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PubMed2026

Multicancer Detection Tests for Population-Wide Screening of Asymptomatic Individuals: A Systematic Review.

PURPOSE: Multicancer detection (MCD) tests aim to detect different cancer types using a single test. However, evidence on their potential for screening asymptomatic populations remains limited. We consolidated evidence from prospective cohort studies evaluating blood-based MCD tests in primarily asymptomatic adults to contextualize upcoming randomized controlled trial results. MATERIALS AND METHODS: We updated and extended a prior review (to September 2023), conducting comprehensive Medline/Embase searches to February 1, 2026. Key outcomes included cancers detected and not detected by MCD tests, false-positive MCD tests, and diagnostic investigation pathways. Risk of bias (RoB) was assessed using a modified Quality Assessment of Diagnostic Accuracy Studies-2 tool. RESULTS: From 2,723 screened records (244 previously shortlisted to 2023, 2,479 records for 2023-2026), we included 18 articles (12 studies, nine MCD tests); of these, 11 articles had not appeared in prior reviews. Cancer detection rates varied widely between studies, for example, new MCD-test-detected invasive cancers diagnosed ≤12 months post-test ranging from 18.8 (95% CI, 11.0 to 30.1) to 43.8 (95% CI, 29.4 to 62.8) per 10,000 tested, with MCD-test-detected invasive stage I to II cancers ranging from 9.0 (95% CI, 4.2 to 17.2) to 21.0 (95% CI, 11.6 to 35.5) per 10,000 tested. False-positives exceeded MCD-test-detected cancers (eg, approximately 1.6-fold in PATHFINDER, 1.5-fold K-DETEK, 4.2-fold DETECT-A, 8.1-fold SeekInCare studies). Diagnostic investigation pathways were prespecified/suggested in four of eight interventional studies. Where reported, the median time to diagnostic resolution varied from <0.1 months to 4 months for MCD-test-detected cancers, with substantially higher 75th percentiles (3.1-7 months), and similar patterns were observed for false-positive MCD tests. No study was judged to have overall low RoB. CONCLUSION: Substantial heterogeneity in cancer yield metrics likely reflects differences in MCD technologies, diagnostic pathways, follow-up duration, and background standard-of-care screening. Long-term follow-up, randomized trials, fully-paired test comparisons, and implementation research are essential to determine the potential of MCD tests for population screening.

Journal Article↗

PubMed1977

Influence of excitability on the ventricular fibrillation threshold in dogs.

The influence of the excitability threshold on the ventricular fibrillation threshold was studied in dogs during myocardial ischemia and potassium and aprindine infusion. Interventions that influenced excitability threshold were associated with similar changes in ventricular fibrillation threshold although the percent change in both values differed. Although it is possible that the interventions studied caused parallel but independent changes in excitability threshold and ventricular fibrillation threshold, it is likely that the excitability threshold influences the ventricular fibrillation threshold. An increase in excitability threshold could result in an increase in ventricular fibrillation threshold in spite of an increase in the actual tendency of the heart to fibrillate spontaneously. Such discordance between the "electrical stability of the heart" and the ventricular fibrillation threshold was found during myocardial ischemia.

Animals↗

PubMed2026

Space to grieve and grow: A systematic review of psychosocial interventions for people newly diagnosed with multiple sclerosis.

OBJECTIVE: This systematic review synthesized evidence from intervention studies published over the past 25 years that aimed to improve coping and psychosocial well-being among individuals early in the multiple sclerosis (MS) disease course. The goal was to evaluate intervention characteristics, theoretical foundations, and psychosocial outcomes, and to identify gaps for future research. METHODS: Following PRISMA guidelines, a comprehensive search was conducted across PubMed, CINAHL, PsycINFO, and Web of Science (2000-2025). Eligible studies included quantitative or mixed-methods interventions that addressed coping or psychosocial well-being among adults newly diagnosed with MS. Data extraction and quality assessment were completed independently by multiple reviewers using the Joanna Briggs Institute Critical Appraisal Tools. RESULTS: Seven studies (n = 345) met inclusion criteria, representing cognitive-behavioral therapy, mindfulness, acceptance-based, and nurse- or peer-delivered interventions. The interval between diagnosis and intervention enrollment ranged from 14 days to >4 years, suggesting different phases of adjustment. All interventions produced significant short-term improvements in at least one psychosocial domain (e.g., anxiety, depression, stress, coping, or illness acceptance). However, sustained effects beyond 6-12 months were inconsistent. Common mechanisms across interventions included enhancing self-efficacy, stress management, and adaptive coping. CONCLUSIONS: The available evidence suggests that brief psychosocial interventions for adults in the early years after MS diagnosis are feasible and may provide short-term benefits for selected psychosocial outcomes. However, the evidence base remains limited, heterogeneous, and preliminary. Future studies should more clearly define diagnosis timing, use adequately powered designs and longer follow-up, and examine mechanisms of change.

Humans↗

PubMed2026

Effects of positive psychotherapy on anxiety and quality of life in chronic Urticaria.

INTRODUCTION: Individual, social, and economic consequences including anxiety and poor quality of life are recognised to result from allergic disorders. A positive, realistic viewpoint that emphasises balance and the body is provided by positive psychotherapy. The purpose of this randomized, controlled intervention study was to investigate how counseling based on positive psychotherapy affected anxiety and quality of life. METHODS: Patients in the intervention group had eight sessions of individual counseling based on positive psychotherapy in addition to standard treatment. Other than standard care, the members of the control group received no interventions. The Dermatological Quality of Life Scale (DYQS), Urticaria Activity Score, State-Trait Anxiety Scale, and Personal Information Form were employed as data collection instruments. The study had 66 patients with Chronic Spontaneous Urticaria (CSU), 32 of whom were in the intervention group and 34 of whom were in the control group. RESULTS: The mean scores of the intervention group decreased significantly from pre-test to post-test for urticaria activity (UAS7: 28.22 ± 11.17 to 4.22 ± 4.30, p < 0.001), dermatological quality of life (DLQI: 38.63 ± 7.61 to 5.09 ± 6.19, p < 0.001), situational anxiety (61.63 ± 7.73 to 26.03 ± 4.71, p < 0.001), and trait anxiety (61.56 ± 7.90 to 25.13 ± 3.66, p < 0.001). Furthermore, post-test scores between the intervention and control groups showed statistically significant differences in favor of the intervention group in all primary outcomes, including the total UAS7 score (intervention: 4.22 ± 4.30 vs. control: 21.56 ± 11.81, p < 0.001) and the total dermatological quality of life score (intervention:5.09 ± 6.19 vs. control:30.85 ± 10.17, p < 0.001). CONCLUSIONS: Counseling based on positive psychotherapy has been shown to improve people's quality of life while lowering anxiety and urticaria symptoms. This study demonstrates how these treatments can enhance the quality of life for patients with chronic urticaria by lowering their anxiety and illness symptoms.

Humans↗

PubMed2025

A randomized controlled trial to unveil the influence of an exercise intervention on brain integrity and gut microbiome structure in individuals with HIV.

OBJECTIVE: Exercise intervention programs enhance physical fitness, cognition, neuroimaging measures, and alter the structure of the gut microbiome in individuals without HIV. However, interventional studies exploring the effects of exercise in persons with HIV (PWH) have not included neuroimaging or gut microbiome analyses. DESIGN: A randomized controlled trial conducted at Washington University in St. Louis, MO, USA. METHODS: 65 PWH (aged ≥40 years, self-reported sedentary lifestyle) were randomly assigned to a 6-month cardiorespiratory and resistance training (EXS) or stretching control (SIS) intervention in a 2 : 1 ratio. Longitudinal change in cognition, cerebral blood flow (CBF), physical and cardiorespiratory fitness, and gut microbiome diversity and composition were examined among participants ( n  = 62) who completed any portion of the intervention (ClinicalTrials.gov: NCT02663934). RESULTS: Better fitness and better cognitive performance were associated with greater phylogenetic diversity in gut microbiome composition at baseline. Longitudinal findings indicated slight but significant improvements in psychomotor speed and executive function, reductions in body mass index, improvements in physical fitness, and increased gut microbiome diversity. These changes were observed regardless of assigned intervention group. There were no observed changes in CBF for either group. CONCLUSIONS: These findings highlight physical fitness as a modifiable factor in PWH that may improve cognitive performance and change gut microbiome composition. Both interventions were beneficial, suggesting light stretching exercise or study participation alone could have been sufficient to introduce positive cognitive shifts in previously sedentary PWH. Longer interventions with more participants are needed to identify changes in neuroimaging metrics related to brain integrity.

Humans↗

PubMed2026

Effects of apple phenolics on the human metabolome: modulation of key metabolic pathways.

Apples are widely recognized for their potential health benefits, partly attributed to their phenolic compounds. However, their impact on human metabolism remains incompletely understood. This study investigated metabolic effects of apple-derived phenolic compounds using untargeted metabolomics approach across multiple biofluids. In a crossover intervention study, 30 healthy men consumed a phenolic-rich apple juice or a placebo for two weeks. Blood, urine and saliva samples were collected before and after each intervention and analyzed by direct infusion ultra-high resolution mass spectrometry. Consumption of apple phenolic compounds resulted in significant alterations of the human metabolome, including increased levels of phenolic-derived degradation products and microbial-associated metabolites across all biofluids. Pathway enrichment analysis revealed pronounced effects on phenylalanine and tyrosine metabolism, as well as linoleic and arachidonic acid metabolism, Overall, these findings demonstrate that apple phenolic compounds induce measurable, microbiota-associated and systemic metabolic changes, providing new insights into their metabolic fate and biological relevance.

Humans↗

PubMed1992

Statistical problems in the design of antiarrhythmic drug trials.

Although many aspects of design, monitoring, and analysis in trials of antiarrhythmic drugs are similar to those of other intervention studies, several features are different. These include decisions on how to identify the subjects, timing of the intervention with respect to the disease process, time of randomization, methods for measurement of outcome, and interim monitoring for harm or benefit. The resolution of these issues depends almost entirely on the specification of the question of interest.

Anti-Arrhythmia Agents↗

PubMed2026

Carrot Juice Intake Modulates Oncogenic and Inflammatory Pathways in Advanced Colorectal Adenomas: A Pilot Feasibility Study.

Carrots are a rich dietary source of carotenoids and polyacetylenes, bioactive compounds with demonstrated anti-inflammatory and anticancer properties in experimental models. Epidemiological evidence suggests that carrot consumption is associated with a reduced risk of colorectal cancer; however, clinical data linking carrot intake to molecular changes in premalignant colorectal tissue remain limited. In this pilot intervention study, 20 patients with advanced colorectal adenomas were enrolled. Fifteen participants consumed carrot juice daily for 21 days, while five served as untreated controls. Paired adenoma biopsies were collected before and after the intervention and were analyzed using gene expression microarrays to assess transcriptional responses. Carrot juice intake was well tolerated, with adherence exceeding 95% and no reported adverse events. Transcriptomic analysis revealed modulation of key pathways implicated in colorectal carcinogenesis, including downregulation of the WNT, PI3K-AKT, and MAPK signaling pathways, as well as cyclooxygenase-2-related inflammatory pathways and cytokine signaling. These changes were consistent with reduced oncogenic signaling and attenuation of inflammatory activity within adenoma tissue. In summary, short-term carrot juice consumption was associated with coordinated suppression of molecular pathways involved in colorectal adenoma progression. These findings provide preliminary clinical evidence that a whole-food dietary intervention may influence early carcinogenic processes and support the need for larger controlled studies evaluating clinical outcomes.

Journal Article↗

PubMed2026

The Impact of Hemoglobin Concentration on Prognosis in Patients With Diabetic Foot: A Systematic Review and Meta-Analysis of Risk Factors for Adverse Outcomes and Clinical Management.

BackgroundDiabetic foot (DF) complications, including diabetic foot ulcers (DFUs), lead to significant morbidity, disability, and economic burden. Hemoglobin (Hb) levels may influence the prognosis of DF patients, but their relationship with adverse clinical outcomes remains unclear. This systematic review and meta-analysis aimed to assess the association between hemoglobin concentration and the risk of adverse outcomes in diabetic foot patients, including amputation and mortality.MethodsWe followed PRISMA guidelines to conduct a systematic literature review. A meta-analysis was performed on observational studies assessing the impact of hemoglobin levels on amputation, mortality, and ulcer incidence. A random-effects model was applied, and risk bias was evaluated using the Newcastle-Ottawa Scale.ResultsA total of 22 observational studies involving 10,984 patients were included. Our meta-analysis revealed that lower hemoglobin levels were significantly associated with a higher risk of amputation (OR = 0.97, 95% CI: 0.94-0.99, P < .001), and lower hemoglobin concentrations were found in amputation cases compared to non-amputation cases (SMD = -0.14, 95% CI: -0.24 to -0.04, P < .01). However, no significant association was found between hemoglobin levels and mortality (OR = 0.99, 95% CI: 0.33-2.89, P > .05). Sensitivity and publication bias analyses indicated robust results.ConclusionLower hemoglobin levels were associated with higher odds of amputation in patients with diabetic foot. However, pooled effects were small and heterogeneity was substantial across studies; therefore, hemoglobin likely functions primarily as a marker of overall disease burden and perioperative risk rather than a proven modifiable target. Prospective interventional studies are needed to determine whether correcting anemia improves limb outcomes and survival.

Humans↗

PubMed1992

Effects of epilepsy on daily functioning in northern Ecuador: summary of findings of a population-based research project.

215 patients with epilepsy and 125 healthy controls were questioned on the effects of epilepsy on social functioning as part of a population-based study of epilepsy in Northern Ecuador. 144 of these patients and 98 of the controls were followed, over a period of 1 year during an intervention study and their response to treatment assessed. Economic, intellectual and social functioning were examined. In the patient group, function was affected in important areas, most clearly, work. The low opinion the community had of the intellectual and physical abilities of patients might affect a patient's own view of themselves and sometimes diminish their opportunity for development. At 12 months, as a result of treatment, a significantly lower level of patients reported effects on function in some areas, though control individuals' views of their functional impairment had not shifted to any extent. Moreover, despite improvement, more patients at 12 months acknowledged fear of seizures, especially their unpredictability, as a handicapping factor, particularly in working outside or away from home. This seems to indicate that even when seizures are controlled, for many patients, the uncertainties of the condition remain and continue to affect their view of their capabilities.

Activities of Daily Living↗

PubMed1978

Weight and blood pressure. Findings in hypertension screening of 1 million Americans.

In the nationwide Community Hypertension Evaluation Clinic screening of more than 1 million people, the group classifying itself as overweight had prevalence rates of hypertension 50% to 300% higher than other screenees. Frequency of hypertension in overweight persons aged 20 to 39 years was double that of normal weight and triple that of underweight persons. Among those aged 40 to 64 years, the overweight group had a 50% higher hypertension prevalence rate than the normal-weight group and 100% higher than the underweight group. With each higher degree of blood pressure elevation, relative frequency of hypertension with overweight was larger. Thus this study confirms, in the largest group surveyed to date, similar findings in previous cross-sectional surveys. It is also consistent with data from longitudinal and intervention studies on the importance of overweight in relation to hypertension.

Adult↗

PubMed1979

Psychological intervention in coronary heart disease: a review.

Psychological intervention studies designed to reduce cardiac morbidity are reviewed. Preliminary findings suggest that various psychotherapeutic modalities may be effective. Such studies also provide an avenue through which the physical and psychological mechanisms involved in coronary heart disease and their interactions may be clarified. Implications for clinical interventions are also discussed.

Adaptation, Psychological↗

PubMed1992

The postoperative pain experience: a description based on the McGill Pain Questionnaire.

In surgical nursing practice, postoperative pain is of particular concern because of its documented effect on recovery and behaviors associated with recovery. Yet, little is known about the nature of this pain, other than its intensity. In this study, a description of the nature of the postoperative pain experience was generated from analysis of patient responses to the McGill Pain Questionnaire in four nursing intervention studies. The combined sample included 246 adult cholecystectomy patients. Patient descriptions of pain on the third postoperative day suggest a circumscribed sensory experience of moderate intensity. Sensory descriptors selected reflect two levels of noxious stimulation, one at the deeper somatic level (e.g., throbbing, stabbing, cramping, pulling, and burning) and one at a more superficial level (e.g., pricking, sharp, pinching, itching, sore, and tender). Descriptors of deeper pain tended to reflect greater intensity. The overall experience was characterized by 16 descriptors, selected by more than 30% of the sample and reflecting sensory, affective, and evaluative dimensions of the pain experience. Comparison of the findings from this combined sample drawn from hospitals in the northeastern United States were remarkably similar to those reported by Taenzer in Canada. The descriptors selected support, extend, and validate the kind of "sensation information" needed in preoperative instruction used in nursing practice and for abdominal surgery and can be useful in the assessment and management of postoperative pain.

Adult↗

PubMed1976

Problems in assessing infarction size by epicardial mapping: preliminary studies with quinidine.

Some of the laboratory difficulties in assessing infarction size produced by intermittent coronary artery occlusion were demonstrated by using an epicardial mapping technique in anesthetized open-chest dogs. Intermittent occlusion of a left anterior descending coronary artery branch resulted in a marked elevation of the ST segment above the baseline in the areas of the myocardium supplied by this vessel. Repeated occlusions after administration of normal saline as a control produced less ST-segment elevation thn that noted during control occlusions; however, repeated occlusions after infusion of quinidine produced a further lessening in ST-segment elevation. The problems encountered in interpreting these results are emphasized. Long-term coronary occlusion studies were performed in order to correlate epicardial electrograms with histological findings of ischemia or myocardial necrosis. Our investigations show that epicardial mapping tended to underestimate the area of injury, and this limits the interpretation of drug intervention studies such as those in which quinidine is administered. Therefore, caution should be exerted when using epicardial mapping techniques to assess the effect of various pharmacological interventions on infarction size in open-chest dogs.

Animals↗

PubMed2025

Enhanced barrier precautions to prevent transmission of Staphylococcus aureus and Carbapenem-resistant organisms in nursing home chronic ventilator units.

OBJECTIVE: Assess the feasibility and effect of Enhanced Barrier Precautions (EBP) on the transmission of Staphylococcus aureus (SA) and carbapenem-resistant organisms (CRO) among residents in nursing home chronic ventilator units (NH-CVU). DESIGN: Pre-post interventional study. SETTING: Two community-based nursing homes with CVUs in Maryland. A total of 56 residents were enrolled in the baseline period and 64 residents were enrolled in the intervention period. METHODS: During a 3-month baseline and intervention period, residents were swabbed monthly to estimate SA and CRO acquisition. During a 2-month training period, EBP was implemented for residents with chronic wounds, medical devices, or history of multidrug-resistant organism (MDRO) colonization. During the subsequent 3-month intervention period, healthcare personnel (HCP) wore gowns and gloves for high-contact care activities when residents were on EBP. Whole genome sequencing assessed resident-to-resident transmission. RESULTS: At baseline, NH-CVU1 used gowns and gloves for all direct contact, while NH-CVU2 used EBP only for residents with a history of MDRO colonization. After training, the proportion of NH-CVU2 residents on EBP increased from 65% in the baseline period to 87% in the intervention period. Glove use was high (93-98%) in both NH-CVUs. Gown use increased from 39% to 77% in NH-CVU1 and from 26% to 72% in NH-CVU2. Resident-to-resident transmission of SA or CRO decreased by 25% in NH-CVU1 (p = 0.60) and by 67% in NH-CVU2 (p = 0.05). CRO transmission decreased by 33% in NH-CVU1 (p = 0.54) and by 83% in NH-CVU2 (p = 0.02). CONCLUSIONS: EBP is feasible and potentially decreases overall and CRO transmission in nursing home CVUs.

Humans↗

PubMed2026

Characterisation of Trichuris incognita n sp in Côte d'Ivoire: a morphological, genomic, and genome-wide association with drug sensitivity study.

BACKGROUND: Trichuriasis is a neglected tropical disease that affects up to 500 million individuals and can cause considerable morbidity. For decades, trichuriasis was thought to be caused by one species of whipworm, Trichuris trichiura. The aim of this study was to investigate the origin of differences in response rates to the best available anthelmintic treatment for trichuriasis-a combination of albendazole and ivermectin-in Côte d'Ivoire by analysing the parasite population. METHODS: In this morphological, genomic, and genome-wide association study (GWAS) with drug sensitivity we used long-read and short-read sequencing approaches and assembled a high-quality reference genome of Trichuris incognita n sp isolated in a primary interventional study conducted in the Lagunes district of Côte d'Ivoire. Children aged 6-12 years were screened between July 14, 2022, and July 31, 2022; children positive for T trichiura on duplicate Kato-Katz smears and with infection intensity of 200 eggs per gram or more were eligible and treated first with albendazole (400 mg) and ivermectin (200 μg/kg) then with oxantel pamoate (20 mg/kg). We constructed a species tree of the Trichuris genus using 12 434 orthologous groups. We sequenced individual worms, which were used to confirm the phylogenetic placement and investigate patterns of adaptation through comparative genomic analyses. Finally, we conducted a GWAS to compare albendazole-ivermectin sensitive worms to drug non-sensitive worms. FINDINGS: 670 children were screened, of whom 243 were enrolled and from whom 271 worms were isolated after the first treatment and 827 worms after the second treatment. Sufficient DNA was recovered from 747 worms of which 721 were suitable for further bioinformatic analysis; of these, 179 were albendazole-ivermectin sensitive worms and 542 were drug non-sensitive worms. We present and characterise a new, human-infecting Trichuris species named T incognita n sp, which is morphologically indistinguishable from T trichiura, but forms a distinct phylogenetic clade, closer to Trichuris suis than to the canonical human-infective T trichiura. Comparative genomic analysis of genes suspected to confer resistance to either albendazole or ivermectin in helminths revealed a high number of β-tubulin orthologs, present in the whole population of T incognita n sp, compared with the canonical T trichiura species, but these genes were not associated with a resistant phenotype. The GWAS did not provide conclusive evidence of adaptation to drug pressure within the same species. INTERPRETATION: Our results demonstrate that trichuriasis can be caused by multiple whipworm species, and that differences in response rates might result from species responding differently to drug treatment, rather than from the intraspecies establishment of resistance. This discovery, coupled with the high tolerability of T incognita n sp to albendazole-ivermectin, marks a substantial shift in how we understand and approach whipworm infections. FUNDING: European Research Council.

Trichuris↗

PubMed1992

The effects of ocean sounds on sleep after coronary artery bypass graft surgery.

OBJECTIVE: To investigate the influence of ocean sounds (white noise) on the night sleep pattern of postoperative coronary artery bypass graft (CABG) patients after transfer from an intensive care unit. DESIGN: A before and after trial with an experimental and a control group was used in this intervention study. SETTING: A large public hospital with primary, secondary, and tertiary care facilities. PATIENTS: A consecutive sample of 60 first-time CABG patients was systematically assigned to the experimental or the control group. INTERVENTION: For the experimental group, the sounds were played on the Marsona Sound Conditioner (Marpac Corporation, Wilmington, NC) for three consecutive nights posttransfer from the ICU. No control of environment, except for the elimination of white noise, was done for the control group. MAIN OUTCOME MEASURES: The Richards-Campbell Sleep Questionnaire, a visual analog scale, provided self-reported sleep scores on six variables. Analysis of covariance was used to test the difference between the posttest scores of the groups, with the pretest used as the covariate. RESULTS: There were significant differences in sleep depth, awakening, return to sleep, quality of sleep, and total sleep scores; the group receiving ocean sounds reported higher scores, indicating better sleep. There was no difference in the falling asleep scores. CONCLUSION: The use of ocean sounds is a viable intervention to foster optimal sleep patterns in postoperative CABG patients after transfer from the ICU.

Adult↗

PubMed1978

Side-effects of antihypertensive treatment: a placebo-controlled study.

1. A questionnaire, modified from Bulpitt & Dollery (1973), inquired about 20 symptoms commonly associated with hypertension or its drug therapy in 1017 subjects (age 30--69 years). Groups consisted of (a) active therapy, (b) placebo, (c) no tablets, and (d) a non-study control group. The response rate was 96% in the first three groups and 92% in group (d). 2. The subjects in groups (a), (b) and (c) constituted part of a placebo-controlled, patient-blind intervention study in the treatment of mild hypertension (The Australian National Blood Pressure Study). 3. After age/sex adjustment of the data, only sleepiness and self-assessed depression were found to be more common in the actively treated group. Impotence, failure of ejaculation and nocturia were age-related symptoms. Generally, complaint rate was higher in females. 4. The knowledge of a mild hypertensive condition or its modern drug therapy lead to very few symptoms in a non-hospital population who already have a fairly high 'complaint level'.

Adult↗