Tag: pubmed

J Gerontol A Biol Sci Med Sci. 2026 Jul 7:glag176. doi: 10.1093/gerona/glag176. Online ahead of print.

ABSTRACT

BACKGROUND: Polypharmacy is common in older adults with comorbidities. This study aims to estimate its global prevalence, temporal trends, and dose-response associations with adverse health outcomes.

METHODS: PubMed, Embase, The Cochrane Library, Web of Science and Scopus were searched from inception to June 30, 2025. Random-effects meta-analyses were used to pool prevalence estimates of polypharmacy based on mixed thresholds and relative risks. Study quality was assessed using Hoy’s method. Hazard ratios (HRs) from individual studies were synthesised using random-effects dose-response meta-analysis in studies that provided sufficient quantitative exposure information.

RESULTS: A total of 545 studies, providing 565 prevalence estimates, were included, comprising 16,620,414 older adults from 56 countries worldwide. The pooled global prevalence of polypharmacy was 50.4% (95% confidence interval [CI]: 48.2-52.7%; 95% prediction interval: 6.8-93.5%). It demonstrated a significant increasing temporal trend in polypharmacy prevalence over calendar years. Compared with non-polypharmacy, polypharmacy was associated with a significantly higher risk of multiple adverse outcomes. Dose-response meta-analyses showed a monotonic increase in risk with each additional medication for mortality (HR: 1.05, 95%CI: 1.03-1.06, P＜0.001), emergency (HR: 1.02, 95%CI: 1.02-1.03, P＜0.001), and hospital admission (HR: 1.04, 95%CI: 1.02-1.07, P＜0.001). Outcome-specific thresholds ranged from 4.55 to 5.46 medications. A pooled estimate of approximately five medications was obtained as a descriptive summary across outcomes.

CONCLUSION: Polypharmacy affects approximately half of older adults worldwide and has increased steadily over time. It is associated with an increased risk of multiple adverse health outcomes, with risks increasing progressively as medication burden rises.

PMID:42412515 | DOI:10.1093/gerona/glag176

Phys Rev Lett. 2026 Jun 19;136(24):247201. doi: 10.1103/95t3-rvxg.

ABSTRACT

We develop an ab initio approach to describe the statistical behavior of finite-size fluctuations in the deterministic Kuramoto-Sakaguchi model. We obtain explicit expressions for the covariance function of fluctuations of the complex order parameter and determine the variance of its magnitude entirely in terms of the equation parameters. Our results rely on an explicit complex-valued formula for the solution of the Adler equation. We present analytical results for both the sub- and the supercritical case. Moreover, our framework does not require any prior knowledge about the structure of the partially synchronized state. We corroborate our results with numerical simulations of the full Kuramoto-Sakaguchi model. The proposed methodology is sufficiently general such that it can be applied to other interacting particle systems.

PMID:42412468 | DOI:10.1103/95t3-rvxg

Phys Rev Lett. 2026 Jun 19;136(24):247102. doi: 10.1103/9hhg-2ddm.

ABSTRACT

First passage phenomena arise across physics, biology, and finance when stochastic processes first reach a threshold, triggering downstream events. Examples include the irreversible exit from a domain, a biochemical reaction, and a financial selloff. While typical formulations involve diffusive motion, many stochastic processes are better described as velocity jump processes, characterized by persistent motion interrupted by stochastic velocity changes. Despite their ubiquity, first passage properties of velocity jump processes remain underdeveloped in higher dimensions, especially under directional bias. We present a general framework to estimate the mean first passage time (MFPT) and higher moments of the survival probability for fixed-speed velocity jump processes where possible reorientations range from strong alignment to full angular anisotropy. For low Knudsen numbers, when the mean free path is small compared to the distance to the target, we derive a universal form for the MFPT in which two bias functions encode broad classes of angular distributions, including von Mises-Fisher, wrapped Cauchy, and elliptical families. In the narrow-capture limit of a vanishingly small target, directional persistence induces anomalous scaling, including regimes where the MFPT remains finite whereas standard diffusion would predict divergence. Finally, we obtain a Langevin representation that accurately reproduces first passage statistics. Analytical predictions are confirmed by numerical simulations.

PMID:42412457 | DOI:10.1103/9hhg-2ddm

Phys Rev Lett. 2026 Jun 19;136(24):243601. doi: 10.1103/1t2q-qm97.

ABSTRACT

Quantum non-Gaussian states, which cannot be written as mixtures of Gaussian states, are necessary to achieve a quantum advantage in continuous variable systems. They represent an important benchmark for the realization of an advanced quantum light source, as they cannot be made by simple means such as displacement and squeezing. We introduce an attenuation-resistant sufficient criterion for quantum non-Gaussian states based on the second- and third-order correlation functions, g^{(2)} and g^{(3)}. The general nonlinear bound for classical mixtures of Gaussian states is sqrt[g^{(3)}]+3sqrt[g^{(2)}]≥2. Any mixture of Gaussian states must fulfill this inequality, thus, the violation of it represents a direct confirmation of quantum non-Gaussianity. We experimentally show the non-Gaussianity of the state produced by a quantum dot single-photon source, where we obtain sqrt[g^{(3)}]+3sqrt[g^{(2)}]=0.174(13), which represents a statistical significance of more than 100 standard deviations.

PMID:42412451 | DOI:10.1103/1t2q-qm97

Phys Rev Lett. 2026 Jun 19;136(24):241901. doi: 10.1103/vcld-225s.

ABSTRACT

We report the first observation of the radiative decay D_{s0}^{*}(2317)^{+}→D_{s}^{*+}γ with a statistical significance exceeding 10 standard deviations. The signal is observed in the continuum e^{+}e^{-}→cc[over ¯] process, using combined data samples of 980.4 fb^{-1} from Belle and 427.9 fb^{-1} from Belle II, collected at the KEKB and SuperKEKB asymmetric-energy e^{+}e^{-} colliders, respectively. The branching fraction ratio B[D_{s0}^{*}(2317)^{+}→D_{s}^{*+}γ]/B[D_{s0}^{*}(2317)^{+}→D_{s}^{+}π^{0}] is measured to be [7.13±0.70(stat)±0.26(syst)]%. This result provides crucial discrimination between theoretical models of the D_{s0}^{*}(2317)^{+} structure.

PMID:42412448 | DOI:10.1103/vcld-225s

Phys Rev Lett. 2026 Jun 19;136(24):244001. doi: 10.1103/qf5l-xnln.

ABSTRACT

We adapt the microcanonical framework of equilibrium statistical mechanics to predict the statistics of short linear waves in inhomogeneous moving media. For steady inhomogeneities and background flow, we compute the wave spectrum at any location in the domain based on an ergodic prescription for the action density in phase space, constrained by conservation of absolute frequency. We illustrate the method for shallow-water waves subject to a background flow or to topographic inhomogeneities, and for deep-water surface capillary waves over a background flow, validating the predicted maps of root-mean-square surface elevation and interfacial slope against numerical simulations.

PMID:42412444 | DOI:10.1103/qf5l-xnln

JAMA Netw Open. 2026 Jul 1;9(7):e2621797. doi: 10.1001/jamanetworkopen.2026.21797.

ABSTRACT

IMPORTANCE: Recurrent invasive pneumococcal disease (rIPD) constitutes a clinically relevant proportion of all IPD cases. Improved understanding of these cases can inform priorities for prevention through vaccination.

OBJECTIVE: To describe the incidence of rIPD and associated risk factors in adults with a primary episode of IPD.

DESIGN, SETTING, AND PARTICIPANTS: This population-based, multicenter cohort study was performed during active surveillance for IPD in adults in Calgary and the Toronto-Peel regions of Canada from January 1, 2004, to December 31, 2022. rIPD was defined as IPD occurring 30 days or longer after a primary episode. Canadian reference laboratories performed serotyping; population data were obtained from Statistics Canada and the Alberta Interactive Health Data Application. Data were analyzed from September 3, 2024, to November 28, 2025.

MAIN OUTCOMES AND MEASURES: Incidence of rIPD over time. Risk factors for rIPD were assessed using multivariable logistic regression.

RESULTS: From 2004 to 2022, 7006 adult patients survived a primary episode of IPD, 274 (3.9%) of whom had rIPD. The median age at primary infection in patients with rIPD was 53.6 (IQR, 41.4-66.0) years; 168 patients (61.3%) were male. The incidence rate ratio (IRR) of rIPD compared with primary IPD rate in surveillance populations was highest in the first year after primary IPD (IRR, 152; 95% CI, 124-185). From 5 to 17 years after primary IPD, the IRR was 15 (95% CI, 11-20). Factors associated with recurrent disease included history of stem cell transplant or hematologic cancer (odds ratio [OR], 5.17; 95% CI, 3.35-7.98), HIV infection (OR, 4.47; 95% CI, 2.84-7.04), experiencing homelessness (OR, 1.87; 95% CI, 1.30-2.69), and alcohol use disorder (OR, 1.50; 95% CI, 1.07-2.11). Primary infection with serotype 3 (OR, 0.33; 95%, 0.16-0.67) or serotype 7F (OR, 0.42; 95% CI, 0.21-0.87), and being 65 years or older (OR, 0.55; 95% CI, 0.34-0.90) were associated with reduced odds of rIPD. At the primary episode, 4812 of 5470 patients (88.0%) were eligible for pneumococcal vaccine, and 1344 of 4812 (27.9%) had been vaccinated. Of patients with known vaccine status between the first and second episodes, 167 of 229 (72.9%) were eligible for vaccine and only 37 of 167 (22.2%) received one.

CONCLUSIONS AND RELEVANCE: In this cohort study, the risk of rIPD was higher than the risk of primary IPD throughout 17 years of follow-up. Most patients with primary IPD had indications for pneumococcal vaccine but were unvaccinated. These findings suggest that patients with IPD should be prioritized to receive recommended vaccination doses.

PMID:42412432 | DOI:10.1001/jamanetworkopen.2026.21797

JAMA Netw Open. 2026 Jul 1;9(7):e2622016. doi: 10.1001/jamanetworkopen.2026.22016.

ABSTRACT

IMPORTANCE: Opioid prescribing has decreased in the US for more than a decade. However, less is known about how prescribing trends differ by prescriber specialty and separately for short-term and long-term opioid prescribing for which the indications, clinical decision-making, and potential for harm vary substantially.

OBJECTIVE: To characterize opioid analgesic prescribing trends in the US between January 1, 2010, and December 31, 2024, by prescriber specialty, analyzing short-term and long-term opioid use episodes separately.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used administrative claims data for commercially insured and Medicare Advantage patients (aged ≥65 years and <65 years with long-term disability) with at least 90 days of enrollment in medical and prescription coverage. Statistical analysis was performed from May 2025 to September 2025.

MAIN OUTCOMES AND MEASURES: Prescribing volume, daily dose, and prescription duration.

RESULTS: The study identified 110 288 218 opioid fills by 14 959 612 patients during the 15-year study period. Among opioid fills, 59.4% were attributed to female patients; the median (IQR) age at opioid fill was 61 (50-71) years. From 2010 to 2024, decreases in opioid prescribing were greater for long-term than short-term opioid use episodes (eg, commercial cohort: 81.3% reduction [from 33.2 fills per 100-person years in 2010 to 6.2 in 2024] and 74.6% reduction [from 36.2 fills per 100-person years in 2010 to 9.2 in 2024]), respectively. The proportion of all opioid fills written by primary care clinicians decreased (eg, Medicare Advantage with disability cohort: from 52.2% to 47.2%), whereas those written by pain medicine specialists increased (eg, Medicare Advantage with disability cohort: from 17.1% to 25.7%). Distinct trends for short-term and long-term opioid use episodes were observed in prescription characteristics, such as daily dose and duration.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of opioid prescribing trends in the US between 2010 and 2024, decreases in prescribing were greatest in long-term opioid use episodes, and prescribing was increasingly concentrated among pain medicine specialists. These findings suggest the need to balance reductions in opioid prescribing with provision of nonopioid pain treatments and raise concerns about access to care for patients taking opioids for chronic pain management.

PMID:42412429 | DOI:10.1001/jamanetworkopen.2026.22016

NEJM Catal Innov Care Deliv. 2026 Jan;7(1):CAT240478. doi: 10.1056/CAT.24.0478. Epub 2025 Dec 17.

ABSTRACT

Heart failure remains a leading cause of potentially avoidable hospital admissions throughout the United States and a significant driver of unnecessary, avoidable costs within value-based care programs. In a baseline population of 3233 hospital emergency department (ED) visits for heart failure, which occurred over 12 months ending in June 2023 across six WellSpan Health acute care hospitals, 2868 (88.7%) resulted in inpatient admissions. Among those admissions, 2535 (96.0%) were deemed potentially avoidable by the U.S. Centers for Medicare and Medicaid Services (CMS) Prevention Quality Indicator (PQI) 08 heart failure admission quality indicator. Collectively, these admissions totaled US$27,618,825 in potentially avoidable total costs of care. Through process improvements that modified triaging algorithms related to heart failure exacerbations where shortness of breath or lower extremity edema were present, 92.2% of triaged patients with heart failure were managed in an ambulatory setting, with 84.7% avoiding an ED visit within 24 hours. The 12% cost reduction goal was almost achieved just 1 year into the intervention, with an 11.2% reduction in potentially avoidable admissions (CMS PQI 08, a core quality measure) and a US$3,352,248 reduction in total costs of care. This novel intervention executed with Lean management principles was a pragmatic process improvement that can be readily replicated by other systems to reduce unnecessary, avoidable referrals of mild to moderate heart failure exacerbations to hospital EDs.

PMID:42412420 | DOI:10.1056/CAT.24.0478

Transbound Emerg Dis. 2026;2026(1):e5747471. doi: 10.1155/tbed/5747471.

ABSTRACT

Highly pathogenic avian influenza (HPAI) is a devastating viral disease causing substantial economic losses in the poultry industry and posing potential zoonotic risks. Located along the East Asian-Australasian Flyway (EAAF), South Korea has experienced recurrent outbreaks of HPAI since 2003. Following the severe 2016-2017 epidemic, the government implemented strengthened control measures, including restrictions on duck farming and organizational restructuring. This study quantitatively evaluated structural changes in the spatiotemporal patterns and transmission dynamics of HPAI before and after the 2017 policy reinforcement, utilizing a complete dataset covering 12 epidemic waves between 2003 and 2025. Our analysis suggests a distinct shift in HPAI occurrence patterns from large-scale, clustered epidemics to more sporadic occurrences in the post-2017 period. Pre-2017 epidemics, particularly the 5th and 6th waves, exhibited intense spatiotemporal clustering and high transmission potential. Conversely, post-2017 epidemics showed a significant reduction in outbreak density and the disappearance of large-scale clusters. Notably, the 12th wave displayed a more circular diffusion pattern with outbreaks confined to specific regions, suggesting relatively more geographically contained spread. However, despite the overall reduction in scale, high spatiotemporal interaction intensity was intermittently observed, such as in the 11th wave, indicating that residual risks of explosive local transmission persist even during smaller epidemics. These findings suggest that the post-2017 pattern was temporally consistent with strengthened control policies aimed at reducing mechanical connectivity between farms, although this ecological analysis cannot separate policy effects from other time-varying epidemiological and surveillance-related factors. Nevertheless, a decline in case numbers does not necessarily imply the elimination of local transmission risk, highlighting the need to advance precise and risk-based surveillance and response strategies to effectively manage residual risks.

PMID:42412408 | DOI:10.1155/tbed/5747471