Tag: pubmed

JAMA Netw Open. 2026 Mar 2;9(3):e263274. doi: 10.1001/jamanetworkopen.2026.3274.

ABSTRACT

IMPORTANCE: Given the common use of weight-inducing (WI) medications, it is crucial to understand the potential association of these medications with the effectiveness of obesity treatments.

OBJECTIVE: To assess the association between tirzepatide and weight reduction among participants with overweight or obesity who initiated WI medications during the SURMOUNT-1, -3, and -4 trials.

DESIGN, SETTING, AND PARTICIPANTS: This post hoc analysis of the phase 3 randomized clinical trials SURMOUNT-1 (December 4, 2019, to April 1, 2022), SURMOUNT-3 (March 29, 2021, to May 12, 2023), and SURMOUNT-4 (March 29, 2021, to May 18, 2023) assessed the association between tirzepatide and weight reduction among participants taking concomitant WI medications. Randomized participants (lead-in and randomized treatment period data) who started taking 1 or more WI medications for 3 or more months (≥1 week for oral corticosteroids) during the trial were included in the analysis. Statistical analysis was performed from July to December 2025 in the modified intent-to-treat population.

MAIN OUTCOMES AND MEASURES: WI medication use was summarized for all treatment arms from weeks 0 to 72 (SURMOUNT-1 and SURMOUNT-3) or weeks 0 to 88 (SURMOUNT-4). A mixed model of repeated measures was used to assess percentage change in weight from week 0 to week 72 or week 88 in the efficacy analysis sets (excluding off-treatment data), with 1 or more postbaseline weight measures.

RESULTS: This post hoc analysis comprised the WI medication subgroups of SURMOUNT-1 participants (N = 442; mean [SD] age, 48.0 [12.5] years; 325 women [73.5%]; mean [SD] body weight, 105.9 [22.4] kg), SURMOUNT-3 participants (N = 100; mean [SD] age, 49.5 [12.0] years; 75 women [75.0%]; mean [SD] body weight, 102.7 [23.5] kg), and SURMOUNT-4 participants (N = 134; mean [SD] age, 51.8 [11.9] years; 91 women [67.9%]; mean [SD] body weight, 111.8 [23.7] kg). Approximately one-fifth of participants used 1 or more WI medications (SURMOUNT-1, 17.4% [442 of 2539]; SURMOUNT-3, 17.3% [100 of 579]; and SURMOUNT-4, 20.0% [134 of 670]). Among them, 72.9% in SURMOUNT-1 (322 of 442), 68.0% in SURMOUNT-3 (68 of 100), and 64.9% in SURMOUNT-4 (87 of 134) were taking 1 nonsteroid WI medication, with 2.0% in SURMOUNT-1 (9 of 442), 3.0% in SURMOUNT-3 (3 of 100), and 2.2% in SURMOUNT-4 (3 of 134) using 3 or more medications. The mean (SD) duration of treatment with nonsteroid WI medications was 50.9 (28.8) weeks in SURMOUNT-1, 50.9 (29.3) weeks in SURMOUNT-3, and 58.1 (34.9) weeks in SURMOUNT-4. The mean percentage weight change compared with placebo from randomization to 72 weeks for those treated with tirzepatide and using WI medication was -13.3% (95% CI, -16.0% to -10.7%) for 5 mg to -21.3% (95% CI, -23.9% to -18.7%) for 15 mg in SURMOUNT-1 and -26.1% (95% CI, -30.0% to -22.3%) for the maximum tolerated dose in SURMOUNT-3, and from randomization to 88 weeks, it was -18.6% (95% CI, -20.9% to -16.3%) for the maximum tolerated dose in SURMOUNT-4.

CONCLUSIONS AND RELEVANCE: In this post hoc analysis of 3 randomized clinical trials for participants taking at least 1 concomitant WI medication, tirzepatide treatment was associated with weight loss comparable with the primary study results. These findings suggest that people with overweight or obesity who require treatment with WI medications may be able to achieve clinically meaningful weight reduction with tirzepatide.

TRIAL REGISTRATION: ClinicalTrials.gov Identifiers: NCT04184622, NCT04657016, NCT04660643.

PMID:41885866 | DOI:10.1001/jamanetworkopen.2026.3274

JAMA Netw Open. 2026 Mar 2;9(3):e263515. doi: 10.1001/jamanetworkopen.2026.3515.

ABSTRACT

IMPORTANCE: Worldwide, 480 000 deaths are attributable to opioids annually. The risk that they pose to children through family members’ prescriptions is unknown.

OBJECTIVE: To quantify the association between opioid prescriptions dispensed to a household family member and a serious opioid intoxication event (SOE) in a child.

DESIGN, SETTING, AND PARTICIPANTS: This case-control, population-based study used data from Denmark’s comprehensive nationwide longitudinal prescription and health care registries over a 27-year period from April 1, 1995, to June 30, 2022. Among 3 761 618 Danish residents younger than 20 years, cases were individuals who experienced an SOE. For each case, there were 10 matched population-based controls without a prior SOE. Household family members were individually linked to case and control participants. Statistical analyses were performed between August 2024 and January 2025.

EXPOSURE: An analgesic prescription filled by a household family member within 3 months before a child’s SOE. The study included 3 categories of children whose family members were (1) exposed to prescription opioids, (2) exposed to nonsteroidal anti-inflammatory drugs (NSAIDs), and (3) unexposed.

MAIN OUTCOME AND MEASURES: SOE, defined as death, hospitalization, or emergency department visit due to opioid intoxication. The incidence rate ratio of SOEs among children whose family members redeemed an opioid prescription was compared with those in unexposed households and with those whose family members filled NSAID prescriptions. Conditional logistic regression was used to compute adjusted odds ratios (AORs), controlling for potential sociodemographic and mental health confounders. Subsequently, analyses were stratified by sex, age brackets (<13 vs ≥13 years), SOE calendar year, and hospital disposition. Finally, a sensitivity analysis was conducted restricting the interval between prescription dispensing and the SOE to 1 month.

RESULTS: A total of 2000 children (median age at SOE, 17.8 years [IQR, 15.7-19.0 years]; 1096 boys [54.8%]) experienced an SOE and were matched with 19 840 controls (median age at index, 17.7 years [IQR, 15.6-19.0 years]; 10 872 boys [54.8%]). Among 2000 cases, 1116 (55.8%) were hospitalized and 60 (3.0%) died. Having a family member fill an opioid prescription (319 cases and 1137 controls) was associated with increased odds of an SOE compared with unexposed children (1398 cases and 16 181 controls; AOR, 2.87; 95% CI, 2.45-3.38) and with children exposed to NSAIDs (283 cases and 2522 controls; AOR, 2.22; 95% CI, 1.81-2.72). Odds of an opioid-related death were nearly 4-fold higher compared with unexposed children (15 cases and 33 controls vs 42 cases and 496 controls, respectively; AOR, 3.70; 95% CI, 1.55-8.84). The association remained robust in stratified and sensitivity analyses.

CONCLUSIONS AND RELEVANCE: This study suggests that children of family members prescribed opioids had increased odds of opioid intoxication-related death and other SOEs compared with children of unexposed families or those exposed to nonopioid analgesics. Public health strategies to mitigate the opioid crisis should consider unique pediatric aspects that can reduce the likelihood of pediatric SOEs.

PMID:41885863 | DOI:10.1001/jamanetworkopen.2026.3515

JAMA Netw Open. 2026 Mar 2;9(3):e263529. doi: 10.1001/jamanetworkopen.2026.3529.

ABSTRACT

IMPORTANCE: Understanding how prior policies, systemic factors, and public health events have shaped mammography use among US women is essential for interpreting the 2024 US Preventive Services Task Force (USPSTF) recommendation update and identifying gaps to inform equitable public health strategies.

OBJECTIVE: To analyze mammography use trends in US women aged 40 to 49 and 50 to 74 years from 2002 to 2022 and assess variation by sociodemographic, health care access, behavioral, and geographic factors, including associations with the 2009 USPSTF recommendation and the COVID-19 pandemic.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from the Behavioral Risk Factor Surveillance System biennial cancer screening module (2002-2022). Joinpoint regression with a jump model was used to account for methodological changes in the Behavioral Risk Factor Surveillance System beginning in 2011. Data were analyzed from March to September 2025.

MAIN OUTCOMES AND MEASURES: The primary outcome was the average biennial percentage change in mammography use from 2002 to 2022, calculated as a weighted average of jump model-estimated biennial changes. Subgroup analyses were conducted by sociodemographic, health care access, behavioral, and geographic factors.

RESULTS: Among 2 619 292 US women, mammography use showed a downward trend, with nonsignificant biennial changes of -0.54% (95% CI, -1.25% to 0.16%) for ages 40 to 49 years and -0.16% (95% CI, -0.49% to 0.16%) for ages 50 to 74 years from 2002 to 2022. Declines were significant among young women without health insurance (-1.54%; 95% CI, -2.89% to -0.17%), current smokers (-1.36%; 95% CI, -2.43% to -0.27%), unmarried women (-1.10%; 95% CI, -1.61% to -0.59%), and non-Hispanic White women (-0.58%; 95% CI, -1.09% to -0.07%). Following the 2009 USPSTF recommendation, mammography use decreased significantly among younger non-Hispanic White (-0.88%; 95% CI, -1.59% to -0.16%), Asian (-2.45%; 95% CI, -4.20% to -0.25%), and uninsured (-2.39%; 95% CI, -4.57% to -0.16%) women, with no significant reduction among non-Hispanic Black women (-0.59%; 95% CI, -1.20% to 0.03%). Across both age groups, mammography use was consistently lower in Western than in Eastern states.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, mammography use did not significantly decline in the overall population; however, significant reductions were observed among non-Hispanic White, Asian, and uninsured women aged 40 to 49 years from 2010 to 2022. These findings highlight the need for clear, risk-based screening communication and targeted strategies to promote guideline-concordant decision-making, particularly among younger women.

PMID:41885862 | DOI:10.1001/jamanetworkopen.2026.3529

JAMA Netw Open. 2026 Mar 2;9(3):e263594. doi: 10.1001/jamanetworkopen.2026.3594.

ABSTRACT

IMPORTANCE: Neighborhood-level socioeconomic deprivation has been associated with higher incidence and severity of pediatric critical illness; however, structural factors underlying observed differences have received limited attention.

OBJECTIVE: To describe the association between area-level deprivation, rurality, and incidence of critical care admission among children.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used linked data of individuals aged 0 to 17 years who were admitted to intensive care units in British Columbia (BC), Canada, between 2014 and 2023. Data were analyzed from June to November 2025.

EXPOSURES: Age, sex, rurality, and neighborhood situational vulnerability (a measure of socioeconomic disadvantage).

MAIN OUTCOMES AND MEASURES: The primary outcome was the incidence rate of critical care admission. Poisson regression models were used to estimate incidence rate ratios (IRRs) between exposure groups. The possible interaction between situational vulnerability quintile and population center type was examined.

RESULTS: A total of 10 048 children were admitted 13 990 times to intensive care units (incidence rate of 154 per 100 000 person years). Most admissions were for male children (7641 [54.6%]) and children younger than 5 years (7528 [53.8%]). The IRR for rural or small population centers compared with medium or large was 1.35 (95% CI, 1.28-1.41). Similarly, the IRR for the most vs least deprived quintile was 1.31 (95% CI, 1.23-1.39); however, in medium or large population centers, there was no association between situational vulnerability quintile and critical care admission (eg, quintile 5 vs 1: IRR 1.04; 95% CI, 0.97-1.12). Those in rural or small areas of the most deprived quintile had the highest overall rate (IRR, 2.02; 95% CI, 1.87-2.19 vs highest quintile in large or medium population centers).

CONCLUSIONS AND RELEVANCE: In this retrospective cohort study there was higher burden of critical care admission for children living in rural areas and small population centers, and areas with higher situational vulnerability. The association between situational vulnerability and critical care incidence was unique to rural or small regions. Targeted strategies are needed to address contributing factors and ensure timely access to pediatric acute care in underserved areas.

PMID:41885861 | DOI:10.1001/jamanetworkopen.2026.3594

JAMA Netw Open. 2026 Mar 2;9(3):e263601. doi: 10.1001/jamanetworkopen.2026.3601.

ABSTRACT

IMPORTANCE: US territory nativity and/or residence may be associated with health because it affects environmental exposures, insurance coverage, prenatal care, and other factors. Investigations of preterm birth in the US territories are limited.

OBJECTIVE: To assess the association between maternal territory status and preterm birth, as well as whether insurance type modified associations.

DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of restricted-use birth certificates of in-hospital, singleton births in the US and territories from 2014 to 2023.

EXPOSURES: Maternal territory status was defined for births in territories where data were available (Guam, Northern Mariana Islands, Puerto Rico, and Virgin Islands) for the following groups: (1) those with territory nativity and residence; (2) those with territory nativity and mainland residence; (3) those with mainland nativity and territory residence; and (4) those with mainland nativity and residence (reference group). Insurance type (private, Medicaid, or other) was evaluated as well.

MAIN OUTCOMES AND MEASURES: Preterm birth (live birth before 37 weeks’ gestation).

RESULTS: Among 28 627 700 births, 465 291 (1.6%) had any maternal territory status (nativity or residence). This group had a mean (SD) age of 27.1 (6.0) years, and 297 593 (64.0%) had Medicaid insurance. The highest preterm birth rate was among those with territory nativity and residence (10.5%; 95% CI, 10.4%-10.7%); the lowest was among those with mainland nativity and residence (8.4%; 95% CI, 8.4%-8.5%). Individuals with territory nativity and residence had an adjusted relative risk (aRR) of 1.30 (95% CI, 1.29-1.32) for preterm birth compared with the reference group. There was significant interaction between territory residence and insurance. Compared with individuals with mainland residence and private insurance, those with territory residence and Medicaid had the highest preterm birth risk (aRR, 1.57; 95% CI, 1.55-1.59), followed by territory residence and private insurance (aRR, 1.42; 95% CI, 1.39-1.45).

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, maternal territory nativity and residence were associated with preterm birth. Territory residence was associated with a higher risk of preterm birth, regardless of insurance type. Privately insured-individuals in US territories had a higher risk of preterm birth than Medicaid-insured individuals in the mainland. Given differential access to health care, health insurance, and other social exposures between territory and mainland populations, future work should explore causal effects and related policies that may improve birth outcomes in US territories.

PMID:41885860 | DOI:10.1001/jamanetworkopen.2026.3601

Psychol Rep. 2026 Mar 26:332941261436663. doi: 10.1177/00332941261436663. Online ahead of print.

ABSTRACT

Cyber dating abuse involves psychological and relationally harmful behaviours enacted through digital technologies within romantic relationships. Although prior research links dispositional variables to cyber dating abuse, perpetration and victimisation frequently co-occur, complicating the interpretation of individual differences. This study examined associations among personality traits, romantic jealousy, empathy, and gender with psychological and relational cyber dating abuse perpetration and victimisation in 503 young adults aged 18 to 25 in the UK. Hierarchical regression analyses accounted for overlap across forms of cyber dating abuse involvement. Psychological and relational perpetration and victimisation were strongly interrelated, with other forms of involvement accounting for most explained variance across models. After modelling this overlap, dispositional variables explained small but statistically significant increments in variance, with behavioural jealousy and lower agreeableness most consistently associated with perpetration. Dispositional variables did not meaningfully predict psychological victimisation, and gender effects were modest and inconsistent. Overall, the findings suggest cyber dating abuse is best understood as a relational phenomenon characterised by co-occurring perpetration and victimisation, with individual differences shaping how behaviours are expressed rather than serving as primary drivers.

PMID:41885857 | DOI:10.1177/00332941261436663

Immunohorizons. 2026 Mar 10;10(3):vlag013. doi: 10.1093/immhor/vlag013.

ABSTRACT

Reproductive disorders such as endometriosis and polycystic ovary syndrome (PCOS) are increasingly recognized as immune-mediated conditions, yet their immunopathology remains poorly understood. Menstrual blood, a noninvasive and biologically relevant sample, offers a unique window into reproductive tract immunity but has been underutilized in this context. We optimized Cytek’s® 25-color high-dimensional flow cytometry panel by incorporating a mitochondrial dye to investigate immune cell profiles in menstrual mononuclear cells (MMCs) from healthy individuals, and those with endometriosis or PCOS, in comparison with matched peripheral blood mononuclear cells (PBMCs). This enabled detailed assessment of 40 immune cell subsets and 546 immunological parameters, including markers of activation, exhaustion, migration, and mitochondrial content. MMCs displayed a distinct immune landscape compared to PBMCs, enriched with tissue-resident NK cells, macrophages, and dendritic cells, alongside changes in mitochondrial mass for various cell subsets and other markers such as PD-1. These findings support a metabolically active, tissue-adapted immune environment within menstrual fluid, representative of the reproductive tract. Exploratory analyses of MMCs from individuals with endometriosis or PCOS revealed disease-specific trends: for example, mitochondrial mass differed across Tregs, CD4 central memory cells, plasmablasts, and cDC1s, with endometriosis and PCOS exhibiting distinct patterns rather than a uniform “reproductive disorder” phenotype. Although these disease-associated findings did not consistently reach statistical significance due to the small cohort size, they demonstrate the potential of menstrual blood immunoprofiling to uncover biologically meaningful differences across diverse immune cell populations. Together, this study establishes menstrual fluid as a valuable, non-invasive sample for immunological assessment and a promising avenue for future biomarker discovery in reproductive disorders.

PMID:41885004 | DOI:10.1093/immhor/vlag013

Hum Vaccin Immunother. 2026 Dec 31;22(1):2638034. doi: 10.1080/21645515.2026.2638034. Epub 2026 Mar 26.

ABSTRACT

Since the Covid-19 pandemic entered its endemic phase, France, Italy, and Hungary, as well as many other European countries, have observed a rise in vaccine hesitancy. This study employs a mixed-methods approach to understand the reasons behind this trend by linking statistical observations with in-depth view of vaccine hesitancy. A total of 3,021 adults were surveyed from France, Italy, and Hungary via nationally representative surveys, examining views toward these vaccines. We employed both pooled and un-pooled linear regression analyses. In each country, 20 semi-structured interviews were conducted. Our pooled survey analysis reveals that hesitancy toward Covid-19 and influenza vaccines was higher among respondents reporting mistrust in healthcare providers [95% CI = -0.26,-0.17; P < .001] and lower among those with underlying health conditions. Additionally, older adults were less likely to receive Covid-19 vaccines but more likely to receive an influenza vaccine. Those without a Covid-19 vaccination were 18% points more likely to be unvaccinated against influenza [95% CI = 0.11,0.24; P < .001]. The interviews highlight that these broader patterns reflect a post-pandemic landscape characterised by heightened ambivalence and complexity in vaccine decisions, in which people find it difficult to decide independently and rely more on experts. The interviews also revealed various influences on vaccine hesitancy, including safety concerns, diminished fear of disease, and online misinformation. These indicate that post-pandemic vaccine hesitancy reflects shifting attitudes shaped by shared pandemic experiences across countries, underscoring the need for continued research and monitoring in light of how post-pandemic vaccine hesitancy differs from pre-pandemic forms.

PMID:41884998 | DOI:10.1080/21645515.2026.2638034

J Econ Entomol. 2026 Mar 26:toag073. doi: 10.1093/jee/toag073. Online ahead of print.

ABSTRACT

The intensification of agriculture in tropical landscapes has posed significant challenges to pest management programs worldwide. While primary pests have been the focus of biotechnological advancements in crop design, the impact on early season pests often has been overlooked. Consequently, outbreaks of these pests have been reported globally. The Bt maize event MON 95379 expressing Cry1B.868 and Cry1Da_7 was approved for commercial use in Brazil in 2020. Although it has high efficacy against primary maize lepidopteran pests, there is no information on its effects on early season pests. In this context, our purpose was to investigate MON 95379 (Cry1B.868 + Cry1Da_7) levels of protection across tropical maize germplasm against Elasmopalpus lignosellus (Zeller) (Lepidoptera: Pyralidae) and Agrotis ipsilon (Hufnagel) (Lepidoptera: Noctuidae). Bt hybrids expressing Cry1B.868 + Cry1Da_7, Cry1A.105 + Cry2Ab2 + Cry3Bb1, and Cry1A.105 + Cry2Ab2 + Vip3Aa + Cry3Bb1 + RNAi exhibited no symptoms of plant mortality after 15 d post-infestation by E. lignosellus, a statistically significant improvement compared to the average observed in a non-Bt hybrid (∼85%). Similarly, low levels of plant mortality (<10%) were recorded across all Bt hybrids during the same evaluation for A. ipsilon, while the non-Bt hybrid showed an average plant mortality rate of 60%. These findings indicate that MON 95379 (Cry1B.868 + Cry1Da_7) may fit as an effective tool for managing early season pests in maize.

PMID:41884990 | DOI:10.1093/jee/toag073

J Dual Diagn. 2026 Mar 26:1-12. doi: 10.1080/15504263.2026.2638188. Online ahead of print.

ABSTRACT

Objective: Black individuals in the United States have high rates of obesity and cigarette smoking, both of which increase health risks. One factor that has demonstrated significant relations to cigarette smoking outcomes is anxiety sensitivity. Yet, work examining these relations among Black individuals with obesity who smoke is nonexistent. Therefore, the present study examined the role of anxiety sensitivity in relation to several smoking outcomes among Black individuals with obesity who smoke. Methods: Participants were 161 Black adults with obesity who endorsed daily combustible cigarette smoking (M_age = 47.1 years, SD = 14.19, age range 19-73 years; 65.2% female). Results: Results indicated that greater levels of anxiety sensitivity were statistically significantly and positively related to increased cigarette dependence, severity of problems when trying to quit, perceived barriers to smoking cessation, and smoking abstinence expectancies, including negative mood, somatic symptoms, and harmful consequences. Importantly, findings were observed above and beyond the variance accounted for by age, sex, education, income, perceived physical health, average number of cigarettes smoked per day, hazardous drinking, and cannabis use. Conclusions: These findings suggest that Black individuals with obesity who smoke and exhibit higher levels of anxiety sensitivity may be at increased risk for processes known to sustain smoking behavior and impede quitting success.

PMID:41884970 | DOI:10.1080/15504263.2026.2638188