Tag: pubmed

Front Oncol. 2026 Jan 6;15:1718288. doi: 10.3389/fonc.2025.1718288. eCollection 2025.

ABSTRACT

BACKGROUND: Systemic inflammation and immune dysregulation are recognized as key determinants of cancer progression and survival. The pan-immune-inflammation value (PIV), a hematologic-based composite biomarker, may reflect the host’s immune-inflammatory status. Its prognostic significance in brain metastases (BM), however, remains undefined.

METHODS: In a single-center retrospective cohort, 3,856 consecutive patients with radiologically confirmed BM diagnosed between 2013 and 2021 were included. PIV was calculated as neutrophil count × platelet count × monocyte count, divided by lymphocyte count. All blood cell counts were recorded in units of 10^9 cells per liter. Complete blood counts were taken within 7 days before the start of treatment. The optimal PIV cut-off, derived using maximally selected log-rank statistics, defined low and high PIV groups. OS was analyzed using multivariable Cox models adjusted for age, performance status, number of BM and extracranial metastases. A PIV-augmented GPA nomogram was developed and internally validated with bootstrap resampling. Time-dependent concordance indices, calibration and integrated discrimination improvement (IDI) were used to assess model performance. Subgroup and sensitivity analyses examined robustness across systemic and local treatment modalities, primary tumor types, sex and alternative PIV parameterizations.

RESULTS: The PIV cut-off separated 1,570 patients with low PIV and 2,286 with high PIV. High PIV was associated with worse OS and remained independently prognostic (hazard ratio 1.40; 95% confidence interval 1.29-1.52; p < 0.001), with consistent effects across treatment modalities, primary tumor types and sex. Alternative cut-offs and modeling PIV as a continuous variable (per 1-standard-deviation increase) produced effect estimates similar to the primary analysis. Adding PIV to the GPA modestly improved discrimination and increased IDI by 0.010 (95% confidence interval 0.006-0.015; p < 0.001); the PIV+GPA nomogram showed good 1-year calibration.

CONCLUSIONS: PIV is an independent prognostic factor for OS in BM patients. Incorporating this marker into the Graded Prognostic Assessment modestly improves risk stratification and supports an accessible nomogram for individualized survival prediction. External prospective validation, including longitudinal assessment of the pan-immune-inflammation value and integration with molecular and imaging markers, is needed before routine clinical implementation.

PMID:41568367 | PMC:PMC12815847 | DOI:10.3389/fonc.2025.1718288

Front Psychiatry. 2026 Jan 6;16:1721514. doi: 10.3389/fpsyt.2025.1721514. eCollection 2025.

ABSTRACT

OBJECTIVE: This study investigated how personality (Temperament, Character) influences the occurrence and onset age of Bipolar Disorder (BD). Unlike previous studies, Temperament and Character Inventory (TCI) dimensions as well as profiles were examined regarding BD onset age.

METHODS: We recruited within 5 years 179 adults with prevalent BD (37.4% males, mean age 48.0 ± 12.0 years) attending a general hospital outpatient clinic, in euthymia during the previous 3 months, and 96 controls (36.5% males, mean age 40.4 ± 12.6 years), a convenience sample of community adults recruited via snowball sampling. All participants completed TCI-140. Associations of personality with diagnosis were investigated using logistic regressions while case-only linear and Cox regressions examined associations of personality with onset age. Analyses included TCI dimensions, continuous and binary (dichotomized utilizing Greek general population medians), and profiles (all possible combinations of Temperament or Character high/low binary dimensions), adjusting for potential confounders.

RESULTS: In logistic regressions, BD risk was associated with higher scores in Novelty Seeking (NS), Harm Avoidance (HA) and Self-Transcendence (ST) and lower in Self-Directedness (SD) and Cooperativeness (CO). In linear and Cox regressions, high NS indicated earlier onset compared to low (B=-4.70 [-8.10, -1.30]; HR = 1.60 [1.15, 2.22]), while high SD indicated delayed onset (B = 5.24 [1.87, 8.62]; HR = 0.57 [0.40, 0.79]). In exploratory profile analyses, Narcissistic (high NS, HA and Reward Dependence [RD]) and Histrionic (high NS, low HA, high RD) Temperament profiles and Cyclothymic (low SD, high CO, high ST) and Melancholic (low SD, CO and ST) Character profiles were associated with earlier BD onset, while the Reliable (low NS, low HA, high RD) Temperament profile and Bossy (high SD, low CO, low ST), Creative (high SD, CO and ST) and Organized (high SD, high CO, low ST) Character profiles were associated with delayed onset. These associations, however, lost statistical significance after correcting for multiple comparisons and should be interpreted cautiously.

CONCLUSION: This study reaffirmed previous associations of TCI dimensions with BD risk, with two (NS, SD) also significantly relating for the first time to onset age. TCI profiles tentatively provided a more nuanced understanding of BD’s onset than dimensions but warrant further investigation in larger samples.

PMID:41568281 | PMC:PMC12815727 | DOI:10.3389/fpsyt.2025.1721514

J Orthop Surg Res. 2026 Jan 21. doi: 10.1186/s13018-025-06630-1. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the functional and radiographic outcomes of full arthroscopic subtalar joint arthroscopy combined with a calcaneal distractor for the management of Sanders type II and III calcaneal fractures.

METHODS: A retrospective analysis was conducted on 26 patients (26 feet) with Sanders type II and III calcaneal fractures who underwent treatment utilizing a full arthroscopic subtalar arthroscopy technique combined with a calcaneal distractor. The surgeries were performed in the Department of Orthopedics at Xuzhou Central Hospital between January 2019 and December 2022. The cohort included 20 males and 6 females, with a mean age of 47.96 ± 8.87 years (range: 34-66 years). According to the Sanders classification, 7 fractures were type II and 19 were type III. Preoperative assessments yielded the following scores: a mean Visual Analogue Scale (VAS) score for pain of 7.35 ± 1.06 points (range: 4-9), a mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score of 52.27 ± 9.52 points (range: 55-85), and a mean SF-36 quality of life score of 92.04 ± 4.88 points (range: 80-100).All patients underwent fixation via the combined subtalar joint arthroscopy and calcaneal distractor approach. Postoperative evaluations focused on wound healing status, quality of fracture reduction, and evidence of bony union. Functional outcomes and pain levels were assessed using the VAS, AOFAS ankle-hindfoot score, and the SF-36 questionnaire. A comparison of preoperative and final follow-up scores was performed using the independent samples t-test.

RESULTS: All procedures were successfully completed without intraoperative complications. The mean operative time was 69.7 ± 10.4 min (range: 40-110). All surgical incisions achieved primary healing, with no instances of soft tissue infection, necrosis, or sensory disturbances observed during the postoperative period. Postoperative radiographic measurements of the calcaneus, including its length, width, height, Böhler’s angle, and Gissane’s angle, demonstrated significant improvement compared to preoperative values (all P < 0.01). Furthermore, no statistically significant differences were observed in these parameters between the immediate postoperative period and the final follow-up (all P > 0.05), indicating well-maintained fracture reduction and satisfactory healing. The patients showed significant improvement in the VAS, AOFAS, and SF-36 scores postoperatively compared to their preoperative status (all P < 0.01). At the final follow-up, functional outcomes were satisfactory. According to the AOFAS ankle-hindfoot scale, the scores were graded as excellent in 24 cases and good in 2 cases, yielding an excellent-good rate of 100.0%.

CONCLUSION: The combined technique of full arthroscopic subtalar arthroscopy and a calcaneal distractor demonstrates high precision in fracture reduction and satisfactory clinical outcomes, establishing it as a reliable and effective method for managing Sanders type II and III calcaneal fractures.

PMID:41566367 | DOI:10.1186/s13018-025-06630-1

J Health Popul Nutr. 2026 Jan 21. doi: 10.1186/s41043-026-01239-4. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to analyze trends in colorectal cancer (CRC) burden attributable to lifestyle factors in China (1990-2021), focusing on shifts of lifestyle, and to project future trajectories to inform public health strategies.

METHODS: Data from the Global Burden of Disease Study 2021 were utilized to assess deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) for CRC linked to nine lifestyle factors (including: diet low in whole grains, diet low in milk, diet low in fiber, diet low in calcium, diet high in red meat, diet high in processed meat, smoking, high alcohol use, and high BMI). Statistical analyses included estimated annual percentage change (EAPC), Joinpoint regression, age-period-cohort modeling, and Autoregressive Integrated Moving Average (ARIMA) projections (2022-2050).

RESULTS: Between 1990 and 2021, the burden of CRC attributable to most dietary factors declined, with significant reductions in low fiber (DALYs EAPC: -3.77) and low calcium intake (DALYs EAPC: -3.18). In contrast, processed meat intake showed an increase (DALYs EAPC: 1.64). Alcohol-related CRC burden rose slightly (DALYs EAPC: 0.35), while high BMI showed a marked increase (DALYs EAPC: 2.31). ARIMA projections suggest continued declines in dietary risk-related CRC burden. In contrast, the burden attributable to high body-mass index (BMI) is projected to rise substantially through 2050.

CONCLUSIONS: While improved dietary habits have reduced CRC burden in China, rising obesity pose growing threats. Public health policies must prioritize interventions targeting processed meat intake, and weight management to curb future CRC incidence and mortality.

PMID:41566355 | DOI:10.1186/s41043-026-01239-4

Syst Rev. 2026 Jan 21. doi: 10.1186/s13643-025-03062-0. Online ahead of print.

ABSTRACT

BACKGROUND: Differentiated Service Delivery (DSD) models for HIV are antiretroviral therapy (ART) mechanisms for stable people living with HIV (PLHIV) and are meant to be patient-centered to achieve treatment goals. One key element to achieve treatment goals is clients’ satisfaction with DSD models. Despite extensive implementation and scale-up of DSD models in sub-Saharan Africa, satisfaction levels remain unclear. Thus far, no comprehensive systematic review and meta-analysis regarding clients’ satisfaction level with DSD models and associated factors has been published. Therefore, we aim to conduct a systematic review and meta-analysis (1) to establish the level of clients’ satisfaction with DSD models, (2) to determine which specific DSD models clients are most likely to be satisfied with, and (3) to identify factors associated with clients’ satisfaction with DSD models.

METHODS: All eligible studies reporting empirical evidence will be identified using a predetermined search strategy in several electronic databases such as EMBASE, PubMed, Scopus, Web of Science, CINAHL, and ProQuest. Observational studies that have been conducted in sub-Saharan African countries regardless of the year of publication will be included in the systematic review and meta-analysis. We will conduct this review and meta-analysis according to the guidelines by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A random effects model will be used to conduct the meta-analysis using Stata 19.5 software. Heterogeneity will be assessed by using Cochran’s Q test and the I² statistic. Bias will be evaluated using Egger’s and Begg’s tests as well as visually by funnel plot.

DISCUSSION: To the best of our knowledge, this review and meta-analysis will be the first to be conducted in the sub-Saharan Africa region to synthesize empirical evidence regarding clients’ satisfaction with DSD models and associated factors, as well as identify common DSD models most clients are likely to be satisfied with. Collection of existing evidence will improve and guide implementation, scale-up, and adoption of different DSD models. Such knowledge can inform program managers and implementers which DSD models are likely to result in desired HIV treatment outcomes.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420251085833.

PMID:41566351 | DOI:10.1186/s13643-025-03062-0

BMC Med. 2026 Jan 21. doi: 10.1186/s12916-026-04641-1. Online ahead of print.

ABSTRACT

BACKGROUND: To examine associations between public park characteristics within different walking distances from residential locations and depression, to distinguish between features within parks (e.g. amenities, attractions, facilities, tree cover) and park metrics in the home area (e.g. number of parks, size, and total area), and to employ rigorous geospatial analysis linking the best available objectively measured park and urban green space (UGS) exposures to validated depression outcomes across multiple scales.

METHODS: This population-based cross-sectional study utilised baseline data from 329,363 UK Biobank participants resident in urban areas. Prevalent diagnosed depression was defined as an ICD-10 code of F32 (depressive episode) or F33 (recurrent depressive disorder). Park characteristics and urban green space data were derived from Ordnance Survey Great Britain datasets and spatially linked to participants’ residential addresses. Three definitions of Home Catchment Area size were tested for every individual respondent: 400 m (m), 800 m, and 1600 m, as proxies for a 10-,20- and 40-min return walk respectively. Logistic regression models assessed associations with robust statistical approaches including assessment of interaction, correction for multiple testing, confounder adjustment, and sensitivity analyses.

RESULTS: Specific park characteristics within 20-min and 40-min catchments were associated with reduced depression likelihood among women only. Within 40-min catchments, protective associations were observed for recreational amenities (cafés: odds ratio (OR) 0.89, 95% confidence interval (CI) 0.85-0.93; toilets: OR 0.85, 95% CI 0.79-0.91), attractions (OR 0.83, 95% CI 0.80-0.87), sports facilities (OR 0.84, 95% CI 0.79-0.90), and tree canopy coverage (e.g. > 20%, OR 0.88, 95% CI 0.85-0.91). In a 20-min catchment, each 1% increase in urban greenspace classified as parks was associated with 11% reduced depression odds among women (OR 0.89, 95% CI 0.82-0.95). No significant protective associations were observed among men, with some paradoxical adverse associations identified.

CONCLUSIONS: This study provides robust evidence for protective associations between park characteristics and depression among women, but not men. Findings support proximity-based planning concepts but challenge the current policy and practice focus on 20-min neighbourhood and identify park features which optimise preventive potential. Results have direct implications for evidence-based urban planning policy internationally, providing a framework for developing mental health-supporting green infrastructure that recognises sex-based differences.

PMID:41566331 | DOI:10.1186/s12916-026-04641-1

Ann Gen Psychiatry. 2026 Jan 21. doi: 10.1186/s12991-025-00624-3. Online ahead of print.

ABSTRACT

BACKGROUND: Dyslipidemia and inflammation play key roles in the pathophysiology of depression and are significantly associated with the plasma atherogenic index (AIP). However, a reliable biomarker for diagnosing depression remains elusive. The hsCRP/HDL-C ratio, combining C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol (HDL-C), may serve as a potential composite indicator.

OBJECTIVE: This study aims to explore the relationship between the hsCRP/HDL-C ratio and depression.

METHODS: NHANES data (2015-2020) from 10,357 participants were analyzed. Depression was assessed using the PHQ-9, and dyslipidemia with AIP. Participants were grouped based on their hsCRP/HDL-C ratio. Statistical methods included Student’s t-test, chi-square test, logistic regression, restricted cubic spline (RCS) model, and mediation analysis.

RESULTS: RCS regression analysis showed a nonlinear relationship between the hsCRP/HDL-C ratio and depression. The two-piece logistic regression model was used to calculate the threshold effect, and the likelihood ratio test (p < 0.05) indicated that the inflection point for hs-C/H was 11.608. When the hsCRP/HDL-C ratio was below this threshold, a positive correlation with depression was observed (OR: 1.04, 95% CI: 1.01-1.07). When the hsCRP/HDL-C ratio was equal to or greater than the threshold, a negative correlation was found (OR: 0.99, 95% CI: 0.97-1.00). Subgroup analysis showed consistent results, with marital status being the only factor that significantly influenced this relationship. Mediation analysis revealed that AIP partially mediated the relationship between hsCRP/HDL-C ratio and depression, explaining 11.2% of the total effect (95% CI: 2.26%-27.00%).

CONCLUSIONS: A higher hsCRP/HDL-C ratio is associated with increased depression risk. Interventions targeting CRP levels and lipid abnormalities may help reduce this risk.

PMID:41566323 | DOI:10.1186/s12991-025-00624-3

BMC Public Health. 2026 Jan 21. doi: 10.1186/s12889-025-26092-8. Online ahead of print.

ABSTRACT

BACKGROUND: High blood pressure (BP) is becoming increasingly common among young adults, with university students representing a particularly vulnerable group, posing a growing public health challenge worldwide. The study explores the relationship between BMI and demographic characteristics related to elevated BP in this group, the study addresses a critical gap in local data and supports broader efforts to reduce the future burden of hypertension in South Africa.

OBJECTIVES: This study aimed to examine the association between BMI, demographic data, and elevated BP among university students in South Africa.

METHODS: A cross-sectional research study was conducted with university students. The researchers measured the participants’ anthropometrics and BP and obtained their demographic data. Binary logistic regression was used to identify factors associated with elevated BP whilst descriptive statistics, t-tests and chi-square tests were used to profile the study’s variables.

RESULTS: The prevalence of elevated BP was 46.4%. Elevated BP was more common among males (51.2%) and among students aged 25 years and older (58.9%). There was a significant association between BMI category and elevated BP, with students who were overweight showing an adjusted odds ratio (OR) of 1.98 (95% CI: 1.37-2.87), and students living with obesity showing an adjusted OR of 4.45 (95% CI: 2.73-7.27), compared to those with normal BMI. Additionally, pursuing a postgraduate degree and residing off campus were associated with increased odds of elevated BP. In contrast, being female was associated with lower odds of elevated BP (adjusted OR = 0.22, 95% CI: 0.16-0.31).

CONCLUSION: BMI, gender, educational level, and residence are significant predictors of high BP among university students. Early intervention is necessary to prevent hypertension in students.

PMID:41566312 | DOI:10.1186/s12889-025-26092-8

Zhonghua Liu Xing Bing Xue Za Zhi. 2026 Jan 10;47(1):113-118. doi: 10.3760/cma.j.cn112338-20250623-00430.

ABSTRACT

Objective: To understand the molecular epidemiological characteristics and influencing factors of natural scavengers of hepatitis B surface antigen (HBsAg) in the community population. Methods: From 2010 to 2015, people from the Wuwei Hepatitis B Prevention and Treatment Demonstration Zone were used as the research object to conduct health examinations and follow-up visits. Using the nested case-control study method, 99 HBsAg natural clearancers during the follow-up period were selected as the case group, and 316 HBsAg natural clearancers who did not have HBsAg natural clearance were selected as the control group. Data were collected using questionnaires, serology, and single-nucleotide polymorphism detection. Results: Among the 99 HBsAg natural clearance cases, 45 cases were male (45.45%) and 54 cases were female (54.55%); among the 316 control cases, 156 cases were male (49.37%) and 160 cases were female (50.63%); the genotypes of Notch3 gene rs1043994 loci CC, CT and TT genotypes accounted for 63.64%, 32.95% and 3.41%, respectively, and the frequency in the control group was 77.21%, 21.84% and 0.95%, respectively. The difference in genotype distribution between the two groups was statistically significant (P=0.014). The distribution frequencies of the Notch4 gene rs367398 AA, AG, and GG genotypes in the case group were 11.36%, 50.00% and 38.64%, respectively. In the control group, the frequencies were 5.38%, 43.99% and 50.63%, respectively. The genotype distribution difference between the two groups was statistically significant (P=0.043). Analysis of multivariate logistic regression model showed that factors related to the natural clearance of HBsAg include age ≥60 years old (OR=3.14, 95%CI: 1.33-7.41, P=0.009), Notch3 gene rs1043994 locus CT genotype (OR=1.82, 95%CI: 1.06-3.13, P=0.031), and TT genotype (OR=5.58, 95%CI: 1.05-29.59, P=0.044), Notch4 gene rs367398 locus AA genotype (OR=2.89, 95%CI: 1.17-7.13, P=0.021). Conclusion: In a community-based population of HBsAg carriers, individuals aged ≥60 years, those with the Notch3 gene rs1043994 locus (CT, TT) and the Notch4 gene rs367398 locus (AA) were more likely to experience natural clearance of HBsAg.

PMID:41566273 | DOI:10.3760/cma.j.cn112338-20250623-00430

Zhonghua Liu Xing Bing Xue Za Zhi. 2026 Jan 10;47(1):105-112. doi: 10.3760/cma.j.cn112338-20250722-00514.

ABSTRACT

Objective: To evaluate the performance of blocking the mother to child transmission of HBV in Jiangsu Province, to standardize the practice of blocking the mother to child transmission of HBV. Methods: Five counties (districts) were selected in northern, central and southern Jiangsu; the local data of maternal HBV screening and blocking mother to child transmission of HBV during 2021-2023 were extracted from relevant information systems. Chi-square test, Cochran-Armitage test and Firth’s penalized likelihood logistic regression model were used for statistical analyses. Results: From 2021 to 2023, a total of 63 805 pregnant women were surveyed in HBV screening, the HBsAg positive rate was 4.46%. In the positive women, 18.46% were at high-risk for mother to child transmission of HBV indicated by HBeAg or HBV-DNA levels; the rate of antiviral therapy during pregnancy increased from 33.78% in 2021 to 82.20% in 2023 (P<0.001). In 2 844 HBV-exposed live-born infants, the annual timely injection rates of hepatitis B immune globulin exceeded 98.30% each year (P=0.627), and the annual timely injection rate of hepetitis B vaccine birth dose increased from 95.25% in 2021 to 99.12% in 2023 (P<0.001). The annual post-vaccination serological test rate in HBV-exposed infants increased from 68.83% in 2021 to 92.82% in 2023 (P<0.001). In the post-vaccination serological test of 2 343 children, the annual HBsAb negative rate fell from 18.59% in 2021 to 6.92% in 2023 (P<0.001). Eight cases of blocking failure were identified (0.34%), the blocking failure rate in the pregnant women at high risk was 1.65%. Multivariate analysis revealed that the risk for blocking failure was 6.75 times (aOR=6.75,95%CI: 1.46-64.47) higher in high-risk pregnant women who received no antiviral therapy than in those who received antiviral therapy during pregnancy. Conclusions: From 2021 to 2023, the measures of blocking the mother to child transmission of HBV in Jiangsu is effective. Antiviral therapy for pregnant women at high risk is the key determinant of success. In the blocking transmission practice, it is necessary to increase the antiviral treatment rate in pregnant women at high-risk, further standardize the post-vaccination serological test procedures and strengthen the booster vaccination in HBsAb-negative children.

PMID:41566272 | DOI:10.3760/cma.j.cn112338-20250722-00514