Tag: pubmed

JAMA Netw Open. 2026 Jan 2;9(1):e2554793. doi: 10.1001/jamanetworkopen.2025.54793.

ABSTRACT

IMPORTANCE: The 2022 Supreme Court decision Dobbs v. Jackson Women’s Health Organization and the subsequent legal restrictions to abortion have prompted national discussion about the importance of abortion access for maternal health. A commonly cited statistic in these debates, based on data from 1998 to 2005, is that the risk of death associated with childbirth is approximately 14 times higher than that of abortion.

OBJECTIVE: To estimate the ratio of pregnancy-related to abortion-related mortality using updated data (2018-2021), capturing increased detection of maternal death and increased safety of abortion since the original estimate.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included all births (live and stillbirths) and pregnancy-related deaths from the National Vital Statistics System from 2018 to 2021. The number of abortion related deaths was obtained from the Pregnancy Mortality Surveillance System, and the number of abortions was obtained from the Guttmacher Institute. Data were analyzed between February and October 2025.

MAIN OUTCOMES AND MEASURES: Pregnancy-related deaths were identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes A34, O10 to O95, O96, O98 to O99. Pregnancy- and abortion-related mortality ratios were calculated per 100 000 births and abortions, respectively, per year and overall. To calculate the ratio, the pregnancy-related mortality rate per 100 000 births was divided by the abortion-related mortality rate per 100 000 abortions. Sensitivity analyses excluded ICD-10 codes commonly misclassified as pregnancy related and COVID-19-related deaths.

RESULTS: During the period between 2018 and 2021, there were 14 902 571 births and 3 662 580 abortions. The mean ratio between pregnancy-related and abortion-related mortality was 69.6 (range, 52.9-105.2). Excluding nonspecific causes of pregnancy-related death, the mean pregnancy- to abortion-related mortality ratio was 52.9 (range, 38.2-74.2). Further excluding COVID-19-related mortality, the ratio was 44.3 (range, 34.5 to 74.2).

CONCLUSIONS AND RELEVANCE: This cross-sectional study found that the ratio of pregnancy- to abortion-related mortality from 2018 to 2021 ranged from 44.3 to 69.6, at least 3 times higher than the ratio of 14.7 calculated using data from 1998 to 2005. These findings suggest that by taking away the option to end a pregnancy, abortion bans force pregnant people to take on the increased health risks associated with continued pregnancy.

PMID:41563758 | DOI:10.1001/jamanetworkopen.2025.54793

JAMA Netw Open. 2026 Jan 2;9(1):e2554809. doi: 10.1001/jamanetworkopen.2025.54809.

ABSTRACT

IMPORTANCE: People with HIV experience higher rates of frailty and falls than age-matched people without HIV.

OBJECTIVE: To estimate the life-years lost, quality-adjusted life-years (QALYs) lost, and costs attributable to prefrailty, frailty, and falls among people with HIV and viral suppression in the United States.

DESIGN, SETTING, AND PARTICIPANTS: This decision analytic modeling study used the Frailty Policy Model, a microsimulation model, to project lifetime health and cost outcomes associated with frailty and falls among people with HIV in the United States. The model simulated individuals representing people with HIV and viral suppression in the United States aged 40 years and older in 2022, and results were scaled to the estimated population size of 521 994 individuals. Simulation model parameters were drawn from the Advancing Clinical Therapeutics Globally (ACTG) A5322 Study, the Multicenter AIDS Cohort Study (MACS)/Women’s Interagency HIV Study (WIHS) Combined Cohort Study, and published literature. Data analysis was conducted from November 2023 to October 2025.

EXPOSURES: Prefrailty, frailty, and falls.

MAIN OUTCOMES AND MEASURES: Life-years lost, QALYs lost, and costs attributable to prefrailty, frailty, and falls.

RESULTS: The simulated individuals representing people with HIV and viral suppression had a mean (SD) age of 56 (10) years; 25% were female; 41% had prefrailty, and 7% had frailty. The model projected that the simulated individuals would have a remaining life expectancy of 20.3 (95% uncertainty interval [UI], 19.7-20.8) years, with a mean of 12.0 (95% UI, 11.2-12.8) years with prefrailty or frailty and 10.1 (95% UI, 8.2-12.1) falls per person. Scaled to the population level, the model projected that there would be 31 000 (95% UI, 16 000-57 000) life-years lost, 214 000 (95% UI, 130 000-292 000) QALYs lost, and $5.0 (95% UI, $3.2-$7.2) billion in lifetime costs attributable to prefrailty. There would be 1 352 000 (95% UI, 84 000-3 336 000) life-years lost, 1 091 000 (95% UI, 209 000-2 500 000) QALYs lost, and $8.8 (95% UI, $4.7-$14.2) billion in lifetime costs attributable to frailty. There would be 183 000 (95% UI, 120 000-266 000) life-years lost, 141 000 (95% UI, 94 000-198 000) QALYs lost, and $3.4 (95% UI, $2.2-$4.8) billion attributable to falls.

CONCLUSIONS AND RELEVANCE: In this decision analytic modeling study of frailty and falls among people with HIV and viral suppression, the lifetime QALYs lost and costs attributable to frailty and falls were substantial. These findings highlight the potential clinical and economic benefits that could result from interventions to identify, prevent, and treat frailty and falls among people with HIV.

PMID:41563756 | DOI:10.1001/jamanetworkopen.2025.54809

JAMA Netw Open. 2026 Jan 2;9(1):e2554820. doi: 10.1001/jamanetworkopen.2025.54820.

ABSTRACT

IMPORTANCE: Generative artificial intelligence (AI) has rapidly entered mainstream use in the US, but its association with mental health has not been characterized.

OBJECTIVE: To examine the associations of the extent and type of generative AI use among US adults with negative affective symptoms in a large, nationally representative sample.

DESIGN, SETTING, AND PARTICIPANTS: This survey study used data from a 50-state US internet nonprobability survey conducted between April and May 2025. Survey respondents were aged 18 years and older. Data were analyzed in August 2025.

EXPOSURE: Participants self-reported generative AI and social media use.

MAIN OUTCOMES AND MEASURES: The outcome of interest, negative affect, was measured using the Patient Health Questionnaire 9-item (PHQ-9).

RESULTS: There were 20 847 unique participants, with mean (SD) age 47.3 (17.1) years and 10 327 (49.5%) female, 10 386 (49.8%) male, and 134 (0.6%) nonbinary participants; 2152 participants (10.3%) reported using AI at least daily, including 1053 participants (5.1%) who reported daily use and 1099 participants (5.3%) who reported use multiple times per day. Among participants who used daily or more frequently, 1033 (48.0%) reported use for work, 246 (11.4%) for school, and 1875 (87.1%) for personal applications. In survey-weighted regression models, daily or more frequent AI use was significantly more common among men, younger adults, those with higher education and income, and those in urban settings. Greater AI use was associated with greater levels of depressive symptoms in sociodemographic-adjusted regression models: (daily use: β = 1.08 [95% CI, 0.55-1.62]; multiple times per day: β = 0.86 [95% CI, 0.35-1.37]) compared with nonuse, and with greater likelihood of reporting at least moderate depressive symptoms (odds ratio [OR], 1.29 [95% CI, 1.15-1.46]); similar patterns were observed for anxiety and irritability. The highest estimates were observed among individuals using AI for personal use (β = 0.31 [95% CI, 0.10-0.52]) and those aged 25 to 44 years (β = 1.22 [95% CI, 0.70-1.74]) or 45 to 64 years (β = 1.38 [95% CI, 0.72-2.05]).

CONCLUSIONS AND RELEVANCE: This survey study found that AI use was significantly associated with greater depressive symptoms, with magnitude of differences varying by age group. Further work is needed to understand whether these associations are causal and explain heterogeneous effects.

PMID:41563755 | DOI:10.1001/jamanetworkopen.2025.54820

JAMA Netw Open. 2026 Jan 2;9(1):e2554831. doi: 10.1001/jamanetworkopen.2025.54831.

ABSTRACT

IMPORTANCE: Recovery after a motor vehicle crash can be slow, frustrating, and incomplete with lingering neurocognitive complications.

OBJECTIVE: To examine whether a prior concussion is associated with increased risk of long-term disability after a motor vehicle crash.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included adults surviving a motor vehicle crash treated in Ontario, Canada, from April 2003 to March 2023 with analyses to November 2025.

EXPOSURE: Prior concussion.

MAIN OUTCOME AND MEASURES: Long-term disability defined by official social service records, comparing those with a prior concussion and those with no history of a prior concussion.

RESULTS: A total of 907 984 patients injured in a motor vehicle crash were included (mean [SD] age, 37 [14] years; 472 435 male [52.0%]); 19 851 patients had a prior concussion and 888 133 had no prior concussion. A total of 54 678 patients were subsequently diagnosed with long-term disability over 9 543 505 patient-years of follow-up (mean [SD], 10.5 [5.8] years), equal to an absolute risk of 1 in 17 per decade (5.7 per 1000 patient-years). Patients with a prior concussion had a 15% higher adjusted risk of long-term disability (95% CI, 9%-21%; P < .001) compared with those with no prior concussion. The increased risk of long-term disability was independent of other measured risk factors, applied to diverse patient groups, and included those involved as passengers or pedestrians. The increased risk extended across a spectrum of crash severity, was accentuated for single-vehicle events, replicated in analyses with artificial intelligence models adjusting for confounding, and remained distinct from the risks of death, readmission, or short-term health care costs.

CONCLUSIONS AND RELEVANCE: This population-based cohort study suggests a significant increased risk of long-term disability after a motor vehicle crash, particular among patients with a prior concussion. More efforts at concussion prevention and traffic safety counseling may be justified for patients.

PMID:41563754 | DOI:10.1001/jamanetworkopen.2025.54831

Eur Arch Paediatr Dent. 2026 Jan 21. doi: 10.1007/s40368-026-01165-3. Online ahead of print.

ABSTRACT

BACKGROUND: The clinical efficacy of preventive dental treatments (PDTs) is well established. However, limited evidence exists regarding parental acceptance and its impact on children’s oral health-related quality of life (COHRQoL).

OBJECTIVE: To assess factors influencing parental acceptance of PDTs and their impact on COHRQoL.

METHODS: A cross-sectional, observational study was conducted amongst 200 parents of children aged 6-14 years who had been exclusively advised PDTs by a paediatric dentist. Sociodemographic factors, parental knowledge, and attitudes were assessed using a validated questionnaire. Parental acceptance of PDTs was recorded at the time the preventive treatment plan was explained. For those who accepted and underwent PDTs, COHRQoL was measured at baseline and 6 months post-treatment using the short-form parental/caregiver perception questionnaire (P-CPQ-8), family impact scale (FIS-8), and a global oral health rating scale. Data were analysed using appropriate statistical tests.

RESULTS: Only 36.5% of parents accepted PDTs. Non-acceptance was mainly due to perceived non-necessity (21.3%). Acceptance was significantly associated with education, family size, residence, prior dental visits, awareness, and attitudes. Logistic regression identified higher education, urban residence, and frequent dental visits as strong predictors for parental acceptance of PDTs. Following PDTs, COHRQoL improved significantly, with reductions in global oral health scores (1.19 ± 1.22 to 0.81 ± 0.77), P-CPQ-8 scores (9.22 ± 2.84 to 7.86 ± 2.59), and FIS-8 scores (7.58 ± 2.49 to 7.03 ± 2.15).

CONCLUSION: Parental acceptance of PDTs is moderate and influenced by sociodemographic and behavioural factors. PDTs significantly improved COHRQoL, emphasising that parents should recognise their importance whilst dentists must play an active role in motivating and guiding parents towards preventive care.

PMID:41563692 | DOI:10.1007/s40368-026-01165-3

Eur Arch Paediatr Dent. 2026 Jan 21. doi: 10.1007/s40368-026-01168-0. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effect of socio-economic background on oral health knowledge and cultural beliefs of parents and associate knowledge to proactive behaviours.

METHODS: This is a cross-sectional study with a convenient sample consisting of parents seeking dental care for their children at two different dental centres. Data were collected via a structured, interview-based questionnaire, covering demographic characteristics and parental oral health knowledge and behaviours. Analysis was performed based on parental socioeconomic background determined by monthly family income (< 1400€ low, 1400-2500€ medium). Differences within and between groups were assessed using chi-square and Fisher’s exact tests and associations with demographic or behavioural characteristics using multivariate regression analysis (statistical significance p < 0.05).

RESULTS: Of the participants, 111 were from low and 105 from medium socio-economic backgrounds, with the latter demonstrating significantly better oral health knowledge and more proactive behaviours, such as regular preventive dental visits and lower consumption of sugary snacks (p < 0.05). Parents from low socio-economic backgrounds showed poor knowledge regarding aetiopathogenesis of common dental diseases, with significant differences for the effect of microbes in dental plaque accumulation formation (p = 0.03) and for brushing (p = 0.02) and sugary snack consumption (p = 0.04) in caries development. Multivariate regression analysis showed that area of residency and mother’s occupation were significantly associated with decreased knowledge, that was associated with infrequent brushing and frequent sugary snack consumption.

CONCLUSION: Significant associations highlighted the need for targeted educational interventions and public health policies to reduce oral health disparities and improve awareness.

PMID:41563691 | DOI:10.1007/s40368-026-01168-0

Eur Arch Paediatr Dent. 2026 Jan 21. doi: 10.1007/s40368-026-01169-z. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to evaluate and compare the effects of custom-made camouflaged caterpillar, camouflaged alligator and conventional syringes on anxiety and behaviour in children during local anaesthesia administration.

METHODS: This was a randomised controlled study in which 150 children aged between 7 and 9 years were randomly assigned to receive local anaesthesia using a custom-made camouflaged caterpillar, a camouflaged alligator or a conventional syringe. A pulse oximeter was used to measure pulse rate. Children were scored using the Venham’s Clinical Anxiety Scale (VCAS) and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale. Data were analysed using repeated measures ANOVA, one-way ANOVA followed by Tukey’s honestly significant difference (HSD) post-hoc test, and chi-square tests. After the treatment, the child was asked to fill out the Venham’s Picture Test (VPT). In addition, parents were asked to fill out the Parental Emotional Stress Questionnaire (PESQ) and recall questionnaire.

RESULTS: The mean increase in the pulse rate was lowest in the custom-made caterpillar camouflaged syringe group, with a statistically significant difference. The mean scores of VCAS (0.66 ± 0.69), FLACC (1.38 ± 1.05), and VPT (0.62 ± 0.75) were lowest in the custom-made caterpillar camouflaged syringe group, which signified better behaviour of a child than the other two groups. The parental emotional stress quotient in the custom-made caterpillar camouflaged group revealed satisfactory outcomes with the procedure.

CONCLUSION: Custom-made caterpillar camouflaged syringes for local anaesthesia effectively decreased the anxiety of children.

PMID:41563690 | DOI:10.1007/s40368-026-01169-z

Braz J Microbiol. 2026 Jan 21;57(1):40. doi: 10.1007/s42770-025-01851-2.

ABSTRACT

Dental caries is a highly prevalent multifactorial oral disease that can cause both local and systemic lesions. The aim of this study was to evaluate the in vitro antiseptic effect of a topical solution containing polyhexamethylene guanidine hydrochloride (PHMGH) and its possible toxic effects in vivo. PHMGH was tested (0.31-625.0 ppm) against Streptococcus mutans, Streptococcus sanguinis, Streptococcus salivarius, Streptococcus mitis, Streptococcus sobrinus, Lactobacillus casei, and Enterococcus faecalis by determining the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm inhibitory concentration (MBIC₇₅), fractional inhibitory concentration index (FICI), and bactericidal kinetics. The polymer was effective against all microorganisms, with MIC and MBC ranging from 0.31 to 1.24 ppm; lower values were observed especially against S. mitis and E. faecalis when compared to commercial chlorhexidine digluconate. PHMGH inhibited 75% of the microbial biofilms, including S. mutans, with the MBIC₇₅ of PHMGH and CLX being similar for this microorganism. The combination of the polymer with CLX exerted indifferent effects against the cariogenic microorganisms. Regarding bactericidal kinetics, the polymer caused higher percent reductions in the microorganisms than CLX; at concentrations of 3.000 and 1.000 ppm, with 2 and 4 min of exposure, respectively, inducing 100% bacterial death. Given the promising results, rats received daily oral instillations of four drops of PHMGH at a concentration of 625 ppm for 90 days, mimicking a mouthwash. None exhibited alterations in mucosae or tongue, as well as no body weight and histological changes were observed in the oral mucosa, tongue, esophagus, stomach, and intestine. The toxicological evaluation showed that the treated animals did not present significant alterations in the parameters of hepatotoxicity and nephrotoxicity and DNA damage. Regarding the histopathological analyses of the digestive organs, there were no statistics differences, except for the mononuclear inflammatory infiltrate in the intestinal mucosa, which was significantly higher in treated animals. Under the present experimental conditions, PHMGH exerted in vitro antimicrobial activity against dental caries microorganisms, with no evidence of in vivo toxicity; thus, it becomes a promising and less costly option for the development of oral antiseptic products.

PMID:41563683 | DOI:10.1007/s42770-025-01851-2

Curr Hypertens Rep. 2026 Jan 21;28(1):9. doi: 10.1007/s11906-025-01359-y.

ABSTRACT

PURPOSE OF REVIEW: To discuss available data on renal denervation (RDN) for treating hypertension and how expanding access to RDN may improve rates of controlled hypertension while helping address hypertension treatment disparities.

RECENT FINDINGS: RDN is an FDA-approved procedure for the treatment of patients with confirmed uncontrolled hypertension, with proven efficacy and safety in randomized sham-controlled trials. Centers for Medicare & Medicaid Services completed a national coverage analysis for RDN coverage for the treatment of uncontrolled hypertension. By summarizing the available data on RDN and hypertension statistics among different race and ethnicities in the United States, our review highlights the potential for RDN to improve treatment control rates, without increasing medication burden. By expanding coverage for the procedure, RDN may be an important tool to reduce significant treatment disparities in hypertension.

PMID:41563652 | DOI:10.1007/s11906-025-01359-y

Endocrine. 2026 Jan 21;91(1):45. doi: 10.1007/s12020-025-04537-9.

NO ABSTRACT

PMID:41563647 | DOI:10.1007/s12020-025-04537-9