Tag: pubmed

MSMR. 2026 Jul 31;33(6-7):40-47.

ABSTRACT

This annual summary quantifies the impacts of various illnesses and injuries among members of the active component of the U.S. Coast Guard in 2025, using a disease classification system and morbidity burden measures derived from the Global Burden of Disease Study. In 2025, injuries, mental health disorders, and musculoskeletal system diseases were the categories of medical conditions associated with the most medical encounters, greatest numbers of members affected, and largest numbers of hospital days among active duty U.S. Coast Guard members. The morbidity burdens of Coast Guard members in 2025 are similar to those reported for Department of War active component service members. Mental health diagnoses, particularly mood and substance abuse disorders, in 2025 disproportionately accounted for more than half of all hospital bed days of Coast Guard members.

PMID:42623652

Am Nat. 2026 Sep;208(3):299-313. doi: 10.1086/741600. Epub 2026 Apr 1.

ABSTRACT

AbstractTerritorial behavior plays a key role in shaping the emergent population dynamics and spatial distribution of animal species, yet given its complexity, our understanding of the mechanisms driving territorial formation remains limited. This study used an integrated step selection analysis and a complete territorial location dataset to parameterize a mechanistic home range analysis (MHRA) model, allowing an examination of territorial dynamics in Canada lynx (Lynx canadensis) at a population peak. MHRA models were parameterized using data from two study sites, allowing an analysis of territorial formation and movement under contrasting harvest regimes. In an unharvested region, the model successfully predicted the behavior of a nonterritorial individual that used a mix of territorial space and poor-quality (unoccupied) habitat. In the high-harvest region, the model correctly predicted neighboring lynx response to an observed territorial shift following the harvest of a territorial lynx. This predictive accuracy suggests that territorial behaviors in this cyclically fluctuating species are driven by the interplay among territorial saturation, prey availability, and human exploitation. This approach provides a framework for understanding territorial processes grounded in individual movement patterns while offering insights relevant to population ecology and wildlife management across territorial species.

PMID:42623644 | DOI:10.1086/741600

Am Nat. 2026 Sep;208(3):314-331. doi: 10.1086/741601. Epub 2026 Apr 1.

ABSTRACT

AbstractThe ubiquitous regression to the mean (RTM) effect complicates statistical inference regarding the relationship between baseline levels of a biological variable and its subsequent change. We demonstrate that common RTM correction methods are problematic: the Berry et al. method, popularized by Kelly and Price in The American Naturalist, is unreliable for hypothesis testing or effect size estimation, leading to systematic bias and inflated error rates. Conversely, while the Blomqvist method is theoretically unbiased, its high sampling variance limits its practical utility in small to moderate datasets. Using a structural linear model, we show that the most robust approach to navigating RTM is not to correct the data but to evaluate the uncorrected crude slope against a structural null expectation derived from measurement repeatability-the proportion of total variance attributable to true individual differences. We illustrate this approach using empirical data from studies of lizard thermal physiology and bird telomere dynamics. Ultimately, we argue that any conclusion regarding a differential treatment effect is statistically unfounded without a clear understanding of the experiment’s repeatability.

PMID:42623641 | DOI:10.1086/741601

MSMR. 2026 Jul 31;33(6-7):33-39.

ABSTRACT

This annual summary documents the nature, numbers, and trends of conditions of medical evacuations from U.S. Africa Command, U.S. Central Command, U.S. Pacific Command, and U.S. Southern Command in 2025, with comparisons to the prior 4 years. From 2021 to 2025, disease and non-battle injuries, rather than combat trauma, led to nearly all medical evacuations within 4 U.S. combatant commands: U.S. Africa Command (AFRICOM), U.S. Central Command (CENTCOM), U.S. Pacific Command (PACOM), and U.S. Southern Command (SOUTHCOM). In 2025 CENTCOM and PACOM had the highest volumes of medical evacuations, with mental health disorders the leading cause in both theaters of operations.

PMID:42623638

MSMR. 2026 Jul 31;33(6-7):28-31.

ABSTRACT

This annual summary utilizes data from the Theater Medical Data Store (TMDS) to document service member health care encounters during deployments to 4 theaters of operation, U.S. Africa Command, U.S. Central Command, U.S. Pacific Command, and U.S. Southern Command, where large concentrations of U.S. service members are deployed without access to permanent medical facilities. In 2025, musculoskeletal system conditions were the leading cause of in-theater medical care in U.S. Africa Command (AFRICOM), U.S. Central Command (CENTCOM), and U.S. Southern Command (SOUTHCOM), while in U.S. Pacific Command (PACOM) mental health disorders were the leading cause of medical care. This year’s expanded analysis, including 4 combatant commands, of deployed service member health care, reveals that CENTCOM accounted for almost 90% of all in-theater medical encounters in 2025.

PMID:42623637

WMJ. 2026;125(3):391-393.

ABSTRACT

BACKGROUND: Sputum cultures are essential for guiding targeted antibiotic therapy; however, they are often underutilized. This quality improvement initiative aimed to enhance sputum culture ordering through an antimicrobial stewardship pharmacist-led intervention.

METHODS: A retrospective review of pneumonia hospitalizations from January 2021 through December 2022 evaluated the impact of a policy change allowing antimicrobial stewardship pharmacists to order sputum cultures. Statistical analyses compared preintervention and postintervention sputum culture ordering rates, adjusting for patient demographics, hospital admission location, and other covariates.

RESULTS: Sputum culture orders increased from 36% before the intervention to 50% after the intervention, with a 29% higher likelihood of sputum culture ordering after the intervention (risk ratio, 1.29; 95% CI, 1.19-1.38; P < .001).

CONCLUSIONS: This intervention demonstrates the potential for antimicrobial stewardship programs to improve adherence to guideline-based practices through pharmacist-led initiatives.

PMID:42623624

WMJ. 2026;125(3):383-387.

ABSTRACT

INTRODUCTION: Invasive cervical cancer continues to disproportionately affect racially and ethnically minoritized populations and individuals living in rural areas. We analyzed trends in cervical cancer incidence by race, ethnicity, and geography in Wisconsin from 1998 through 2022.

METHODS: Cervical cancer incidence rates (per 100 000 individuals with a cervix) were analyzed by race/ethnicity and county using data from the Wisconsin Cancer Reporting System.

RESULTS: Overall incidence declined 28%, from 8.2 to 5.9 cases per 100 000, but declines were not evenly distributed across populations. Compared with non-Hispanic White individuals, non-Hispanic Black individuals had nearly twice the incidence rate throughout the study period. Although Hispanic individuals experienced the largest relative decline (40.8%, 15.7 to 9.3 per 100 000), incidence remained higher among non-Hispanic White individuals. Milwaukee County, Wisconsin’s most socially vulnerable county, had among the highest incidence rates and slowest decline over time (19.8%).

DISCUSSION: Because cervical cancer is largely preventable, the persistence of substantial disparities in Wisconsin highlights structural inequities that warrant urgent attention.

PMID:42623622

WMJ. 2026;125(3):378-382.

ABSTRACT

INTRODUCTION: Chronic medical conditions affect approximately 129 million Americans. The complexities of chronic illness, coupled with limited health care resources and clinician time, can complicate treatment management, and contribute to poor health outcomes. The effect of group medical visits (GMVs) on patient wellness has not been well established.

METHODS: Mixed-methods approach using both quantitative and qualitative data was used to evaluate wellness following completion of GMV programs. Patients completed pre- and post-GMV assessments using the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. GMV programs included Yoga for Cancer, Stress Reduction and Resiliency, Mindful Eco-Wellness, and Mindfulness for Your Health from 2017 to 2024. The PROMIS-29 is a validated health questionnaire that assesses 7 domains: anxiety, depression, fatigue, sleep disturbance, participation in social roles, pain, and physical function. Clinicians and patients also participated in qualitative interviews regarding their GMV experiences.

RESULTS: Among 76 participants who completed pre- and post-GMV PROMIS-29 assessments, fatigue scores improved and participation in social roles increased significantly. Improvements were also observed in anxiety, depression, sleep disturbance, and physical function, although these changes were not statistically significant. Themes identified from interviews with 15 clinicians and 10 patients included patient empowerment, sense of community, patient satisfaction, integrative care, and trust.

DISCUSSION: Improvements in PROMIS-29 domains suggest that GMVs may have the potential to enhance patient health and wellness. The themes discovered portray a positive outlook on GMVs, with mindfulness practices and the sense of community that is cultivated within a group setting highlighted as especially important.

CONCLUSIONS: GMVs were associated with improvements in fatigue and participation in social roles and were viewed favorably by patients and clinicians. Although additional controlled studies are needed, GMVs may represent a promising approach to supporting wellness among patients living with chronic conditions.

PMID:42623621

JMIR Med Educ. 2026 Aug 20;12:e92700. doi: 10.2196/92700.

ABSTRACT

This paper critically assesses the role of generative AI in anatomical illustration, identifying fundamental barriers that currently preclude AI from replacing human medical illustrators. Despite the promise of unprecedented efficiency, contemporary models exhibit persistent anatomical inaccuracies and “hallucinations” of nonexistent structures-flaws stemming from statistical pattern-matching rather than genuine anatomical understanding. These systems further lack pedagogical intent, clinical context, and the capacity for deliberate visual judgment, while raising unresolved ethical and copyright concerns regarding training data. Although a specialized AI for this purpose is theoretically feasible, its development as a standalone goal remains economically nonviable given the niche nature of the profession. Rather than replacing human illustrators, AI’s future role will be augmentative, with the requisite anatomical intelligence likely emerging as a byproduct of broader advances in clinical applications such as surgical planning and personalized medicine. For AI-generated imagery to become educationally and clinically reliable, it will require rigorous human supervision, curated gold standard datasets, and a foundation of genuine anatomical comprehension.

PMID:42623607 | DOI:10.2196/92700

MSMR. 2026 Jul 31;33(6-7):21-27.

ABSTRACT

This annual summary documents the frequencies, rates, trends, and distributions of ambulatory visits, or outpatient care, among members of the active component of the U.S. Armed Forces, based on standardized records from U.S. military and civilian medical facilities worldwide. In 2025, U.S. active component service members (ACSMs) completed 17,478,210 ambulatory, or outpatient, visits for health care, yielding an annual rate of 13.7 visits per person-year (p-yr). Over the previous 4 years the rate of ambulatory health care encounters steadily declined, driven primarily by sharp post-pandemic reductions in COVID-19 and ‘other’ administrative health care encounters. Five major categories of diagnosis from ACSM ambulatory care visits in 2025 accounted for almost four-fifths (79.6%) of all ACSM outpatient care: musculoskeletal system diseases, ‘other’ (administrative) encounters, mental health disorders, nervous system and sensory organ diseases, and symptoms, signs and ill-defined conditions; this is consistent with previous years. While the most frequent diagnoses of specific conditions for both male and female ACSMs were joint pain, lower back pain, and adjustment disorders, men had higher rates of sleep apnea and alcohol dependence, while women had higher rates of generalized anxiety and anemia due to iron deficiency.

PMID:42623605