Tag: pubmed

JMIR Serious Games. 2026 Apr 27;14:e87847. doi: 10.2196/87847.

ABSTRACT

BACKGROUND: Problematic gaming and internet gaming disorder (IGD) symptoms are prevalent in adolescence, yet the longitudinal interplay between physical activity (PA), loneliness, and IGD symptoms, as well as potential sexual differences, remains unclear.

OBJECTIVE: This study aimed to examine reciprocal within-person associations between PA, loneliness, and IGD symptoms among Chinese adolescent gamers and test sexual differences in these associations.

METHODS: We conducted a three-wave prospective cohort study among 1332 Chinese adolescents selected using convenience sampling from five middle schools in central China who had engaged in online gaming during the previous year (n=441, 33.1%, females; mean age 3.64, SD 0.76, years). PA, loneliness, and IGD symptoms were assessed using the Physical Activity Rating Scale-3, the three-item short form of the University of California, Los Angeles Loneliness Scale, and the nine-item Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition IGD Checklist, respectively, at three 6-month intervals: wave 1 (baseline, T1), wave 2 (T2), and wave 3 (T3). A random intercept (RI) cross-lagged panel model (CLPM) and multigroup analyses were conducted.

RESULTS: RI-CLPM indicated that at the within-person level, higher PA predicted decreased subsequent loneliness (T1→T2: β=-0.12, 95% CI -0.16 to -0.08; T2→T3: β=-0.13, 95% CI -0.17 to -0.08) and IGD symptoms (T1→T2: β=-0.10, 95% CI -0.16 to -0.04, P=.009; T2→T3: β=-0.10, 95% CI -0.16 to -0.04). Increased loneliness (β=-0.22, 95% CI -0.26 to -0.18) and increased IGD symptoms (β=-0.08, 95% CI -0.12 to -0.04) each predicted later reductions in PA, indicating a mutually reinforcing cycle. Increased loneliness also predicted an increase in subsequent IGD symptoms (T1→T2: β=0.14, 95% CI 0.11-0.17), and increased IGD symptoms, in turn, predicted greater loneliness in the next wave (T1→T2: β=0.18, 95% CI 0.14-0.22). Multigroup models indicated that the protective effect of PA on later loneliness and the prospective effect of loneliness on subsequent IGD symptoms were stronger among girls than boys. In males, PA significantly predicted loneliness (β=-0.08 to -0.09, 95% CI -0.15 to -0.01), and loneliness significantly predicted IGD symptoms (β=0.09, 95% CI 0.03-0.15). In females, the cross-lagged effects from PA to loneliness were significant but stronger (β=-0.17, 95% CI -0.23 to -0.11), and the paths from loneliness to later IGD symptoms were also significant (β=0.16, 95% CI 0.11-0.21).

CONCLUSIONS: PA, loneliness, and IGD symptoms are reciprocally linked in adolescent gamers. By using RI-CLPM to distinguish within-person changes from stable between-person differences, this study extends prior research based mainly on cross-sectional designs or traditional CLPMs and provides a clearer understanding of the dynamic interplay among behavioral, emotional, and gaming-related factors. The findings highlight that interventions aiming to prevent IGD symptoms should simultaneously promote PA and reduce loneliness, with particular attention to sex-specific patterns, especially in girls.

PMID:42044501 | DOI:10.2196/87847

J Immunol. 2026 Apr 15;215(4):vkag064. doi: 10.1093/jimmun/vkag064.

ABSTRACT

The immune system is a complex “network of networks,” where interactions between various immune cell subsets determine immune competence and influence disease onset or control. These interactions dictate whether the body remains in a healthy state or develops pathological conditions. Traditional statistical methods largely ignore these interactions and rely only on statistical changes in cell frequencies. To address this gap, we developed CyNET (Cytometry Network), a network science-based analysis platform that quantifies immune system properties at both the systems and subset levels. We used CyNET to analyze immune development across different age groups, examining peripheral blood cells from healthy newborns, adults (20-55 yr), and elderly individuals (≥70 yr) using CyNET and single-cell RNA sequencing. The analysis revealed that changes in the centrality of immune subsets, rather than just their frequency alone, provide deeper insights into biological functions. For instance, although CD28- CD8 T cells increase in frequency with age, their reduced centrality and diminished intracellular interaction potential explain cellular senescence and exhaustion. Additionally, CyNET identified key systems properties-such as -network edge density, degree centralization, and assortativity score-that reflect immune system development and help characterize the immune network’s functional architecture across different ages.

PMID:42044498 | DOI:10.1093/jimmun/vkag064

J Immunol. 2026 Apr 15;215(4):vkag044. doi: 10.1093/jimmun/vkag044.

ABSTRACT

Salmonella Paratyphi A is a major cause of paratyphoid fever. Despite growing global concern, knowledge of S. Paratyphi A immunity remains limited, and no licensed vaccine exists. In a controlled human infection model (CHIM) homologous S. Paratyphi A rechallenge showed a non-significant reduction in risk of acute disease. This study evaluates humoral immunity following experimental S. Paratyphi A exposure and vaccination with a bivalent S. Typhi-S. Paratyphi A conjugate vaccine (Sii-PTCV). Serum samples from 2 UK CHIM studies and a Phase I trial in India of Sii-PTCV were analyzed. S. Paratyphi A-specific IgG, serum bactericidal activity (SBA), antibody-dependent monocyte phagocytosis (ADMP), and neutrophil phagocytosis (ADNP) were measured pre and post-exposure or vaccination. Statistical differences were assessed using Wilcoxon matched-pairs signed rank test or the Mann-Whitney test. Experimental challenge significantly increased IgG, SBA, ADMP, and ADNP (all P < 0.0001), with strongest responses in participants who developed systemic infection. No immune marker correlated with protection in rechallenged individuals. Baseline antibody levels were higher in the Indian cohort than in the United Kingdom (P = 0.0041), suggesting prior natural exposure enhances humoral immunity. Vaccination with Sii-PTCV induced significantly greater responses than challenge, particularly for IgG (P < 0.0001), SBA (P < 0.001), and ADMP (P < 0.001). This study highlights differences in S. Paratyphi A immunity between naive and exposed populations. Both challenge and vaccination with S. Paratyphi A elicited strong humoral responses, with vaccination producing higher magnitude responses. The bivalent vaccine shows promise for paratyphoid prevention, though a clear correlate of protection remains to be defined.

PMID:42044495 | DOI:10.1093/jimmun/vkag044

JMIRx Med. 2026 Apr 27;7:e76822. doi: 10.2196/76822.

ABSTRACT

BACKGROUND: Generative artificial intelligence models, especially reasoning large language models (LLMs), are gaining adoption in health care for diagnostic decision support and medical education. DeepSeek R1 is a reasoning LLM that generates extended chain-of-thought explanations to make its decision-making process more explicit. Traditional medical benchmarks often lack complexity and authenticity, motivating the adoption of scenario-rich datasets, such as the Massive Multitask Language Understanding Pro (MMLU-Pro) professional medicine subset, which provides multispecialty clinical vignettes for reasoning-centric evaluation.

OBJECTIVE: The objective of this study is to assess the diagnostic accuracy, reasoning quality, reasoning transparency, and practical usability of DeepSeek R1 and Gemini 3 Pro across closed- and open-ended clinical scenarios, with the intention of guiding their prospective application in practical clinical education and training. This evaluation was conducted by analyzing 162 diverse medical scenarios (both closed- and open-ended) from the MMLU-Pro health subset.

METHODS: In a 2-phase, dual-model evaluation, DeepSeek R1 and Gemini 3 Pro were applied to 162 matched clinical vignettes from the MMLU-Pro professional medicine subset spanning 21 specialties. Closed-ended, multiple-choice, and open-ended prompts were constructed for the same scenarios, and model outputs were coded for accuracy, reasoning steps, and citation behavior; descriptive statistics and the McNemar test were used to compare performance across formats.

RESULTS: DeepSeek R1 achieved an accuracy of 86.4% (140/162 scenarios) on closed-ended tasks and 80.9% (131/162) on open-ended questions across 162 clinical scenarios, indicating modest attenuation of performance when answer cues were removed. Gemini 3 Pro demonstrated 90.7% (147/162) closed-ended and 88.9% (144/162) open-ended accuracy on the same scenarios, showing a similar pattern of decreased performance without answer options. Error analysis indicated that incorrect answers typically involved longer reasoning chains, suggesting overthinking. In a structured review of open-ended responses, DeepSeek R1 produced an average of 18.7 (range 0-52) references per case, with 5.2 unrelated references and 13.1 (range 3-67) reasoning steps, whereas Gemini 3 Pro averaged 22.5 (range 12-50) references, 1.9 (range 0-8) unrelated references, and 4.4 (range 1-10) reasoning steps per case.

CONCLUSIONS: DeepSeek R1 demonstrated moderate-to-excellent accuracy and reasoning in evaluating both closed- and open-ended medical scenarios. In parallel, Gemini 3 Pro showed broadly comparable but distinct performance and reasoning patterns. While the closed-ended format may inflate accuracy due to cueing, the open-ended evaluation yielded richer insights into the fidelity of reasoning. Side-by-side evaluation of two large reasoning models highlights the importance of format, specialty, and citation behavior when considering clinical and educational use. Continued validation across a wider range of specialties and real-world contexts will enhance the model’s trustworthiness for diagnostic and teaching applications.

PMID:42044491 | DOI:10.2196/76822

J Agric Food Chem. 2026 Apr 27. doi: 10.1021/acs.jafc.6c00179. Online ahead of print.

ABSTRACT

Microalgae are promising future food sources with short growth cycles and high nutritional value. UPLC-HRMS analysis of eight edible microalgal species identified over 500 lipid molecular species, including glycolipids, phospholipids, sphingolipids, glycerides, and betaine lipids. Nannochloropsis gaditana exhibited the highest lipid content, with polar lipids accounting for 75.2% of the total lipids and ahigh eicosapentaenoic acid content of 29.9% of the total fatty acids, while Dunaliella salina was highly enriched in sphingolipids (50.3% of the total lipids), making the two species ideal industrial raw materials for glycolipid and sphingolipid production, respectively. These eight edible microalgal species were abundant in polyunsaturated fatty acids. In addition, a rare acylated derivative of sulfolipid, acyl-sulfoquinovosyldiacylglycerol (acSQDG), was identified in five microalgal species. Multivariate analysis confirmed lipid classes as effective biomarkers for discriminating the eight cross-phyla edible microalgal species. Overall, this study provides comprehensive lipidomic characterization of these eight microalgae and offers valuable guidance for the industrial development of microalgal oils.

PMID:42044488 | DOI:10.1021/acs.jafc.6c00179

J Glaucoma. 2026 May 1;35(5):317-325. doi: 10.1097/IJG.0000000000002696. Epub 2026 Apr 21.

ABSTRACT

PRCIS: Micropulse transscleral cyclophotocoagulation (MP-TSCPC) has gained considerable acceptance as a preferred cyclodestructive intervention for refractory glaucoma, offering significantly enhanced safety profiles through precisely controlled pulse energy delivery while maintaining equivalent therapeutic outcomes compared with traditional modalities.

OBJECTIVE: To compare the efficacy and safety profiles of MP-TSCPC versus continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) in patients with refractory glaucoma.

MATERIALS AND METHODS: This prospective, randomized, single-blind study included 52 patients (52 eyes) with refractory glaucoma assigned to either MP-TSCPC or CW-TSCPC. Patients were followed for 18 months. Secondary outcomes included absolute IOP values, medication reduction, preservation of visual acuity, visual function parameters, quality of life, and complication rates. Success was defined as IOP between 6-21 mm Hg without medications (complete success), with medications (qualified success), or either (cumulative success). Patients were followed for 18 months.

RESULTS: At 18 months, 47 eyes completed follow-up (24 in MP-TSCPC and 23 in CW-TSCPC). The MP-TSCPC group (n=24) achieved a 34.43% IOP reduction from baseline, compared with 42.86% in the CW-TSCPC group (n=23), P=0.052. Complete success rates were 25.00% (6/24) for MP-TSCPC and 21.74% (5/23) for CW-TSCPC (P=0.999), while qualified success rates were 29.16% (7/24) and 39.13% (9/23), respectively (P=0.550). The cumulative success rates were 54.17% for MP-TSCPC and 60.87% for CW-TSCPC (P=0.706). The CW-TSCPC group experienced significantly higher rates of postoperative pain (56.52% vs. 20.83%, P=0.012) and prolonged inflammation (34.78% vs. 8.33%, P=0.039). Visual function parameters remained stable in both groups throughout the study period. Quality of life improved significantly in the MP-TSCPC group but not in the CW-TSCPC group, although between-group differences were not statistically significant.

CONCLUSION: MP-TSCPC demonstrated comparable efficacy to CW-TSCPC in IOP reduction and success rates for refractory glaucoma management, while offering a significantly improved safety profile with less postoperative pain and inflammation. These findings suggest that MP-TSCPC may be considered as a preferred initial cyclodestructive option when balancing efficacy and safety, though larger studies are needed to confirm these findings.

PMID:42044484 | DOI:10.1097/IJG.0000000000002696

Neurol Neuroimmunol Neuroinflamm. 2026 Jul;13(4):e200586. doi: 10.1212/NXI.0000000000200586. Epub 2026 Apr 27.

ABSTRACT

BACKGROUND AND OBJECTIVES: Inebilizumab and rituximab (RTX) are anti-CD19 and anti-CD20 B cell-depleting antibodies, respectively. They are both used in the treatment of neuromyelitis optica spectrum disorders (NMOSD). However, limited data on both drugs exist regarding real-world clinical applications. This study aimed to assess the efficacy and safety of inebilizumab vs low-dose RTX in NMOSD patients through a retrospective-prospective multicenter analysis.

METHODS: This study collected data on aquaporin-4 immunoglobulin G seropositive NMOSD patients from 6 cities in China among those receiving either inebilizumab or low-dose RTX (500 mg), with a 1-year follow-up. Analyses assessed outcomes using inverse probability of treatment weighting and doubly robust models.

RESULTS: We included a total of 229 patients, comprising 119 treated with inebilizumab and 110 with low-dose RTX. The cohort was predominantly female (217/229, 94.76%). The median follow-up duration was 12.0 months (range: 4.0-12.0) in the inebilizumab group and 12.0 months (range: 7.0-12.0) in the low-dose RTX group. Relapses occurred in 8/119 (6.72%) inebilizumab recipients vs 24/110 (21.82%) low-dose RTX recipients (hazard ratio [HR] 3.77, 95% confidence interval [CI] 1.56-9.14; p = 0.003). Adjusted annualized relapse rates were significantly lower in the inebilizumab group (0.06) than in the low-dose RTX group (0.24), corresponding to an incidence rate ratio (IRR) of 3.65 (95% CI 1.59-8.39; p = 0.003). Adverse events (AEs) occurred in 35 patients (29.42%) with inebilizumab, including 2 serious adverse events (SAEs; 1.68%), vs 44 patients (40.00%) with low-dose RTX (4 SAEs [3.64%]). Both AE and SAE rates showed no statistical difference between groups. The rate of patients with at least 1 infection in inebilizumab group was lower than that in the low-dose RTX group (p = 0.003).

DISCUSSION: In this short-term study, inebilizumab demonstrated greater efficacy in reducing relapse risk, along with significantly lower rates of key adverse events, compared with low-dose RTX in patients with NMOSD. These findings support the use of inebilizumab as an effective and well-tolerated therapeutic option in a broader NMOSD population.

CLASSIFICATION OF EVIDENCE: This short-term study with a 12-month observation period provides Class III evidence that in patients with NMOSD, inebilizumab is more effective than low-dose RTX in reducing relapses.

PMID:42044464 | DOI:10.1212/NXI.0000000000200586

JCO Clin Cancer Inform. 2026 Apr;10(2):e2500172. doi: 10.1200/CCI-25-00172. Epub 2026 Apr 27.

ABSTRACT

PURPOSE: Curating high-quality clinical and genomic data sets from patients with cancer to predict hospital readmission using machine learning (ML) models.

METHODS: We extracted data from electronic health records for patients with cancer in the University of California, San Diego Health System, to curate clinicogenomic data sets for lung, breast, and colon cancers. We constructed ML models to predict the risk of hospital readmission 30, 60, and 90 days postdischarge. Standard ML models (logistic regression, random forest [RF], gradient boosting [GB], neural network) and multitask neural network models were developed to simultaneously predict all three readmission outcomes.

RESULTS: Our results revealed that rehospitalization is most frequent in colon cancer within 30 days. For the 30-day hospitalization prediction, GB achieved the highest area under the precision recall curve (PR-AUC) for lung (0.415) and breast (0.470) cancers and RF achieved the overall highest PR-AUC for colon cancer (0.621). Explainability analysis revealed that health care metrics (such as the number of previous admissions and average length of stay), risk scores composed of diagnosis codes, and treatments are significant features in predicting readmission within cancer types. It also identified EGFR mutations as a potential predictor of readmission in colon cancer.

CONCLUSION: The study highlights the potential of integrating clinical and genomic data for predicting adverse outcomes in patients with cancer. The standard ML approaches were able to successfully capture patterns in readmission and outperformed the more complex models. Limitations include the relatively small data set from a single institution. Ultimately, this study highlights the value of curating and maintaining clinicogenomic information at an institution level to streamline data set curation and model development.

PMID:42044461 | DOI:10.1200/CCI-25-00172

Turk Arch Pediatr. 2026 Mar 5;61(3):206-213. doi: 10.65717/TurkArchPediatr.2026.25004.

ABSTRACT

OBJECTIVE: To describe demographic, clinical, and laboratory characteristics of patients with juvenile localized scleroderma (JLS), determine the presence of extracutaneous involvement (ECI) and other comorbidities, and assess treatment response.

MATERIALS AND METHODS: Retrospective single-center cohort study of JLS patients followed between 2015 and 2025 who met Padua classification criteria and had ≥6 months of regular follow-up. Clinical, laboratory, and treatment data were systematically collected, and ECI was analyzed using comparative statistics.

RESULTS: Among 87 patients, 77% were female. Mean ages at symptom onset, diagnosis, and last visit were 7.1, 9.0, and 14.4 years, respectively, with a median diagnostic delay of 1.2 years. The most frequent subtype was linear scleroderma (36.7%), followed by circumscribed (31.0%), generalized (20.6%), mixed-type (6.8%), and pansclerotic morphea (4.6%). The lower extremities were the most commonly affected, accounting for 54 of 136 sites (39.7%). The ECI occurred in 47.1% of patients, mainly musculoskeletal, and was linked to generalized/pansclerotic subtypes, limb involvement, higher erythrocyte sedimentation rate, higher disease activity scores, and poorer response to conventional disease-modifying antirheumatic drugs (cDMARDs). Overall, 85 patients received at least 1 cDMARD, with 85.9% responding. Methotrexate regimens had high response rates; 14.1% were non-responsive to at least 2 cDMARDs, and 5.7% had active disease at last visit.

CONCLUSION: The JLS carries substantial cutaneous and extracutaneous morbidity, particularly in generalized and pansclerotic subtypes with limb involvement. These findings underscore the importance of early recognition, systematic assessment of ECI, and close longitudinal monitoring in specialized centers and support the need for prospective studies to refine risk stratification and optimize treatment strategies for refractory JLS.

PMID:42044443 | DOI:10.65717/TurkArchPediatr.2026.25004

Turk Arch Pediatr. 2025 Oct 3;61(2):170-172. doi: 10.5152/TurkArchPediatr.2025.25006.

NO ABSTRACT

PMID:42044435 | DOI:10.5152/TurkArchPediatr.2025.25006