Background: Long-term overactive bladder (OAB) care involves treatment changes that are not captured by initial-prescription persistence alone. We examined treatment pathways, symptom burden, and xerostomia. Methods: This prospective nonrandomized cohort included 106 adults initially managed with solifenacin 5 mg, solifenacin 10 mg, or mirabegron 50 mg. Telephone interviews were completed by 83 participants after a mean of 32.6 months (range 29.8–35.3); 76 had reliable linked data, and 75 had current Overactive Bladder Symptom Score (OABSS). Treatment pathways, reasons for modification, and global patient-reported outcomes were described. Current antimuscarinic use and xerostomia were examined using exact testing and logistic regression. Results: 20 participants were receiving their index oral regimen, 22 a different oral monotherapy, 17 no treatment, 16 nonoral or other urological management, and one combination therapy. Median current OABSS was 3; 41/75 participants achieved a reduction of at least three points. Global improvement was reported by 65/76. Among 17 untreated participants, eight reported symptom improvement as the reason for discontinuation. Xerostomia occurred in 21/32 current antimuscarinic users and 11/44 nonusers (odds ratio 5.73, 95% confidence interval 2.11–15.55). Conclusions: At long-term follow-up, most patients reported sustained symptomatic improvement, often sufficient to permit discontinuation; discontinuation therefore did not uniformly indicate treatment failure. Current antimuscarinic use was associated with xerostomia. These observations support periodic reassessment of symptoms and tolerability without establishing comparative drug efficacy.
Background: Artificial intelligence (AI) is increasingly used in obstetric ultrasound, cardiotocography, wearable fetal electrocardiography, and remote maternal-fetal monitoring. Evidence on real-world implementation, including feasibility, acceptability, workflow, task sharing, sustainability, equity, cost, and user experience, remains limited. This review aimed to map global real-world implementation evidence for AI-enabled obstetric monitoring and identify outcomes, determinants, gaps, and research priorities for scale-up. Methods: We conducted a scoping review using the Arksey and O’Malley framework with Levac refinements, Joanna Briggs Institute guidance, and PRISMA-ScR. PubMed/MEDLINE, Web of Science, and Dimensions were searched from January 2010 to May 2026 and Scopus from January 2010 to December 2025. We included studies on AI-enabled obstetric monitoring in clinical or community settings and primary research on implementation readiness. We classified findings as operational (Tier 1) or readiness (Tier 2), mapped outcomes to RE-AIM, and interpreted determinants using NASSS. Results: Thirteen studies met the criteria: ten on AI-enabled obstetric ultrasound, two on AI-assisted cardiotocography, and one on wearable fetal electrocardiography. Seven were Tier 1 and six Tier 2; ten were conducted in LMICs or mainly represented LMIC stakeholders. Included studies reported higher ultrasound process-quality measures, shorter expert-review time, feasible image acquisition, high acceptability, and potential for task sharing. Selection bias, confounding, short follow-up, and reliance on proximal outcomes limited inference. No randomized trial showed improved maternal or neonatal outcomes, and no complete cost-effectiveness evaluation met the criteria. Conclusions: Implementation evidence remains sparse, recent, and concentrated in AI-enabled ultrasound. Pragmatic comparative studies, long-term implementation research, economic evaluation, safety monitoring, referral completion, and equitable scale-up should be prioritized.
Introduction: Post-prostatectomy urinary incontinence represents a major determinant of postoperative quality of life. Functional magnetic stimulation (FMS) is a non-invasive pelvic floor rehabilitation modality used in the conservative management of post-prostatectomy urinary incontinence; however, rehabilitation-related factors influencing treatment response remain insufficiently defined. The objective of this study was to evaluate real-world outcomes after an FMS protocol and to identify clinical and therapeutic factors associated with an investigator-defined exploratory response. Materials and Methods: This retrospective, single-center cohort study included 67 men treated with functional magnetic stimulation for urinary incontinence after radical prostatectomy. The primary endpoint was the post-FMS response score, assessed using an investigator-defined, non-validated 0–5 ordinal clinical response scale. Clinical, oncological, surgical, and rehabilitation-related variables were analyzed. Associations with treatment response were evaluated using univariable analyses and primary multivariable ordinal logistic regression. Results: A total of 67 patients were included, with a median age of 67 years [IQR: 63–70], a median PSA of 9.0 ng/mL [IQR: 6.45–14.08], a median number of FMS sessions of 11 [IQR: 8–13], and a median time from prostatectomy to first FMS session of 48 days [IQR: 30–83]. Any improvement was observed in 56 patients (83.6%), while investigator-defined exploratory response threshold was achieved in 28 patients (41.8%) and good/excellent response in 21 patients (31.3%). Patients aged ≤65 years had higher response scores than those aged >65 years (3 [IQR: 2–4] vs. 2 [IQR: 0.75–3], p = 0.025). Timing of FMS initiation was not associated with response when analyzed as a continuous variable. No statistically significant associations were detected between post-FMS response scores and PSA, ISUP grade group, EAU risk classification, or surgical approach in this cohort; however, clinically relevant associations cannot be excluded given the modest sample size. In the primary multivariable ordinal logistic regression model, older age was independently associated within the fitted model with lower odds of achieving a higher post-FMS response category (OR = 0.927, 95% CI: 0.859–0.999, p = 0.048), while the number of completed FMS sessions was independently associated within the fitted model with higher odds of achieving a higher response category (OR = 1.093, 95% CI: 1.009–1.184, p = 0.029). FMS initiation after 120 days was not independently associated with response category (OR = 0.447, 95% CI: 0.096–2.081, p = 0.305). Conclusions: Subjective functional improvement was observed after FMS in this retrospective outcome-evaluable cohort; however, because standardized baseline continence severity and a comparator group were unavailable, treatment efficacy cannot be established. Younger age and a greater number of completed FMS sessions were associated with higher post-FMS response categories in the exploratory multivariable analysis. However, the association with session number should not be interpreted as evidence of a causal dose–response relationship. Timing of FMS initiation was not associated with response when analyzed continuously. Exploratory 120-day and 180-day threshold analyses produced nominal subgroup differences but should be considered potentially data-dependent and hypothesis-generating only.
Background/Objectives: Chronic medical conditions may contribute to psychological burden among individuals with cancer. This study examined associations between chronic medical conditions and posttraumatic stress, depressive symptoms, anxiety, and perceived stress among Puerto Rican adults with a self-reported cancer diagnosis. Methods: This quantitative secondary analysis used baseline data from a longitudinal study (N = 402) conducted in Puerto Rico following Hurricane Maria. The analytic sample included 108 adults with a self-reported cancer diagnosis. Psychological outcomes were assessed using the PCL-5, PHQ-8, GAD-7, and PSS. Mann–Whitney U and chi-square tests were conducted, followed by multivariable logistic and linear regression models adjusting for co-occurring conditions, age, and gender. Results: Asthma was associated with higher posttraumatic stress, depressive symptoms, and perceived stress scores; arthritis with higher depressive symptoms, anxiety, and perceived stress; and thyroid disorders with higher anxiety symptoms. Unadjusted analyses showed associations between asthma and clinically significant posttraumatic stress symptoms (OR = 3.13) and thyroid disorders and anxiety symptoms (OR = 2.90). After adjustment, thyroid disorders remained associated with clinically significant anxiety (aOR = 2.70, p = 0.041), whereas asthma was no longer significantly associated with posttraumatic stress (aOR = 2.45, p = 0.116). Self-reported depression was associated with all psychological outcomes in adjusted models. Conclusions: Specific chronic medical conditions were associated with psychological burden among adults with cancer, supporting psychological screening and coordinated care.
Handball is a high-intensity contact sport that imposes significant mechanical stress on the shoulder joint through repetitive, high-velocity overhead throwing, predisposing athletes to a wide spectrum of shoulder injuries. This narrative review examines the factors associated with shoulder injuries in handball players, highlighting underlying structural, adaptive and functional mechanisms across male and female athletes. A literature search of PubMed/MEDLINE was conducted to synthesize current evidence on bony anatomy, soft tissue adaptations and neuromuscular characteristics in handball cohorts. Factors associated with shoulder injury or symptoms can be broadly categorized into three conceptual domains: (i) bony anatomy and structural features, (ii) soft tissue adaptations and (iii) dynamic functional and neuromuscular factors. Bony factors include reduced acromiohumeral distance, increased humeral retrotorsion as a sport-specific skeletal adaptation and variations in glenoid morphology that may influence glenohumeral stability. Soft tissue adaptations include posterior capsular tightness, anterior capsular laxity and alterations in shoulder range of motion, particularly glenohumeral internal rotation deficit (GIRD) accompanied by external rotation gain (ERG), which may influence glenohumeral kinematics and potentially contribute to shoulder symptoms or overuse conditions. Beyond these structural features, dynamic functional factors, including shoulder rotator muscle strength imbalances, impaired scapular control and training-load management, play a central role in injury development. Therefore, a comprehensive assessment encompassing anatomical correlates, soft tissue characteristics and functional/neuromuscular characteristics may support the development of targeted injury-prevention and rehabilitation strategies in handball players.
