Tag: pubmed

JAMA Netw Open. 2026 Jul 1;9(7):e2624553. doi: 10.1001/jamanetworkopen.2026.24553.

ABSTRACT

IMPORTANCE: The number of older adults living with frailty who undergo surgery is rapidly increasing worldwide. Life-space mobility (LSM) can capture physical and social dimensions of recovery and has been linked to functional decline and reduced quality of life.

OBJECTIVE: To examine postoperative recovery using LSM among older adults living with frailty and to identify factors associated with restricted mobility and readmission.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study within the larger Functional Improvement Trajectories After Surgery study used a convergent mixed-methods exploratory design. Seventeen hospitals across Canada included older adults aged 65 years or older with a clinical frailty score (CFS) of 3 or more who underwent major elective noncardiac surgery from March 2021 to June 2023. Data were analyzed from September to October 2025.

EXPOSURE: Elective noncardiac surgery among older adults.

MAIN OUTCOMES AND MEASURES: LSM (range 0-120, with higher scores indicating more mobility) was measured at 1 to 2 months and 6 months postoperatively, with retrospective presurgery LSM captured at 1 to 2 months. Multivariable linear mixed-effects models and multivariable mixed-effects logistic regression were used to identify factors associated with LSM trajectories, restricted mobility (ie, LSM < 60), and hospital readmission.

RESULTS: This study included 204 participants (mean [SD] age, 72.8 [5.6] years; 108 males [53%]). The mean (SD) LSM was 65.1 (26.7) presurgery, 56.6 (26.7) at 2 months postsurgery, and 64.9 (25.9) at 6 months postsurgery. Eighty participants (39.2%) had restricted mobility presurgery, 114 (56.4%) at 2 months postsurgery, and 84 (41.2%) at 6 months postsurgery. Restricted mobility was associated with being a woman (odds ratio [OR], 4.72; 95% CI, 2.27-9.84), greater frailty (OR, 10.42; 95% CI, 3.56-30.49), and concurrent need for support from formal or informal caregivers (OR, 5.43; 95% CI, 2.72-10.86). Elevated-risk surgery was associated with hospital readmission at 6 months (OR, 3.18; 95% CI, 1.48-7.25).

CONCLUSIONS AND RELEVANCE: In this nested cohort study, mean LSM recovered by 6 months postsurgery, but 41% of older adults still had restricted mobility. Being a woman, having greater frailty, and needing support from caregivers were associated with poor recovery. Integrating life-space assessments into individualized perioperative care planning may enhance evaluation of functional recovery, inform shared decision-making, and guide support strategies.

PMID:42485039 | DOI:10.1001/jamanetworkopen.2026.24553

JAMA Netw Open. 2026 Jul 1;9(7):e2624561. doi: 10.1001/jamanetworkopen.2026.24561.

ABSTRACT

IMPORTANCE: Despite the increasing prevalence of autism spectrum disorder (ASD) in the US, underlying temporal trends in newly recorded diagnoses remain poorly understood.

OBJECTIVE: To evaluate age- and sex-specific incidence trends of ASD from 2016 to 2024 and quantify the temporal patterns before and after the COVID-19 pandemic and diagnostic substitution.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used electronic health record data from a large US health care system. Analyses were conducted from October to December, 2025. The study population included 171 134 participants (stratified as children [0-9] years, adolescents [10-18] years, and adults [≥19] years) who maintained continuous engagement with the health care system, defined as having at least 1 clinical encounter annually from 2016 to 2024.

MAIN OUTCOMES AND MEASURES: The primary outcome was the annual incidence of newly recorded diagnoses of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes F84.0 and F84.5. Temporal trends were analyzed using joinpoint regression to calculate annual percentage changes (APCs) and identify significant inflection points.

RESULTS: Among 171 134 participants (mean [SD] age, 26.78 [16.38], 63.8% female), females received autism diagnoses a mean (SD) of 3.4 years later than males (age at diagnosis, 15.7 years for female individuals vs 12.3 years for male individuals; P < .001). Male autism incidence remained stable or declined 2016 to 2024; female incidence increased significantly post-2020 (APC, 19.0%; 95% CI, 12.1% to 33.4%). In the pediatric cohort, decreasing annual incidence among males (APC, -2.0%; 95% CI, -3.7% to -0.3%; to APC, -2.0%, 95% CI, -3.7% to -0.3%) alongside increasing incidence for females since 2020 (APC, 17.4; 95% CI, 9.0% to 45.3%). In adolescent males, incidence declined from 2016 to 2018 (APC, -29.6%; 95% CI, -48.9% to -1.2%), and stabilized from 2018 to 2024. In adolescent females, autism incidence increased significantly between 2020 and 2024 (APC, 22.3%; 95% CI, 6.1% to 62.8%). In adult males, autism incidence showed a downward trend in the 2016 to 2024 period, while in adult females, the APC from 2016 to 2024 was positive, but the finding was not statistically significant (APC, 8.0%; 95% CI, -0.9% to 20.0%).

CONCLUSIONS AND RELEVANCE: In this cohort study, ASD diagnoses increased disproportionately among females after 2020 while remaining stable or declining among males. These patterns suggested that increasing ASD prevalence reflected improved identification of historically underrecognized presentations rather than a uniform population-level increase. These findings highlight the need for screening strategies that address sex-specific presentations.

PMID:42485038 | DOI:10.1001/jamanetworkopen.2026.24561

Curr Protoc. 2026 Jul;6(7):e70412. doi: 10.1002/cpz1.70412.

ABSTRACT

This unit provides information to aid in the selection and proper use of a laboratory balance. Laboratory balances are used for measuring the mass of an object and come in two main types: mechanical and electronic. Electronic balances generally come with a computer interface to facilitate the collection, storage, and manipulation of the data. In addition to weighing objects, electronic balances also perform a range of computations, including counting objects, measuring density, statistics, and pipet volume calibration. Balances vary widely in terms of their capacity (how heavy an object they can accurately weigh), precision, accuracy, repeatability, and robustness. Understanding the various characteristics of a laboratory balance is necessary to be sure that the balance is well suited for your particular scientific or industrial needs. This unit also discusses the proper use and maintenance of a laboratory balance. In general, laboratory balances are relatively easy to use and require little maintenance. © 2026 Wiley Periodicals LLC. Basic Protocol 1: Measuring mass using a top-loading balance Basic Protocol 2: Measuring mass using an analytical balance.

PMID:42485036 | DOI:10.1002/cpz1.70412

JAMA Psychiatry. 2026 Jul 22. doi: 10.1001/jamapsychiatry.2025.3698. Online ahead of print.

ABSTRACT

IMPORTANCE: No recent study has examined whether method of abortion is associated with psychotropic medication use, an indicator of mild mental health problems.

OBJECTIVE: To examine whether medication or procedural abortions were associated with increased risk of psychotropic medication use.

DESIGN, SETTING, AND PARTICIPANTS: This population-based Danish registry cohort study followed the psychotropic medication redemptions of females aged 12 to 38 years having elective, first first-trimester abortions between January 1, 2000, and December 31, 2018, from 1 year before their medication or procedural abortion until their first psychotropic medication prescription claim (redemption), December 31, 2018, emigration from Denmark, or death, whichever came first. Analyses were conducted between June 2023 and June 2025.

EXPOSURE: First abortion method (first medication abortion or first procedural abortion).

MAIN OUTCOMES AND MEASURES: Any first psychotropic medication prescription redemption, first antidepressant medication redemption, and first antianxiety medication redemption during the study period. Incidence rate ratios (IRRs) were calculated in adjusted regression models. Bonferroni-corrected P values were used to account for multiple tests.

RESULTS: Of 67 390 females included in this study (mean [SD] age, 21.8 [4.6] years), 4575 (6.8%) had a prior psychiatric diagnosis; 33 793 had a record of a first medication abortion, 33 597 had a record of a first procedural abortion, and 19 979 (29.6%) had a first psychotropic medication redemption during the study period. In fully adjusted models, using the conventional P value level of .05, compared with the year before a medication or procedural abortion, there were small increased risks of any first psychotropic medication redemption in the first year after medication abortion (IRR, 1.10; 95% CI, 1.02-1.19; P = .01) and procedural abortion (IRR, 1.09; 95% CI, 1.01-1.16; P = .02). There were no statistically significant associations in 1 to 2 years and 2 to 5 years after abortion relative to the year before an abortion for each abortion method. There were decreased risks of any first psychotropic medication redemption more than 5 years after medication abortion (IRR, 0.85; 95% CI, 0.78-0.91; P < .001) and more than 5 years after procedural abortion (IRR, 0.83; 95% CI, 0.78-0.88; P < .001). Using the Bonferroni-corrected P value of .002, the small increased risks of psychotropic medication redemption observed in the first year after an abortion no longer met the criteria for statistical significance, while the lower risks for more than 5 years after abortion continued to meet the criteria for statistical significance.

CONCLUSIONS AND RELEVANCE: In this Danish population-based cohort study, compared with the year before a medication or procedural abortion, small increased risks of psychotropic medication prescription redemptions were observed during the first year after abortion, and decreases in risk of psychotropic medication prescription redemptions were observed more than 5 years after abortion when using conventional levels of statistical significance. The small increased risks observed in the first year after an abortion no longer met the criteria for statistical significance following Bonferroni adjustment for multiple statistical tests. Additional research may be needed to replicate and understand these results.

PMID:42485031 | DOI:10.1001/jamapsychiatry.2025.3698

Mem Cognit. 2026 Jul 22. doi: 10.3758/s13421-026-01919-w. Online ahead of print.

ABSTRACT

This study investigated how aging affects the perceptual span, the spatial limit of visual processing, in traditional Chinese with the gaze-contingent moving-window paradigm. The viewing was either unrestricted or involved varying window sizes where a constant one-character left window was paired with a manipulated right window that revealed two, three, or four upcoming characters. Older readers had slower reading speed, although they did not differ from young readers in gaze durations. In addition, while reading performance was statistically comparable between the four-character window and full-line conditions in both groups, the two groups differed in their reliance on near- and far-foveal information. In particular, there was a larger boost in reading performance for the older readers than for the young readers when the window increased from two to three upcoming characters. In contrast, the young readers exhibited a larger gain than the older readers when the window included the fourth upcoming characters. Together, older Chinese readers appear to be more sensitive to information within three upcoming characters, but were less so to further ones. These findings highlight the interplay between script characteristics and cognitive aging in reading and constrain the range of parameters in developmentally valid computational models of eye-movement control in reading.

PMID:42484992 | DOI:10.3758/s13421-026-01919-w

Spine Deform. 2026 Jul 22. doi: 10.1007/s43390-026-01513-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Lumbar spondylolysis is a common cause of pediatric low back pain. Although CT is highly sensitive, MRI is often used first to avoid radiation. Pars defects may be missed on MRI, potentially delaying care. The frequency and clinical impact of these missed diagnoses remain poorly defined. The purpose of this study is to assess how often spondylolysis is missed on MRI reports.

METHODS: A single-institution retrospective review was performed of pediatric patients with lumbar spondylolysis treated between 2021 and 2024. All patients underwent MRI for evaluation of low back pain. MRI reports were reviewed to determine whether spondylolysis was identified. STIR sequences were examined for pars hyperintensity. Demographic variables, radiologist fellowship training, and time from symptom onset to orthopaedic treatment were recorded. Groups with and without missed MRI diagnoses were compared using independent t tests and Chi-square analyses.

RESULTS: Among 102 patients with spondylolysis, 21 (20.6%) had MRI reports that failed to identify the pars defect. Among missed cases, 13/21 (61.9%) demonstrated hyperintense pars signal on STIR sequences that was not reported. Patients with missed MRI diagnoses had significantly longer delays to treatment initiation compared with those correctly diagnosed (10.6 ± 7.6 vs 6.7 ± 6.4 months from symptom onset; p = 0.042). Fellowship-trained musculoskeletal or neuroradiologists identified spondylolysis in 82.3% of cases compared with 64.7% among non-fellowship-trained radiologists, though this difference was not statistically significant (p = 0.100).

CONCLUSION: Lumbar spondylolysis is missed in ~ 20% of MRI reports, of which the majority demonstrate pathognomonic edema on the STIR sequence. This was associated with significant delays in treatment. There should be a high index of suspicion in pediatric patients with clinical histories suggestive of spondylolysis, even if MRI reports are negative.

PMID:42484990 | DOI:10.1007/s43390-026-01513-9

J Endocrinol Invest. 2026 Jul 22. doi: 10.1007/s40618-026-02992-3. Online ahead of print.

ABSTRACT

PURPOSE: Childhood hypoglycemia is associated with relevant morbidity and likely long-term neurological sequelae. Diagnostic thresholds and management strategies remain quite heterogeneous, particularly beyond the neonatal period. We aimed to evaluate current diagnostic and therapeutic practices for pediatric hypoglycemia management in Italy among members of the Italian Society of Pediatric Endocrinology and Diabetology (SIEDP) and the Italian Society of Metabolic Diseases and Newborn Screening (SIMMESN).

METHODS: An anonymous electronic survey including 43 questions about management of pediatric hypoglycemia was sent to SIEDP and SIMMESN members. Descriptive statistics and comparative statistical analysis between respondents of the two societies were run.

RESULTS: A total of 118 respondents participated. Most of them reported direct clinical experience in pediatric hypoglycemia and routinely used critical sampling during hypoglycemic episodes. Diagnostic thresholds were heterogeneous: 34.7% reported 50 mg/dL, 33.1% 60 mg/dL, and 22.0% 70 mg/dL. Comparative analysis between societies showed no differences in most diagnostic procedures, but significant differences emerged in diagnostic thresholds (p = 0.005), with SIMMESN members selected 60 mg/dL more frequently (adjusted p = 0.020), and SIEDP members more frequently 70 mg/dL (adjusted p = 0.013). SIMMESN members reported more frequent use of genetic testing for etiological diagnosis. SIEDP respondents showed a frequent used of continuous glucose monitoring in the follow-up.

CONCLUSION: Management of pediatric hypoglycemia in Italy is largely aligned with international recommendations. Clinically relevant variability persists, particularly in diagnostic thresholds, adoption of molecular analysis, and technologies, likely reflecting different clinical focus and patient populations. Our findings highlight the need for harmonized national recommendations and shared diagnostic definitions across scientific societies.

PMID:42484965 | DOI:10.1007/s40618-026-02992-3

Eur Arch Paediatr Dent. 2026 Jul 22. doi: 10.1007/s40368-026-01247-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary aim was to assess the educational experience, knowledge, attitude, behaviour, and perceived barriers regarding silver diammine fluoride (SDF) use by Egyptian paediatric dentists. A secondary aim was to analyse how these domains are related.

METHOD: This cross-sectional survey used a pre-validated questionnaire, distributed electronically to all registered Egyptian paediatric dentists (n = 745) between March and May 2025. Data were analysed using SPSS version 23.0, with statistical significance set at p < 0.05.

RESULTS: A total of 546 paediatric dentists completed the survey (73% response rate). Most respondents (96.7%) were familiar with SDF, mainly through dental school (53.8%), and reported greater exposure during postgraduate training. Overall, 84.1% demonstrated moderate-good knowledge and positive attitudes towards SDF use, particularly for non-aesthetic primary teeth (88.7%) and patients with behavioural (85.6%) or medical (85%) challenges. However, clinical application remained limited, mainly for arresting caries lesions in primary teeth (32.4%), with patient or caregiver non-acceptance (89.1%) being the main barrier. Knowledge, attitude, and practice were positively correlated, and higher academic qualifications were significantly associated with greater knowledge and more frequent SDF use.

CONCLUSION: Although Egyptian paediatric dentists showed good awareness and positive attitudes towards SDF, its clinical use remained limited by parental reluctance and aesthetic concerns. Broader adoption may be supported by integrating SDF into undergraduate curricula, enhancing postgraduate training, and promoting targeted education campaigns.

CLINICAL RELEVANCE: Improved education and training on SDF can enhance its clinical use for managing caries in uncooperative or high caries-risk children. Addressing aesthetic concerns and caregiver acceptance may further support its wider adoption in paediatric practice. Individualised caries-risk assessment, integrated within a holistic caries-management plan, is essential for achieving successful SDF outcomes.

PMID:42484964 | DOI:10.1007/s40368-026-01247-2

Hernia. 2026 Jul 22;30(1):297. doi: 10.1007/s10029-026-03792-7.

ABSTRACT

PURPOSE: This study aimed to evaluate which surgical approach is more beneficial for patients with umbilical hernia, and compare the clinical outcomes between the laparoscopic group and the open group.

MATERIALS AND METHODS: The databases of PubMed, EMBASE, and the Cochrane Library were used to search for eligible studies from their inception to December 31, 2025. Mean difference (MD), Odds ratios (OR), and 95% confidence intervals (CI) were pooled to analyze. The Newcastle-Ottawa Scale (NOS) scores were used to evaluate the quality of the included studies. This study was performed with Stata (V.18.0) software.

RESULTS: A total of thirteen studies involving 62,588 patients were included in this study. By comparing the postoperative outcomes, we found that the laparoscopic group had longer operative time (MD = 1.50, I²=97.28%, 95%CI = 0.54 to 2.47, P < 0.1), shorter postoperative hospital stay (MD=-0.57, I²=96.14%, 95%CI=-1.1 to -0.01, P < 0.1), fewer overall complications (OR = 0.65, I²=0.00%, 95%CI = 0.49 to 0.85, P < 0.1), fewer wound infection (OR = 0.55, I²=13.20%, 95%CI = 0.40 to 0.76, P < 0.1), fewer wound healing disorder (OR = 0.54, I²=0.00%, 95%CI = 0.30 to 1.00, P < 0.1), more respiratory complications (OR = 3.16, I²=0.00%, 95%CI = 1.88 to 5.32, P < 0.1), more heart related complications (OR = 3.75, I²=0.00%, 95%CI = 1.84 to 7.66, P < 0.1), more ileus (OR = 8.43, I²=0.00%, 95%CI = 2.98 to 23.84, P < 0.1), less bleeding (OR = 0.36, I²=0.00%, 95%CI = 0.14 to 0.91, P < 0.1) and shorter follow-up time (MD=-0.24, I²=0.00%, 95%CI=-0.41 to -0.08 P < 0.1).

CONCLUSION: Compared with open umbilical hernia surgery, laparoscopic surgery has more advantages in reducing postoperative hospital stay, wound infection, and overall complications.

PMID:42484912 | DOI:10.1007/s10029-026-03792-7

Cancer Causes Control. 2026 Jul 22;37(8):131. doi: 10.1007/s10552-026-02219-z.

ABSTRACT

OBJECTIVES: Observational studies examining the association between vitamin D and head and neck cancer (HNC) have reported conflicting results. We conducted a two-sample MR study to investigate the causal association between genetically predicted serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of HNC and its major subtypes: oral cavity, laryngeal, hypopharyngeal, and HPV-negative oropharyngeal cancers.

DESIGN: Genetic instruments were selected from GWAS of 441,291 individuals (UK Biobank). Cancer outcomes were obtained from the HEADSpAcE consortium. Multiple sclerosis (MS) was analyzed as a positive control. We identified 115 independent genetic instruments for serum 25(OH)D. Causal estimates were primarily derived using inverse variance weighted (IVW) MR, supported by MR-Egger, weighted median, and mode-based methods. Extensive sensitivity analyses assessed heterogeneity, pleiotropy, and directionality.

RESULTS: We identified 115 independent genetic instruments for serum 25(OH)D levels, which explained 5.12% of the total phenotypic variance. The mean F-statistic was 198.3 and satisfied MR assumptions. Only 17 of 682 (2.5%) SNP-confounder associations reached nominal significance (p < 5 × 10⁻⁸), and none remained significant after Bonferroni correction, indicating no systematic confounding. Higher 25(OH)D levels were associated with a reduced risk of MS (IVW OR = 0.84, 95% CI 0.71-0.99, p = 0.038; weighted median OR = 0.82, 95% CI 0.70-0.96, p = 0.015), while no evidence of a causal association was observed between 25(OH)D and risk of HNC or any subtype (all IVW p > 0.05; ORs ranging from 0.95 to 1.25). Sensitivity analyses revealed no evidence of horizontal pleiotropy, influential outliers, or reverse causation for any cancer outcome.

CONCLUSIONS: This study provides robust genetic evidence that circulating 25(OH)D levels are not a major causal determinant of HNC risk and that our instruments are not confounded by major lifestyle or UV-related factors.

PMID:42484911 | DOI:10.1007/s10552-026-02219-z