Tag: pubmed

Anim Sci J. 2026 Jan-Dec;97(1):e70150. doi: 10.1111/asj.70150.

ABSTRACT

This study investigated the effect of the revision of Japan’s Carcass Trading Standard for Pork (CTSP) in January 2023, which increased the optimal carcass weight (CWT) range by 3 kg, on the profitability and growth productivity of commercial pig farms. We analyzed data from 116 Japanese farrow-to-finish farms in 2022 and 2023. The study found that the mean CWT significantly increased from 76.1 to 77.1 kg (p < 0.05), with 77% of farms increasing their CWT. Statistical analysis revealed that farms that had increased their CWT by more than 2 kg saw a significantly higher increase in margin over feed cost per market pig compared with farms that had decreased their CWT (p < 0.05). This increased profit was primarily driven by higher sales revenue per market pig owing to the increased CWT, while feed cost per pig was statistically similar across all change groups. In conclusion, the CTSP revision successfully encouraged most farms to increase CWT, providing a clear economic advantage in terms of margin over feed cost.

PMID:41556269 | DOI:10.1111/asj.70150

Cancer Med. 2026 Jan;15(1):e71528. doi: 10.1002/cam4.71528.

ABSTRACT

INTRODUCTION: Lung cancer (LC) is the top cancer killer in women, yet lung cancer screening (LCS) uptake is substantially lower than mammography. Leveraging the reach of mammography programs may improve LCS uptake, but the potential gain in LC detection from this approach is unknown. This study aimed to determine the proportion of women with LC eligible for both screenings, potential LC detection via integrated screening, and factors influencing each screening uptake among those dually eligible.

METHODS: This retrospective cross-sectional study included 345 women newly diagnosed with LC presenting at a Midwestern Comprehensive Cancer Center (2019-2020). Pre-diagnosis LCS-eligibility was determined per 2013 and 2021 USPSTF criteria, LCS-uptake per 2013 criteria, and mammography-eligibility per 2016 criteria. We assessed sociodemographic variables associated with screening uptake among dually eligible women.

RESULTS: Among 345 women (mean [SD] age 64.8 [11.35] years), 73.3% were eligible for mammography, while 43.5% were eligible for LCS (2013), increasing to 49.3% (2021). Mammography uptake (41.5%) substantially exceeded LCS uptake (13.9%). Overall, 45.2% were eligible for both screenings, representing 92.4% (157/170) of all LCS-eligible (2021) cases. Notably, 20.3% were LCS-eligible (2021) and received mammography, that is, 41.2% (70/170) of LCS-eligible cases. Among dually eligible women, rural residency correlated with lower LCS uptake (odds ratio [OR], 0.42; 95% CI = 0.19-0.94; p = 0.031), whereas receiving mammography correlated with higher LCS uptake (OR, 2.67; 95% CI = 1.21-5.87; p = 0.013).

CONCLUSION: A substantial proportion of women with LC who are LCS-eligible underwent mammography, representing a missed opportunity for earlier LC detection. Integrating these screenings could enhance LC detection, especially for rural residents who experience disparities in LCS but not mammography uptake.

PMID:41556249 | DOI:10.1002/cam4.71528

J Trop Pediatr. 2026 Jan 2;72(1):fmaf057. doi: 10.1093/tropej/fmaf057.

ABSTRACT

The pediatric intensive care unit (PICU) at the Academic Hospital Paramaribo (AHP), operational since 2017, is the only tertiary referral center for critically ill children in Suriname. This study aims to describe the clinical and demographic characteristics and outcomes of critically ill children treated in the PICU over 2 years, and to assess risk factors associated with mortality during PICU admission. A retrospective study of admissions from children 16 years and younger admitted to the PICU of the AHP between January 1, 2021, and December 31, 2022. During the study period, 424 PICU admissions were included, of which 91% were acute and unplanned. The most frequent medical reasons for admission were convulsions (8.5%), pneumonia/lung abscess/empyema (7.5%), and bronchiolitis (7.3%). One hundred thirty-six admissions (32.0%) received mechanical ventilation, and 104 (24.5%) required inotropes. The median PICU stay was 3 days (interquartile range 0-6), with a mortality rate of 12.0%. In the multivariate analysis, only male gender, mechanical ventilation, and inotropes were associated with increased risk of death. The results of this benchmarking study can ultimately serve as a valuable resource for policy-makers and important stakeholders in the process of improving the care provided to critically ill children in Suriname.

PMID:41556154 | DOI:10.1093/tropej/fmaf057

Health Technol Assess. 2026 Jan;30(2):1-28. doi: 10.3310/AAVV3131.

ABSTRACT

BACKGROUND: For women with chronic or gestational hypertension who remain well, early term birth (at 37-38 weeks’ gestation) may reduce maternal complications, caesareans and stillbirths, but it may increase neonatal morbidity compared with expectant care. Expectant care may increase costs. There are no high-quality data to guide care, which currently involves maternal-fetal surveillance and intervention for maternal or fetal compromise, which may be rapid or unexpected.

OBJECTIVE: To investigate optimal timing of birth for women with chronic or gestational hypertension who reach term and remain well.

DESIGN: Pragmatic, unmasked, multicentre randomised trial with a health economic analysis.

SETTING: Fifty United Kingdom hospitals.

PARTICIPANTS: Inclusion: maternal age ≥ 16 years, chronic or gestational hypertension, singleton pregnancy, live fetus, 36⁺⁰-37⁺⁶ weeks’ gestation and able to give documented informed consent. Exclusion: contraindication to either trial arm (e.g. pre-eclampsia), blood pressure ≥ 160/110 mmHg until controlled, major fetal anomaly anticipated to require neonatal care unit admission or participation in another timed birth trial.

INTERVENTIONS: Planned early term birth at 38^+0-3 weeks’ (intervention) or ‘usual care at term’ (control, revised from ‘expectant care until at least 40⁺⁰ weeks’, August 2022).

MAIN OUTCOME MEASURES: Maternal coprimary: composite of ‘poor maternal outcome’ (severe hypertension, maternal death or maternal morbidity and superiority hypothesis). Neonatal coprimary: neonatal care unit admission ≥ 4 hours (non-inferiority hypothesis). Each coprimary is measured until primary hospital discharge or 28 days post birth (whichever is earlier). Key secondary: caesarean birth.

RANDOMISATION: 1 : 1 ratio, minimised for key prognostic variables: site, hypertension type and prior caesarean.

BLINDING: It was not possible to mask care providers or participants to the intervention. For the coprimary maternal outcome, there was local site principal investigator/delegate sign-off based on review, masked to allocated group, of primary case notes.

RESULTS: From 2019 to 2022, 403 participants were randomised (37% of target 1080) to intervention (n = 201) or control (n = 202). The funder stopped the trial during the coronavirus disease discovered in 2019 pandemic for delayed recruitment. In the intervention (vs. control) group, birth was a median of 0.9 weeks earlier (38.4, interquartile range 38.3-38.6 vs. 39.3, interquartile range 38.7-39.9 weeks). There was no evidence of a difference in ‘poor maternal outcome’ (13% vs. 12%, respectively; adjusted risk ratio 1.16, 95% confidence interval 0.72 to 1.87). For ‘neonatal care unit admission ≥ 4 hours’, the intervention was considered to be non-inferior to control, as the adjusted risk difference, 95% confidence interval upper bound did not cross the 8% pre-specified non-inferiority margin (7% vs. 7%, respectively; adjusted risk difference 0.003, 95% confidence interval -0.05 to +0.06), although event rates were lower than estimated. There was no evidence of a difference in caesarean (29% vs. 36%, respectively; adjusted risk ratio 0.81, 95% confidence interval 0.61 to 1.08).

LIMITATIONS: Recruitment was 37% of the anticipated sample size (as above).

CONCLUSIONS: Despite being unable to recruit to target in this study, we observed that most women with chronic or gestational hypertension required labour induction and planned birth at 38^0-3 weeks (vs. usual care), which resulted in birth an average of 6 days earlier and there were no differences in poor maternal outcome or neonatal morbidity. Our findings provide reassurance about planned birth at 38^0-3 weeks as a clinical option for these women.

FUTURE WORK: An individual participant data meta-analysis is planned to address whether the intervention (vs. control) reduces caesarean; low adverse event rates would make unfeasible mounting another randomised trial.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 16/167/123.

PMID:41556143 | DOI:10.3310/AAVV3131

Am J Med Genet A. 2026 Jan 20. doi: 10.1002/ajmga.70041. Online ahead of print.

ABSTRACT

Genetic conditions suspected in children often require genetic testing for accurate diagnoses, but testing remains costly. Case management teams review genetic test requests to improve access for patients while reducing the financial burden for medical institutions. Limited data exist on the diagnostic yields of genetic testing in the inpatient versus outpatient setting and the impact to care denial of inpatient genetic testing may pose. This study investigates diagnostic yields between patients approved for versus denied inpatient genetic testing and its impact to care. One thousand and fifty-two charts of children admitted inpatient who received a genetic consult between July 2018 and June 2023 were reviewed; charts of children that followed up at the outpatient genetics clinic after inpatient discharge were additionally reviewed. Collected data included recommendations, completion, and results of genetic testing, and management recommendations based on a diagnosis. Statistical analysis assessed differences between the groups. Private insurance holders and patients with no prematurity history were less likely to be approved for inpatient genetic testing. The outpatient group had nearly twice the diagnostic yield and management recommendations did not differ between the groups. Inclusion of genetic providers in the review of inpatient genetic testing requests should be considered to improve outcomes.

PMID:41556137 | DOI:10.1002/ajmga.70041

J Antimicrob Chemother. 2026 Jan 19;81(2):dkag002. doi: 10.1093/jac/dkag002.

ABSTRACT

BACKGROUND: Gender shapes health behaviours, access, and outcomes, thereby influencing antibiotic use. Intersecting socio-economic factors, such as education, labour force participation, and political representation, further mediate gender differences in the risk of antimicrobial resistance (AMR). However, evidence linking gender inequalities to antibiotic consumption remains limited.

METHODS: This study is an observational, country-level analysis using IQVIA MIDAS® data on yearly antibiotic consumption (defined daily doses/DDDs) from 70 countries (2000-22). We used four gender equality indicators: proportion of females with secondary or higher education, female-to-male labour force participation (FMLFP) ratio, proportion of women in parliament, and share of female population. Using country and year fixed-effects regression models, the study estimated within-country associations between these indicators and overall antibiotic consumption, as well as by antibiotic class, controlling for income, education, healthcare access, and health spending, and demographics. Sensitivity was assessed through an alternative model specification, stratified analyses by income groups and by time periods.

RESULTS: Antibiotic consumption varied widely across countries with an average of 19.13 DDDs per day per 1000 population. Our main findings are that higher female education (P < 0.05) and FMLFP ratio (P < 0.01) were significantly associated with lower antibiotic consumption, while a higher share of females in the population was significantly associated with slightly higher consumption (P < 0.01). Women’s parliamentary representation showed no significant association. These associations remained directionally consistent across alternative model specifications and income groups.

CONCLUSIONS: Gender inequalities influence antibiotic consumption patterns. The study underscores the need for a community-based approach in tackling AMR, specifically, investments in gender-responsive AMR strategies.

PMID:41556127 | DOI:10.1093/jac/dkag002

Eur J Anaesthesiol. 2026 Jan 20. doi: 10.1097/EJA.0000000000002355. Online ahead of print.

ABSTRACT

Research that assesses causal relations based on observational data remains challenging because of the well known tension between natural causal thinking and classic statistical association methods. This tension, over a period of decades, has generated the development of a statistical framework, with specific methods and reasoning, to allow the drawing of causal inference. A part of this framework is the directed acyclic graph (DAG), a specific type of causal diagram that is based on graph theory. This intuitive representation of the mechanistic processes of a specific problem, and the logical consequences that come with it, closes the gap between observed associations and causality. The advantage of integrating DAGs into observational research has been emphasised in several reviews. This review is an anaesthetist-friendly (re-)introduction to this graphical reasoning. We provide some examples of how this framework can be used beyond observational data and studies. We explain how important aspects of randomised controlled trials like covariate adjustments, handling of missing data and protocol violations can be both understood and taught by drawing and interpreting a DAG. We consider the case of the titration paradox and show how combining knowledge of how a specific dataset was built, with pharmacology, into a more advanced DAG, can help solve and understand these seemingly paradoxical findings. In all of this, we use anaesthesia-oriented examples to illustrate how DAGs can be a valuable scientific language that helps us to understand, organise and communicate study results and research questions.

PMID:41556118 | DOI:10.1097/EJA.0000000000002355

Psychol Med. 2026 Jan 20;56:e26. doi: 10.1017/S0033291725103139.

ABSTRACT

BACKGROUND: Parental prenatal mood and anxiety disorders (PMADs) are linked to child neurodevelopmental disorders (NDDs), but evaluations of the magnitude and mechanisms of this association are limited. This study estimates the strength of the association and whether it is impacted by genetic and environmental factors.

METHODS: A systematic search of PubMed, CENTRAL, PsycINFO, OVID, and Google Scholar was performed for articles published from January 1988 to September 2025. Of 2,420 articles screened, 74 met the inclusion criteria. Meta-analyses were conducted on 21 studies, and 53 were included in the narrative synthesis. We conducted random-effects meta-analyses, along with tests for heterogeneity (I²) and publication bias (Egger’s test). The review followed PRISMA and MOOSE guidelines.

RESULTS: Maternal PMADs were associated with a significantly increased risk of attention-deficit/hyperactivity disorder (ADHD; odds ratio [OR] 1.91, 95% confidence interval [CI] 1.45-2.52) and autism spectrum disorder (ASD; OR 1.75, 95% CI 1.43-2.14) in children. Paternal PMADs were also associated with the risk of NDDs, with combined odds for ASD and ADHD (OR = 1.23, 95% CI 1.14-1.33). Several studies suggested that the link between parental PMADs and offspring NDDs might be impacted by both genetic and environmental factors, including the impact of ongoing parental depression on child behavior.

CONCLUSIONS: Parental PMADs are associated with increased risk of NDDs in children. These findings likely reflect a combination of inherited liability and environmental processes; clarifying mechanisms will require genetically informed designs. Regardless of mechanism, offering optional, family-centered developmental support may help promote child well-being in families where a parent is experiencing PMADs.

PMID:41556101 | DOI:10.1017/S0033291725103139

Biomed Khim. 2025 Dec;71(6):441-453. doi: 10.18097/PBMCR1599.

ABSTRACT

Sepsis-associated encephalopathy (SAE) is a condition characterized by acute brain dysfunction developed in the absence of a primary infection in the central nervous system. The aim of this study was to perform a pilot, untargeted metabolomic profiling of the blood plasma of SAE patients to identify metabolic changes potentially associated with the pathological condition and to generate hypotheses for further studies of its pathogenesis, as well as to the search for promising biomarkers, and the assessment of the severity of the patient’s condition. Metabolomic profiling was performed using HPLC-HR-MS, followed by statistical analysis of the obtained data. This blinded, randomized, controlled clinical trial revealed significant differences in the metabolic profiles of the study and control groups. Functional analysis showed the metabolic pathways most affected by pathological processes in SAE patients. These included metabolism of acylcarnitines, lysophosphatidylcholines, and taurine, folate biosynthesis, and the drug metabolism involving the cytochrome P450 pathway. In SAE patients with impaired consciousness, including delirium and coma, decreased levels of long-chain acylcarnitines and lysophosphatidylcholines were observed. The metabolomic profiles of SAE patients differed significantly between the groups of deceased and surviving patients: concentrations of sulfur-containing amino acids were significantly lower in the group of deceased than in the group of survivors. Our study identified 64 candidate biomarkers that could potentially be used to predict sepsis outcomes. However, further study is needed using an expanded and independent cohort of patients.

PMID:41556075 | DOI:10.18097/PBMCR1599

Biomed Eng Comput Biol. 2026 Jan 17;17:11795972251407864. doi: 10.1177/11795972251407864. eCollection 2026.

ABSTRACT

BACKGROUND: Explainability (xAI) is critical for fostering trust, ensuring safety, and supporting regulatory compliance in healthcare AI systems. Large Language Models (LLMs), with impressive capabilities, operate as “black boxes” with prohibitive computational demands and regulatory challenges. Small Language Models (SLMs) with open-source architectures present a pragmatic alternative, offering efficiency, potential interpretability, and alignment with data privacy frameworks. This study evaluates whether token-level attribution (TLA) methods can provide technical traceability in SLMs for clinical decision support.

METHODS: The Captum 0.7 attribution library was applied to a Qwen-2.5-1.5B model on 20 breast cancer cases from a publicly available dataset. Hardware requirements were profiled on consumer-grade GPU. Using perturbation-based integrated gradients, we analyzed how clinical input features statistically influenced token generation probabilities.

RESULTS: Attribution heatmaps successfully identified clinically relevant input features, with high-attribution tokens corresponding to expected clinical factors. The model occupied minimal storage, enabling local deployment without cloud infrastructure. This validates that SLMs can provide algorithmic traceability required for regulatory frameworks.

CONCLUSIONS: This proof-of-concept demonstrates the technical feasibility of combining SLMs with perturbation-based xAI methods to achieve auditable clinical AI within practical hardware constraints. While TLA provides statistical associations, bridging toward causal clinical reasoning requires further research.

PMID:41556064 | PMC:PMC12812195 | DOI:10.1177/11795972251407864