Geriatr Gerontol Int. 2026 Jul;26(7):e70634. doi: 10.1111/ggi.70634.
NO ABSTRACT
PMID:42387272 | DOI:10.1111/ggi.70634
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Am J Cardiovasc Drugs. 2026 Jul 1. doi: 10.1007/s40256-026-00809-5. Online ahead of print.
ABSTRACT
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) who survive myocardial infarction (MI) remain at high risk for recurrent cardiovascular events and heart failure (HF). Although glucagon-like peptide-1 receptor agonist (GLP-1 RA) reduces cardiovascular events in stable atherosclerotic disease, its impact among patients with established MI has not been comprehensively synthesized.
OBJECTIVES: To evaluate the association between GLP-1 RA use and cardiovascular outcomes in patients with T2DM across MI-defined cohorts.
METHODS: We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Heterogeneity was evaluated using the I2 statistic, and 95% prediction intervals (PIs) were calculated to estimate the expected range of true effects in future clinical settings. Outcomes included all-cause mortality, cardiovascular death, study-defined major adverse cardiovascular events (MACE), MI, stroke, and HF or hospitalization for HF. A sensitivity analysis using the Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment was performed to account for the small number of included studies and substantial heterogeneity. Statistical analysis was performed using R software version 4.5.0.
RESULTS: Seven studies, including 37,393 patients with T2DM from MI-defined populations (9556 receiving GLP-1 RA), were analyzed. GLP-1 RA use was associated with lower all-cause mortality (HR, 0.67; 95% CI, 0.49-0.90; I2 = 87.3%; PI, 0.27-1.63; P = 0.0085), reduced study-defined MACE (HR, 0.69; 95% CI, 0.56-0.84; I2 = 55.6%; PI, 0.44-1.06; P = 0.0002), and fewer HF events or hospitalizations for HF (HR, 0.78; 95% CI, 0.62-0.98; I2 = 77.6%; PI, 0.42-1.45; P = 0.0306). No significant associations were observed for cardiovascular death (HR, 0.85; 95% CI, 0.67-1.06; I2 = 0%; PI, 0.42-1.69; P = 0.15), recurrent MI (HR, 0.82; 95% CI, 0.62-1.09; I2 = 63%; PI, 0.41-1.63; P = 0.1753), or stroke (HR, 0.91; 95% CI, 0.68-1.22; I2 = 61.2%; PI, 0.40-2.05; P = 0.5237). In the sensitivity analysis using the HKSJ adjustment, statistical significance was lost for all endpoints, including all-cause mortality (P = 0.05), study-defined MACE (P = 0.13), and HF or hospitalization for HF (P = 0.06).
CONCLUSIONS: In patients with T2DM across MI-defined populations, GLP-1 RA use showed signals toward lower all-cause mortality, study-defined MACE, and HF-related events; however, these findings remain exploratory because of substantial heterogeneity, wide PIs, and attenuation of statistical significance under HKSJ adjustment.
REGISTRATION: PROSPERO identifier no. CRD420251270326.
PMID:42387250 | DOI:10.1007/s40256-026-00809-5
Behav Res Methods. 2026 Jul 1;58(8):216. doi: 10.3758/s13428-026-03073-2.
ABSTRACT
Large language models (LLMs) are rapidly being integrated into psychological and behavioral research as research tools, evaluation targets, human simulators, and cognitive models. Yet recent evidence reveals severe measurement unreliability: personality assessments degenerate under factor analysis, moral preferences reverse with punctuation changes, and theory-of-mind accuracy varies widely with trivial rephrasing. These “measurement phantoms”-statistical artifacts masquerading as psychological phenomena-threaten the validity of a growing body of research. Guided by the dual-validity framework that integrates psychometrics with causal inference, this article presents a six-stage workflow that scales validity requirements to research ambition-using LLMs to code text requires basic reliability and accuracy, whereas claims about psychological properties demand comprehensive construct validation. Researchers must (1) explicitly define their research goal and corresponding validity requirements, (2) develop and validate computational instruments through psychometric testing, (3) design experiments that control for computational confounds, (4) execute protocols transparently, (5) analyze data with methods appropriate for nonindependent observations, and (6) report findings within boundaries and use results to refine theory. The workflow is illustrated through an example of model evaluation-“LLM selfhood”-showing how systematic validation can distinguish genuine computational phenomena from measurement artifacts. By establishing validated computational instruments and transparent practices, this workflow provides a path toward building a robust empirical foundation for AI psychology research.
PMID:42387246 | DOI:10.3758/s13428-026-03073-2
World J Pediatr. 2026 Jul 1. doi: 10.1007/s12519-026-01055-0. Online ahead of print.
ABSTRACT
BACKGROUND: Multiple clinical studies have confirmed that combining biologics and/or small molecules (tofacitinib or upadacitinib) exhibits favorable efficacy and manageable safety in adult patients with inflammatory bowel disease (IBD). However, data on the application of this therapy in pediatric IBD are limited and lack systematic integration and analysis. This study aims to evaluate the safety and efficacy of combining biologics and/or small molecules for the treatment of pediatric IBD and provide high-quality evidence-based guidance for pediatric clinical treatment decision making.
METHODS: We systematically searched multiple databases from inception to January 1, 2026 and included all studies that used combination therapy with biologics and/or small molecules in pediatric IBD. We conducted a pooled analysis of clinical remission rate, endoscopic remission rate, adverse event incidence, pediatric ulcerative colitis activity index (PUCAI) scores, pediatric Crohn’s disease activity index (PCDAI) scores, and changes in laboratory parameters.
RESULTS: A total of 12 studies meeting the inclusion criteria were included in the analysis, involving 217 pediatric patients with IBD. All patients had failed treatment with at least one biologic agent or immunomodulator. The primary treatment regimens included anti-tumor necrosis factor (TNF)-α + vedolizumab (accounting for 37.2%) and anti-TNF-α + ustekinumab (accounting for 28.6%). The pooled clinical remission rate was 69% [95% confidence interval (CI) = 52%-84%], the endoscopic remission rate was 51% (95% CI = 18%-83%), and the corticosteroid-free remission rate was 66% (95% CI = 41%-88%). Significant reductions were observed in C-reactive protein, fecal calprotectin, and erythrocyte sedimentation rate, as well as in PCDAI and PUCAI scores. The pooled adverse event rate was 17% (95% CI = 6%-31%), with infection being the most common. Pooled rate of serious adverse events was 11% (95% CI = 4%-20%), with no reported cases of malignancy or fatality. The clinical remission rate for ulcerative colitis was lower than that for Crohn’s disease, and the incidence of adverse events was higher, although these differences were not statistically significant.
CONCLUSIONS: For pediatric patients with IBD that is unresponsive to monotherapy, combining biologics and/or small molecules may represent an effective and relatively safe treatment option, achieving high clinical remission rates and improvements in biological markers. However, high-quality prospective studies are needed to confirm long-term efficacy and safety.
PMID:42387245 | DOI:10.1007/s12519-026-01055-0
Acta Neurochir (Wien). 2026 Jul 1. doi: 10.1007/s00701-026-06971-8. Online ahead of print.
ABSTRACT
PURPOSE: The efficacy and safety of various dural sealants for dural closure have been evaluated in randomized controlled trials (RCTs). However, their associations with postcraniotomy complications remain to be compared.
METHODS: A Bayesian network meta-analysis (BNMA) was designed on the basis of studies published in PubMed, Embase, the Cochrane Library, Scopus, and Web of Science through July 9, 2025. Quality assessment was conducted using the National Institutes of Health (NIH) scale. BNMA was performed in R 4.5.1 with the “GeMTC” package, with SUCRA values and league tables generated to display comprehensive pairwise comparisons among different sealants. The certainty of evidence for each network estimate was assessed using the Confidence in Network Meta-Analysis (CINeMA) framework.
RESULTS: Eleven studies (3094 patients who underwent craniotomy) were included. TissuePatchDural (RR = 0.03, 95% CrI (0.0007, 0.42), SUCRA = 90.52%), autologous materials (RR = 0.09, 95% CrI (0.003, 0.69), SUCRA = 73.07%) and synthetic hydrogels (RR = 0.16, 95% CrI (0.04, 0.48), SUCRA = 59.68%) had 95% CrIs excluding 1, suggesting a lower risk of postcraniotomy cerebrospinal fluid leakage than for conventional closure alone. Autologous materials showed a favorable probability for meningitis prevention (RR = 0.13, 95% CrI (0.02, 0.74), SUCRA = 82.70%). The SUCRA values indicated favorable probabilities for TissuePatchDural to prevent surgical site infection and pseudomeningocele and for autologous materials to reduce the risk of unplanned interventions, although these secondary outcomes lacked statistical significance.
CONCLUSION: The results of this BNMA suggest that compared with conventional closure alone, TissuePatchDural has a greater probability of reducing cerebrospinal fluid leakage, whereas autologous materials showed favorable efficacy signals for postoperative meningitis.
PMID:42387243 | DOI:10.1007/s00701-026-06971-8
Nat Med. 2026 Jul 1. doi: 10.1038/s41591-026-04514-3. Online ahead of print.
ABSTRACT
Blood pressure (BP)-lowering therapy reduces cardiovascular risk, but whether its proportional benefits increase with longer treatment duration remains unclear. We conducted an individual participant-level data meta-analysis of 51 randomized trials from the Blood Pressure Lowering Treatment Trialists’ Collaboration (358,642 participants; median follow-up: 4.2 years). Using Cox proportional hazards models, we estimated time-stratified hazard ratios (HRs) for major cardiovascular events (MACE; fatal or non-fatal stroke, ischemic heart disease or heart failure) across annual follow-up intervals up to more than 5 years, standardized to a 5-mmHg systolic BP reduction. Network meta-analysis examined whether temporal patterns differed across antihypertensive drug classes. Annual MACE incidence was highest during year 1 (3.0% treatment versus 3.6% control), declined during years 1-5 and then rose at more than 5 years (3.1% versus 3.4%). BP lowering reduced MACE risk, with benefits established early and not progressively increasing over time. A 5-mmHg systolic BP reduction was associated with a 12% lower MACE risk in year 1 (HR = 0.88, 95% confidence interval (CI): 0.84-0.91), with modest attenuation thereafter: HRs were 0.88 (0.85-0.92) in years 1-2, 0.94 (0.90-0.98) in years 2-3, 0.87 (0.83-0.92) in years 3-4, 0.97 (0.91-1.03) in years 4-5 and 0.94 (0.87-1.01) at more than 5 years (P for trend = 0.006). Similar patterns occurred across five drug classes. These findings indicate that the relative cardiovascular benefits of BP lowering emerge within months and do not increase over time, suggesting that prioritizing higher-risk individuals for treatment yields greater clinical utility than prolonged treatment in low-risk individuals.
PMID:42387214 | DOI:10.1038/s41591-026-04514-3
Br J Cancer. 2026 Jul 1. doi: 10.1038/s41416-026-03529-4. Online ahead of print.
ABSTRACT
BACKGROUND: Cancer is a major cause of mortality after solid organ transplantation (SOT). Quantifying this risk is difficult due to heterogeneous reports and methodological limitations.
METHODS: We conducted a population-based cohort study linking data between the UK Transplant Registry, National Cancer Registry, Civil Registration of Deaths, and Hospital Episode Statistics for all SOT recipients in England between 1st June 1992 and 31st December 2015.
FINDINGS: Among 50,762 SOT recipients, 22,361 deaths were recorded, of which 3550 (15.9%) were due to cancer, making it the second leading cause of mortality. Overall cancer (excluding non-melanomatous skin cancer) standardised mortality ratio (SMR) was 2.12 (95% CI: 2.05-2.19). Cancer mortality was highest among lung recipients (SMR 3.49; 95% CI: 2.96-4.06), and lowest in kidney recipients (SMR 2.00; 95% CI: 1.92-2.08). Non-Hodgkin’s Lymphoma had highest mortality after SOT (SMR 9.86; 95% CI: 9.01-10.75) and was elevated across all transplant types. However, liver and kidney cancer mortality was disproportionately elevated among liver (SMR: 9.30; 95% CI: 7.53-11.24) and kidney transplant recipients (SMR: 5.11; 95% CI: 4.34-5.93), respectively. Several cancers showed no increased mortality.
INTERPRETATION: De novo cancer remains a major cause of long-term mortality after SOT in England, with risk stratified by cancer and/or allograft.
PMID:42387207 | DOI:10.1038/s41416-026-03529-4
EJNMMI Res. 2026 Jul 1. doi: 10.1186/s13550-026-01468-y. Online ahead of print.
ABSTRACT
BACKGROUND: Manual segmentation of prostate cancer metastases on PSMA PET/CT and SPECT/CT is time-consuming and poorly scalable, particularly in highly metastatic patients. This study evaluated nnU-Net-based automatic segmentation models trained on PET and SPECT either separately or jointly and assessed whether PET-derived information can improve SPECT lesion segmentation. Seventy-three patients with metastatic castration-resistant prostate cancer treated with ¹⁷⁷Lu-PSMA were retrospectively included: 48 from the Henri Becquerel Cancer Center (HBCC) and 25 from Nantes University Hospital (NUH). For each patient, ⁶⁸Ga-PSMA PET/CT and ¹⁷⁷Lu-PSMA SPECT/CT were acquired before and during the first treatment cycle respectively. All images were manually segmented by four nuclear medicine physicians in consensus. Four nnU-Net models were trained: M1 (PET/CT only), M2 (SPECT/CT only), M3 (joint PET/CT+SPECT/CT, unimodal input at inference), and M4 (SPECT/CT with PET/CT segmentation as a priori input). Models were first trained and internally validated on HBCC data, then retrained on the full HBCC cohort and externally validated on NUH data.
RESULTS: For PET/CT segmentation, M1 and M3 achieved comparable performance. M1 reached DSCs of 0.83 ± 0.19 (internal) and 0.76 ± 0.22 (external), while M3 achieved 0.83 ± 0.16 (internal) and 0.77 ± 0.21 (external). For SPECT/CT, the PET-guided model M4 (DSC: 0.63 ± 0.24 internal; 0.78 ± 0.14 external; PPV: 0.65 ± 0.26 internal; 0.75 ± 0.23 external) provided the best results. Compared with the SPECT-only model M2 (DSC: 0.61 ± 0.26 internal; 0.70 ± 0.25 external; PPV: 0.63 ± 0.25 internal; 0.71 ± 0.24 external), M4 showed no statistically significant difference in internal validation (DSC p = 0.35), while being statistically significant in external validation (DSC p = 0.014).
CONCLUSION: The nnU-Net framework enables accurate lesion segmentation on both ⁶⁸Ga-PSMA PET/CT and ¹⁷⁷Lu-PSMA SPECT/CT. While PET-only and joint PET+SPECT models perform similarly on PET images, incorporating PET-derived segmentations as prior information tends to improve SPECT/CT lesion segmentation. This PET-guided SPECT segmentation strategy leverages the higher spatial resolution of PET and represents a key step towards fully automated extraction of volumetric and dosimetric biomarkers for personalized prostate cancer treatment.
PMID:42387196 | DOI:10.1186/s13550-026-01468-y
Dermatol Ther (Heidelb). 2026 Jul 1. doi: 10.1007/s13555-026-01840-9. Online ahead of print.
ABSTRACT
INTRODUCTION: Topical therapy plays an essential role in psoriasis management. However, lack of rapid improvement may negatively impact adherence. The calcipotriol and betamethasone dipropionate (CAL/BDP) cream based on polyaphron dispersion (PAD) technology has demonstrated high efficacy, favorable safety, and convenience compared with CAL/BDP gel in phase III trials. This post-hoc analysis aims to assess early treatment response to CAL/BDP PAD-cream at Week (W) 4.
METHODS: This was a post-hoc pooled analysis of adults with mild-to-moderate psoriasis from two multicenter, investigator-blind, phase III trials (MC2-01-C2 and MC2-01-C7). Patients were randomized 3:1:3 to CAL/BDP PAD-cream (N = 551), PAD-cream vehicle (N = 178), or CAL/BDP gel (N = 542) once daily for 8 weeks. Physician’s Global Assessment (PGA) and Subject’s Global Assessment (SGA) were assessed at W1 and W4. At W4, early responders were defined as patients achieving PGA controlled disease (i.e., any improvement from baseline to a PGA score of 0-1), while PGA success was defined as a PGA score of 0-1 combined with a minimum 2-point improvement from baseline. SGA controlled disease and SGA success were also assessed. Comparisons between groups were performed by logistic regression models using multiple imputation. Rates of PGA/SGA concordance were assessed by simple percent agreement.
RESULTS: At W4, CAL/BDP PAD-cream was associated with a significantly higher proportion of patients achieving early response compared with CAL/BDP gel (32.1% vs 21.4%, P < 0.0001). Differences were already significant at W1 (7.8% vs 4.8%, P = 0.0410). PGA success at W4 was also higher with CAL/BDP PAD-cream than with CAL/BDP gel (23.6% vs 14.8%, P < 0.0001). Rates of SGA controlled disease and success were also statistically significantly higher for CAL/BDP PAD-cream at W4. Concordance between PGA/SGA assessments at W4 was observed in 65.5% (controlled disease) and 69.5% (success) of patients treated with CAL/BDP PAD-cream.
CONCLUSION: CAL/BDP PAD-cream was associated with significantly higher early response rates at W4 than CAL/BDP gel, suggesting earlier clinical improvements.
PMID:42387164 | DOI:10.1007/s13555-026-01840-9
Sci Rep. 2026 Jul 1. doi: 10.1038/s41598-026-60239-w. Online ahead of print.
ABSTRACT
Physical inactivity is prevalent among university students, and psychosocial factors shape participation patterns. This study examined the concurrent and independent associations between fatigue, appetite-related eating behaviours, and perceived barriers to physical activity. A total of 666 students aged 18-24 participated in this cross-sectional study. Data were collected using the Chalder Fatigue Scale, the University Students’ Eating Behaviour Scale, and the Barriers to Physical Activity Participation Scale. Analyses included Pearson correlations, multiple linear regression, and bootstrapped indirect association analyses. Fatigue was positively associated with perceived barriers (r = .336, p < .01). Both physical and mental fatigue were positively associated with personal and social barriers (β = 0.136-0.227), while mental fatigue was associated with environmental barriers (β = 0.195). Eating behaviours, particularly satiety responsiveness (β = 0.142-0.235) and hunger (β = 0.110-0.157), showed independent positive associations with barrier domains; slowness in eating was associated only with personal barriers (β = 0.087). Bootstrapped analyses indicated small but statistically significant indirect association patterns. Fatigue and appetite-related eating behaviours are modest but consistent correlates of perceived physical activity barriers. These findings should be interpreted as cross-sectional associations rather than causal or directional mechanisms.
PMID:42387156 | DOI:10.1038/s41598-026-60239-w