injections, rhizotomies, or kyphoplasties to bring relief to patients. However, some IPMPs perform procedures traditionally performed by spine surgeons, such as minimally invasive spine surgery, neural decompression, and spinal fusion. The line between spine procedures performed by spine surgeons and interventional pain management procedures performed by IPMPs has blurred. This study aimed to determine the incidence of IPMPs performing interventional spinal procedures traditionally performed by spine surgeons.

METHODS: IPMPs were identified through the American Society of Interventional Pain Physicians (ASIPP) DoctorFinder database. Each physician’s Scopus profile was evaluated to determine academic productivity. Personal physician websites were queried to determine whether they offered minimally invasive or open spinal procedures. Potential associations and differences among IPMPs performing interventional spinal procedures were analyzed using descriptive statistics, independent-sample t-tests, and chi-square analyses.

RESULTS: After neurosurgeons and orthopedic surgeons were removed from the initial list of 325 registered healthcare providers, 269 providers were included in the analysis (mean [SD] age, 56.3 [9.6] years). Physician degrees included MD (n = 237) and DO (n = 32). Some physicians held an additional degree (MS [n = 4], PhD [n = 4], and unspecified [n = 38]). Of the 269 healthcare providers, 130 had Scopus research profiles (mean publications, 24.2; mean h-index, 6.0; mean citations, 925.6). Seventy-four physicians (27.5%) performed interventional spinal procedures: 35 (13.0%) performed minimally invasive lumbar decompression (mild procedure), 33 (12.3%) performed Superion or Vertiflex interspinous spacer insertion, 18 (6.7%) performed spinal arthrodesis or fusion, 26 (9.7%) performed discectomies, 11 (4.1%) performed Minuteman interspinous-interlaminar fusion, 1 (0.4%) performed disc replacement, and 14 (5.2%) performed other unspecified decompressive spinal procedures. There were no significant differences in age (p = 0.62), publication number (p = 0.19), h-index (p = 0.53), citation count (p = 0.44), and fellowship incidence (p = 0.19) between IPMPs who performed interventional spine procedures and those who did not. No significant associations were found between sex (p = 0.19), medical degree (MD: p = 0.07, DO: p = 0.11), or number of publications (p = 0.38) and whether interventional spinal procedures were performed.

CONCLUSIONS: The incidence of invasive spine procedures performed by IPMPs is high. Future studies must analyze patient-reported outcomes, and differences in the training for traditional spine surgery interventions performed by surgeons and interventional pain spinal procedures performed by IPMPs must be better defined.

PMID:42102410 | DOI:10.3171/2025.10.SPINE241562

J Neurosurg Spine. 2026 May 8:1-10. doi: 10.3171/2025.12.SPINE25166. Online ahead of print.

ABSTRACT

OBJECTIVE: Traumatic central cord syndrome (TCCS) is the most common incomplete spinal cord injury, yet the optimal management strategy remains controversial, particularly for older adults who often present with worse outcomes. The authors aimed to determine whether surgical intervention confers different benefits across age groups, focusing on 1-year functional and neurological recovery.

METHODS: The authors retrospectively analyzed 890 patients with TCCS from the multi-institutional Spinal Cord Injury Model Systems (SCIMS) Database between 2006 and 2021. TCCS was defined as an American Spinal Injury Association (ASIA) Impairment Scale grade C or D cervical injury and at least a 5-point discrepancy favoring lower extremity motor score over upper extremity motor score. Missing admission ASIA data were addressed via validated random forest imputation. The authors compared surgical versus nonsurgical groups using full optimal matching to reduce confounding, achieving balanced cohorts (698 patients in the surgical group vs 179 in the nonsurgical group). The authors then applied a causal forest algorithm to detect heterogeneous treatment effects and used segmented regression to identify age-related inflection points. The primary outcome was the Physical Function Composite Score (PFCS) (range 0-300), which captures physical independence, mobility, and occupational function. Sensitivity analyses further evaluated neurological recovery on the basis of ASIA motor scores and stricter criteria for TCCS identification after the exclusion of imputed data.

RESULTS: Across the matched cohort, surgery was associated with mean PFCS improvement of 6.6 points (95% CI -4.5 to 17.8), which did not reach statistical significance. However, subgroup analysis revealed that age was the strongest effect modifier of surgical benefit (relative importance 42.8%, p < 0.001). Segmented regression identified an inflection at approximately 64 years of age. Patients older than 64 years demonstrated a significant improvement of 34.7 points (95% CI 12.2-57.2), whereas younger individuals showed no statistically significant surgical benefit (-4.1 points, 95% CI -16.8 to 8.6). All sensitivity analyses were consistent with the results of our primary findings.

CONCLUSIONS: The authors’ findings suggest that the effectiveness of surgical intervention for TCCS may be influenced by age, with adults older than 64 years experiencing differentially greater functional and neurological benefit. These results may inform patient-specific treatment decisions and clinical guidelines. Prospective research is needed to validate these observations, elucidate underlying mechanisms, and guide evidence-based TCCS management.

PMID:42102409 | DOI:10.3171/2025.12.SPINE25166

J Neurosurg Pediatr. 2026 May 8:1-14. doi: 10.3171/2025.12.PEDS25331. Online ahead of print.

ABSTRACT

OBJECTIVE: Tethered cord syndrome (TCS) is heterogeneous, and a filum with lipomatous tissue can present in multiple patterns. The aim of this study was to determine whether filum characteristics are associated with particular symptomatology.

METHODS: A descriptive cross-sectional retrospective study was conducted over 2 years (2023-2025) at a single institution. Patients with TCS and filum with lipomatous tissue were evaluated using 24 TCS-related variables and 10 filum-related variables. Statistical methods included using the chi-square test and ANOVA for frequency differences, multivariable logistic regression with odds ratios, and statistical weight analysis.

RESULTS: Sixty-eight patients (35 male, mean age 9.01 years) were included in the analysis. A significantly younger age at diagnosis was seen in patients with proximal lipomatous tissue (mean 4.67 ± 3.90 years), lipomatous tissue > 3 cm (mean 7.07 ± 3.17 years), conus medullaris below L2 (mean 6.43 ± 3.74 years), and syrinx (mean 5.42 ± 3.03 years). Vesicourethral dyssynergia was more frequent in patients with filar lipoma versus lipomatous filum (58.3% vs 26.8%), those with complete conus versus caudal regression (63.6% vs 26.3%), and those with vertebral dysraphism versus without (44.4% vs 18.8%). In the multivariate analysis, smaller total lipomatous tissue was associated with less overactive bladder (OR 0.04 and 0.044). Conus medullaris below L2 (OR 31.5) and proximal lipomatous tissue (OR 18.1) were related to underactive bladder. Proximal lipomatous tissue (OR 26.2) and low-lying conus (OR 9.8) were associated with high-risk neurogenic bladder. Lipomatous filum < 1 cm was associated with idiopathic scoliosis (OR 3.25). Distal lipomatous tissue interactions such as filum ≤ roots with distal lipomatous tissue (OR 121.20), dural adhesion with distal lipomatous tissue (OR 43.90), and yin-yang signal pattern with distal lipomatous tissue (OR 19.40) were associated with foot deformities. The yin-yang signal intensity pattern on MRI and vertebral dysraphism (OR 5.8) increased the likelihood of moderate-to-severe sciatic pain.

CONCLUSIONS: Filum patterns were associated with features of TCS, supporting classification of the filum based on lipomatous tissue.

PMID:42102406 | DOI:10.3171/2025.12.PEDS25331

J Neurophysiol. 2026 May 8. doi: 10.1152/jn.00572.2025. Online ahead of print.

ABSTRACT

An exercise-induced increase in cerebral blood flow (CBF) serves as a candidate mechanism underlying a postexercise executive function (EF) benefit. Here, healthy young adults completed four 20-min interventions of active and passive (via mechanical flywheel) cycle ergometry at pedal cadences of 55 and 85 revolutions per minute (rpm). Active and passive exercise were used because each modality increases CBF – albeit via distinct mechanisms – and different pedal cadences were used because an increase in passive exercise cadence is thought to increase CBF. Hence, we sought to determine whether the magnitude of a passive exercise increase in CBF influences the magnitude of a postexercise EF benefit. Transcranial Doppler ultrasound measured middle cerebral artery velocity (MCAv) to estimate CBF and the antisaccade task completed at pre- and post-intervention was used to assess changes in EF. Results showed that active exercise produced a larger baseline to steady state increase in MCAv than passive exercise, and both modalities showed an increase in MCAv with increasing pedal cadence. Moreover, both modalities produced a post-intervention reduction in antisaccade reaction times (RTs); however, frequentist and Bayesian statistics indicated the RT benefit did not vary with exercise modality nor pedal cadence, and the RT reduction was not correlated with active or passive exercise-mediated changes in CBF changes. Accordingly, active and passive exercise provide a comparable immediate postexercise EF benefit, and an exercise-mediated change in CBF does not provide a unitary account for the benefit.

PMID:42102395 | DOI:10.1152/jn.00572.2025