Tag: pubmed

Invest Ophthalmol Vis Sci. 2025 Feb 3;66(2):68. doi: 10.1167/iovs.66.2.68.

ABSTRACT

PURPOSE: This study aims to evaluate the metabolism of serum-modified nucleosides in uveitis by using liquid chromatography-tandem mass spectrometry (LC-MS) and to develop potential diagnostic biomarkers for uveitis.

METHODS: Forty-two patients with different subtypes of uveitis (idiopathic uveitis, Vogt-Koyanagi-Harada [VKH] disease, and ankylosing spondylitis [AS]) and 32 healthy controls were recruited in this retrospective case-control study. The concentrations of 23 modified nucleosides in patient serum were quantified by LC-MS. The data was statistically analyzed with SPSS and GraphPad Prism.

RESULTS: The data revealed that 13 out of 23 modified nucleosides (m6A, m1A, m6Am, Cm, ac4C, Gm, m1G, m2G, m2,2G, Um, m3U, m5U, and m5Um) effectively showed quantifiable chromatographic peaks. The statistical results indicated that there were extremely significant differences for m2G, Gm, Cm, and m1G between healthy controls and uveitis patients. The differences for Gm, m6A,and m5U were able to further assort idiopathic uveitis and uveitis with systemic inflammation including VKH and AS. Interestingly, each specific subtype of uveitis is characterized by its signature combination of serum-modified nucleotides comparing with healthy controls.

CONCLUSIONS: This study revealed that the metabolism of serum-modified nucleosides in uveitis patients display significant differences from healthy controls. The signature combination of serum modified nucleotides for each subtype of uveitis may be applied for the potential diagnosis of uveitis.

PMID:40014362 | DOI:10.1167/iovs.66.2.68

JAMA Netw Open. 2025 Feb 3;8(2):e2462069. doi: 10.1001/jamanetworkopen.2024.62069.

ABSTRACT

IMPORTANCE: Homicide is one of the leading causes of death in the US, especially among adolescents and adults younger than 45 years. While geographic, racial and ethnic, and sex differences in homicide rates have been documented, a comprehensive assessment across all sociodemographics is needed.

OBJECTIVE: To assess variation in US homicide rates from 2000 to 2019 across geographic location, race and ethnicity, sex, and age.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used deidentified death records from the National Vital Statistics System and population estimates from the National Center for Health Statistics for all individuals living in the US from January 1, 2000, to December 31, 2019. Data analysis was completed in April 2023.

EXPOSURE: County, race and ethnicity (American Indian or Alaska Native, Asian or Pacific Islander, Black, Hispanic or Latino, and White), age (0-14, 15-24, 25-44, 45-64, and ≥65 years), and sex (female and male) as reported on death certificates.

MAIN OUTCOMES AND MEASURES: The main outcome was homicide rates per 100 000 individuals. Validated small-area estimation models were used to estimate county-level homicide rates by race and ethnicity, age, and sex (50 unique populations). Estimates were corrected for race and ethnicity misclassification on death certificates and were age standardized.

RESULTS: Between 2000 and 2019, there were 367 827 (95% uncertainty interval [UI], 366 683-369 046) homicides in the US, with decedents most commonly being male (77.7% [95% UI, 77.5%-77.8%]), aged 15 to 44 years (69.8% [95% UI, 69.6%-69.9%]), and Black (46.0% [95% UI, 45.5%-46.5%]). The highest homicide rates were among Black males aged 15 to 24 years (74.6 [95% UI, 72.3-77.0] per 100 000 population) and 25 to 44 years (70.0 [95% UI, 68.4-71.4] per 100 000 population) followed by American Indian and Alaska Native males aged 15 to 24 years (24.5 [95% UI, 19.2-31.0] per 100 000 population) and 25 to 44 years (33.5 [95% UI, 28.6-38.8] per 100 000 population). Homicide rates higher than 100 deaths per 100 000 population among American Indian or Alaska Native or Black males aged 15 to 44 years were observed in 143 counties; more than 25% of counties with this homicide level among Black males were in Arkansas, Louisiana, and Mississippi, and all counties with this homicide level among American Indian or Alaska Native males were in North Carolina. Despite national homicide rates remaining stable over the study period (6.1 [95% UI, 6.0-6.2] per 100 000 population for both years; incidence rate difference, 0.04 [95% UI, -0.16 to 0.07]), homicide rates increased in most counties (range, 1631 of 3051 [53.5%] to 1406 of 1488 [94.5%]) among American Indian or Alaska Native, Black, and White males and females younger than 65 years.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of US homicide rates, substantial variation was found across and within county, race and ethnicity, sex, and age groups; American Indian and Alaska Native and Black males aged 15 to 44 years had the highest rates of homicide. The findings highlight several populations and places where homicide rates were high, but awareness and violence prevention remains limited.

PMID:40014342 | DOI:10.1001/jamanetworkopen.2024.62069

JAMA Netw Open. 2025 Feb 3;8(2):e2462117. doi: 10.1001/jamanetworkopen.2024.62117.

ABSTRACT

IMPORTANCE: Short and long sleep durations are adversely associated with cardiovascular disease (CVD), type 2 diabetes, and mortality. It remains unclear how sleep duration trajectories over time are associated with mortality and whether these associations vary by well-documented sex, race, and socioeconomic sleep disparities.

OBJECTIVE: To investigate the association of 5-year sleep duration trajectories with all-cause and cause-specific mortality among US adults, predominantly those in low-income groups.

DESIGN, SETTING, AND PARTICIPANTS: The Southern Community Cohort Study included participants aged 40 to 79 years recruited and enrolled (from March 2002 to September 2009) from community health centers by using random sampling methods across 12 states in the Southeastern US. Participants completed a follow-up survey between 2008 and 2013. Data analysis was performed from August 10 to November 30, 2023.

EXPOSURES: Sleep duration was self-reported at study enrollment and at 5-year follow-up. At each time point, sleep was categorized as short (<7 hours), healthy (7-9 hours), or long (>9 hours). Nine sleep trajectories were defined based on 5-year change or consistency in sleep duration category between enrollment and follow-up.

MAIN OUTCOME AND MEASURES: Cause of death was ascertained via linkage to the National Death Index through December 31, 2022. Multivariable-adjusted Cox proportional hazards regression analysis was performed to estimate hazard ratios (HRs) and 95% CIs for mortality outcomes (all-cause, CVD, cancer, and neurodegenerative disease) associated with sleep duration trajectory.

RESULTS: Participants included 46 928 adults (mean [SD] age, 53.0 [8.8] years; 65.4% women; 63.3% self-identified as Black and 36.7% as White; and 47.5% with a household income <$15 000 per year). Overall, 66.4% of participants had suboptimal 5-year sleep trajectories. Race varied across sleep trajectories; 53.0% of participants in the optimal trajectory were Black, compared with 84.5% in the long-short trajectory. During a median 12.6 (IQR, 11.3-13.1) years of follow-up, 13 579 deaths occurred (4135 from CVD, 3067 from cancer, and 544 from neurodegenerative diseases). Compared with the optimal sleep duration trajectory, suboptimal trajectories were associated with as much as 29% greater risk of all-cause mortality in fully-adjusted models. For all-cause and CVD-specific mortality, the long-long (HRs, 1.27 [95% CI, 1.14-1.41] and 1.22 [95% CI, 1.01-1.48], respectively) short-long (HRs, 1.29 [95% CI, 1.17-1.42] and 1.22 [95% CI, 1.03-1.45], respectively), and long-short (HRs, 1.19 [95% CI, 1.05-1.35] and 1.32 [95% CI, 1.07-1.63], respectively) trajectories were associated with the greatest risk. After adjustment for comorbid conditions, no associations were observed for mortality due to cancer or neurodegenerative disease. Observed associations varied by race and household income, with the greatest risk observed among White adults with greater household incomes.

CONCLUSIONS AND RELEVANCE: In this cohort study of 46 928 US residents, nearly two-thirds of participants had suboptimal 5-year sleep duration trajectories. Suboptimal sleep duration trajectories were associated with as much as a 29% increase in risk of all-cause mortality. These findings highlight the importance of maintaining healthy sleep duration over time to reduce mortality risk.

PMID:40014341 | DOI:10.1001/jamanetworkopen.2024.62117

Chaos. 2025 Feb 1;35(2):023167. doi: 10.1063/5.0241503.

ABSTRACT

The Atlantic Meridional Overturning Circulation (AMOC) stability landscape is commonly investigated with single-realization hysteresis diagrams driven by freshwater input in the North Atlantic Ocean. However, the effect of CO2 forcing on one side and the role of internal climate variability on the timing of tipping and the AMOC hysteresis on the other side remain less explored. Here, we address this gap by running three independent AMOC hysteresis simulations, consisting of a slow ramp-up plus ramp-down in the CO2 concentration (0.2 ppm/year) within the PlaSim-Large-Scale Geostrophic (LSG) intermediate complexity model. We show that the realizations of the CO2-driven hysteresis cycle, and particularly, the timing of the tipping and recovery, are remarkably affected by internal climate variability. In one of the three simulations, we even observe a reversed cycle, where the AMOC recovers at a higher CO2 level than at the collapse point. While statistical Early Warning Signals (EWSs) show some success in detecting the tipping points, we also find that the internal variability in the EWS considerably reduces the predictability of collapse and leads to false positives of an approaching AMOC tipping. We suggest that the AMOC collapse in the presence of internal climate variability may have characteristics that deviate substantially from the behavior seen in simple models and that caution is needed when interpreting results from a single-experiment realization. Our findings highlight the need for a probabilistic approach in defining a “safe operating space” for AMOC stability, since it might not be possible to define a single critical CO2 threshold to prevent AMOC collapse.

PMID:40014327 | DOI:10.1063/5.0241503

JAMA. 2025 Feb 27. doi: 10.1001/jama.2025.1042. Online ahead of print.

ABSTRACT

IMPORTANCE: Health-related social needs are drivers of worse health and high health care spending. In North Carolina Medicaid’s 1115 waiver, the Healthy Opportunities Pilots (HOP) program allows for nonmedical services to address health-related social needs, such as healthy food boxes and housing navigation, financed by Medicaid, in 3 regions of North Carolina.

OBJECTIVE: To determine whether individual participation in the HOP program is associated with lower Medicaid spending.

DESIGN, SETTING, AND PARTICIPANTS: Comparative interrupted time series evaluation using North Carolina Medicaid data from March 2021 through November 2023. The 13 227 HOP enrollees were compared with 73 469 Medicaid beneficiaries reporting a health-related social need (a HOP eligibility criterion), but who were ineligible for HOP due to county of residence.

EXPOSURE: Participation in HOP.

MAIN OUTCOMES AND MEASURES: The primary outcome was the sum of spending by Medicaid on medical and HOP services per beneficiary per month. Secondary outcomes included health care use (emergency department visits, inpatient admissions, and outpatient visits).

RESULTS: Among 13 227 HOP and 73 469 comparison group members, the mean age was 23.4 (SD, 18.8) years, 63.9% were female, 42.4% were Black, and 57.4% were White (participants could report >1 race). Mean monthly preindex spending was $828 (SD, $5105). Of HOP enrollees, 89% received at least 1 HOP service, and 85% of services were food services. The comparative interrupted time series analysis estimated that spending increased at the month of HOP enrollment (change in level, $687; 95% CI, $420-$954). However, the trend in spending for HOP participants was differentially lower (change in trend, -$85 per beneficiary per month; 95% CI, -$122 to -$48; P < .001) relative to a counterfactual scenario without HOP. Taken together, these findings indicated that monthly spending was equivalent to estimated counterfactual expenditures by month 8 after starting HOP and lower thereafter. Emergency department visit trend was differentially lower for HOP participants (-6 per 1000 person-months; 95% CI, -8 to -4). There was no statistically significant differential trend in hospitalizations (-1 per 1000 person-months; 95% CI, -2 to 0) or outpatient visits (1 per 1000 person-months; 95% CI, -7 to 9).

CONCLUSIONS AND RELEVANCE: Results of this study suggest that the HOP program was associated with increased spending at enrollment, followed by a subsequently lower spending trend.

PMID:40014313 | DOI:10.1001/jama.2025.1042

Ann Nucl Med. 2025 Feb 27. doi: 10.1007/s12149-025-02028-5. Online ahead of print.

ABSTRACT

BACKGROUND: We planned this retrospective study to evaluate the effect of the central vs peripheral location effect on the success of selective internal radiation therapy (SIRT) with ⁹⁰Yttrium-90 (⁹⁰Y) glass microspheres in hepatocellular carcinomas (HCC).

MATERIAL AND METHODS: Thirty-eight patients diagnosed with HCC who were eligible for SIRT with ⁹⁰Y glass microspheres were included in this study. The location being central versus peripheral was defined as explained: Straight lines through the bifurcation of the right and left branches of the portal vein to the center of the HCC and the peripheral surface of the liver were traced on the same plane. The coefficient was determined as a ratio of the center of the HCC to the distance from the hilum of the liver at the portal vein bifurcation. Value under ½ accepted as central location (Group 1, n = 17), over ½ values are accepted as peripheral location (Group 2, n = 21). Treatment responses were analyzed after 2 months of the treatment with magnetic resonance imaging, and 2-deoxy-2-[¹⁸F]fluoro-D-glucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT) for FDG-avid ones. Differences in treatment responses rates, treatment approach, the absorbed doses and the volumes of each liver segments between groups were investigated.

RESULTS: In Group 1; mean age was 67. In 5 cases split infusion, in 10 cases tumor selective treatment approach were applied. According to PERCIST/mRECIST criteria treatment responses categories: complete response in 2/1 cases, partial response in 7/9 cases, stable disease in 3/4 cases, progressive diseases in 2/3 cases; respectively. AFP value decreased in 2 cases, increased in 7 cases, and was stable in 1 case. Mean absorbed doses were 347.9 Gy for tumor, 140.6 Gy for perfused normal tissue, and 26.1 Gy for the normal liver. In Group 2; the mean age was 71.5. In 5 cases split infusion, and in 1 case non-selective treatment approach were applied. According to PERCIST/mRECIST criteria treatment responses categories: complete response in 7/6 cases, partial response in 7/10 cases, stable disease in 2/2 cases, and progressive diseases in 3/3 cases; respectively. AFP value decreased in 9 cases, increased in 2 cases, and was stable in 2 cases. Mean absorbed doses were 495.9 Gy for tumor, 134 Gy for perfused normal tissue, and 17.3 Gy for the normal liver.There is no statistically significant difference in terms of gender, treatment response rates, tumor volumes, perfuse tissue volumes between 2 groups. However, tumor-selective approach and absorbed doses of the perfused normal tissue and the tumor were significantly higher in Group 2 (p = 0.007, 0.04, and 0.02; respectively).

CONCLUSION: Contrary to expectation, centrally located HCCs could be treated as successfully as peripherally located HCCs. However, the complete response rate in the peripheral located tumor is more frequent than centrally located ones.

PMID:40014290 | DOI:10.1007/s12149-025-02028-5

J Racial Ethn Health Disparities. 2025 Feb 27. doi: 10.1007/s40615-025-02335-7. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: To identify demographic predictors, with a focus on race and socioeconomic status, for advanced treatment modality, mortality, and increased length of stay (LOS) in upper gastrointestinal (GI) hemorrhage treatment.

METHODS: Hospitalizations with acute upper GI hemorrhage from 2016 to 2021 were identified in the Healthcare Cost and Utilization Project’s National Inpatient Sample. Cases were divided into interventional radiology (IR) and non-IR (endoscopic) treatments. Statistical analyses calculated significant odds ratios via 95% confidence intervals. The primary outcome of interest was mortality rate. The secondary outcome of interest was the mean LOS. Confounding factors affecting mortality were also examined.

RESULTS: There was no significant difference in likelihood of an IR procedure or mortality between White patients and both Non-Hispanic (NH) Black and Hispanic patients. NH Black patients had significantly longer LOS in days compared to White patients (12.61 vs 9.57) that persisted when matching for age and sex (13.78 vs 9.92), socioeconomic status (12.94 vs 10.07), chronic comorbidities (11.33 vs 8.88), blood transfusions (14.46 vs 10.21), and vasopressor use (14.43 vs 10.29) (p < 0.001). These LOS differences were not seen under matching conditions post-COVID-19.

CONCLUSION: This study presents racial disparities in LOS following acute upper GI hemorrhage, but no differences in advanced treatment utilization or mortality. Confounders were responsible for LOS differences in non-IR treatment, but NH Black patients had persistently longer LOS than White patients after IR treatment.

PMID:40014285 | DOI:10.1007/s40615-025-02335-7

J Racial Ethn Health Disparities. 2025 Feb 27. doi: 10.1007/s40615-025-02318-8. Online ahead of print.

ABSTRACT

OBJECTIVES: People from ethnic minority backgrounds are exposed to greater risk of patient safety events (such as healthcare-acquired infections and medication errors) occurring in their healthcare. However, evidence of the type and frequency of patient safety events occurring in cancer care among patients from ethnic minority background is lacking. This study sought to address this evidence gap.

DESIGN: A two-stage retrospective medical record review was conducted at four cancer services in two Australian states. Eligible medical records at each service that were identified as belonging to ethnic minority patients were reviewed by two clinician researchers in stage one, followed by authentication of extracted data by a site-specific cancer clinician in stage two. Descriptive statistics were used to report the frequency and type of safety events. Chi-square and independent sample T-tests were used to examine the association between safety events and patient socio-cultural indicators.

RESULTS: A total of 628 patient records were included. Of the 628 patient records, 212 (33.75%) documented at least one safety event. A total of 410 safety events were documented in the 212 patient records. Medication-related safety events were most commonly documented (121/410, 29.5%), followed by clinical process/procedure-related safety events (76/410, 18.5%) and patient accidents (60/410, 14.6%). The occurrence of a safety event was associated with patient records that documented ‘no interpreter was required’.

CONCLUSION: Patient safety events in cancer care occur frequently among patients from ethnic minority backgrounds. Unsafe cancer care for this population is associated with inadequate use of interpreters, lack of shared understanding and expectations of care processes linked to cultural and linguistic barriers. Approaches to enhance engagement are required.

PMID:40014284 | DOI:10.1007/s40615-025-02318-8

Res Child Adolesc Psychopathol. 2025 Feb 27. doi: 10.1007/s10802-025-01296-z. Online ahead of print.

ABSTRACT

Adverse Childhood Experiences (ACEs) are generally associated with impaired life functioning, including mental health. Prevalent globally, ACEs’ effects vary across cultural settings and groups. The present study assessed horizontal and vertical individualism and collectivism – key cultural dimensions – as moderators of ACEs’ relations to adolescent aggressive behavior. The study was conducted in Vietnam, a Southeast Asian nation with high levels of collectivism but with levels of individualism increasing with globalization. The cross-sectional study included 644 high-school students (mean age = 16.6 years; 54% female). Self-report measures assessed ACEs, adolescent aggressive behavior, and individualism and collectivism. Given collectivism’s focus on supporting one’s social communities, it was hypothesized that collectivism would serve as a protective factor for statistical effects of ACEs on aggression. All four moderator analyses involving collectivism supported this hypothesis; i.e., at high levels of collectivism, relations between ACEs and aggression were significantly smaller than at low levels of collectivism. Statistical effects were largest for vertical (endorsing hierarchical power structures) collectivism. In the one significant individualism moderator analysis, individualism served as a risk factor for (i.e., increased) statistical effects of ACEs on proactive aggression. Results highlight the importance of the horizontal-vertical sub-dimensions, as they may provide for more precise theoretical explanatory and intervention models. For instance, concern for the power hierarchy’s reactions (vertical collectivism) to one’s aggression vs. concern for harm to one’s groups (horizontal collectivism) by one’s aggression have different implications for prevention and treatment that may be useful for maximizing interventions’ effectiveness.

PMID:40014281 | DOI:10.1007/s10802-025-01296-z

Oral Radiol. 2025 Feb 27. doi: 10.1007/s11282-025-00811-8. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the fractal analysis data of ultrasonography (USG) images of the submandibular and parotid glands before and after parenchymal stimulation to assess for any changes.

METHODS: The study was conducted by taking 240 USG images of bilateral parotid and submandibular glands of 30 patients before and after stimulation. Patients chewed gum for stimulating their salivary glands. Fractal analysis was performed on the USG images, and the data obtained were statistically compared.

RESULTS: The fractal analysis value of the USG images of the parotid gland was 1.45, both before and after stimulation, indicating no statistically significant difference (p = 0.866). In the submandibular gland, this value was the same before and after stimulation (fractal analysis = 1.42), showing no statistically significant difference (p = 0.748). Parotid and submandibular glands were compared. USG fractal analysis values before and after stimulation and the overall values were statistically significantly different between the different salivary glands (p < 0.05).

CONCLUSION: According to fractal analysis, there was no change in the parenchyma of the submandibular and parotid glands despite the stimulation. Submandibular and parotid glands could be distinguished by fractal analysis.

PMID:40014279 | DOI:10.1007/s11282-025-00811-8