Clinics最新文献

{"title":"Impact of the COVID-19 pandemic on outpatient follow-up among people living with HIV retained in care at a University Center in Brazil","authors":"Mariana Velho Menoia ,&nbsp;Guilherme Barbosa Pinto ,&nbsp;Erika Yukie Ishigaki ,&nbsp;Nicoly Caroline de Andrade Delmondes ,&nbsp;Daniel Ayabe Ninomiya ,&nbsp;Olavo Henrique Munhoz Leite ,&nbsp;Marcello Mihailenko Chaves Magri","doi":"10.1016/j.clinsp.2026.100966","DOIUrl":"10.1016/j.clinsp.2026.100966","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of the COVID-19 pandemic on outpatient follow-up and clinical outcomes of People Living with HIV (PLHIV) at a specialized infectious diseases clinic in southeastern Brazil.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using medical records and responses to a structured questionnaire from PLHIV followed between March 2020 and December 2021. Clinical and laboratory data (CD4 count, viral load, and antiretroviral therapy changes) were reviewed, and questionnaire responses were used to assess COVID-19 history, vaccination, and mental health symptoms.</div></div><div><h3>Results</h3><div>A total of 125 patients were included (mean age 38.6-years; 64.1% male). Prior to the pandemic, 80.3% had CD4 counts &gt; 200 cells/µL and 82.1% had undetectable viral load, increasing to 89.7% and 84.6%, respectively, during the pandemic. Twenty-six patients (22.2%) changed their antiretroviral regimen, mainly due to switching to the nationally recommended first-line therapy. Among the 55 respondents to the questionnaire, 13 (24%) reported confirmed COVID-19 infection; of these, 2 (15.4%) required hospitalization. Overall, 53 (96.4%) reported having received the COVID-19 vaccination. Symptoms of depression and anxiety were reported by 27.7% and 45.4% of participants, respectively.</div></div><div><h3>Conclusion</h3><div>Despite the logistic challenges associated with the COVID-19 pandemic, viral suppression, immunologic recovery, and retention in care remained stable in this selected cohort of patients with continuous follow-up, reflecting the resilience of the healthcare service and sustained treatment adherence.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100966"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147747527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel machine learning model of smartphone-based 1-minute sit-to-stand test for prediction of six-minute walk test distance in patients with COPD","authors":"Simin Xie ,&nbsp;Xiao Ge ,&nbsp;Lin Huang ,&nbsp;Wenyu Zhu ,&nbsp;Yue Yang ,&nbsp;Min Zhou ,&nbsp;Jieming Qu ,&nbsp;Yi Guo","doi":"10.1016/j.clinsp.2026.100923","DOIUrl":"10.1016/j.clinsp.2026.100923","url":null,"abstract":"<div><h3>Background</h3><div>Regular assessment of exercise tolerance is essential for managing COPD, nevertheless, the standard 6-Minute Walk Test (6MWT) is difficult to perform outside clinical settings. This study aimed to develop and validate a smartphone-based digital 1-Minute Sit-to-Stand Test (1MSTST) to estimate 6-Minute Walking Distance (6MWD) by integrating data from the phone's Inertial Motion Unit (IMU) with advanced machine learning algorithms, offering a convenient alternative for remote functional assessment.</div></div><div><h3>Methods</h3><div>The enrolled COPD patients completed the smartphone-based digital 1MSTST and 6MWT with a minimum 15-minute rest period between the two tests. Accelerometer and gyroscope data were recorded by a smartphone throughout the 1MSTST. Systolic and Diastolic Blood Pressure (SBP, DBP), Heart Rate (HR) and Pulse Oxygen Saturation (SpO₂) were measured before and after the 1MSTST and 6MWT. The authors used a smartphone-based dataset of 66 subjects and algorithms such as Extreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), Support Vector Machine (SVM), Linear Regression (LR) and Random Forest (RF) to estimate the prediction of digital 1MSTST to 6MWD. The correlation between the features extracted from digital 1MSTST and the 6MWD was analyzed.</div></div><div><h3>Results</h3><div>A total of 66 patients with stable COPD were enrolled to build the predictive model for 6MWD. The change of HR and SBP after 1MSTST was higher than that of 6MWT (paired <em>t</em>-test, ΔHR: <em>p</em> &lt; 0.0001, ΔSBP: <em>p</em> &lt; 0.0001) with no significant difference in the change of DBP and SpO₂ (paired <em>t</em>-test, ΔDBP: <em>p</em> = 0.974, ΔSpO₂: <em>p</em> = 0.072). Pearson correlation analysis identified the top seven features that were strongly correlated with 6MWD. The RF machine learning model had the best performance to predict the 6MWD (R-square = 0.86, MAE = 24.3). Bland-Altman analysis indicates that the RF model provides a bias of -0.61 ± 31.04 and that the limits of agreement (95%, 1.96 SD) range from -60.22 to 61.45.</div></div><div><h3>Conclusions</h3><div>The smartphone-based digital 1MSTST, combined with machine learning, can accurately estimate 6MWD. The significance of this study lies in proposing a novel assessment paradigm that may serve as a practical tool for remote monitoring of exercise capacity in COPD management.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100923"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated serum Slit3 independently predicts disease activity and interstitial lung disease in rheumatoid arthritis","authors":"Xuepei Zhang ,&nbsp;Maohua Shi ,&nbsp;Dongmei Guo ,&nbsp;Yangtao Yu ,&nbsp;Hongwei Zhang ,&nbsp;Guoqiang Chen","doi":"10.1016/j.clinsp.2026.100935","DOIUrl":"10.1016/j.clinsp.2026.100935","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid Arthritis (RA) is a chronic inflammatory disease often linked to Interstitial Lung Disease (ILD). Slit guidance Ligand-3 (Slit3), a member of the axon guidance molecule superfamily, mediates a series of biological activities, including the regulation of the inflammatory response and fibrosis. This study explored Slit3’s clinical significance as a serum biomarker for RA-ILD.</div></div><div><h3>Methods</h3><div>Between November 2022 and April 2024, patients diagnosed with RA were included in the Foshan First People's Hospital. The clinical data of patients were collected from hospital records, and the serum level of Slit3 was measured using an enzyme-linked immunosorbent assay. Logistic regression was employed to determine odds ratios for Slit3 and other indicators associated with the development of RA-ILD.</div></div><div><h3>Results</h3><div>In total, 232 patients were included. Patients with RA in the high Slit3 subgroup were older, were more likely to be positive for rheumatoid factor and anti-cyclic citrullinated peptide antibody, and had higher levels of erythrocyte sedimentation rate and C-reactive protein. They also showed higher Disease Activity Scores (DAS28-CRP, DAS28-ESR, SDAI) as well as elevated pro-inflammatory cytokine interleukin-6. Notably, logistic regression analysis indicated that the elevated serum level of Slit3 was an independent predictor of RA-ILD.</div></div><div><h3>Conclusions</h3><div>Elevated serum level of Slit3 was associated with higher disease activity and served as an independent risk factor of RA-ILD. Slit3 may hold promise as a useful serum biomarker and therapeutic target for RA-ILD.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100935"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiopulmonary fitness and quality of life improvements in atrial fibrillation patients following exercise-based cardiac rehabilitation: meta-analysis of randomized control trials","authors":"Zhen Zhang ,&nbsp;Jialing He ,&nbsp;Yinlan Hu ,&nbsp;Shuyao Wang ,&nbsp;GuoShu Yang ,&nbsp;Duan Luo ,&nbsp;Xu Bao ,&nbsp;Guijun He ,&nbsp;Xianchen Yang ,&nbsp;Hanxiong Liu","doi":"10.1016/j.clinsp.2026.100907","DOIUrl":"10.1016/j.clinsp.2026.100907","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;In this meta-analysis, the authors aimed to provide a comprehensive overview of the benefits of exercise and its potential implications in the management of atrial fibrillation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;The authors conducted searches in PubMed, MEDLINE, EMBASE, and Cochrane databases using the terms “atrial fibrillation”, “exercise”, “cardiac rehabilitation”, or “physical activity”. The endpoints included the 6-Minute Walk Test (6MWT), maximal Oxygen uptake (VO&lt;sub&gt;2&lt;/sub&gt;max) measured by Cardiopulmonary Exercise Testing (CPET), maximal power measured by CPET, resting Heart Rate (HR), Left Ventricular Ejection Fraction (LVEF), data from the 36-Item Short Form Survey Instrument (SF-36), and AF recurrence post-ablation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The present analysis included 11 randomized control trials published in the past 15-years, involving a total of 1251 patients. The pooled analysis showed significant increases in VO&lt;sub&gt;2&lt;/sub&gt;max, 6MWT, and maximal power in AF patients post-exercise (-3.05, 95 % CI: [-4.79, -1.3], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 84 %, &lt;em&gt;p&lt;/em&gt; &lt; 0.0001; -42.07, 95 % CI: [-56.22, -27.93], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 0 %, &lt;em&gt;p&lt;/em&gt; &lt; 0.00001; -16.39, 95 % CI: [-20.76, -12.01], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 72 %, &lt;em&gt;p&lt;/em&gt; &lt; 0.00001, respectively). Sensitivity analysis results remained consistent but significantly reduced heterogeneity. The authors found that the recurrence rate was significantly lower in patients who exercised (RR = 0.76, 95 % CI: [0.62, 0.95], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 0 %, &lt;em&gt;p&lt;/em&gt; = 0.01). Quality of life was assessed using the SF-36 scale, which includes eight domains. The pooled results are as follows: physical function (WMD = -6.46, 95 % CI: [-10.48, -2.44], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 52 %, &lt;em&gt;p&lt;/em&gt; = 0.002), role physical (WMD = -13.02, 95 % CI: [-16.68, -9.36], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 32 %, &lt;em&gt;p&lt;/em&gt; &lt; 0.00001), general health (WMD = -7.80, 95 % CI: [-12.35, -3.25], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 62 %, &lt;em&gt;p&lt;/em&gt; = 0.0008), bodily pain (WMD = -3.54, 95 % CI: [-6.82, -0.26], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 0 %, &lt;em&gt;p&lt;/em&gt; = 0.03), vitality (WMD = -8.34, 95 % CI: [-14.31, -2.36], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 74 %, &lt;em&gt;p&lt;/em&gt; = 0.006), social function (WMD = -6.44, 95 % CI: [-12.17, -0.72], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 71 %, &lt;em&gt;p&lt;/em&gt; = 0.03), role emotional (WMD = -12.18, 95 % CI: [-16.46, -7.90], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 0 %, &lt;em&gt;p&lt;/em&gt; &lt; 0.00001), and mental health(WMD = -6.79, 95 % CI: [-11.69, -1.88], &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; = 72 %, &lt;em&gt;p&lt;/em&gt; = 0.007). Sensitivity analysis resulted in consistent outcomes with heterogeneity reduced to 0 % for all domains.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The present study found that exercise rehabilitation benefits patients with atrial fibrillation. Exercise can improve quality of life and possibly reduce recurrence. While it enhances cardiorespiratory fitness (VO&lt;sub&gt;2&lt;/sub&gt;max, 6MWT, maximal power), it does not signific","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100907"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertophic osteoarthropathy and clubbing: the role of prostaglandin E2","authors":"Katherine Cajiao ,&nbsp;Ana Monegal ,&nbsp;Manuel Morales-Ruiz ,&nbsp;Helena Florez ,&nbsp;Nuria Guañabens ,&nbsp;Pilar Peris","doi":"10.1016/j.clinsp.2026.100893","DOIUrl":"10.1016/j.clinsp.2026.100893","url":null,"abstract":"<div><div>Genomic studies support the role of Prostaglandin E2 (PGE2) in the pathogenesis of primary Hypertrophic Osteoarthropathy (HOA), with mutations in the 15-hydroxyprostaglandin dehydrogenase encoding gene resulting in increased PGE2 levels. The aim of this study was to analyse the clinical characteristics, comorbidities, and potential role of PGE2 in primary and secondary forms of HOA and/or digital clubbing.</div></div><div><h3>Methods</h3><div>Twenty-two patients (14 men/8 women) aged 15- to 78-years (50.8 ± 14.7) diagnosed with clubbing and/or HOA attended the Rheumatology Department for over 15-years. The authors reviewed the clinical characteristics of the patients, including associated comorbidities, image findings, Bone Turnover Markers (BTM), serum and urinary levels of PGE2, treatment, and the clinical evolution of these subjects.</div></div><div><h3>Results</h3><div>Most patients presented associated clinical conditions for HOA and/or clubbing, with only one, the youngest (15-years old), having primary HOA. Pulmonary disorders constituted the most frequent associated condition. All the subjects evaluated (18/22) presented increased urinary PGE2 levels, with most also presenting increased serum PGE2 values. BTM were assessed in most subjects (21/22), showing increased values in most (15/21), particularly in PINP and CTX. Eight patients were treated with selective inhibitors of Cyclooxygenase-2 (COX-2), improving their symptoms.</div></div><div><h3>Conclusions</h3><div>All subjects with primary or secondary HOA and/or clubbing of the series presented increased PGE2 values, particularly in urine, supporting the role of this mediator in the etiopathogenesis of this disorder. When the treatment of the associated condition is not possible, the use of COX-2 seems to be an effective symptomatic therapeutic approach in this entity.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100893"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147501520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of the C-PLAN index in patients with advanced esophageal cancer treated with immune checkpoint inhibitors","authors":"Shanshan Shao ,&nbsp;Hu Zhang ,&nbsp;Yawen Gu ,&nbsp;Xiuyuan Yang ,&nbsp;Junxing Huang","doi":"10.1016/j.clinsp.2026.100917","DOIUrl":"10.1016/j.clinsp.2026.100917","url":null,"abstract":"<div><h3>Background</h3><div>Despite significant advancements in immunotherapy for advanced esophageal cancer, there remains a critical need for reliable biomarkers to predict long-term clinical outcomes. The C-PLAN index, a novel composite score integrating C-Reactive Protein (CRP), lymphocyte dynamics, nutritional risk, and the Neutrophil-to-Lymphocyte Ratio (NLR), was developed to serve as a potential prognostic tool in this setting.</div></div><div><h3>Methods</h3><div>This study included 228 patients with advanced esophageal cancer who received PD-1/PD-L1 inhibitors between January 2018 and March 2023. Patients were stratified into low-risk (score ≤ 2), Medium-risk (score 3–4), or high-risk (score ≥ 5) groups based on the C-PLAN index. Clinical outcomes, including Overall Survival (OS) and Progression-Free Survival (PFS), were assessed over a 24-month follow-up period. Nonlinear associations between the C-PLAN index and OS/PFS were evaluated using restricted cubic splines. Cox proportional hazards models identified independent prognostic factors for OS, while time-dependent Receiver Operating Characteristic (ROC) curves compared the predictive accuracy of the C-PLAN index with that of NLR.</div></div><div><h3>Results</h3><div>Of the 228 patients enrolled, 189 were included in the final analysis. Significant differences in baseline characteristics were observed across risk groups: low-risk patients exhibited higher Body Mass Index (BMI) and albumin levels, whereas high-risk patients had larger tumor sizes, elevated CRP, Lactate Dehydrogenase (LDH), NLR, and C-PLAN scores. The median PFS was significantly longer in the low-risk group compared with intermediate- and high-risk groups (<em>p</em> &lt; 0.001). A significant nonlinear relationship between the C-PLAN index and both OS and PFS was observed (p for nonlinearity &lt; 0.001). Multivariable analysis identified NLR, poorly differentiated histology, and the C-PLAN index as independent predictors of mortality. Time-dependent ROC analyses revealed that the C-PLAN index demonstrated superior predictive accuracy compared to NLR at both 12-months (Area Under the Curve [AUC], 0.710 vs. 0.496) and 24-months (AUC, 0.897 vs. 0.740).</div></div><div><h3>Conclusion</h3><div>The C-PLAN index provides a robust and clinically meaningful prognostic tool for patients with advanced esophageal cancer treated with immune checkpoint inhibitors. Its superior predictive performance compared to traditional markers such as NLR highlights its potential utility in risk stratification and guiding treatment decisions.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100917"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New population-specific cephalic index standards for Malaysian subadults: prevalence, growth patterns, and clinical implications from a CT imaging study","authors":"Sharifah Nabilah Syed Mohd Hamdan ,&nbsp;Rabi’ah Al-Adawiyah Rahmat ,&nbsp;Selva Malar Munusamy ,&nbsp;Norliza Ibrahim","doi":"10.1016/j.clinsp.2025.100855","DOIUrl":"10.1016/j.clinsp.2025.100855","url":null,"abstract":"<div><h3>Objective</h3><div>Population-specific Cephalic Index (CI) classifications are lacking for Malaysian subadults. This study aimed to develop a new CI classification and determine the prevalence of deformational brachycephaly using Computed Tomography (CT) images.</div></div><div><h3>Methods</h3><div>A total of 520 CT images from subadults aged 0- to 20-years were included in the study. Two cranial measurements were obtained: the maximum Cephalic Length (CL) and the maximum Cephalic Width (CW), derived from axial CT images. The CI was subsequently calculated using the formula: CW/CL × 100. In addition, a simple linear regression analysis was performed to evaluate the relationship between CI and age.</div></div><div><h3>Results</h3><div>The modified CI ranges for the Malaysian subadult population were defined as follows: dolichocephalic ≤ 78.8, mesocephalic 78.9–89.0, brachycephalic 89.1–94.0, and hyperbrachycephalic ≥ 94.1. The predictive equation derived was y = 87.08–0.47x +0.01ײ (y = CI and x = Age in years). A significant negative correlation was found between age and CI (<em>r</em> = -0.101, p &lt; 0.001), with the index decreasing by approximately 0.026 per year. This indicates a natural trend towards a less brachycephalic head shape with maturation.</div></div><div><h3>Conclusion</h3><div>This new, population-specific classification provides an essential reference tool for clinicians and researchers to accurately detect, manage, and treat cranial deformities in Malaysian subadults, with significant applications in pediatrics, anthropology, and forensic medicine.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100855"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strongyloidiasis in primary care: Challenges in the diagnosis and management of a neglected infection","authors":"Guilherme França da Silva,&nbsp;Pablo Lorran Pereira Santos,&nbsp;Paula Yuri Sugishita Kanikadan,&nbsp;Ronaldo Cesar Borges Gryschek,&nbsp;Fabiana Martins de Paula,&nbsp;Marcelo Andreetta Corral","doi":"10.1016/j.clinsp.2026.101150","DOIUrl":"10.1016/j.clinsp.2026.101150","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 101150"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of physical activity, sleep with functional disability in Chinese older adults: a five-year prospective study","authors":"Xuewei Zhao ,&nbsp;Jiani Zeng ,&nbsp;Lijuan Zhang ,&nbsp;Haibo Zhang ,&nbsp;Jingjing Huang ,&nbsp;Lei Jiang ,&nbsp;Jun Zhao","doi":"10.1016/j.clinsp.2026.100863","DOIUrl":"10.1016/j.clinsp.2026.100863","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the associations of Physical Activity (PA) and sleep with functional disability among older adults.</div></div><div><h3>Method</h3><div>A total of 1927 participants were enrolled from the China Health and Retirement Longitudinal Study (CHARLS) between 2015 and 2020. Activities of Daily Living (ADL) were used to assess functional status. Sleep consisted of nighttime sleep (healthy sleep, or unhealthy sleep) and daytime nap sleeping (extended, moderate, short, or none), and PA was classified as sufficient or insufficient. Effects of sleep and PA on ADL Disability (ADLD) among the elderly were examined using logistic regression analysis, with Odds Ratios (ORs) and 95% Confidence Intervals (95% CIs) calculated.</div></div><div><h3>Results</h3><div>After a follow-up of 5-years, healthy nighttime sleep was linked to a decreased odds of ADLD (OR = 0.77, 95% CI: 0.60‒0.98). In participants with sufficient PA, healthy nighttime sleep was linked to the odds of ADLD (OR = 0.68, 95% CI: 0.52‒0.90). No multiplicative interaction of PA and nighttime sleeping was found. Moreover, the association between healthy nighttime sleep and decreased risk of ADLD was consistent in females (OR = 0.64, 95% CI: 0.45‒0.91) and those with complications (OR = 0.63, 95%CI: 0.46‒0.87).</div></div><div><h3>Conclusion</h3><div>Healthy nighttime sleep may be beneficial for preventing ADLD in older people. The benefits of sufficient PA with healthy sleep on reducing the risk of ADLD remain uncertain.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100863"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146185063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equivalence between FTP and RCP: Assessment of association, agreement and sex effect","authors":"Paulo Engelke ,&nbsp;Lavínia Vivan ,&nbsp;Vinícius Ribeiro dos Anjos Souza ,&nbsp;Claudio Andre Barbosa de Lira ,&nbsp;Katja Weiss ,&nbsp;Thomas Rosemann ,&nbsp;Beat Knechtle ,&nbsp;Marilia Santos Andrade","doi":"10.1016/j.clinsp.2026.100977","DOIUrl":"10.1016/j.clinsp.2026.100977","url":null,"abstract":"<div><h3>Objectives</h3><div>Functional Threshold Power (FTP) is widely used for performance evaluation and training prescription in endurance sports. Although FTP is strongly associated with power at the Respiratory Compensation Point (RCP), its interchangeability remains debated. This study examined the relationship and agreement between FTP and RCP in amateur triathletes and tested whether sex influences this relationship.</div></div><div><h3>Methods</h3><div>Forty-nine amateur triathletes (male and female) participated. Each athlete completed a maximal cardiorespiratory cycling test and an FTP test, separated by at least 72 h. Linear regression models were used to test the association between FTP and RCP. A regression model including the interaction term (FTP × sex), equivalent to an ANCOVA framework, was applied to assess sex effects on the FTP-RCP relationship. Agreement between methods was assessed using Bland-Altman analysis. Two-way analysis of variance (ANOVA) was performed to examine the effects of sex, test type, and their interaction on absolute power (W), power relative to total body mass, and power relative to lean mass.</div></div><div><h3>Results</h3><div>FTP and RCP were strongly correlated (<em>r</em> = 0.916; p &lt; 0.001). The interaction term FTP × sex was not significant (β = -0.135, p = 0.524), indicating that the regression slopes do not differ between males and females. Thus, the relationship between FTP and RCP was statistically similar across sexes. However, Bland-Altman analysis revealed wide limits of agreement, indicating poor interchangeability between FTP and RCP at the individual level.</div></div><div><h3>Conclusions</h3><div>FTP is strongly associated with RCP, and the relationship is independent of sex. Despite this association, FTP and RCP are not interchangeable measures. Caution is warranted when using FTP as a direct surrogate for RCP in training prescription and performance assessment.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100977"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}