ABSTRACT Background This study investigates obstetric outcomes and factors influencing preterm birth among Chinese-American and American Indian or Alaskan Native women to address the gap in knowledge and inform targeted interventions. Methods A retrospective cohort study was conducted using 2022 data from the National Vital Statistics System (NVSS), covering 50 U.S. states and the District of Columbia. The study included 40,983 Chinese-American and 35,648 AIAN women aged ≥18 years. Based on gestational age(GA), preterm birth was defined as extremely preterm birth (GA <276/7 weeks), very preterm birth (GA 280/7 to 316/7 weeks), moderately preterm birth (GA 320/7 to 336/7 weeks) and late preterm infants (GA 340/7 to 366/7 weeks). Bivariate analyses and multivariable logistic regression were used to estimate odds ratios (OR) and 95% confidence intervals (CIs) for preterm birth predictors. Results The preterm birth prevalence was 7.56% in Chinese-American women (5.86% late preterm) and 12.09% in AIAN women (8.98% late preterm). In both groups, preterm birth was associated with higher rates of adverse infant outcomes (low birth weight, NICU admission, surfactant therapy) and maternal complications. For Chinese-American women, significant risk factors included maternal age ≥35 years (OR = 1.23), weight gain <5.0 kg (OR = 1.67), chronic hypertension (OR = 3.18), gestational hypertension (OR = 2.58), previous preterm birth (OR = 3.96), infertility treatment (OR = 1.30), and multiple pregnancies (OR = 21.17); protective factors included higher education (e.g. master’s degree: OR = 0.73), prenatal care (OR = 0.54), and weight gain ≥13.6 kg (OR = 0.52). For AIAN women, key risk factors included age ≥35 years (OR = 1.27), weight gain <5.0 kg (OR = 1.39), chronic hypertension (OR = 2.85), gestational hypertension (OR = 2.79), previous preterm birth (OR = 3.30), and multiple pregnancies (OR = 16.18); protective factors included prenatal care (OR = 0.37) and weight gain ≥13.6 kg (OR = 0.67). Conclusions Preterm birth disparities exist between Chinese-American and AIAN women, with shared and population-specific risk/protective factors. Routine practice should prioritize targeted monitoring for high-risk groups and promote prenatal care and optimal weight gain.

ABSTRACT Objective To evaluate the effect of lutikizumab intervention on patients with osteoarthritis (OA) and provide an evidence-based reference for the clinical application of lutikizumab intervention in patients with osteoarthritis. Methods Literature databases such as PubMed, Embase, web of science, and the Cochrane Library were searched to collect relevant data on randomized controlled trials (RCTs), clinical trials, and single/double arm non-randomized controlled trials studies of therapy interventions for patients with OA, and meta-analysis was performed using RevMan 5.4. Results A total of 6 randomized controlled studies were included, including 737 patients with osteoarthritis. Meta-analysis showed that compared with the control group, lutikizumab intervention had more gains, IL-α (0.3 mg/kg, Q2W, week2) (MD = -0.67, 95% CI [−1.25,-0.09]; Z = 2.26; p = 0.02), IL-1β (3 mg/kg,Q2W,week2) (MD = -0.58, 95% CI [−1.14, −0.02]; Z = 2.03; p = 0.04) and hsCRP (200 mg,Q2W,week8) (MD = -1.79, 95% CI [−2.09, −1.50]; Z = 11.80; p < 0.00001). Conclusion Reducing the OA process with lutikizumab provides a theoretical basis for further investigation of the function of lutikizumab in patients with OA.IL-1 is not only an inflammatory mediator in osteoarthritis, but also a key molecule connecting biomechanical abnormalities and tissue damage.IL-1 inhibitors precisely regulate the spatiotemporal expression of IL-1, and individualize the biomechanical intervention regimens or combination of multiple interventions to achieve optimal therapeutic effects.

ABSTRACT Objectives Hashimoto’s thyroiditis (HT) is a T-cell mediated autoimmune disease characterized by the progressive destruction of thyroid gland. Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score and systemic inflammatory index (SII) are novel markers of inflammation. We aimed to compare HALP score and SII values of patients with HT to those in healthy control subjects in the present study. Methods Patients diagnosed with HT and healthy volunteers (as controls) were included in the study. The SII and HALP score were calculated using the following formulas: SII = (Platelet count×Neutrophil count)/Lymphocyte count. HALP score = (Hemoglobin×Serum Albumin×Lymphocyte count)/Platelet count. SII and HALP score of patients with HT and healthy controls were compared. Results Median SII of the patients with HT (510 (140–3646)) was significantly higher than that of the control subjects (422 (102–2173)) (p < 0.001). Median HALP score of the HT group (47 (7–149)) was significantly lower than that of the control group (54 (10–160)) (p < 0.001). The sensitivity and specificity of SII (when higher than 452%) in detecting HT were 61% and 62%, respectively (AUC: 0.64, p < 0.001, 95%CI: 0.61–0.67). A HALP score lower than 49.5% threshold had 64% sensitivity and 57% specificity in detecting HT (AUC: 0.61, p < 0.001, 95%CI: 0.57–0.64). In logistic regression analysis (considering age, gender, eGFR, TSH, CRP, ESR, BMI), a unit increase in SII increased the risk of HT by 0.3% (p < 0.001, OR: 1.003, 95%CI: 1.002–1.004). HALP score was also an independent risk factor for HT. A unit increase in HALP score decreased the risk of HT by 2% (p < 0.001, OR: 0.977, 95%CI: 0.968–0.985). Conclusion We recommend that, due to their inexpensive and easily assessable nature, SII and HALP score could serve as additional diagnostic tools in HT.

ABSTRACT Objectives This study evaluated the effectiveness and safety of maintenance therapy with capecitabine ± bevacizumab in Vietnamese patients with mCRC after disease control following first-line chemotherapy. Methods A retrospective cohort study was conducted at Vietnam National Cancer Hospital (March – May 2025). Eligible patients had mCRC, achieved response or stable disease after CAPOX plus bevacizumab, and received maintenance capecitabine alone or with bevacizumab. The primary endpoint was progression-free survival (PFS). Safety was assessed using CTCAE v5.0. Kaplan – Meier and Cox regression analyses were performed. Results Among 148 patients, 54 (36.5%) received capecitabine alone and 94 (63.5%) received bevacizumab – capecitabine. Baseline characteristics were balanced. Median PFS was 9.9 months (95% CI: 7.5–12.4) with bevacizumab – capecitabine vs. 5.8 months (95% CI: 4.3–7.4) with capecitabine alone (HR = 0.477, p = 0.001). Multivariable analysis showed that bevacizumab use (HR = 0.384, p = 0.001), achieving CR/PR after induction (HR = 0.416, p = 0.003), and absence of peritoneal metastases (HR = 1.758, p = 0.046) were independently associated with improved PFS. Both regimens were well tolerated, with no treatment-related deaths. The most common toxicity was hand – foot syndrome (27.7% vs. 25.9%). Hypertension and rare events (GI perforation, thrombosis) occurred only in the bevacizumab group but were infrequent. Grade 3–4 adverse events were uncommon and manageable. Conclusions In this first real-world study from Vietnam, maintenance therapy with bevacizumab plus capecitabine significantly improved PFS compared to capecitabine alone, with acceptable safety. These findings support the use of biologic-based maintenance strategies in appropriate patients and provide valuable evidence for guiding mCRC treatment in resource-constrained settings.

ABSTRACT Background Periprosthetic joint infection (PJI) is a severe complication of total joint arthroplasty (TJA), with traditional risk factors including diabetes and obesity. Emerging evidence suggests functional gastrointestinal disorders (FGIDs) may influence systemic inflammation and infection susceptibility. This study investigated whether preexisting FGIDs are independent risk factors for PJI. Methods A retrospective 1:1 matched case-control study analyzed 896 patients (448 PJI vs. 448 non-PJI) undergoing primary TJA (2013–2023). PJI was diagnosed using modified 2018 Musculoskeletal Infection Society criteria, and FGIDs (irritable bowel syndrome [IBS], functional diarrhea [FD], functional constipation [FC]) were classified per Rome IV criteria. Multivariable logistic regression identified PJI risk factors after adjusting for demographics, comorbidities, and surgical variables. Results Univariate analysis revealed significantly higher FC prevalence in PJI cases (14.3% vs. 8.3%, p = 0.0043), while IBS and FD showed no association. Multivariate analysis confirmed FC as an independent PJI risk factor (odds ratio [OR] = 1.844, 95% confidence interval [CI]:1.199–2.872, p = 0.0059), alongside diabetes (OR = 1.714, 95%CI:1.116–2.661, p = 0.0148), and surgery duration >2 hours (OR = 2.220, 95%CI:1.242–4.125, p = 0.0088). Perioperative antibiotic usage reduced PJI risk (OR = 0.405, 95%CI:0.232–0.686, p = 0.0010). Conclusion Functional constipation was identified as a novel independent risk factor for PJI, alongside established metabolic comorbidities and prolonged surgery. These findings underscore the gut-joint axis in PJI pathogenesis and advocate integrating FGID screening into preoperative risk stratification. Antibiotic prophylaxis remains critical for minimizing infection risk in TJA patients.

ABSTRACT Background Microvascular dysfunction (MD) is advocated as one of the main pathogenic mechanisms of Takotsubo syndrome (TTS). Several studies investigated MD in TTS using different techniques; however, no systematic review of these data is currently available. Methods We searched the main scientific database (Embase, Medline, Scopus, PubMed) for articles written in English language using the following keywords: (‘takotsubo’ OR ‘broken heart’ OR ‘apical ballooning’ OR ‘stress cardiomyopathy’) AND (‘microvascular’). Case reports: studies not performed in human subjects or investigating microvascular function in organs other than the heart were excluded. Results 35 studies matched the inclusion criteria. Microvascular function was assessed by standard coronary angiography-derived indexes (n = 17), invasive measurement (n = 10, index of microcirculatory resistance (IMR) in n = 7), echocardiography (n = 5), nuclear medicine (n = 3), and cardiac magnetic resonance imaging (CMR) in n = 2, with some studies applying more than 1 technique. When established cutoff values were used, MD prevalence largely varied (35% to 100%). Although comprehensive clinical correlates were scarcely reported, MD was consistently associated with higher systolic impairment. Blood-based inflammatory biomarkers analysis was performed in one study only, providing inconclusive results. Clinical outcomes associated with MD were reported in four studies including higher rates of major cardiovascular events and long-term mortality. Conclusions MD in TTS has a variable prevalence. It is absent in a relevant proportion of the cases, making it questionable as it should be considered a pre-requisite for disease onset. The presence and extent of MD in TTS is a promising prognostic marker; no data in humans currently confirm its role as a therapeutic target.

ABSTRACT Objectives To review the efficacy of lemborexant (LEM), a dual orexin-receptor antagonist approved in multiple countries for treatment of insomnia in adults, by assessing the consistency of the available LEM objective and subjective evidence. Methods Data from 2 pivotal phase 3, randomized, double-blind, parallel-group, placebo (PBO)-controlled studies are reviewed. Study 304 (1-month) and Study 303 (12-months; only first 6 months included here) evaluated the efficacy/safety of LEM 5 mg (LEM5) and LEM 10 mg (LEM10) in adults with insomnia disorder. Objective sleep onset (latency to persistent sleep [LPS]) and sleep maintenance (wake after sleep onset [WASO] and total sleep time [TST]) were assessed with polysomnography in Study 304. Subjective sleep onset latency (sSOL) and sleep maintenance (sWASO and sTST) were assessed with sleep diaries in both studies. Other patient-reported efficacy measures included Insomnia Severity Index-total score (ISI-TS), ISI-daytime functioning (ISI-DF), Fatigue Severity Scale (FSS), and Patient Global Impression-Insomnia (PGI-I). Results Compared with PBO, significantly larger decreases (improvements) from baseline in LPS, sSOL, WASO, and sWASO and significantly larger increases (improvements) from baseline in TST and sTST were observed within the first week of LEM treatment (as early as within the first 1–2 nights) and were sustained throughout the treatment period (1–6 months) (all p < 0.05, except for sWASO at Month 1). These improvements aligned with significantly larger decreases (improvements) from baseline in ISI-TS, ISI-DF, and PGI-I (all p < 0.05). Significantly larger decreases (improvement) from baseline in FSS scores were observed at 3 and 6 months (both p < 0.05). Conclusion LEM showed concordance in its ability to improve objective and subjective measures of nighttime sleep, as well as daytime functioning and patient perception of nighttime sleep. These findings demonstrate that LEM is effective both objectively and from the patient’s perspective, supporting LEM as a valuable treatment option for adults with insomnia.