Current international guidelines recommend blood pressure (BP) thresholds for patients eligible for endovascular thrombectomy (EVT). Previous studies have suggested that both low and high admission BPs are associated with poor functional outcome after EVT. However, the association between admission BP and outcomes after EVT remains poorly understood.The aim of this study was to investigate the relationship between admission systolic BP (SBP) and outcomes in patients treated with EVT and to assess whether this association is modified by IV thrombolysis (IVT) treatment and recanalization status. In this observational, international, multicenter cohort study, we used data from the EVA-TRISP registry. Consecutive patients treated with EVT with available admission SBP were included. The primary outcome was 90-day functional outcome. Secondary outcomes included 90-day mortality, 24-hour NIH Stroke Scale (NIHSS), successful recanalization, and symptomatic intracranial hemorrhage (sICH). We used multivariable regression to study the relation between admission SBP and outcomes and to assess effect modification by IVT treatment and recanalization status. We included 10.963 EVT patients. At baseline, the mean age was 72.8 years (SD 13.5), 50.2% were female and the median NIHSS at presentation was 15 (interquartile range 9-19). The association between admission SBP and functional outcome, mortality, and 24-hour NIHSS score was U-shaped, and the nadir was around 150 mm Hg. Below 150 mm Hg, every 10 mm Hg decrease in SBP was associated with higher odds of poor functional outcome (adjusted odds ratio (aOR) 1.07 [95% CI 1.02-1.11]) and mortality (aOR 1.17 [1.12-1.23]). Above 150 mm Hg, every 10 mm Hg increase in SBP was associated with higher odds of poor functional outcome (aOR 1.05 [1.01-1.08]), mortality (aOR 1.04 [1.01-1.09]), and higher 24-hour NIHSS score (β-coefficient 0.28 [0.17-0.40]). We found a positive linear relationship between admission SBP and sICH (1.04 [1.01-1.08]). IVT treatment modified the association between admission SBP and outcomes after EVT. In 5544 EVT-only treated patients, there was no longer a clear association between higher admission SBP values and worse outcome. Lower and higher admission SBP was associated with worse outcomes in the complete cohort. In EVT-only patients, this association was less evident, suggesting that high admission BP alone should not always delay or preclude treatment with EVT in otherwise eligible patients.

Smoking remains a leading cause of preventable morbidity and mortality globally, with significant public health and economic implications. In Jordan, smoking prevalence among men is alarmingly high, necessitating a deeper understanding of its determinants. This study aims to identify sociodemographic factors influencing smoking behavior among Jordanian men aged 15-59 years using nationally representative data. The study utilized data from the 2023 Jordan Population and Family Health Survey (JPFHS) to analyze sociodemographic factors influencing smoking behavior. Descriptive statistics and binary logistic regression analyses were performed. Associations were assessed using adjusted odds ratios (AORs) and 95% confidence intervals (CIs), with statistical significance set at p < 0.05. Our study included 5,873 Jordanian men, with 3,072 (52.30%) classified as non-smokers, 2,615 (44.52%) as everyday smokers, and 186 (3.17%) as someday smokers. Multivariable analysis revealed several factors significantly associated with higher odds of smoking, including increasing age, working in agriculture, services, and skilled manual occupations, being widowed, residing in Zarqa, being in the poorest or richest wealth categories, and using the internet at least once a week or almost every day (p < 0.05). On the other hand, living in Tafiela and reading newspapers or magazines at least once a week were significantly associated with lower odds of smoking (p < 0.05). Our study identified several sociodemographic factors significantly associated with smoking among Jordanian men, including older age, working in agriculture or skilled manual labor, widowhood, residence in Zarqa, extreme wealth levels, and frequent internet use. In contrast, newspaper readership and residence in Tafiela were protective. These findings highlight the importance of targeted public health interventions aimed at high-risk groups and strengthening tobacco control efforts across the country.

We investigated a KPC-2-producing Enterobacterales (KPC-2 CPE) outbreak in a Korean hospital from July to September 2019, which subsided following enhanced surveillance and strict infection control. The study aimed to elucidate transmission dynamics using epidemiological and genomic methods. The study period covered the outbreak and a 9-month post-outbreak observation. Investigations included a matched case-control study and whole-genome sequencing (WGS) of isolates, including long-read sequencing for two isolates. Single nucleotide polymorphism (SNP) analysis (≤ 6 SNPs for clonality, ≤ 15 for relatedness) was used to construct transmission networks. A total of 42 KPC-2 CPE cases were identified: 34 Klebsiella pneumoniae, 4 Escherichia coli, 1 Enterobacter asburiae, and 3 cases co-colonized with K. pneumoniae and E. coli. Among these, 33 were hospital-linked and 9 were imported. Retrospective tracing indicated that covert transmission began a month before the outbreak, and 13 hospital wards were identified as potential acquisition sites. Genomic analysis revealed all but one K. pneumoniae belonged to ST307, cgMLST 439, which grouped into three clades. Clade 1 was linked to a specific hospital ward, supported by the case-control study (adjusted odds ratio, 3.63; 95% confidence interval, 1.36-9.63); Clade 2 was spread between wards via a haemodialysis unit and shared healthcare personnel. Imported cases had the same clones as early hospital-linked cases, suggesting undetected introduction before enhanced surveillance. Additionally, an IncX3 plasmid carrying blaKPC-2 was found in both K. pneumoniae and E. coli, indicating horizontal gene transfer. This study demonstrates that clonal spread of KPC-2 CPE can remain undetected without enhanced active surveillance, underscoring the need for early detection. Genomic analysis clarified ST307 K. pneumoniae transmission through unrecognised epidemiological links and horizontal blaKPC-2 transfer to E. coli.

Patients with multiple myeloma (MM) often use cardiovascular medications due to their increased risk of cardiovascular diseases. This study investigated the associations of baseline use of these drugs with survival and adverse events in MM patients initiating daratumumab, lenalidomide, or bortezomib combination treatments. Data from Phase III trials (CASTOR, MAIA, and POLLUX) were analysed, focusing on beta-blockers, calcium channel blockers, ACE inhibitors (ACEI), angiotensin II receptor blockers (ARBs), diuretics, and statins. Cox proportional hazard analysis and logistic regression were used to assess associations with survival and grade ≥ 3 adverse events. Among 1804 patients, ACEI/ARBs were most common (31%), followed by beta-blockers (23%), statins (21%), calcium channel blockers (17%), and diuretics (16%). ACEI/ARBs was associated with better progression-free survival (adjusted hazard ratio (aHR) [95% CI] = 0.84 [0.71-0.99], P = 0.034) but also higher odds of grade ≥ 3 adverse events (adjusted odds ratio (aOR) = 1.45 [1.06-1.97], P = 0.019). Diuretics were similarly associated with grade ≥ 3 adverse events (aOR = 1.53 [1.01-2.34], P = 0.047). Other cardiovascular drugs showed no significant associations. While ACEI/ARBs may improve progression-free survival, they pose safety concerns. It is reassuring that other cardiovascular drugs were not significantly associated with MM treatment outcomes. Further research is essential to fully understand the implications of these medications.

Following marijuana legalization in several U.S. states, motivations for its use have expanded, especially among marginalized populations. While prior research links marijuana use with disordered eating, little is known about this relationship within sexual minority groups, who are already at elevated risk for body dissatisfaction and unhealthy weight control behaviors. This study examines associations between marijuana use and unhealthy weight control and muscle-enhancing behaviors among sexual minority men in the U.S. We conducted a secondary analysis using data from the Men's Body Project, a cross-sectional study on body image and health behaviors. The sample included sexual minority men across diverse backgrounds. Logistic regression was used to assess associations between marijuana use and seven behaviors considered risk factors linked to body image concerns: fasting, vomiting, laxative use, diet pill use, muscle-building supplement use, protein powder use, and anabolic steroid use. Marijuana users had significantly greater odds of engaging in all measured behaviors. Adjusted odds ratios (AORs) ranged from 1.88 (fasting) to 3.12 (diet pill use), all with p-values < 0.001. Other notable associations included vomiting (AOR = 2.61), laxative use (AOR = 2.23), protein powder use (AOR = 2.60), and anabolic steroid use (AOR = 2.62). Our results suggest a significant association between marijuana use and elevated odds of engaging in unhealthy weight control and muscle-enhancing behaviors among sexual minority men. Findings highlight the need for tailored public health interventions addressing both substance use and body image within LGBTQ + communities.

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne disease with a high mortality rate. While research has focused on high-risk rural populations and healthy individuals in endemic regions, such as Jeju Island, data on patients with underlying chronic diseases remain limited. This study aimed to evaluate the seroprevalence of SFTS virus (SFTSV) in patients with various chronic diseases across the Republic of Korea. Serum samples (N = 2948) collected from 10 regional biobanks between 2009 and 2019 were analyzed using a double-antigen sandwich enzyme-linked immunosorbent assay. The overall seroprevalence was 1.22% (36/2948). Seropositivity was significantly higher in males (1.73%) than in females (0.73%, p = 0.013) and increased with age (p = 0.001), peaking at 2.73% in individuals aged 70–79. Geographically, the highest rates were in Gyeongbuk (3.03%), Jeonnam (2.40%), and Gangwon (1.83%). Multivariable logistic regression showed older age (adjusted odds ratio 1.47 per 10-year increase, 95% confidence interval: 1.12–1.97) as the strongest independent predictor of seropositivity. Patients with hepatobiliary/pancreatic cancer (3.16%) and prostate cancer (2.50%) exhibited higher seroprevalence than those in other disease groups. SFTSV exposure is non-negligible among those with chronic diseases, particularly older males in rural provinces. Public health strategies should specifically address these vulnerable populations.

The effects of emergency department (ED) transition care programmes on health-related quality of life (HRQoL) remain underexplored. This single-centre study examined the changes in HRQoL following the implementation of the Case management for At-Risk patients in the ED (CARED) programme, explored associations with frailty and identified factors linked to low HRQoL. A quasi-experimental pre-post design was employed. Participants were recruited from the ED over 6 months as part of the CARED programme. At intake, trained case managers verified demographic and medical details and conducted a comprehensive geriatric assessment incorporating the Clinical Frailty Scale (CFS; version 2.0). The EQ-5D-5L was administered at baseline and repeated 3 months post-CARED. Analyses included the chi-square test, Mann-Whitney U test, Wilcoxon signed-rank test and logistic regression (α = 0.05). The final sample comprised 151 participants (mean age 77.4 ± 6.9 years; 75.5% female). Most (80.1%) had no-to-mild frailty, while 19.9% exhibited moderate-to-very severe frailty. Post-CARED, significant within-group improvements were observed in the overall cohort and those with no-to-mild frailty across EQ-5D-5L scores and domains (P < 0.001), whereas improvements among individuals with greater frailty were limited. Between-group comparisons showed significantly poorer baseline and follow-up HRQoL among those with greater frailty, particularly in mobility, self-care and usual activities (P < 0.05). Logistic regression identified male sex as the sole independent risk factor for low post-CARED EQ-5D-5L index scores (adjusted odds ratio 3.14, 95% confidence interval 1.40, 7.00). The CARED programme was associated with improved HRQoL, particularly among less frail individuals, while male participants had a three-fold higher likelihood of low post-intervention HRQoL.

This study aims to investigate changes in the pediatric emergency department morbidity spectrum following the relaxation of non-pharmaceutical interventions in a large pediatric referral center in southern China, focusing on the incidence, proportion, and distribution of respiratory, gastrointestinal, and allergic conditions. A retrospective analysis was conducted on 320,268 pediatric emergency encounters at Shenzhen Maternal and Child Health Hospital, with encounters from the pandemic period (March 2021-March 2022) compared to those from the post-pandemic period (March 2023-March 2024). Data on demographics, presenting complaints, and diagnoses were extracted from the hospital's information system, and statistical analyses, including independent sample t tests, chi-square tests, and multivariable logistic regression, were performed using R, version 4.4.3. The results showed that relaxation of non-pharmaceutical interventions was associated with a significant 79.5% surge in pediatric emergency visits and a shift in the disease spectrum, marked by substantial rebounds in respiratory (77.50%-87.92%; χ2 = 5984.295, P < .001), gastrointestinal (15.40%-16.90%; χ2 = 5120.999, P < .001), and allergic dermatitis symptoms (4.80%-6.05%; χ2 = 232.202, P < .001). In addition, the number of intensive care unit admissions increased from 0.69% to 0.85% (a relative increase of 23.2%), with preschool (3-6 years) and school-aged (≥6 years) children exhibiting the most pronounced respiratory symptoms, particularly in winter and spring. Multivariate analysis confirmed the post-NPI period as an independent predictor for respiratory (adjusted odds ratio [aOR] = 1.994, 95% confidence interval [CI]: 1.955-2.034), gastrointestinal (aOR = 1.120, 95% CI: 1.098-1.143), and allergic symptoms (aOR = 1.234, 95% CI: 1.194-1.276). These results suggest that dynamic surveillance, targeted prevention strategies for high-risk age groups and seasons, and optimized resource allocation may enhance pediatric emergency preparedness during the post-pandemic era.

Objective: Irisin, a myokine involved in metabolism and glucose regulation, has been associated with obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease, with inconsistent findings. This study assessed irisin levels in individuals with overweight/obesity with and without newly diagnosed diabetes and examined its association with subclinical atherosclerosis. Methods: Ninety participants were divided into 3 groups: 30 individuals with newly diagnosed T2DM and overweight/obesity (Group 1), 30 individuals with overweight/obesity without diabetes (Group 2), and 30 controls (Group 3). Anthropometrics, glycemic markers, lipid profile, serum irisin, highsensitive C-reactive protein (hs-CRP), and carotid intimal-media thickness (CIMT) were measured. Spearman’s correlation and logistic regression were applied. Results: Serum irisin levels were higher in groups with overweight/obesity than in controls (P = .002) but did not differ by diabetic status. In subgroup analyses, irisin correlated positively with glycated hemoglobin (r = 0.56, P = .001), low-density lipoproteins (LDL-C) (r = 0.50, P = .005), hs CRP (r = 0.38, P = .038), and CIMT (r = 0.63, P &lt; .001) in Group 1 and with LDL-C (r = 0.37, P = .042) and CIMT (r = 0.40, P = .030) in Group 2. In multivariate regression, irisin remained independently associated with increased CIMT in individuals with T2DM and overweight/obesity (adjusted odds ratios (aOR) = 2.03 (95% CI = 1.04-3.94)) and in the overall cohort with overweight/obesity (aOR = 1.98 (95% CI = 1.15-3.42)). Conclusions: Serum irisin is elevated in obesity, irrespective of diabetic status, and is independently associated with subclinical atherosclerosis, suggesting its potential role as an early biomarker of cardiovascular risk. Cite this article as: Assaad SN, Abo Elwafa RA, Gamal Eldin OA, Hassanein NA, Bondok ME. Irisin and subclinical atherosclerosis in individuals with overweight/obesity with and without newly diagnosed type 2 diabetes mellitus. Endocrinol Res Pract. Published online February 6, 2026. doi: 10.5152/erp.2026.25739.

Effects of GLP-1 Receptor Agonists on Major Cardiovascular Events Among Patients with Atopic Dermatitis: A Population-Based Study.

Some observational studies have suggested that lower pulmonary function increases the risk of cognitive decline or dementia; however, the evidence remains inconclusive. We performed 2-sample Mendelian randomization (MR) analyses to investigate the potential associations between forced vital capacity (FVC) and a range of dementia- and cognition-related outcomes. FVC was selected as the primary indicator of pulmonary function because it is less effort- and cognition-dependent and better reflects overall lung capacity. Outcomes included 6 dementia types: all-cause dementia, Alzheimer disease (AD), dementia with lewy bodies, Parkinson disease dementia, frontotemporal dementia, and vascular dementia, and 6 cognitive domains, including intelligence, fluid intelligence (reasoning and problem-solving ability independent of acquired knowledge), cognitive performance, numeric memory, executive function, and prospective memory. All genetic associations were reported per 1-standard-deviation increase in genetically predicted FVC - expressed as log-odds ratios (log-ORs) for dementia outcomes and standard-deviation changes for cognitive outcomes. The inverse-variance weighted method was used as the primary analysis, complemented by MR-Egger, weighted median, weighted mode, simple mode and MR-PRESSO for sensitivity analyses. False discovery rate (FDR) correction, colocalization, and reverse MR analyses were also performed. This study provides genetic evidence supporting an association between reduced pulmonary function and cognitive impairment. Further studies are needed to clarify the underlying mechanisms. Higher genetically predicted FVC was associated with a lower risk of AD (log-OR per 1-SD increase = -0.24; P = .002; FDR-adjusted P = .011). An inverse association was also observed with all-cause dementia (log-OR per 1-SD increase = -0.37; P = .031), but it did not remain significant after FDR correction (FDR-adjusted P = .094). No significant associations were observed for other dementia subtypes or cognitive outcomes. The results were robust in sensitivity analyses, with no significant findings in reverse MR. Colocalization analysis did not support shared causal variants between FVC and AD (PP.H4.abf <0.75).

Background: Interstitial lung diseases (ILDs) are a heterogeneous group of disorders characterized by variable degrees of inflammation and fibrosis affecting the pulmonary interstitium. Advances in molecular biology and genetics have greatly expanded our understanding of ILD pathogenesis, uncovering novel mechanisms and supporting precision medicine approaches. Genetic Insights: Genetic factors play a pivotal role in ILD heterogeneity, influencing disease onset, severity, and progression. To date, more than 30 genes with different inheritance patterns (autosomal dominant, recessive, or X-linked) have been associated with ILDs. These genes are primarily involved in surfactant metabolism, telomere maintenance, immune regulation, and epithelial repair. Emerging evidence also implicates genes encoding aminoacyl-tRNA synthetases. This review summarizes the main genetic alterations underlying ILD pathogenesis and discusses their impact on diagnostic and therapeutic approaches, highlighting how identification of disease-causing variants can improve diagnostic accuracy, refine prognostic assessment, and inform recurrence risk. Methods: A narrative review was conducted through targeted PubMed and Embase searches using disease- and gene-related keywords. Studies were prioritized based on predefined conceptual criteria, including clinical relevance, strength and replication of genetic associations, and availability of functional or translational evidence. Conclusions: This synthesis brings together the latest genetic insights into pediatric ILDs and their clinical implications. Integrating genomic data into clinical practice may enable earlier diagnosis, tailored follow-up, individualized therapeutic strategies, and more informed genetic counseling. However, important challenges remain, including incomplete genotype–phenotype correlations and limited functional validation for several disease-associated genes, which currently constrain full clinical translation.

Nursing and Medical Staff Knowledge, Attitudes, and Practices Related to Intimate Partner Violence Against Women in Emergency Departments: A Cross-Sectional Survey in Southeast Spain.

The primary objective of the study was to estimate the prevalence of primary headache disorders (HDs) among Emiratis aged 18-65 years in Dubai. The secondary objective was to assess the association of primary HDs and MIDAS scores with various demographic and clinical factors. Primary HDs pose a significant public health challenge, necessitating precise diagnostic and management strategies. Limited data on prevalence of primary HDs among Emirati population living in Dubai, United Arab Emirates, underscore the need for investigation. A cross-sectional study utilizing telephonic interviews included Emirati individuals aged 18-65 years for 6 months from November 1, 2022, to May 30, 2023. The Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation questionnaire was used for collecting data. The prevalence of different types of primary HDs including frequent episodic tension-type headache (TTH), episodic migraine headache, chronic migraine, and infrequent episodic TTH was determined. Disability caused by primary HDs was determined using the MIDAS scores. Of the 2681 eligible participants, the study included 2000 participants (39.3 ± 11 years; female: 52.7%). Primary HDs were prevalent among 39.1% (n = 781), particularly in the age group of 31-40 years (35.9%). About 41.2% (n = 322) of participants reported frequent episodic TTH, whereas 34.8% (n = 272) reported episodic migraine. About 51.9% of the participants reported grade I (little/no disability) MIDAS level. Independent factors associated with primary HDs based on multivariable analysis were female sex (adjusted odds ratio [aOR] 1.53; 95% confidence interval [CI] 1.24-1.91), marital status (aOR 3.94; 95% CI 1.81-8.62), educational attainment (aOR 2.79; 95% CI 1.54-5.06), and employment status (aOR 1.69; 95% CI 1.14-2.51). Disability, as measured by MIDAS, was significantly associated with age and the type of medical consultation sought (p = 0.025 and p < 0.001, respectively). The type of primary HDs was significantly associated with age (p = 0.022), marital status (p = 0.042), type of headache management (p < 0.001), and medication used (p < 0.001). One-year prevalence of primary HDs was 39.1% in adult Emiratis residing in Dubai. Individuals who were females, divorced/separated, widow/widower, held a high academic degree, or who were self-employed were more likely to develop primary HDs, whereas age did not appear to influence primary HDs. Further, age and type of consultation were significantly associated with disability caused by primary HDs.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease globally, but its prevalence and severity remain poorly characterized in the general population. Our aim was to estimate the prevalence of MASLD and the risk of advanced fibrosis in a large Swedish general population cohort. From the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort, we analyzed 27,763 participants aged 50-64 years who underwent extensive clinical characterization. MASLD was defined as <48HU on non-contrast liver computed tomography (CT) imaging. The risk for advanced fibrosis was assessed using the dynamic aspartate aminotransferase (AST)/alanine transaminase (ALT) ratio. MASLD was present in 18.1% of participants and was more common in men than women (25.5% vs. 11.2%). Prevalence increased with cardiometabolic burden: from 7.0% among those without obesity, hypertension, or Type 2 diabetes mellitus (T2DM) to 70.2% among those with all three conditions. MASLD risk was elevated in individuals with obesity alone (adjusted odds ratio [aOR] 5.56; 95% CI=4.89-6.31), T2DM alone (aOR=2.66; 95% CI=2.13-3.33), or hypertension alone (aOR=1.78; 95% CI=1.59-1.99). The combination of all three conferred the highest risk (aOR=17.1; 95% CI=14.0-20.9). Among persons with MASLD, 24.8% were classified as at risk for advanced fibrosis. Fibrosis risk was independently associated with hypertension (aOR=1.44; 95% CI=1.24-1.66), T2DM (aOR=1.24; 95% CI=1.06-1.46), male sex (aOR=1.20; 95% CI=1.02-1.42), and alcohol consumption (aOR per gram/day=1.02; 95% CI=1.01-1.03). In Sweden, almost one in five middle-aged adults is affected by MASLD, with a quarter of cases at risk of advanced fibrosis. Male sex, obesity, T2DM, and hypertension are important predictors of the prevalence and severity of MASLD.

Identification of the symptomatic aneurysm in patients with multiple intracranial aneurysms (MIAs) represents a challenge. Aneurysm wall enhancement is a potential imaging biomarker to assess symptomatic status among intracranial aneurysms. We aimed to use aneurysm wall enhancement in the identification of symptomatic aneurysms in patients with MIAs. Patients who underwent high-resolution 3 Tesla magnetic resonance imaging between 2018 and 2024 at 3 institutions-one in the United States and 2 in China-were included in the analysis. Eligible patients had MIAs, with at least 1 aneurysm classified as symptomatic. Morphological measurements were obtained from angiography studies. Three-dimensional circumferential aneurysm wall enhancement (3D-CAWE) was assessed for all aneurysms. Multivariate logistic regression was used to identify variables independently associated with symptomatic status. Thirty patients with 82 MIAs were included, 30/82 (36.6%) were symptomatic and 52/82 (63.3%) were asymptomatic. Aneurysmal size (adjusted odds ratio [aOR]: 1.5, 95% CI: 0.95-2.8, P = .1) and size ratio (aOR: 2.2, 95% CI: 0.8-3.2, P = .2) were not associated with symptomatic presentation. Symptomatic aneurysms were more likely to have a higher 3D-CAWE (aOR: 1.15, 95% CI: 1.05-1.24, P = .01) when compared with asymptomatic aneurysms. Receiver operating characteristic analysis revealed that a 3D-CAWE cutoff point of 1.02 has a specificity of 88% and negative predictive value of 79% in detecting symptomatic aneurysms among patients with MIAs. 3D-CAWE can be used in the identification of symptomatic aneurysms in patients with MIAs.

Gender-based violence (GBV) against older women represents a critical public health problem and human rights violation. Older women experience unique vulnerabilities and invisibility regarding GBV, with severe health consequences. The aim was to examine the rates and health impacts of GBV among Spanish women aged ≥65 years and analyze its effect on health and suicidal behavior. A descriptive study analyzed data collected in 2019 from a nationwide macro-survey conducted in Spain, which included 9,568 women aged 16 years and older. A total of 2,357 older women, aged 74.2 ± 6.9 years, were selected. Sociodemographic variables were collected, as was lifetime GBV exposure by perpetrator type (intimate partner violence [IPV], non-partner, combined, and any interpersonal) and form (e.g., physical, psychological, economic, sexual, etc.), along with health outcomes (self-rated health and psychological distress) and suicidal behavior. Among participants, 23.4% reported lifetime IPV (psychological: 14.1%; physical: 6.1%; economic: 8.7%; sexual: 6.1%; controlling behaviors: 17.1%), while 9.3% experienced non-partner violence (family perpetrators: 2.9%; strangers: 2.9%). Overall, 29.0% reported any interpersonal violence exposure. IPV was significantly associated with poorer self-rated health (adjusted odds ratios, aOR = 1.64; 95% CI [1.34, 2.01]), higher psychological distress (aOR = 1.80; [1.45, 2.23]), and increased suicidal ideation (aOR = 3.89; [2.80, 5.40]). Non-partner violence showed associations with suicidal ideation (aOR = 2.44; [1.60, 3.72]). These findings show substantial GBV rates among older women and their significant health impacts, highlighting the need for age-specific screening and intervention strategies in geriatric care settings.

PurposeDiabetic foot ulcer (DFU) and diabetic retinopathy (DR) are severe complications of diabetes mellitus reflecting advanced vascular injury. While DR has been extensively studied as a predictor of DFU, data on the burden and determinants of DR among individuals with DFUs remain limited. This study aimed to evaluate the prevalence, severity, and clinical correlates of DR in individuals with DFUs.MethodsThis observational study included 85 individuals with DFUs and 81 individuals with type 2 diabetes mellitus without DFUs. All participants underwent comprehensive ophthalmologic examination for DR classification. Demographic characteristics, comorbidities, and laboratory parameters were recorded. Unadjusted and adjusted odds ratios (UORs and AORs) with 95% confidence intervals were calculated.ResultsDR was significantly more prevalent in individuals with DFUs than in controls (85.9% vs 51.9%; UOR 5.65, 95% CI 2.67-11.96; p < .001). Proliferative DR was approximately threefold more frequent in the DFU group (33.0% vs 11.1%; UOR 3.93, 95% CI 1.72-8.99; p = .002). Higher Wagner ulcer grades were associated with increased DR prevalence (p = .005). In multivariate analysis, longer duration of diabetes and proteinuria remained independently associated with DR, while HbA1c showed a modest independent association. Among DFU patients, DR was also associated with hypertension, proteinuria, and coronary artery disease.ConclusionIndividuals with DFUs carry a markedly increased burden of DR, particularly proliferative disease, indicating advanced systemic microvascular involvement. DFU should be regarded as a clinical red flag for severe retinopathy, warranting prompt and comprehensive ophthalmologic screening alongside integrated renal and cardiovascular assessment.

Timely administration of antibiotics is critical in the management of infectious diseases, particularly in preventing progression to sepsis. Despite the urgency, the appropriate timing of antibiotic treatment, especially in non-septic infections, remains unclear. This study aimed to assess the association between antibiotic timing and progression to sepsis among patients admitted to the Emergency Department (ED) for suspected infection. A retrospective cohort study utilized data from three tertiary-care hospital EDs between January 2021 and June 2023. Adult patients hospitalized for clinical infection were included. The primary outcome was sepsis development, while secondary outcomes included hospital mortality, Intensive Care Unit (ICU) admission, ICU length of stay (LOS), and hospital LOS. The main exposure was the duration from ED arrival to initial antibiotic administration. Multivariable logistic and negative binomial regression were employed to adjust for confounders and assess associations. The study included 1279 infected adult patients, with 20.5% developing sepsis and 10.3% admitted to the ICU, resulting in 3.8% in-hospital deaths. The median time from ED arrival to initial antibiotic administration was 123min (interquartile range(IQR), 79-241min). Although per-hour delays in antibiotic administration showed association with sepsis development (Adjusted Odds Ratio(aOR) (95% CI) 1.071(1.044-1.099); P < 0.001), the primary threshold analysis demonstrated that significant associations with sepsis (aOR (95% CI), 3.468 (2.131-5.623); P < 0.001), in-hospital mortality (aOR 2.487, 95% CI 1.083-5.440; P = 0.026), adverse clinical outcomes, and prolonged LOS emerged only when delays exceeded 12h. These findings were also confirmed by sensitivity analyses. These hypothesis-generating findings suggest that, in non-severe infections, delays within 12h might not be associated with significantly increased risks, potentially allowing time for diagnostic clarification without apparent harm. However, due to the observational nature of the study and potential biases, prospective studies are required to confirm these associations.

Sonodynamic treatment (SDT) is also beginning to be of interest as an effective noninvasive approach to treat glioblastoma multiforme, in which ultrasonically triggered sensitizers generate an effector of cytotoxic reactive oxygen species (ROS). The current research determined the competence of three structurally novel porphyrin-based sensitizers (named as P1, P2, and P3) under the arm of low-intensity pulsed ultrasound (LIPUS) as an agent that enhances ROS-mediated apoptosis in the cells of the glioma. The authors tested the model of U87-MG human glioblastoma cell cultures under the treatment with porphyrins at the concentration of 27 M down to 10.7 M with and without LIPUS treatment (1 MHz, 1.0W/cm2, 50% duty cycle, 5 min). The effects of the combined porphyrin and LIPUS treatment were also more likely to show effects of increased production of ROS in all of its concentrations compared with monotherapies or control, which was not treated. P3 + LIPUS yielded the highest amount of ROS, with the number increasing 3.2 0.4 times more than control (p < 0.001). To compare, the percentage of apoptosis increased to 46.7% relative to the 8.6% of the untreated cells using the combined SDT (adjusted odds ratio [aOR] = 6.9; 95% confidence interval [CI]: 3.21-5.0). Porphyrin and ultrasound also had a synergistic effect with all the sensitizers and P3 represented the highest synergy index. The multivariate regression analysis showed that interaction between light concentration of sensitizer and the parameters of ultrasound exposure had a statistical significance (p < 0.01) such that it was possible to state that there was upregulated oxidative stress with dual-modality treatment. The findings clearly confirm that a mixture of LIPUS and newly identified porphyrin-based sensitizers is more effective in promoting the intracellular concentration of ROS and triggering an apoptosis in glioma cells than either of the two groups. This synergy has been observed in preclinical studies that are underway on the further development of such a process in the treatment of gliomas. The results are already included in a growing collection of literature on the potential SDT overcoming the disadvantages that are associated with the traditional photodynamic therapy to chemoresistance in gliomas. Besides determining the efficacy of P3, this study provides the requisite quantitative biomarkers and synergy models, which may be implemented to construct intelligent and closed-loop SDT systems. The results form the basis of the quantitative development of adaptive, closed-loop SDT systems in the future.