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Nevin Manimala Statistics

Organic Chemistry as a Catalyst for AI Innovation: Challenges, Methods, and Emerging Paradigms

Chem Rev. 2026 Jun 17. doi: 10.1021/acs.chemrev.5c01081. Online ahead of print.

ABSTRACT

Artificial intelligence and organic chemistry are redefining each other in a fundamentally bidirectional relationship. This Review highlights how the intrinsic challenges of organic chemistry have acted as a catalyst for conceptual and methodological innovation in AI itself. Sparse and heterogeneous reaction data sets spurred the development of self-supervised and few-shot learning paradigms; the combinatorial complexity of multireactant chemistry motivated the transition from graph neural networks to hypergraph architectures; the need to bridge symbolic chemical reasoning with statistical prediction inspired chemical language models grounded in large language model frameworks; and the iterative, decision-intensive nature of synthesis planning catalyzed the rise of autonomous agentic systems. We survey the multimodal landscape of chemical data, tracing the evolution of molecular representations from classical fingerprints to geometric encodings and examining how each representation class shapes downstream model capabilities. We analyze how data scarcity and uneven property distributions have driven advances in transfer learning, self-supervised pretraining, and meta-learning frameworks tailored to molecules and reactions. Reaction prediction, mechanistic inference, and retrosynthesis planning are examined as core areas where chemistry has shaped modern AI techniques. We further explore chemical reasoning through multimodal fusion, generative molecular design, and self-driving laboratories. We conclude by identifying persistent challenges, including data sparsity, selection bias, benchmark-to-lab gaps, and reproducibility.

PMID:42308460 | DOI:10.1021/acs.chemrev.5c01081

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Nevin Manimala Statistics

Neurologic Diagnoses Before and After Traumatic Brain Injury: A Retrospective Cohort Study of Older Veterans

Neurology. 2026 Jul 28;107(2):e218214. doi: 10.1212/WNL.0000000000218214. Epub 2026 Jun 17.

ABSTRACT

BACKGROUND AND OBJECTIVES: Traumatic brain injury (TBI) during mid-to-late life is associated with increased risk of stroke, Parkinson disease (PD), epilepsy, and dementia. These conditions may also predispose to TBI. Thus, we investigated the incidence of dementia, stroke, epilepsy, and PD in older Veterans before and after acute TBI to determine whether there is a bidirectional association.

METHODS: In this retrospective cohort study, we identified Veterans aged ≥55 years who received care at US Veterans Health Affairs (VHA) facilities between October 1, 1999, and September 30, 2021, and who had acute TBI (concurrent International Classification of Diseases (ICD) code + emergency department visit + brain imaging) using VHA databases. We matched participants 3:1 to a non-TBI cohort based on age, sex, race/ethnicity, and visit date. Incident stroke, PD, epilepsy, and dementia were determined from ICD codes one year before and after TBI in the TBI cohort and over a two-year period in the non-TBI cohort. We excluded those with prevalent conditions at least 1 year before the study period. Incidence rate ratios (IRRs) and 95% CIs were calculated by comparing the pre-TBI period with the post-TBI period and with the non-TBI cohort.

RESULTS: We included 13,801 Veterans with acute TBI and a balanced cohort of 41,403 Veterans without TBI (average age 77.8 years, 96.5% male). Veterans with TBI had higher incidence rates of the 4 conditions before TBI compared with the non-TBI cohort: incidence of stroke (IRR = 3.2 [95% CI 2.9-3.5]), dementia (IRR = 3.1, [95% CI 2.9-3.4]), and PD (IRR = 3.0 [95% CI 2.4-3.7]) was 3 times higher, and that of epilepsy was over 4 times higher (IRR = 4.4 [95% CI 3.6-5.4]). Results were slightly attenuated but remained significant after adjusting for comorbidities and health care utilization. Veterans with TBI also had higher incidence rates 1 year after TBI compared with the pre-TBI period. Incident stroke (IRR = 1.83 [95% CI 1.65-2.04]) and epilepsy (IRR = 2.29 [95% CI 1.88-2.78]) rates were twofold higher; dementia incidence was also higher (IRR = 1.24 [95% CI 1.12-1.38]), but PD rates did not differ (IRR = 1.06 [95% CI 0.82-1.36]).

DISCUSSION: We found a bidirectional association between TBI and several neurologic conditions, with higher incidence rates preceding TBI and higher rates after TBI. Generalizability to non-Veteran populations is uncertain. Future studies may determine whether TBI prevention measures for adults with stroke, dementia, PD, and epilepsy are warranted.

PMID:42308449 | DOI:10.1212/WNL.0000000000218214

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Nevin Manimala Statistics

Time-Dependent Association Between Breast Cancer and Risk of Ischemic Stroke: A Nationwide Cohort Study

Neurology. 2026 Jul 14;107(1):e218165. doi: 10.1212/WNL.0000000000218165. Epub 2026 Jun 17.

ABSTRACT

BACKGROUND AND OBJECTIVES: The association between breast cancer diagnosis and treatment and the risk of incident ischemic stroke remains unclear. We investigated ischemic stroke risk among breast cancer survivors and evaluated associations by age, follow-up duration, and type of cancer treatment.

METHODS: We conducted a nationwide, retrospective, matched cohort study using the Korean National Health Insurance Service database. Women aged 18 years and older with newly diagnosed breast cancer who underwent breast cancer surgery between January 2010 and December 2016 and had no prior stroke were identified. Each was matched 1:3 by birth year to cancer-free women. The primary outcome was first ischemic stroke, defined as hospitalization with International Classification of Disease, Tenth Revision codes I63/I64 plus inpatient brain CT or MRI. Subdistribution hazard ratios (sHRs) and 95% CIs were estimated using Fine-Gray models that accounted for death as a competing risk and adjusted for sociodemographic factors and cardiovascular and non-CV comorbidities.

RESULTS: We analyzed 107,606 breast cancer surgery survivors (mean age, 50.0 years) and 322,818 matched cancer-free women. Over a mean 7.2-year follow-up, ischemic stroke occurred in 1,155 survivors (1.07%). Stroke risk was elevated shortly after breast cancer diagnosis (1-year sHR 1.59; 95% CI 1.34-1.89; 3-year sHR 1.17; 95% CI 1.05-1.30) compared with cancer-free women, with stronger associations at 3 and 6 months after diagnosis across all age groups. Over the long term, survivors had a slightly lower risk of stroke (sHR 0.94; 95% CI 0.88-1.00), and in a 1-year landmark analysis including only event-free individuals, the risk was lower (sHR 0.87, 95% CI 0.81-0.93). Among survivors, anthracycline use (sHR 1.25) and combined tamoxifen-aromatase inhibitor therapy (sHR 1.49) were associated with increased risk of stroke, whereas radiation therapy was associated with decreased risk (sHR 0.84). These associations attenuated and became nonsignificant beyond 1 year. Stroke risk was also higher among survivors with low income, hypertension, diabetes, or current smoking.

DISCUSSION: The association between breast cancer and ischemic stroke risk is time dependent, with a short-term increase after diagnosis and treatment followed by a gradual decline over time. These findings highlight the need for proactive stroke risk management, including early CV assessment and ongoing monitoring for thromboembolic events during survivorship.

PMID:42308440 | DOI:10.1212/WNL.0000000000218165

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Nevin Manimala Statistics

Co-Designing and Evaluating a 1-Day Quality Improvement Workshop for Medical Students and Resident Physicians: Tutorial on Applying Kern’s Curriculum Development Framework

JMIR Med Educ. 2026 Jun 17;12:e83657. doi: 10.2196/83657.

ABSTRACT

BACKGROUND: Despite the importance of quality improvement in advancing patient care and safety, there is limited literature describing structured, practical, and co-designed quality improvement education.

OBJECTIVE: This study aimed to (1) describe how learner co-design was operationalized within Kern’s 6-step curriculum development framework to develop a quality improvement workshop for medical students and resident physicians, (2) evaluate preworkshop and postworkshop changes in learners’ self-reported understanding of and confidence in quality improvement, and (3) explore participants’ attitudes toward quality improvement and their perceptions of the workshop’s relevance to future practice.

METHODS: Using Kern’s 6-step curriculum development model, informed by Kolb’s Experiential Learning Theory, we co-designed a 1-day quality improvement workshop with medical students and resident physicians. To address objective 1, the workshop development process was guided by a literature review and a targeted needs assessment. To address objective 2, we used a mixed methods pre-post educational evaluation design. The workshop incorporated expert-led lectures, small-group project design exercises, and peer presentations addressing audit methodology, ethical considerations, and practical implementation. Preworkshop and postworkshop surveys assessed changes in participants’ self-reported understanding of quality improvement concepts, confidence, and attitudes using 10-point Likert scales. Quantitative data were analyzed using the Wilcoxon matched-pairs signed-rank and Fisher exact tests. Semistructured interviews explored participants’ experiences and helped to explain their quantitative responses. Interview transcripts were analyzed using thematic analysis.

RESULTS: Findings from the literature review and targeted needs assessment identified gaps in practical quality improvement education related to project design, implementation, and ethical considerations, which informed workshop co-design. In total, 31 learners attended the workshop, and 77.4% (24/31) completed preworkshop and postworkshop surveys. There was a significant improvement in participants’ understanding of the Plan-Do-Study-Act cycle (preworkshop median score 2.0, IQR 1.0-2.8 vs postworkshop median score 4.0, IQR 4.0-5.0; P<.001). Confidence in engaging in quality improvement projects improved significantly (preworkshop median score 4.5, IQR 2.3-7.0 vs postworkshop median score 7.5, IQR 6.3-8.0; P=.004). Self-reported knowledge of additional methodologies, including Six Sigma, Lean, and root cause analysis, also improved significantly. Participants rated the workshop highly (median score 9.5 out of 10). Qualitative findings indicated that participants perceived improved capability in project planning, greater ethical awareness, and stronger motivation to apply learning in clinical practice. These findings reflect self-reported learning experiences rather than objectively verified skill development.

CONCLUSIONS: Learner co-design was successfully integrated within Kern’s curriculum development framework to develop a practical quality improvement workshop informed by identified learner needs. Participation in the workshop was associated with improved self-reported understanding, confidence, and positive perceptions of relevance and usefulness. Future research should examine longer-term outcomes and evaluate adaptation across broader educational settings.

PMID:42308427 | DOI:10.2196/83657

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Nevin Manimala Statistics

The Utility of Large Language Models to Assist With Emergency Triage Decisions Within Otolaryngology

Otolaryngol Head Neck Surg. 2026 Jun 17. doi: 10.1002/ohn.70313. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether contemporary large language models can match clinician performance in evaluating the urgency of emergency otolaryngology referrals.

STUDY DESIGN: Blinded cross-sectional diagnostic reasoning study.

SETTING: Simulated emergency referral environment modeled on tertiary care otolaryngology practice.

METHODS: Thirty emergency referral scenarios spanning the spectrum of otolaryngologic urgency were independently evaluated by 4 large language models (GPT-5, GPT-4, DeepSeek, and Grok) and 4 clinicians (otolaryngology attending and resident, emergency attending and resident). Outputs were anonymized and scored by 10 blinded otolaryngologists for appropriateness of urgency and quality of explanation using a three-point scale. Statistical analyses included nonparametric group comparisons, adjusted ordinary least squares modeling with case-level control, and correlation of each entity’s case profile with that of the otolaryngology attending.

RESULTS: Inter-rater reliability was excellent. The otolaryngology attending achieved the highest overall performance. GPT-5 demonstrated comparable mean performance, with no statistically significant difference in either domain. GPT-4 scored modestly lower but received higher mean ratings than both emergency clinicians. DeepSeek and the otolaryngology resident demonstrated intermediate performance, while Grok and the emergency clinicians performed lowest. Group-level analyses showed no significant difference between the large language model and otolaryngology cohorts; both were rated higher than emergency clinicians in this sample.

CONCLUSION: GPT-5 demonstrated triage performance comparable to the otolaryngology attending in this controlled sample. Large language models may support emergency decision-making and education when specialist consultation is limited, but require supervision, transparency, and local calibration.

PMID:42307998 | DOI:10.1002/ohn.70313

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Nevin Manimala Statistics

Is COVID-19 Infection A Risk Factor for Intubation-Related Acquired Airway Stenosis?

Otolaryngol Head Neck Surg. 2026 Jun 17. doi: 10.1002/ohn.70304. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether COVID-19 is a risk factor for developing airway stenosis in intubated patients.

STUDY DESIGN: Retrospective case-control study with planned chart review.

SETTING: Temple University Health Systems hospitals in Philadelphia, PA.

METHODS: Chart review of patients 18 to 90 years old diagnosed with COVID-19 who underwent endotracheal intubation and had a post-extubation CT scan at our institution between February 2020 and December 2022 was performed. Patients without COVID-19 matched for age, sex, and BMI who were intubated within one year served as a control group. Outcome variables included endoscopic and radiographic evidence of airway stenosis. Descriptive statistics were analyzed using Chi-squared and unpaired two-tailed T-test analyses for cohort comparison.

RESULTS: One hundred five COVID-positive and 101 COVID-negative met inclusion criteria. The mean age was 58.6 years. Mean endotracheal tube size was 8.05 for COVID-positive and 7.72 for COVID-negative patients (P = .0075). Twenty-six (24.76%) COVID-positive and 45 (44.55%) COVID-negative patients had COPD (P = .0016). Length of intubation was 8.8 days in COVID-positive patients and 3.5 days for COVID-negative patients (P < .0001). Thirty-five (33.98%) COVID-positive and 1 (0.99%) COVID-negative patient were ventilated while prone (P = .0002). Seventy-eight (75%) COVID-positive and 38 (41.76%) COVID-negative patients received intravenous steroids (P = .0001). Mean length of stay was 38.81 days for COVID-positive and 17.16 days for COVID-negative patients (P < .0004). Six (5.77%) COVID-positive and 2 (1.3%) COVID-negative patients developed airway stenosis (P = .202).

CONCLUSION: Patients with COVID-19 infection were not at an increased risk for intubation-related airway stenosis.

LEVEL OF EVIDENCE: IV.

PMID:42307991 | DOI:10.1002/ohn.70304

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Nevin Manimala Statistics

Time-Trend, Regional and National Prevalence of Vertical Transmission of HIV-1 in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

J Prim Care Community Health. 2026 Jan-Dec;17:21501319261462668. doi: 10.1177/21501319261462668. Epub 2026 Jun 17.

ABSTRACT

BackgroundDespite substantial global progress in HIV prevention and treatment, mother-to-child transmission (MTCT) of HIV remains a major public health challenge in sub-Saharan Africa, which accounts for approximately 65% of the world’s 39.9 million people living with HIV. Vertical transmission rates vary substantially across regions and over time. We conducted a systematic review and meta-analysis to estimate the overall, temporal, regional, and country level prevalence of HIV MTCT in sub-Saharan Africa.MethodsThis research was conducted between June 2024 and May 2025, in accordance with PRISMA guidelines and a protocol registered in PROSPERO (CRD42025637989). We systematically searched six databases (MEDLINE, Embase, PubMed, ScienceDirect, Web of Science, and the Cochrane Library) for articles published in English or French. We included cross-sectional, cohort, and case-control studies involving HIV-positive pregnant women aged ≥18 years that reported MTCT prevalence. Two reviewers independently screened, extracted data, and assessed study quality (Joanna Briggs Institute and Newcastle-Ottawa Scale). Pooled prevalence and 95% CI were calculated using a random-effects model in STATA 17. Heterogeneity (I2), subgroup analyses (by period, region, country), sensitivity analysis, and funnel plots for publication bias were performed.ResultsFrom 5,848 records, 48 studies (86,376 mothers; 2,875,104 infants) across 15 countries were included. The pooled MTCT prevalence was 7.0% (95% CI 5.2-9.4%; I2 = 99.1%). Temporal trends showed a decline from 26.0% (1993-2000) to 8.0% (2001-2010) and 5.0% (2011-2023). Regionally, West Africa had the highest prevalence (12.1%; 95% CI 6.5-21.6%), Southern Africa had the lowest (4.7%; 95% CI 2.6-8.1%). Approximately 9% of HIV-exposed infants were infected by 24-48 months, 6% were infected by 24 months after enrolment, and 7% tested positive at their first HIV test conducted between 1 and 12 weeks of age.ConclusionAlthough MTCT rates have declined, the current 7.0% remains above the WHO target (<5%) with noted significant regional and national disparities. However, this rate should be interpreted cautiously due to the extremely high heterogeneity (I2 = 99.1%) knowing it’s a directional synthesis of available evidence rather than a precise population-level figure.

PMID:42307974 | DOI:10.1177/21501319261462668

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Nevin Manimala Statistics

The role of pro-inflammatory cytokine gene polymorphisms in major depressive disorder: a systematic review

Pharmacogenet Genomics. 2026 Jun 18. doi: 10.1097/FPC.0000000000000609. Online ahead of print.

ABSTRACT

Major depressive disorder (MDD) is a multifactorial psychiatric disorder increasingly associated with immune-inflammatory mechanisms. Pro-inflammatory cytokines, particularly tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), have been implicated in the pathophysiology of MDD through their influence on neuroinflammation, neurotransmitter regulation, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. This systematic review aimed to evaluate the association between TNF-α and IL-1β gene polymorphisms and susceptibility to MDD, treatment response, and related clinical outcomes. A systematic literature search was conducted in PubMed, Embase, and ScienceDirect databases from inception to March 2026, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies investigating TNF-α and IL-1β gene polymorphisms in clinically diagnosed MDD patients were included. Case-control studies published in English involving adult human participants were considered eligible. Data regarding study design, population, polymorphisms, and clinical outcomes were extracted and qualitatively synthesized. A total of 172 records were identified, of which nine studies met the inclusion criteria. Included studies primarily investigated TNF-α rs1800629 and IL-1β rs16944 polymorphisms across diverse populations. Several studies reported significant associations between these polymorphisms and increased susceptibility to MDD, suicide risk, severity of depressive symptoms, age of onset, and antidepressant treatment response. However, some studies reported no statistically significant associations, indicating heterogeneity across ethnic groups and study populations. Variability in age, medication status, and environmental stressors may have contributed to inconsistent findings. The findings of this systematic review support the involvement of inflammatory cytokine gene polymorphisms in the pathophysiology of MDD, particularly TNF-α and IL-1β variants. These polymorphisms may contribute to depression susceptibility and treatment response through immune-inflammatory mechanisms. Further large-scale, ethnically diverse studies incorporating gene-environment interactions and next-generation sequencing approaches are needed to validate cytokine-related genetic biomarkers in MDD.

PMID:42307972 | DOI:10.1097/FPC.0000000000000609

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Nevin Manimala Statistics

HAp-ZrO2-AgNP-reinforced polystyrene dental nanocomposites: Antibacterial, antiplaque and self-cleaning properties

Dent Med Probl. 2026 Jun 17. doi: 10.17219/dmp/213852. Online ahead of print.

ABSTRACT

BACKGROUND: Dental biofilms, primarily driven by Streptococcus mutans, are the main etiological agents of caries and restorative failure.

OBJECTIVES: The aim of the study was to design and synthesize a novel polystyrene (PS)-based nanocomposite reinforced with hydroxyapatite (HAp), zirconia (ZrO2) and silver nanoparticles (AgNPs).

MATERIAL AND METHODS: Hydroxyapatite, ZrO2 and AgNPs were synthesized via wet precipitation, sol-gel and citrate reduction methods, respectively. The nanoparticles (5 wt% total loading) were uniformly dispersed in a toluene-based PS matrix using ultrasonic-assisted solution casting. The resulting films were characterized in terms of morphology (scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force microscopy (AFM)), composition (energy-dispersive X-ray spectroscopy (EDX)), thermal stability (thermogravimetric analysis (TGA)), mechanical properties (tensile strength, Young’s modulus, Vickers hardness), surface wettability (water contact angle (WCA)), antibacterial efficacy (zone of inhibition (ZOI), minimum inhibitory concentration/minimum bactericidal concentration (MIC/MBC), colony-forming unit (CFU) assay), and antibiofilm activity (crystal violet staining, confocal laser scanning microscopy (CLSM)). Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD) test (p < 0.05).

RESULTS: The nanocomposite exhibited a 30% increase in tensile strength (32.5 MPa vs. 25 MPa for pure PS) and a 25% rise in elastic modulus (1.5 GPa vs. 1.2 GPa). The water contact angle increased from 85° ±2° (pure PS) to 115° ±3° (nanocomposite), confirming significantly enhanced hydrophobicity. The composite demonstrated strong antibacterial activity, with a ZOI of 15.3 mm, MIC of 6.25 mg/mL, MBC of 12.5 mg/mL, and 99.8% bacterial reduction within 24 h. Antibiofilm performance was also notable, showing a 91.2% reduction in biofilm biomass after 72 h and 74.8% decrease in biofilm thickness (from 32.5 μm to 8.2 μm). Confocal laser scanning microscopy revealed a marked shift in the live/dead cell ratio (from 4.7:1 to 0.6:1), confirming bactericidal rather than bacteriostatic action. All nanoparticles were homogeneously distributed without agglomeration, as confirmed by SEM/EDX and TEM.

CONCLUSIONS: The HAp-ZrO2-AgNP-reinforced PS nanocomposite integrates enhanced mechanical properties, self-cleaning surface characteristics, and potent, long-lasting antibiofilm activity against S. mutans. While further biocompatibility and clinical translation studies are warranted, this material represents a significant leap toward durable, infection-resistant dental applications.

PMID:42307960 | DOI:10.17219/dmp/213852

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Nevin Manimala Statistics

Initial Injury Type and Violent Reinjury

JAMA Netw Open. 2026 Jun 1;9(6):e2618199. doi: 10.1001/jamanetworkopen.2026.18199.

ABSTRACT

IMPORTANCE: Violent injuries are the leading cause of death among children and young adults in the United States. Violent injury may increase the risk of subsequent injury (ie, violent reinjury), but it is unclear how this risk varies across different injury types (eg, blunt assault, stabbing, firearm).

OBJECTIVE: To describe patterns of violent reinjury across different injury types to inform tailored prevention strategies.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter cohort study included patients who presented with violent injuries to 2 adult and 2 pediatric level I trauma centers in St Louis, Missouri, from January 2016 to December 2023.

EXPOSURES: Violent injuries were classified into 3 injury types: blunt assault, stabbing, and firearm.

MAIN OUTCOMES AND MEASURES: The main outcome was time to recurrent violent injury in years. We used Kaplan-Meier time-to-event analyses to estimate the probability of violent reinjury across different initial (index) and recurrent injury types at 1, 5, and 7 years from index injury.

RESULTS: There were 29 810 individuals with violent injuries during the study period. The age distribution was as follows: 17 228 (57.8%) older than 26 years; 7690 (25.8%), 18 to 26 years; and 4727 (15.8%) younger than 18 years. Most were male (19 933 [66.9%]), and there were 21 126 (70.9%) Black and 7031 (23.6%) White individuals, with 792 (2.7%) belonging to an additional racial group (American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, other, or multiracial), having unknown race, or declining to disclose race. Among 29 038 patients (97.4%) who survived their index injury, 3899 (13.4%) experienced reinjury. The 7-year probability of any reinjury was highest among individuals with index stabbing (19.5% [95% CI, 17.5%-21.8%]) and blunt assault (17.4% [95% CI, 16.6%-18.2%]) injuries. Patients with index blunt assault injuries were more likely to experience blunt assault reinjury (7-year probability: 13.2% [95% CI, 12.6%-13.8%]) compared with other reinjury types. The 7-year probability of firearm reinjury was highest among those with index firearm injuries (12.6% [95% CI, 11.8%-13.4%]).

CONCLUSIONS AND RELEVANCE: In this cohort study of individuals with violent injuries, reinjury was common, but this risk varied across injury types, which may be due to differing contextual factors. Preventing violent reinjury requires attention to these issues to better address the root causes of repeated violence exposure.

PMID:42307949 | DOI:10.1001/jamanetworkopen.2026.18199