Tag: pubmed

JAMA Netw Open. 2025 Nov 3;8(11):e2543701. doi: 10.1001/jamanetworkopen.2025.43701.

ABSTRACT

IMPORTANCE: Although hepatitis C virus (HCV) is an oncovirus, its association with the risk of pancreatic ductal adenocarcinoma (PDAC) is unclear. In addition, it is unknown whether there is differential risk for PDAC across HCV genotypes.

OBJECTIVE: To assess the association between chronic HCV and PDAC.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, national, population-based cohort study was conducted across Veterans Health Administration (VA) sites. The study included veterans with HCV testing documented in the VA or VA-linked Medicare with at least 1 inpatient or outpatient visit between October 1, 2001, and September 30, 2020. Patients were followed-up for at least 18 months after this visit. Data were analyzed from October 2023 to September 2025.

EXPOSURE: HCV status was categorized as chronic HCV, exposure to HCV, or no chronic HCV infection.

MAIN OUTCOMES AND MEASURES: The association of HCV status with PDAC was evaluated using Cox proportional hazards regression, adjusting for demographic and clinical confounders. Analysis was substratified by HCV genotype.

RESULTS: Of 6 330 856 people tested for HCV (5 841 571 men [92.3%]; median [IQR] age, 61.6 years [49.9-70.1]), 246 218 (3.9%) had chronic HCV and 209 492 (3.3%) were exposed. Of the 33 451 individuals (0.5%) who developed PDAC, age at diagnosis was younger among those with vs those without HCV (median [IQR] age, 65.0 [59.9-69.6] years vs 72.4 [66.7-79.0] years). Compared with no HCV infection, chronic HCV infection (adjusted hazard ratio [aHR], 1.76; 95% CI, 1.67-1.86) and HCV exposure (aHR, 1.18; 95% CI; 1.11-1.25) were associated with increased risk of incident PDAC. Hazards for PDAC were greater for HCV genotype 3 (aHR, 2.02; 95% CI, 1.67-2.45) and genotype 1 (aHR, 1.75; 95% CI, 1.64-1.87) than for genotype 2 (aHR, 1.35; 95% CI, 1.14-1.60) compared with no HCV infection.

CONCLUSIONS AND RELEVANCE: In this cohort study of veterans, chronic HCV infection was associated with a 1.8-fold higher risk of PDAC diagnosis, and HCV genotypes 3 and 1 had greater PDAC risk than genotype 2. These findings prompt future research on the mechanisms underlying this association and the impact of HCV treatment on PDAC risk.

PMID:41236736 | DOI:10.1001/jamanetworkopen.2025.43701

Cancer Epidemiol Biomarkers Prev. 2025 Nov 14. doi: 10.1158/1055-9965.EPI-25-1230. Online ahead of print.

ABSTRACT

BACKGROUND: C-reactive protein (CRP) is a widely used inflammatory biomarker that has been related to colorectal cancer (CRC) risk. However, observational studies are prone to confounding and reverse causality.

METHODS: We conducted a two-sample Mendelian randomization using CRP GWAS data from 59,605 Korean individuals and CRC GWAS data from 23,572 cases and 48,700 controls from an East Asia population. The analysis had 80% power to detect an odds ratio (OR) of 1.12 for CRC risk per two-fold increase in CRP levels.

RESULTS: Genetically predicted serum CRP levels (per two-fold increase) were not significantly associated with CRC risk (inverse-variance weighted OR: 0.995, 95% confidence interval: 0.893-1.109, P-value: 0.929). Null findings remained consistent in sensitivity analyses excluding the horizontally pleiotropic effect.

CONCLUSIONS: Despite sufficient statistical power, little evidence supported a causal association between CRP and CRC risk in East Asians.

IMPACT: Our findings suggest that CRP is unlikely to be a key determinant of colorectal carcinogenesis, aligning with prior studies in European populations.

PMID:41236733 | DOI:10.1158/1055-9965.EPI-25-1230

Int J Neurosci. 2025 Nov 14:1-11. doi: 10.1080/00207454.2025.2589395. Online ahead of print.

ABSTRACT

BackgroundWe aimed to evaluate the association between elevated cardiac troponin I (cTnI) and clinical outcomes in AIS patients receiving reperfusion therapy.MethodsWe conducted a multicenter retrospective cohort study of AIS patients treated with thrombolytics at Southern Illinois Healthcare and the University of Oklahoma (2017-2024). Demographic, clinical, laboratory, and radiographic data were collected. Elevation of cTnI was defined as levels above 0.028 ng/mL. For high sensitivity troponins, the cutoff was 15 ng/L for women and 20 ng/L for men.Outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and functional status at 30 days (good outcome defined as mRS ≤2). Overlap-weighted multivariable logistic regression was performed, adjusting for demographics, comorbidities, and stroke severity. Statistical significance was set at p < 0.05.ResultsAmong 496 patients, 143 (29%) had elevated cTnI. Compared with patients with normal cTnI, those with elevated levels were older, had more vascular risk factors, and higher baseline NIHSS. Elevated cTnI was not significantly associated with sICH (OR:3.75, 95%CI 0.52-27.21, p = 0.19), but was independently associated with increased in-hospital mortality (OR:1.96, 95%CI 1.62-6.20, p = 0.025) and decreased odds of good functional outcome at 30 days (OR:0.40, 95%CI 0.19-0.84, p = 0.016). Subgroup analyses showed these associations were most pronounced in older patients and in those with moderate (NIHSS 6-15) to severe (NIHSS 16-20 and > 20) strokes, whereas no significant relationships were observed in younger patients or mild strokes. Normalization of cTnI during hospitalization did not improve survival (p > 0.05).ConclusionsIn our study, elevated cTnI on admission is an independent predictor of poor short-term outcomes in AIS patients treated with reperfusion therapy. Troponin measurement may provide important prognostic information, particularly in older patients and those with more severe strokes.

PMID:41236729 | DOI:10.1080/00207454.2025.2589395

Account Res. 2025 Nov 14:1-11. doi: 10.1080/08989621.2025.2575442. Online ahead of print.

ABSTRACT

BACKGROUND: This article reports on the prevalence of registration of empirical studies presented at three editions of the World Conference on Research Integrity at the time of abstract submission.

METHODS: During registration and abstract submission, applicants were invited to answer questions on registration of the study they presented and their academic background.

RESULTS: Descriptive analyses of the responses regarding a total of 452 abstracts describing empirical studies showed that the prevalence of registration among presenters of empirical research did not increase across the three WCRIs, and was on average 28%. The verifiability of claims of registration did increase over time, however, from 44% to 88% of the abstracts of empirical studies claimed to be registered. Reasons given for not registering varied substantially, but little faith in its usefulness and unfamiliarity were frequently mentioned. Younger researchers tended to register more often than others, and researchers with a biomedical background registered more frequently.

CONCLUSION: We suggest simplifying the registration process and propose that funding agencies, research institutes, and scholarly journals should demand registration of empirical studies.

PMID:41236715 | DOI:10.1080/08989621.2025.2575442

Appl Biochem Biotechnol. 2025 Nov 14. doi: 10.1007/s12010-025-05473-0. Online ahead of print.

ABSTRACT

This study aims to evaluate the potential of green-synthesized titanium dioxide (TiO₂) nanoparticles (NPs) derived from herbal extracts-namely Camellia sinensis (Green Tea), Eclipta prostrata (Bhringraj), Glycyrrhiza glabra (Licorice), and Cinnamomum zeylanicum (Cinnamon)-for enhancing the Sun Protection Factor (SPF) in sunscreen formulations. Addressing the environmental and toxicity concerns associated with conventionally synthesized TiO₂ NPs, this eco-friendly approach offers a sustainable and effective alternative for cosmetic applications without compromising efficacy. The synthesized nanoparticles were characterized using UV-Vis spectroscopy, X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy (FTIR), and then incorporated into oil-in-water emulsions containing 5% homosalate. In vitro SPF was measured using the Labsphere UV-2000S system, while formulation stability was assessed via pH monitoring, rheological behavior, and accelerated centrifugation using the LUMiSizer. Statistical analysis, including one-way ANOVA and effect size metrics (η², Cohen’s d), confirmed significant SPF enhancement, particularly in formulations using Green Tea and Cinnamon-derived TiO₂ NPs, which showed 3.12-fold and 3.11-fold improvements, respectively. Notably, smaller crystallite size (30.2 nm in Green Tea-derived TiO₂) correlated with higher SPF (14.97 ± 0.31). All formulations exhibited excellent physical and thermal stability. These findings underscore the promise of plant-mediated TiO₂ NPs as a viable, sustainable solution for next-generation sunscreen products, with further investigation warranted for scale-up and in vivo validation.

PMID:41236699 | DOI:10.1007/s12010-025-05473-0

Aging Clin Exp Res. 2025 Nov 14;37(1):326. doi: 10.1007/s40520-025-03224-z.

ABSTRACT

BACKGROUND: Ageism and stigma toward individuals with dementia contribute to their social exclusion and negatively impact their well-being. Intergenerational interventions, particularly those based on shared enjoyable experiences, have shown potential in reducing negative stereotypes. This study explored whether a Silent Disco event could challenge ageism and dementia-related stigma by fostering positive intergroup contact.

AIMS: The study assessed the effectiveness of an intergenerational Silent Disco event in reducing ageism and stigma among young adults (21-40 years, M = 32.76 ± 4.70), middle-aged adults (41-60, years M = 51.21 ± 5.88), and young-old adults (61-80 years, M = 66.67 ± 6.10).

METHODS: A 6-item questionnaire with two subscales-“Non-inclusion” and “Unpleasantness of company”-was administered to 115 participants before and after the event to measure negative stereotypes about aging and dementia. Changes in attitudes were analyzed across age groups.

RESULTS: The event reduced stigma-related unpleasantness in the total sample (p = .020) and ageism-related unpleasantness among middle-aged participants (p = .011). However, no statistically significant changes were observed in non-inclusion perceptions for either ageism or stigma.

DISCUSSION: These findings indicate that intergenerational Silent Disco events help reduce specific negative stereotypes-particularly unpleasant perceptions of older adults and people with dementia-with the strongest reduction in ageism-related unpleasantness seen in middle-aged participants. However, the persistence of non-inclusion attitudes highlights the need for broader interventions to address social exclusion.

CONCLUSIONS: Silent Disco events show potential in challenging stereotypes and fostering inclusivity, but additional strategies are needed to promote deeper intergenerational engagement and social inclusion.

PMID:41236675 | DOI:10.1007/s40520-025-03224-z

Geroscience. 2025 Nov 14. doi: 10.1007/s11357-025-02009-6. Online ahead of print.

ABSTRACT

Postoperative delirium is a potentially devastating complication of surgery that commonly affects older adults. Neurofilament light chain (NfL) is a biomarker of neuronal injury with reported associations with the development of postoperative delirium. Previous studies suggest that nighttime dexmedetomidine may help prevent delirium following cardiac surgery. However, the mechanisms involved in the delirium-sparing properties of dexmedetomidine treatment remain unclear. This study investigated circulating NfL levels as an objective molecular biomarker associated with postoperative delirium and investigated whether nighttime dexmedetomidine moderates the association between NfL and delirium severity. Serum collected from participants aged 60 years and older who underwent cardiac surgery in the Minimizing ICU Neurological Dysfunction with Dexmedetomidine Induced Sleep (MINDDS) trial were analyzed for NfL concentrations using single-molecule immunoassays (n = 355 patients with preoperative NfL and delirium severity scores). Delirium assessments were performed using the Confusion Assessment Method (CAM). The primary outcome was the peak CAM-Severity score observed within 3 days after surgery. The analysis investigated the associations between preoperative and postoperative NfL levels and delirium severity, and whether nighttime dexmedetomidine modified these associations. Elevated preoperative NfL was associated with increased delirium incidence (odds ratio = 1.62, 95% confidence interval [1.22-2.14], p = 0.001). A one-standard-deviation increase in preoperative NfL was associated with a 0.32-point increase in CAM-S (95% confidence interval [0.14-0.50], p = 0.001). Dexmedetomidine significantly attenuated the association between preoperative NfL levels and delirium severity suggesting that dexmedetomidine may intervene early in the disease process to mitigate neuronal damage in older adults following surgery. This study provides insight into the use of preoperative NfL levels to predict delirium risk and reveals a novel interaction between dexmedetomidine treatment and delirium severity.

PMID:41236671 | DOI:10.1007/s11357-025-02009-6

Langenbecks Arch Surg. 2025 Nov 14;411(1):12. doi: 10.1007/s00423-025-03890-7.

ABSTRACT

BACKGROUND: Data on multinational 90-day mortality and morbidity rates after surgery for gastric cancer is limited in the literature. This study aimed to understand the 90-day mortality and morbidity outcomes among patients undergoing elective gastric cancer surgery, as in the GASTRODATA Registry, and to identify associated risk factors.

METHODS: We conducted an international prospective study on patients aged ≥ 18 years undergoing elective surgery for gastric cancer with curative intent from January 4 to September 30, 2022. Known metastatic disease, concurrent secondary cancers, gastrointestinal stromal tumour (GIST) and Siewert type I/II oesophagogastric junction malignancies were excluded. Univariate and multivariate logistic regression were used to identify variables associated with the 90-day outcome.

RESULTS: 380 collaborators from 47 countries submitted data on 1538 patients. Median age was 65 years (IQR: 19-94), and 58.5% were males. 90-day morbidity and mortality rates were 38.2% (n = 587) and 2.9% (n = 45), respectively. Pre-operative higher Charlson Comorbidity Index, higher ASA score, pre-operative weight loss > 10%, positive specimen margin, and post-operative pathological IV staging (p value < 0.05) were significantly associated with clinically relevant complications and mortality.

CONCLUSION: Elective gastric cancer surgery has a 90-day morbidity of 38.2% and a 90-day mortality of 2.9% globally. This study provided the most comprehensive international 90-day prospective data to date regarding gastric cancer surgery. Several factors associated with higher morbidity were identified, highlighting the importance of a unified language on surgical morbidity, prehabilitation, and ongoing audits to enhance patient outcomes.

PMID:41236666 | DOI:10.1007/s00423-025-03890-7

Aging Clin Exp Res. 2025 Nov 14;37(1):324. doi: 10.1007/s40520-025-03210-5.

ABSTRACT

BACKGROUND: Declining estrogen in perimenopausal women reduces bone mineral density and increases bone fragility, elevating fall and fracture risk. This presents major challenges for patients and society, yet prior studies lack systematic analysis of this population. This study is the first to utilize mortality and disability-adjusted life years (DALYs) related to falls among perimenopausal women from the Global Burden of Disease (GBD) 2021 database, and to conduct a comprehensive and systematic analysis of the evolving burden of falls in perimenopausal women from 1990 to 2021, as well as to project trends through 2050. This study offers key guidance for optimizing healthcare resource allocation, enhancing patient management, and developing targeted prevention and intervention strategies.

METHODS: This study used GBD 2021 data to systematically analyze fall-related mortality, DALYs, age-standardized rates (ASRs), and estimated annual percentage change (EAPC) among perimenopausal women, examining their associations with the Socio-demographic Index (SDI) at global, regional, and national levels. Joinpoint regression, decomposition, health inequality, and frontier analyses quantified trends, identified factors, and assessed disparities. This study also explored fall risk factors and utilized the Bayesian Age-Period-Cohort (BAPC) model to project global trends in fall burden among perimenopausal women from 2022 to 2050.

RESULTS: Between 1990 and 2021, global mortality attributable to falls among perimenopausal women surged by 116.99% (from 1.67 to 3.63 per 100,000), while DALYs increased by 38.31% (from 116.50 to 188.85 per 100,000). In contrast, age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) declined by 7.00% (EAPC = – 0.30) and 14.62% (EAPC = – 0.56), respectively. Decomposition analysis identified population growth as the predominant contributor to the escalation in mortality (162.91%), while epidemiological changes were the main reason for the reduction (- 63.63%). Marked heterogeneity was observed across SDI strata: low-middle SDI regions exhibited the steepest rise in mortality (138.00%), whereas high-SDI regions achieved the most pronounced reduction in ASMR (- 21.18%). Notably, high-income North America experienced an 106.62% increase in ASMR. The 50-54-year age cohort consistently represented the highest global burden, with low bone mineral density emerging as the principal risk factor. Projections to 2050 suggest ongoing declines in ASMR and ASDR, yet the absolute burden is expected to remain elevated due to persistent demographic expansion.

CONCLUSIONS: Between 1990 and 2021, the global burden of falls among perimenopausal women has exhibited a persistent upward trend, and projections indicate that this burden will likely remain at a high level in the future. This alarming situation underscores the urgent need for targeted interventions. Identifying key risk factors for falls in perimenopausal women is essential for guiding the allocation of public health resources and formulating precise intervention strategies. It is imperative to implement nationwide, cost-effective measures, such as osteoporosis and fall risk screening, the promotion of exercise programs that enhance muscle strength and balance, and, where appropriate, consideration of pharmacological interventions (such as estrogen) to reduce fall risk. This intervention will significantly reduce the risk of falls and associated burdens among perimenopausal women.

PMID:41236661 | DOI:10.1007/s40520-025-03210-5

Eur Radiol. 2025 Nov 14. doi: 10.1007/s00330-025-12132-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the completeness and discordance of outside rectal MRI initial staging reports compared to second-opinion reviews, and to assess the potential clinical impact of major discordance on treatment decisions in patients with rectal adenocarcinoma.

MATERIALS AND METHODS: A retrospective analysis of outside rectal MRI reviews submitted for second-opinion interpretation by subspecialized radiologists from June 2014-March 2020 was conducted. Outside and second review reports were compared side-by-side; cases with discordance (and those with major discordance, i.e., may alter treatment, particularly) were identified. Two colorectal surgeons, blinded to report origins, reviewed cases with major discordance to evaluate their theoretical impact on patient management and rated their confidence level of the reports on a five-point Likert scale (1=lowest confidence).

RESULTS: In 461 patients (median age, 57 years [IQR: 49-67]; 274 male), compared to outside reviews, second reviews demonstrated improved report completeness across tumor characteristics, local extent, and nodal/metastatic disease clinical staging categories. The largest reporting gaps were in tumor morphology (66.4%, 306/461 vs. 98.7%, 455/461) and extramural venous invasion (29.1%, 134/461 vs. 93.9%, 433/461). Overall, 53.8% (248/461) of cases showed discordance, with 56.5% (140/248) classified as major. In this subset, second reviews led to fewer cases with insufficient information, e.g., 18.6% (26/140) to 7.1% (10/140) for Surgeon 1, and changes in surgical planning in 38.1-46.3% (43/113 to 44/95) of patients. Surgeons rated reports from second reviews with higher confidence scores (median, 4 vs. 2-3, p < 0.001).

CONCLUSIONS: Second-opinion reviews may impact patient care and improve surgeons’ confidence for treatment planning.

KEY POINTS: Question Do subspecialist radiologist second-opinion reviews improve rectal MRI report completeness and affect treatment decisions in rectal adenocarcinoma staging? Findings While outside reviews often under-reported key imaging findings, second reviews improved report completeness, which led to increased confidence by our surgeons in treatment planning. Clinical relevance These findings underscore the value of expert interpretation and highlight the need for optimized MRI protocols and broader adoption of structured reporting in rectal cancer staging.

PMID:41236658 | DOI:10.1007/s00330-025-12132-9