JAMA Cardiol. 2026 Jul 8. doi: 10.1001/jamacardio.2026.2104. Online ahead of print.
NO ABSTRACT
PMID:42418169 | DOI:10.1001/jamacardio.2026.2104
Int J Pharm Pract. 2026 Jul 8:riag089. doi: 10.1093/ijpp/riag089. Online ahead of print.
ABSTRACT
OBJECTIVES: To evaluate community pharmacists’ confidence in the management of inflammatory bowel disease (IBD) and to identify areas in which pharmacist-led patient education and counselling could be strengthened.
METHODS: This cross-sectional study was conducted in three phases; questionnaire development and review by an expert panel, reliability assessment, and dissemination to 100 community pharmacies selected through stratified random sampling across Malta. Pharmacists’ confidence across 29 items was assessed using mean rating scores (MRS) on a 5-point Likert scale. Non-parametric analyses examined associations between confidence, demographic variables, and perceived barriers (P < .05 statistically significant).
KEY FINDINGS: Ninety-four pharmacists completed the questionnaire; female (n = 65), > 5 years of community pharmacy experience (n = 56), worked 31-40 hours weekly (n = 39), Master of Pharmacy degree (n = 47). ‘High’ confidence (MRS ≥4/5) was reported for advice on diet and lifestyle, non-prescription medicines for symptom management, medicine storage/stability, and recognizing when referral was required. ‘Moderate’ confidence (MRS 3 to <4/5) was observed for adherence support, relapse, counselling on extraintestinal complications, dosage form administration, corticosteroids, methotrexate, aminosalicylates, and biologics. ‘Low’ confidence (MRS <3/5) was identified for counselling on thiopurines, non-prescription medicines associated with toxic megacolon, vaccines, and pregnancy and women of child-bearing age. The main reported barriers to providing advice were time constraints (n = 70) and patient-related communication challenges (n = 63). Years of experience, hours of practice, and inadequate private consultation space were not significantly associated with pharmacist confidence (P > .05).
CONCLUSIONS: Community pharmacists were more confident in general counselling and referral-related support than in medication-specific counselling and more complex aspects of IBD care.
PMID:42418153 | DOI:10.1093/ijpp/riag089
Biol Trace Elem Res. 2026 Jul 8. doi: 10.1007/s12011-026-05224-0. Online ahead of print.
ABSTRACT
Contamination of aquatic ecosystems by toxic metals and metalloids poses potential health risks to fishing communities with high fish consumption. This study assessed arsenic (As), mercury (Hg), chromium (Cr), and copper (Cu) concentrations in paired hair and nail samples from 50 fishermen on Lake Hawassa, Ethiopia, using MP-AES. Descriptive statistics, Wilcoxon signed-rank tests, correlation analyses, and multiple linear regression were applied to evaluate elemental concentrations, relationships between biomarkers, and the influence of age and fishing experience. Nails generally showed higher elemental levels than hair. Median concentrations in hair and nails were 0.15 and 0.42 µg/g for As, 0.18 and 0.35 µg/g for Hg, 0.43 and 0.70 µg/g for Cr, and 8.73 and 7.73 µg/g for Cu, respectively. Significant differences between biomarkers were found for As (p = 0.029) and Hg (p = 0.038), but not for Cr and Cu. Elevated levels above reference values were more frequent in nails, especially for As (36%), Hg (30%), and Cr (30%). Hair and nail concentrations correlated positively for As (R²=0.15, p = 0.005) and Hg (R²=0.22, p < 0.001). Age and fishing experience were not major determinants, though fishing experience negatively correlated with hair Cr (β=-0.547, p = 0.004), and age with nail Cu (β=-0.511, p = 0.034). The findings confirm measurable exposure to toxic elements and suggest nails may be a more sensitive long-term biomarker than hair. This establishes baseline data and underscores the need for ongoing environmental and health surveillance in the region.
PMID:42418129 | DOI:10.1007/s12011-026-05224-0
Pituitary. 2026 Jul 8;29(4):120. doi: 10.1007/s11102-026-01711-8.
NO ABSTRACT
PMID:42418114 | DOI:10.1007/s11102-026-01711-8
Clin Rheumatol. 2026 Jul 8. doi: 10.1007/s10067-026-08284-8. Online ahead of print.
ABSTRACT
OBJECTIVES: This study aimed to investigate the frequency and associated factors of impaired adrenal response on Synacthen test in patients with rheumatic diseases undergoing low-dose maintenance GC therapy.
METHODS: This single-center, retrospective, observational study included 48 patients with autoimmune rheumatic diseases on maintenance GC therapy (prednisolone ≤ 5 mg/day) who had previously received ≥ 5 mg/day for ≥ 3 months and underwent adrenal function testing between January 2021 and May 2023. Impaired adrenal response was defined by both low baseline cortisol and inadequate response to the standard-dose (250 μg) Synacthen test in this study. Daily dose, treatment duration, cumulative dose, and history of methylprednisolone pulse therapy were evaluated. Statistical comparisons were performed using Mann-Whitney U, Fisher’s exact, and receiver operating characteristic (ROC) analyses.
RESULTS: Impaired adrenal response on Synacthen test meeting the study-defined criteria was identified in 30 of 48 patients (62.5%). Compared with the normal adrenal response group, affected patients had significantly higher cumulative GC doses, lower baseline cortisol levels, and more frequent histories of methylprednisolone pulse therapy. Exploratory ROC analysis identified an optimal cumulative glucocorticoid dose cutoff of 10,371.5 mg associated with impaired adrenal response on Synacthen test (prednisolone equivalent).
CONCLUSIONS: Impaired adrenal response on Synacthen test was frequently observed among patients selected for adrenal function testing during maintenance GC therapy at ≤ 5 mg/day. Higher cumulative GC exposure and prior pulse therapy were associated with impaired adrenal response on Synacthen test, suggesting that a targeted, risk-based approach to adrenal evaluation may be useful even during low-dose treatment. Key Points • Impaired adrenal response on Synacthen test was detected in 62.5% of patients selected for adrenal function testing during maintenance glucocorticoid therapy at ≤ 5 mg/day. • A cumulative glucocorticoid dose ≥ 10,371.5 mg was associated with impaired adrenal response on Synacthen test. • Exploratory ROC analysis identified basal cortisol ≤ 6.1 μg/dL and daily glucocorticoid dose ≥ 3.5 mg as potential thresholds associated with impaired adrenal response on Synacthen test. • Adrenal suppression may occur even in clinically stable patients receiving low-dose therapy.
PMID:42418112 | DOI:10.1007/s10067-026-08284-8
Neurotox Res. 2026 Jul 8;44(4):32. doi: 10.1007/s12640-026-00810-5.
ABSTRACT
Background the deployment of fifth-generation (5G) wireless telecommunications infrastructure, incorporating millimeter-wave (mmWave, 24-100 GHz) and sub-6 GHz frequencies, has renewed scientific and public health interest in the potential neurobiological effects of radiofrequency electromagnetic fields (RF-EMF). While extensive research has examined lower-frequency RF-EMF from 2G/3G/4G technologies, the specific effects of mmWave frequencies on CNS cellular biology-including microglial polarization and intracellular calcium signaling-remain less characterized. This systematic review evaluates experimental evidence from in vitro and in vivo studies on the effects of high-frequency EMF (300 MHz-300 GHz) on neuroimmune responses, microglial function, CNS calcium homeostasis, and related outcomes. Methods PubMed, EMBASE, Web of Science, and the EMF-Portal were searched from inception to January 2026 following PRISMA 2020 guidelines. Experimental (in vitro and animal) studies reporting CNS-relevant outcomes after high-frequency RF-EMF exposure were eligible. Exposure must have been within the 300 MHz to 300 GHz range. Quality assessment used adapted OHAT risk-of-bias criteria. A narrative synthesis was conducted; quantitative pooling was performed where three or more studies reported the same outcome. Results forty-one studies met inclusion criteria (see PRISMA Flow Diagram, Fig. 1): 7 in vitro (cell culture), 29 in vivo (rodent model), and 5 reviews/meta-analyses. The detailed characteristics of all included studies are summarized in Table 1. At specific absorption rate (SAR) levels at or below the International Commission on Non-Ionizing Radiation Protection (ICNIRP) general public exposure guidelines (2 W/kg averaged over 10 g), the majority of studies (27/41, 66%) found no statistically significant effects on neuroinflammatory markers, microglial morphology, or calcium signaling. Eleven studies (27%) reported transient, low-magnitude increases in intracellular Ca²⁺ or pro-inflammatory cytokine expression at exposures near or exceeding guideline limits; these effects were not consistently reproducible across independent laboratories. Three studies (7%) reported effects below guideline thresholds that may warrant further investigation. No study identified neuropathological changes (neuronal death, axonal injury) attributable to RF-EMF at guideline-compliant exposures. Conclusions current experimental evidence does not establish that high-frequency RF-EMF at guideline-compliant exposure levels produces significant adverse effects on microglial polarization, CNS calcium homeostasis, or neuroinflammatory responses. Methodological heterogeneity, inadequate dosimetry, and limited independent replication constrain confidence in both positive and negative findings. Standardized, rigorously controlled experimental studies are needed, particularly for mmWave frequencies (> 6 GHz) where data are sparse. Our findings support the current scientific consensus that high-frequency RF-EMF below regulatory limits does not pose a clearly established neurobiological hazard.
PMID:42418111 | DOI:10.1007/s12640-026-00810-5
J Gastrointest Cancer. 2026 Jul 8;57(1):149. doi: 10.1007/s12029-026-01517-8.
ABSTRACT
PURPOSE: Neutrophils are at the forefront of innate immune response. The prognostic impact of tumour-associated neutrophils (TANs) remains unclear. This study aimed to evaluate the prognostic role of TANs in colorectal cancer (CRC).
METHODS: A systematic review and meta-analysis were conducted using PubMed, Embase, and Scopus to identify studies correlating TANs with time-to-event survival analysis in patients with stages I-IV CRC from the date of inception until April 2024. Articles were included if they involved the identification of TANs through hematoxylin-eosin (HE) or immunohistochemistry (IHC) and reported survival analysis. Data was collected from the tumour core (TC) and invasive margin (IM). The hazard ratios (HRs) were extracted from the study results. Heterogeneity was evaluated using Cochran’s Q and I². Primary and secondary endpoints were overall survival (OS) and disease-free survival (DFS).
RESULTS: Of 4,292 citations found, 18 studies fulfilled eligibility criteria, encompassing 7,406 patients. IHC was used to identify TANs in 12 trials, while six performed HE. Five studies included patients with disease stages I-III, and 13 had stages I-IV. High TANs at the IM were associated with improved OS (HR = 0.64, 95% Confidence Interval [CI] 0.50-0.81, I2 = 48%) and DFS (HR = 0.47, 95% CI 0.25-0.88, I2 = 32%). At the TC, high TANs showed a trend towards better OS (HR = 0.82, 95% CI 0.61-1.10, I2 = 83%) and DFS (HR = 0.48, 95% CI 0.21-1.07, I2 = 93%), although not statistically significant and with high heterogeneity.
CONCLUSION: In this systematic review and meta-analysis, high TANs at the invasive margin (IM), the tumour-host interface, was associated with improved prognosis in CRC. In contrast, no statistically significant association was observed for high TANs at the tumour core (TC).
PMID:42418102 | DOI:10.1007/s12029-026-01517-8
Metabolomics. 2026 Jul 8;22(4):120. doi: 10.1007/s11306-026-02505-6.
ABSTRACT
INTRODUCTION: Cultivation of medicinal plants provides an opportunity for economic gain and health care accessibility. Ensuring consistent quality plant material is important for plants such as Pelargonium sidoides DC used for production of phytomedicines that are available in local and international markets. There is limited research on how agronomic factors affects phytochemicals in P. sidoides roots.
OBJECTIVE: To evaluate the effect of different irrigation regimes and harvesting age on metabolite accumulation in dried roots of P. sidoides.
METHODOLOGY: Irrigation was applied at 75%, 50% and 25% plant available water (PAW) corresponding to well- watered, moderate water deficit and severe water deficit respectively. P. sidoides, which were harvested at 6, 12 and 18 months after imposing the different water deficit treatments, roots dried and subjected to ultra-performance liquid chromatography -quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) coupled with multivariate statistical analysis.
RESULTS: Unsupervised multivariate analysis showed that irrigation did not affect the obtained metabolic features. Orthogonal partial least squares discriminant analysis (OPLS-DA) showed statistically significance difference between 6 versus 12- and 18- months harvest ages. Compounds such as umckalin, epigallocatechin dimer, and gallic acid were increased in 12 and 18 months compared to the 6 months harvest. Sucrose/trehalose was increased by 0.2431- and 0.560- fold in 6 months compared to 12- and 18-months harvest ages respectively. On quantification, umckalin increased from 260.40 mg/kg DW at 6 months to 431.61 mg/kg DW at 12 months, while epigallocatechin rose from 342.98 mg/kg DW to 505.58 mg/kg DW over the same period. Umckalin sulphate was highest at 6 months under 25% PAW (7110.32 mg/kg DW) and decreased at 12 months harvest under the same irrigation level (4522.05 mg/kg DW).
CONCLUSION: The results indicated that younger plants accumulated more primary metabolites and modified secondary metabolites, whereas older plants accumulate more secondary metabolites. Moreover, cultivation of P. sidoides in limited water is plausible.
PMID:42418094 | DOI:10.1007/s11306-026-02505-6
J Community Health. 2026 Jul 8. doi: 10.1007/s10900-026-01594-7. Online ahead of print.
ABSTRACT
Tackle football is the most participated youth sport in the U.S. with leagues beginning as early as age 5. Exposure to cumulative repetitive head impacts (RHI) over years of play is increasingly viewed as a major contributor to chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease documented in contact sport athletes. Amid growing awareness of CTE, parents may turn to online information to guide decisions about youth tackle football participation. This cross‑sectional study examined the readability of online CTE information. Using the search term, ‘CTE,’ 68 URLs providing non‑technical information were identified after applying exclusion criteria. Online software was used to generate metrics from six widely-used readability formulas. Grade-level readability scores were categorized as ≤ Grade 8, 9-12, and ≥ 13 and summarized using descriptive statistics; distributions were compared by URL designation using chi-square tests (P < 0.05). Web page publication/revision date and presence of references were recorded. Median readability scores ranged from high school to early college with few pages meeting the recommended ≤ Grade 8 reading level for the general population. Levels were similarly high across non-commercial (.org,.gov,.edu) and commercial (.com) domains. Nearly 40% lacked clear publication or revision dates; fewer than half (47.1%) included references. Commonly accessed online CTE resources exceed recommended reading levels. This digital barrier impairs parents’ functional health literacy and capacity for informed decision-making. As research on CTE and tackle football participation evolves, there is a need for plain‑language, clearly-sourced, updated online resources tailored to this decisional context.
PMID:42418055 | DOI:10.1007/s10900-026-01594-7
Eur J Pediatr. 2026 Jul 8;185(8):559. doi: 10.1007/s00431-026-07234-5.
ABSTRACT
Over the past decade, new evidence has emerged regarding postnatal corticosteroids use in extremely preterm infants, particularly early prophylactic hydrocortisone. In France, national recommendations published in 2010 address late postnatal corticosteroids use only and do not incorporate the most evidence-based data. We aimed to provide a national overview of prescribing practices in French neonatal intensive care units (NICUs), focusing on prophylactic hydrocortisone. A national survey was conducted between 1 June and 13 August 2024 among all 66 French level III NICUs using a structured online questionnaire. One response per center was gathered. Fifty-five of 66 (83%) NICUs responded. Prophylactic hydrocortisone was used in 33 (60%) centers: 16 (29%) systematically and 17 (31%) selectively. Among users, 21 (64%) targeted the same population as the PREMILOC study. Non-users cited concerns about benefit-risk balance, lack of evidence, and absence of national guidelines. Fear of neurodevelopmental risk was more frequent among non-users (9/22 (41%) vs 1/33 (3%), p < 0.001), while perceived spontaneous intestinal perforation risk did not differ.
CONCLUSION: Hydrocortisone use in French NICUs remain heterogeneous due to safety concerns and a possible uncertainty about the strength of evidence. These findings underscore the need for updated national guidelines to support harmonized, evidence-based care for ELGANs.
WHAT IS KNOWN: • Recent evidence supports prophylactic hydrocortisone to improve survival without bronchopulmonary dysplasia in extremely preterm infants. • French national recommendations (2010) address late corticosteroid use (beyond 3 weeks) and do not incorporate recent evidence-based data.
WHAT IS NEW: • This national survey provides the first overview of hydrocortisone use in French NICUs, highlighting heterogeneity in prescribing practices. • It identifies discrepancies between evidence and clinical practice, supporting the need for updated guidelines.
PMID:42418052 | DOI:10.1007/s00431-026-07234-5