An often-overlooked issue in type 1 diabetes' (T1D) management is the growing prevalence of overweight and obesity, as well as the control of accompanying cardiometabolic risk factors. This cross-sectional study investigates associations of body mass index (BMI) and waist circumference (WC) with glycemic control and other cardiometabolic risk factors in adults with T1D. Patients followed in the Insulin Pump Clinic at a tertiary hospital were selected. Data from clinical records and continuous glucose monitoring-derived parameters were retrospectively documented, from 2022 to 2024. Associations of BMI and WC categories with cardiometabolic risk factors were assessed using linear regression models. Restricted cubic splines analyses were performed to assess for nonlinear associations. Of the 388 patients included, 32.3% were overweight and 13.7% had obesity. A U-shaped relationship was observed between BMI and glycated hemoglobin (HbA1c), with lower and higher BMI associated with increased HbA1c (p for non-linearity = 0.005). A higher time in range was found in the increased WC group (53.1 ± 18.4% vs. 59.8 ± 14.6%, p = 0.036). Patients with obesity had higher systolic (p = 0.013) and diastolic blood pressure (BP) (p = 0.001), non-high-density lipoprotein (HDL) cholesterol (p = 0.022) and triglycerides (p = 0.001) values, when compared to lower BMI categories. Patients with increased WC also presented higher systolic (p = 0.038) and diastolic BP (p = 0.015), non-HDL (p = 0.010) and triglycerides (p < 0.001) values, compared to those with normal WC. In adults with T1D, BMI and WC showed stronger associations with BP and lipid profile than glycemic control, underscoring the importance of comprehensive cardiovascular risk assessment and targeted therapeutic strategies in this population. The online version contains supplementary material available at 10.1007/s40200-025-01718-1.

The early immune mechanisms determining Mycobacterium tuberculosis infection outcome are unclear. Using bulk and scRNA-seq over the first weeks of infection, we describe an unexpected, higher early pulmonary type I IFN response in relatively resistant C57BL/6 as compared with highly TB-susceptible C3HeB/FeJ mice. C57BL/6 mice showed pronounced early monocyte-derived macrophage (MDM) accumulation and extensive CD4+ T cell-MDM interactions in lung lesions, accompanied by high expression of T cell-attractant chemokines by MDMs. Conversely, lesions in C3HeB/FeJ mice were dominated by neutrophils with high expression of pro-inflammatory chemokines, from which CD4+ T cells were spatially segregated. Early type I IFN signaling blockade reduced bacterial load and neutrophil swarming within early TB lesions while increasing CD4+ T cell numbers in both C57BL/6 and C3HeB/FeJ mice, with later more pronounced effects on bacterial load in C3HeB/FeJ mice. These data suggest that early type I IFN signaling during M. tuberculosis infection favors neutrophil accumulation and limits CD4+ T cell infiltration into developing lesions.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique used to treat major depressive disorder (MDD), particularly in patients with treatment resistant depression. More recently, accelerated transcranial magnetic stimulation (aTMS) has shown comparable efficacy while offering a faster treatment option. This review assesses whether aTMS is non-inferior to rTMS. This systematic review compared aTMS and rTMS protocols for MDD treatment. Studies were identified through PubMed, Cochrane Library, and Web of Science (September 2024). Non-MDD populations and non-aTMS techniques were excluded, such as studies that did not qualify as clinical trials, cohort or randomized controlled trial. Inclusion criteria required direct protocol comparisons and a minimum sample of 10 participants. Bias assessment followed the Cochrane Collaboration’s robvis tool. Four studies were included, encompassing a total sample of 219 patients. Results showed symptom improvement across all groups, with accelerated protocols demonstrating faster response in some cases. However, long-term efficacy varied, and no study provided conclusive superiority of one protocol over the other. This study reveals the variability in aTMS protocols and the inconsistency in the depression rating scales selected across studies, noting that the lack of standardised assessment methods limits meta-analytical potential. Short follow-up durations contrast with antidepressant studies, restricting long-term efficacy evaluation. Additionally, improvements in sham methodologies have increased placebo responses, further influencing treatment outcome interpretation. This systematic review highlights the efficacy, tolerability, and cost-effectiveness of aTMS, suggesting its non-inferiority to rTMS and underscoring the need for further research to define the optimal accelerated protocol.

The transition to parenthood often brings challenges to couples' sexual satisfaction, underscoring the need to identify protective factors that can mitigate these effects. Mindfulness has emerged as a potential targetable factor, but its specific mechanisms of action in postpartum couples remain unclear. This study tested the association between mindfulness and postpartum sexual satisfaction among new parent couples and examined whether this relationship was mediated by individuals' and partners' sexual function and sexual distress. Using a dyadic approach, we sampled 161 mixed-sex/gender first-time parent couples at 3months postpartum. Couples completed validated measures of trait mindfulness, sexual satisfaction, sexual function, and sexual distress. Hypotheses were tested using mediation analyses guided by the actor-partner interdependence model. Individual and partner self-reported sexual satisfaction, sexual function, and sexual distress. For men, greater trait mindfulness was associated with higher sexual satisfaction through improved sexual function. For women, greater trait mindfulness was linked to higher sexual satisfaction through reduced sexual distress. Actor effects (ie, an individual's mindfulness influencing their own sexual satisfaction) were significant, while partner effects (ie, one partner's mindfulness influencing the other's sexual satisfaction) were not observed. These findings suggest that trait mindfulness may play a role in enhancing sexual satisfaction during the postpartum period, but through distinct mechanisms for men and women. Specifically, mindfulness appears to improve sexual satisfaction in men through sexual function, and in women through reduced sexual distress. These gender-specific patterns could inform the development of mindfulness-based interventions tailored to the unique challenges faced by men and women during this transitional phase. The strengths include the large, dyadic sample and focus on the early postpartum period. The limitations include the cross-sectional design, which prevents conclusions about causality or long-term effects. This study highlights trait mindfulness as a key factor in postpartum sexual satisfaction, operating through sexual function in men and sexual distress in women, and underscores the need for further research on mindfulness-based interventions for couples.