Biom J. 2025 Oct;67(5):e70077. doi: 10.1002/bimj.70077.
NO ABSTRACT
PMID:40960010 | DOI:10.1002/bimj.70077
Transfusion. 2025 Sep 17. doi: 10.1111/trf.18415. Online ahead of print.
ABSTRACT
BACKGROUND: Anemia is a common condition among critically ill patients. To address this, patient blood management (PBM) programs have been introduced to enhance anemia treatment while reducing the need for transfusions. This study assesses the implementation and effectiveness of an anemia management protocol across multiple intensive care units (ICUs), with a particular emphasis on its impact within the trauma ICU (TICU).
METHODS: We retrospectively reviewed ICU patients at AGH from 2016 to 2020. Adult patients (≥18 years) with an admission hemoglobin <12 g/dL were included. Statistical analyses compared patients receiving the anemia protocol management (AP) versus those receiving standard of care (nonanemia protocol [N-AP]).
RESULTS: Out of 28,420 ICU admissions, 32% of TICU patients met the inclusion criteria, with 43% managed using the AP-significantly higher than in other ICUs (p < .001). Within the TICU, patients receiving the protocol had fewer daily blood draws (p = .04), lower transfusion rates (p = .001), and higher average hemoglobin levels (p = .03) compared to those not managed with the protocol. Over time, protocol use in the TICU increased from 15% in 2016 to 41% in 2020 (p < .001), which correlated with reductions in transfusions and blood draws.
CONCLUSION: The adoption of a structured AP was linked to enhanced anemia management, decreased transfusion requirements, and fewer blood draws in ICU patients. The TICU showed the highest rate of protocol adoption and the most notable improvements. These results support the broader implementation of protocol-driven PBM approaches to optimize outcomes in ICU settings.
PMID:40960001 | DOI:10.1111/trf.18415
Dtsch Arztebl Int. 2025 Nov 14;(Forthcoming):arztebl.m2025.0161. doi: 10.3238/arztebl.m2025.0161. Online ahead of print.
ABSTRACT
BACKGROUND: Germany experienced a steady rise in the prevalence of past 12-month cannabis use from 2012 to 2021. In 2024, cannabis was partially legalized for recreational use. Against this background, it is important to systematically examine consumption patterns in the early phases after legalization.
METHODS: Data are from the 2012 (n2012 = 9084), 2015 (n2015 = 9204), 2018 (n2018 = 9267), 2021 (n2021 = 9046), and 2024 (n2024 = 7534) waves of the Epidemiological Survey of Substance Abuse (ESA), a repeated cross-sectional survey of German-speaking adults in private households.
RESULTS: The prevalence of past 12-month cannabis use rose steadily from 4.6% in 2012 to 8.8% in 2021. The prevalence in 2024 was 9.8%, an additional increase compared to 2021, but is not statistically significant. Most cannabis users consumed marijuana (92.3%) in the form of joints (88.6%). One-quarter of them (25.7%) also belonged to a cannabis social club, and the most frequently stated motivation for using cannabis was “to get high or have fun” (66.8%), followed by “to reduce stress or relax” (61.3%).
CONCLUSION: In the early post-legalization period, there is a small non-significant increase in the prevalence of cannabis use in comparison to 2021. Given the legalization is very recent, it is too soon to observe any clear effect.
PMID:40959988 | DOI:10.3238/arztebl.m2025.0161
Am J Hum Biol. 2025 Sep;37(9):e70131. doi: 10.1002/ajhb.70131.
ABSTRACT
INTRODUCTION: The COVID-19 pandemic has disproportionately affected vulnerable populations, including sexual and gender minority (SGM) people. Food insecurity, prevalent among this population, may influence perceived vulnerability to infection and related psychological outcomes. This study investigated the association between food insecurity and perceived vulnerability to infection among SGM adults in Toronto, Canada, during the third wave of the COVID-19 pandemic.
METHODS: A mixed-methods study was conducted with 338 self-identified SGM adults recruited via respondent-driven sampling to complete an internet-based survey between March and July 2021. Measures included food security status, germ aversion, perceived infectability, and COVID-19 worry. Structural equation modeling (SEM) examined pathways linking food insecurity, discrimination, sleep quality, and perceived vulnerability to disease, adjusting for demographic and socioeconomic covariates.
RESULTS: The SEM showed that discrimination predicted increased food insecurity (β = 0.30, p < 0.001) and poorer sleep quality (β = 0.26, p < 0.001). Sleep quality mediated the relationship between food insecurity and perceived vulnerability to disease (indirect effect = 0.16, p < 0.001). Discrimination had a significant total effect on perceived vulnerability to disease (β = 0.22, p < 0.001).
DISCUSSION: These findings highlight the roles of food insecurity, discrimination, and sleep quality in shaping perceptions of disease vulnerability and risk among SGM people. Interventions addressing food security, mental health, and structural inequities are crucial for mitigating health disparities both during public health crises and in everyday life.
PMID:40959967 | DOI:10.1002/ajhb.70131
Radiol Oncol. 2025 Sep 5;59(3):425-434. doi: 10.2478/raon-2025-0051. eCollection 2025 Sep 1.
ABSTRACT
BACKGROUND: Robotic platforms are increasingly employed in the field of minimally invasive pancreatic surgery. It is essential to develop an innovative method that ensures both safety and efficacy, producing outcomes comparable to those of established treatment modalities. Implementation process should incorporate surgical science, education, local implementation, and non-technical skills. In our study, we describe the safe implementation of a robotic platform in pancreatic surgery within our medical institution.
PATIENTS AND METHODS: We analysed prospectively collected data from the first ten consecutive robotic-assisted distal pancreatectomies (RDP) and pancreatoduodenectomies (RPD). Due to nature of the study basic statistical analysis were performed.
RESULTS: The mean operating time was 211minutes (±49.4) for RDP and 365 minutes (±69.6) for RPD, with blood loss 330 mL for RDP and 195 mL for RPD. Hospital stay was 8.7 days (±3.9) in RDP and 7.9 days (±3.9) in RPD. One patient (10%) in the RDP group developed clinically relevant postoperative pancreatic fistula (CR-POPF) and delayed gastric emptying (DGE). The mean tumour size was 31 mm (±9.8) in the RDP and 27 mm (±7.5) in the RPD. The mean number of lymph nodes harvested was 6 (0-24) in the RDP and 15 (6-22) in the RPD. The R0 resection rate was 60% in the RDP and 70% in the RPD.
CONCLUSIONS: Robotic surgical technology can be safely and effectively integrated into a clinical setting. This integration should be facilitated through a well-established training program and curriculum. Nonetheless, patient selection is important, especially in the early phases of robotic program development.
PMID:40959923 | DOI:10.2478/raon-2025-0051
Alzheimers Dement. 2025 Sep;21(9):e70660. doi: 10.1002/alz.70660.
ABSTRACT
INTRODUCTION: Polygenic risk score (PRS) identifies individuals at high genetic risk for Alzheimer’s disease (AD), but its utility in predicting cognitive trajectories and AD pathologies remains unclear. We optimized PRS (optPRS) for AD, investigated its association with cognitive trajectories and AD phenotypes of cerebral organoids.
METHODS: Using genome-wide association study (GWAS) summary statistics from a European population, we developed optPRS to predict AD in Korean individuals (n = 1634). We analyzed the association between optPRS and cognitive trajectories (n = 771). We generated induced pluripotent stem cell-derived cerebral organoids from patients with high (n = 3) and low (n = 4) optPRS to evaluate amyloid beta (Aβ) and phosphorylated tau (p-tau) levels.
RESULTS: OptPRS predicted AD dementia and Aβ positivity, independent of apolipoprotein E (APOE). Higher optPRSs correlated with rapid cognitive decline. Cerebral organoids from the high optPRS group exhibited increased Aβ insolubility and p-tau levels.
CONCLUSION: OptPRS predicted cognitive decline and AD phenotypes of cerebral organoids, supporting its use in risk assessments and drug-screening platform.
HIGHLIGHTS: Optimized polygenic risk scores (optPRSs) improve the prediction of Alzheimer’s disease (AD) dementia and amyloid beta positivity (Aβ+). High optPRS is associated with faster cognitive decline, particularly in Aβ+. Induced pluripotent stem cell (iPSC)-derived cerebral organoids from high optPRSs show high Aβ insolubility and phosphorylated tau (p-tau). PRS genetic risk stratification provides insight into AD progression and pathology.
PMID:40959898 | DOI:10.1002/alz.70660
Alzheimers Dement. 2025 Sep;21(9):e70678. doi: 10.1002/alz.70678.
ABSTRACT
INTRODUCTION: Little is known about change in sleep duration over time and Alzheimer’s Disease and Related Dementias (ADRD) risk.
METHODS: ADRD cases were identified among Southern Community Cohort Study participants enrolled in Medicare. Sleep duration was reported at enrollment and first study follow-up and categorized (short (< 7 hours), recommended (7-9) and long (> 9)), change was calculated between timepoints. Adjusted Cox proportional hazards regression was used to estimate hazard ratios (HRs, 95% CIs) for incident ADRD.
RESULTS: We identified 2,093 ADRD cases among 17,945 participants. Compared to maintaining optimal sleep duration (7-9 hours) over 5 years, suboptimal changes were associated with 20-69% greater ADRD risk: adjusted HR (95% CI) was 1.50 (1.23-1.82) for long-recommended, 1.56 (1.21-2.01) for long-long, 1.69 (1.25-2.27) for long-short, 1.49 (1.16-1.91) for short-long, and 1.20 (1.06-1.36) for short-short.
DISCUSSION: Suboptimal 5-year change in sleep durations were associated with ADRD risk among lower-income adults underrepresented in ADRD research.
HIGHLIGHTS: The study calculated 5-year change in sleep duration in a large community-based cohort of predominately lower-income adults. Cases of Alzheimer’s Disease and Related Dementias (ADRD) were ascertained from Medicare claims data among 17,945 participants with up to 12 years of follow-up. Compared to maintaining 7-9 hours of sleep, older adults with suboptimal sleep categories were consistently at a greater risk of ADRD.
PMID:40959862 | DOI:10.1002/alz.70678
J Osteopath Med. 2025 Sep 8. doi: 10.1515/jom-2025-0107. Online ahead of print.
ABSTRACT
CONTEXT: As systematic reviews and meta-analyses (SRMAs) are crucial for treatment development, they must provide guidelines that represent diverse patient demographics to promote equitable health care. As new research and treatment modalities are being developed for geographic atrophy (GA), establishing an equitable research foundation is becoming vitally important to physicians as they personalize their treatment plans.
OBJECTIVES: This analysis aims to determine whether SRMAs pertaining to GA are reporting equity-related items utilizing the PROGRESS-Plus framework.
METHODS: We conducted a cross-sectional analysis by searching databases for systematic reviews and meta-analyses concerning GA from the year 2000 to November 2023. From this search, 176 articles returned, but only 57 of them met all the inclusion criteria. After screening the articles for inclusion, data pertaining to PROGRESS-Plus items were extracted. All analyses were conducted in a masked and duplicative fashion. χ 2 tests were employed to determine whether associations existed between the variables.
RESULTS: From the initial search, 176 articles returned, of which 119 were excluded due to duplication, data unrelated to GA, or because it was animal-based research. Of the remaining 57 studies, 26 (45.6 %) included zero PROGRESS-Plus items. Fewer articles from the US-reported equity items (31.3 %, 5/16) compared to other countries (63.4 %, 26/41), which held statistical significance (p=0.028).
CONCLUSIONS: The American Academy of Ophthalmology has created initiatives to increase diversity, equity, and inclusion within the subspecialty. By using the PROGRESS-Plus framework, this study concluded that the majority of the articles pertaining to GA do not meet equity item objectives. As these documents aid physicians in developing treatment plans, these findings are concerning as physicians may find it more difficult to individually tailor treatment plans according to each patient’s holistic needs. Limitations in this study included unintentional omission or misclassification of research documents despite the comprehensive search string and double-blinded analysis. Furthermore, the results of this study cannot be generalized to other areas of research.
PMID:40959859 | DOI:10.1515/jom-2025-0107
Histol Histopathol. 2025 Sep 17:18988. doi: 10.14670/HH-18-988. Online ahead of print.
ABSTRACT
Colorectal cancer (CRC) is a leading cause of cancer-related mortality, with an incidence projected to rise significantly worldwide. While TNM staging remains the cornerstone of prognosis and treatment decisions, additional biomarkers are needed to enhance predictive accuracy and therapeutic targeting. Ferroptosis, an iron-dependent cell death pathway, has emerged as a key regulator of CRC progression and therapy resistance. Circadian rhythms, KLOTHO, and tumor suppressors, such as p53, CDKN1A (p21), and Rb, also play crucial roles in CRC biology. Integrating TNM staging with molecular markers and patient-specific variables offers a more precise, personalized approach to CRC management. In the present work, we analyze the histopathological expression of KLOTHO, ferroptosis markers (TFRC, ALOX-5, ACSL-4, and GPX-4), circadian regulators (CLOCK, BMAL1, PER1, and PER2), and classical tumor suppressors (p53, p21, and Rb) in a cohort of 63 patients diagnosed with CRC. Besides, we have considered important clinical variables, like sex, age, and anatomical location, in our statistical analysis; correlation with the protein expression of these markers was also included for each stage (T1, T2, and T3). Our study reveals that advanced CRC stages (primarily T3) exhibit increased expression of ferroptosis markers (TFRC, ALOX5, ACSL4, and GPX4) and tumor suppressors (p53, p21, and Rb), alongside reduced histopathological detection of KLOTHO and circadian markers (BMAL1, CLOCK, PER1, and PER2) compared with earlier stages. Age, but not sex, influenced the expression of several markers. Tumor location also played a role, with right-sided CRCs showing significant stage-related differences in ferroptosis, tumor suppressor, and BMAL1, whereas left-sided tumors exhibited variations primarily in circadian markers (CLOCK, PER1, and PER2). Correlation analyses across tumor stages indicate dynamic shifts, with tumor suppressors maintaining positive associations with ferroptosis markers and anti-aging/circadian markers showing stage-dependent changes. Despite the inherent limitations of our study, these findings highlight the evolving biomarker landscape in CRC progression, although further research is needed to elucidate their clinical implications.
PMID:40959856 | DOI:10.14670/HH-18-988
Transpl Int. 2025 Sep 1;38:14201. doi: 10.3389/ti.2025.14201. eCollection 2025.
ABSTRACT
Tacrolimus is an immunosuppressant with a narrow therapeutic index and a high intra- and inter-patient variability showing significant challenges in optimal dosing and monitoring. Historically, pre-dose concentration monitoring and simplified area under the curve measurements have been the standard approach. However, recent advances in pharmacokinetic modeling have improved individualized dosing strategies, moving beyond empirical methods. This review explores the evolving landscape of Tacrolimus therapeutic drug monitoring, focusing on advanced modeling techniques that support personalized dosing. Key methodological approaches include Population Pharmacokinetic (PopPK) modeling, Bayesian prediction, Physiologically-Based Pharmacokinetic (PBPK) modeling, and emerging machine learning and artificial intelligence technologies. While no single method provides a perfect solution, these approaches are complementary and offer increasingly sophisticated tools for dose individualization. The review critically examines the potential and limitations of current modeling strategies, highlighting the complexity of translating advanced statistical and mathematical techniques into clinically accessible tools. A significant challenge remains the gap between sophisticated modeling techniques and the practical usability for healthcare professionals. The need for user-friendly platforms is emphasized, with recognition of existing commercial solutions while also noting their inherent limitations. Future directions point towards more integrated, intelligent systems that can bridge the current technological and practical gaps in personalized immunosuppressant therapy.
PMID:40959818 | PMC:PMC12433911 | DOI:10.3389/ti.2025.14201