Journal of International Medical Research最新文献

{"title":"Trends in mortality involving co-reported arrhythmia and dyslipidemia, 1999-2023: A Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research analysis with exploratory projections to 2035.","authors":"Muhammad Huzaifa Ahmed Khan, Awon Muhammad, Ahtisham Khatab, Sheraz Qasim, Javeria Javed, Azooba Khalid, Marium Fawad, Muhammad Omer Khalid, Shameer Iqbal Ghuman, Muhammad Ahsan, Sifat Ullah Safi, Muneeb Khawar","doi":"10.1177/03000605261488122","DOIUrl":"10.1177/03000605261488122","url":null,"abstract":"<p><p>ObjectiveEmerging evidence links dyslipidemia to cardiac structural and electrical remodeling. This study examined national trends in mortality involving co-reported arrhythmia and dyslipidemia among US adults aged ≥65 years from 1999 to 2023 and provided exploratory projections through 2035.MethodsThis retrospective, observational, population-based study used death-certificate data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research multiple-cause mortality database. Deaths among adults aged ≥65 years listing arrhythmia (International Classification of Diseases and Related Health Problems, 10th revision: I44.0-I44.7, I45.0-I45.9, I47.0-I47.9, I48, and I49.0-I49.9) and dyslipidemia (E78) among multiple causes were included. Age-adjusted mortality rates per 100,000 were calculated and stratified by sex, race/ethnicity, census region, and urban-rural status. Joinpoint regression was used to calculate annual percentage changes. An exploratory autoregressive integrated moving average model projected rates through 2035.ResultsA total of 246,710 deaths involving co-reported arrhythmia and dyslipidemia occurred between 1999 and 2023. The age-adjusted mortality rate increased from 4.96 (1999) to 47.9 (2023) per 100,000. The largest increase occurred between 2018 and 2021 (annual percentage change: 17.88%; 95% confidence interval: 14.79 to 21.04). An exploratory autoregressive integrated moving average model projected the age-adjusted mortality rate to reach 68.54 (95% prediction interval: 49.85-87.24) by 2035. Higher rates were observed in males, non-Hispanic White individuals, South and West regions, and nonmetropolitan areas.ConclusionsMortality involving co-reported arrhythmia and dyslipidemia among older US adults increased substantially over 25 years with persistent demographic and geographic disparities. These findings highlight the need for continued surveillance and research into contributing factors.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261488122"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976883","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":"Radiation-induced temporal lobe injury disrupts neuro-immune crosstalk: A key driver of immune dysfunction in locally advanced nasopharyngeal carcinoma.","authors":"Juan Gao, Rongbing Xie, Chanjuan Rao, Jiao Jiao, Weiwei Zhang, Yang Hu, Bin Yang, He Zhao, Ping Yuan, Tao Xie, Caibao Jin","doi":"10.1177/03000605261483860","DOIUrl":"https://doi.org/10.1177/03000605261483860","url":null,"abstract":"<p><p>Nasopharyngeal carcinoma is highly prevalent in China. Combined therapy centered on radiotherapy has significantly improved the 5-year overall survival rate of patients with locally advanced nasopharyngeal carcinoma, exceeding 80%. However, radiation temporal lobe injury remains a serious late complication. Despite advances in precision radiotherapy, its incidence is 5%-15%, considerably affecting the prognosis and quality of life of patients. Radiation temporal lobe injury is triggered by multiple mechanisms, including direct radiation-induced damage to neurons and glial cells, ischemia and hypoxia resulting from endothelial injury, and imbalanced immunoinflammatory responses dominated by M1 microglia. Importantly, radiation temporal lobe injury disrupts neuro-immune crosstalk, leading to a decrease in peripheral lymphocytes and natural killer cells, an increase in pro-inflammatory cytokines, and systemic immune suppression, thereby further increasing the risk of infection and tumor recurrence. This narrative review complies with the Scale for the Assessment of Narrative Review Articles. We systematically retrieved and organized published clinical and preclinical studies on radiation temporal lobe injury and comprehensively summarized the pathogenesis of radiation temporal lobe injury; its regulatory effects on immune function; and current prevention and treatment strategies, including precision radiotherapy optimization and drug intervention. This review aims to provide a theoretical basis for understanding the mechanisms underlying the radiation temporal lobe injury as well as prevention and treatment strategies after radical radiotherapy for nasopharyngeal carcinoma, ultimately improving the long-term quality of life of survivors of nasopharyngeal carcinoma following radical radiotherapy.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261483860"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990276","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":"Cognitive behavioral therapy for insomnia-assisted discontinuation or reduction of benzodiazepine receptor agonists and Z-drugs in chronic insomnia: A systematic review and meta-analysis.","authors":"Chuanji Zhang, Lei Yang, Jiapeng Zhang","doi":"10.1177/03000605261487272","DOIUrl":"10.1177/03000605261487272","url":null,"abstract":"<p><p>BackgroundLong term use of benzodiazepine receptor agonists and Z-drugs for chronic insomnia is associated with challenges, including dependence, withdrawal, rebound insomnia, cognitive impairment, and falls. Cognitive behavioral therapy for insomnia (CBT-I) may support hypnotic deprescribing; however, the certainty of evidence supporting this approach remains unclear.MethodsThis systematic review and meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and registered in PROSPERO (CRD420261399947). Randomized controlled trials evaluating CBT-I, CBT-I-informed, digital, blended, or behavioral-component interventions delivered in the context of benzodiazepine receptor agonist/Z-drug discontinuation or dose reduction were included. Risk of bias was assessed using the risk of bias 2 tool, and the certainty of evidence was rated using Grading of Recommendations Assessment, Development and Evaluation. PubMed was rerun on 2 July 2026 without the randomized-trial search block as a targeted sensitivity search.ResultsThirteen randomized controlled trials were included. After assigning Gardner et al. 2024 only to the longest-follow-up analysis, 6 trials involving 298 participants contributed to early complete discontinuation. The pooled estimate favored CBT-I-assisted interventions, although the evidence remained uncertain (risk ratio = 1.35, 95% confidence interval: 0.87 to 2.11; I² = 59.8%). Evidence for complete discontinuation at the longest available follow-up was highly uncertain (4 trials; 543 participants; risk ratio = 1.64, 95% confidence interval: 0.45 to 5.89; I² = 84.3%). Dose-reduction outcomes were not pooled as confirmatory endpoints because thresholds and time points differed, and repeated time points from the same trial could not be treated as independent observations. No clear difference was found in dropout or intervention noncompletion (10 trials; 885 participants; risk ratio = 0.93, 95% confidence interval: 0.40 to 2.16; I² = 58.6%). Post-treatment Insomnia Severity Index scores were lower with CBT-I-assisted interventions (3 trials; 126 analyzed participants; mean difference = -4.73, 95% confidence interval: -8.46 to -0.99; I² = 0%); however, the evidence remained uncertain because the synthesis was based on three small trials.ConclusionsThis review does not provide high-certainty evidence that CBT-I-assisted interventions reliably improve complete discontinuation of benzodiazepine receptor agonists or Z-drugs. CBT-I may nevertheless have clinical value as a behavioral component of individualized deprescribing programs by supporting dose reduction and insomnia-related coping during gradual tapering. Larger trials with standardized outcomes, long-term follow-up, and complete safety reporting are needed.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261487272"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990310","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":"Postural stability in young adults with low-degree refractive errors: A prospective observational study.","authors":"Emine Çetin Duru, Aynura Sariyeva Aydamirov, Ayna Sariyeva Ismayilov","doi":"10.1177/03000605261489342","DOIUrl":"10.1177/03000605261489342","url":null,"abstract":"<p><p>ObjectiveTo investigate whether uncorrected low-degree refractive errors are associated with alterations in postural stability in young adults using the Biodex Balance System.MethodsThis prospective observational study included 71 young adults classified into three groups: (a) emmetropia (n = 23); (b) low-degree myopia (n = 20); and (c) low-degree astigmatism (n = 28). The emmetropic group served as the comparison group. Postural stability was evaluated using the Biodex Balance System under four testing conditions: (a) eyes open-firm surface; (b) eyes closed-firm surface; (c) eyes open-foam surface; and (d) eyes closed-foam surface. Primary outcomes included the overall stability index and central stability percentage. Secondary outcomes included sway velocity and sway index measurements.ResultsParticipants with low-degree astigmatism demonstrated significantly higher instability and lower central stability compared with the emmetropic and low-myopia groups (both <i>p</i> < 0.001). In unadjusted comparisons, there were no significant differences in the overall stability index or central stability percentage between the low-myopia and emmetropia groups (<i>p</i> = 0.717 and 0.166, respectively). Adjustment for age, sex, and body mass index confirmed significant overall refractive-group effects for both primary outcomes (both <i>p</i> < 0.001). Sway velocity and sway index values were significantly higher in the low-myopia group during eyes-open tasks, particularly in the eyes open-firm surface and eyes open-foam surface conditions (<i>p</i> = 0.001 and <i>p</i> = 0.002, respectively). No significant between-group differences were observed during eyes-closed assessments.ConclusionsUncorrected low-degree refractive errors were associated with measurable differences in postural stability, particularly under conditions relying on visual feedback. Low-degree astigmatism was associated with reduced overall stability, whereas low-degree myopia was associated with greater sway during visually guided tasks. These findings suggest that even mild refractive changes may have functional implications for balance performance in young adults.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261489342"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025144","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":"Multiomics analysis identifies <i>RNASET2</i> as a potential candidate target associated with lung adenocarcinoma.","authors":"Yue Shi, Jiankun Yang, Fangyu Cai, Jian Huang, Jianing Bi, Kun Wang, Guangyou Wang, Xianglong Kong, Yaoguo Lang, Jian Zhang, Shidong Xu, Hai Xu","doi":"10.1177/03000605261488089","DOIUrl":"https://doi.org/10.1177/03000605261488089","url":null,"abstract":"<p><p>ObjectiveLung cancer is the leading cause of cancer-related mortality worldwide, with lung adenocarcinoma representing the predominant subtype. The increasing incidence of lung adenocarcinoma underscores the urgent need to establish novel therapeutic targets for clinical intervention.MethodsWe performed Mendelian randomization and colocalization analyses on large-scale lung adenocarcinoma genome-wide association study datasets. Bulk transcriptome and single-cell RNA sequencing were further applied to explore the function of candidate targets and related cell types.ResultsMendelian randomization revealed that elevated <i>RNASET2</i> expression causally reduced the risk of lung adenocarcinoma (odds ratio = 0.817, 95% confidence interval: 0.754-0.885, <i>p</i> < 0.001), whereas increased <i>BTN3A2</i> expression was associated with an elevated disease risk. Colocalization analysis supported a shared causal variant between <i>RNASET2</i> and lung adenocarcinoma (posterior probability of hypothesis 4 = 78.6%). Bulk transcriptome data demonstrated that <i>RNASET2</i> was upregulated in tumor tissues and was associated with better prognosis. Single-cell RNA sequencing revealed that macrophages were the predominant cell type expressing <i>RNASET2</i>, whereas weak expression was also detected in pulmonary epithelial cells and several other cell populations. There was a trend toward reduced abundance of high <i>RNASET2</i>-expressing macrophage subcluster 0 in tumor tissues, whereas low <i>RNASET2</i>-expressing subcluster 8 tended to accumulate within tumor lesions. Enrichment analysis of their signature genes suggested opposing biological roles in lung adenocarcinoma progression, which warrants further functional verification.Conclusions<i>RNASET2</i> is closely associated with the occurrence and prognosis of lung adenocarcinoma. Macrophage-expressed <i>RNASET2</i> represent a promising candidate molecule for further therapeutic exploration.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261488089"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025146","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":"Goniotomy as a safe and effective option for glaucoma secondary to typical ocular coloboma: A 12-month follow-up case.","authors":"Yuyan Tang, Yujiao Dan, Zhike Xu, Ziyu Jia, Zhen Li","doi":"10.1177/03000605261452485","DOIUrl":"10.1177/03000605261452485","url":null,"abstract":"<p><p>A woman in her mid-50s presented with lifelong poor vision and progressive, painless bilateral visual deterioration. Clinical evaluation revealed markedly reduced visual acuity, elevated intraocular pressure, bilateral inferior iris coloboma, zonular laxity, nuclear cataracts, partially closed angles and hypoplastic trabecular meshwork. Sequential phacoemulsification with intraocular lens implantation combined with a 120° goniotomy was performed in both eyes. Intraoperatively, residual embryonic tissue overlying the trabecular meshwork and a diminished red reflex were observed. Postoperatively, the patient experienced rapid improvement in visual acuity and intraocular pressure, with restoration of corneal clarity and wide opening of the anterior chamber angles within 1 week. Fundus examination subsequently revealed an inferonasal choroidal coloboma with retinal vessels traversing the defect. At 1-year, visual acuity remained significantly improved and intraocular pressure was stable without medication, with no complications such as hypotony or retinal detachment. This case demonstrates the safety and efficacy of combined cataract extraction and goniotomy in patients with complex anterior segment anomalies associated with iris and choroidal coloboma.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261452485"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039163","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":"Efficacy of a multimodal conservative rehabilitation program for bladder control in individuals with incomplete spinal cord injury: A randomized controlled trial.","authors":"Youssef Elbalawy, Zizi M Ibrahim, Olfat Ibrahim Ali, Hany M Elgohary","doi":"10.1177/03000605261464292","DOIUrl":"10.1177/03000605261464292","url":null,"abstract":"<p><p>ObjectiveThe study aimed to evaluate the efficacy of a multimodal intervention on urodynamic outcomes, urinary incontinence severity, and pelvic floor muscle strength in individuals with overactive bladder after incomplete spinal cord injury.MethodsA single-blind randomized controlled trial was conducted on 74 male participants diagnosed with overactive bladder and incomplete spinal cord injury. Participants were randomly assigned to an experimental group or a control group. Treatment was conducted for 8 weeks, three sessions per week. Outcomes were assessed at baseline, post-intervention, and the 8-week follow-up.ResultsThe experimental group showed significantly greater improvements in the measured outcomes compared with the control group (P < 0.001).ConclusionIncorporating a multimodal regimen demonstrated significant efficacy in enhancing bladder capacity, continence, and muscle function in individuals with overactive bladder due to incomplete spinal cord injury.Clinical trial registry (ID: NCT07008157).https://clinicaltrials.gov/study/NCT07008157?cond=Spinal%20Cord%20Injuries&intr=Multimodal%20Rehabilitation%20Program&viewType=Card&rank=1.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261464292"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911967","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":"Variability in β-human chorionic gonadotropin concentrations following evacuation of a hydatidiform mole pregnancy: A retrospective cohort study from Vietnam.","authors":"Le Thuy Tran, Kim Mai Thi Nguyen, Tran Gia Phuc Nguyen, Phuc Nhon Nguyen","doi":"10.1177/03000605261472724","DOIUrl":"https://doi.org/10.1177/03000605261472724","url":null,"abstract":"<p><p>BackgroundGestational trophoblastic disease refers to a group of tumors defined by abnormal trophoblastic proliferation. This disease produces a distinct tumor marker, beta-human chorionic gonadotropin, which can be useful for diagnosis and follow-up. The objective of this study was to investigate the variations in serum beta-human chorionic gonadotropin levels after uterine evacuation as well and the progression of gestational trophoblastic neoplasia.Materials and methodsThis retrospective cohort study was conducted at Tu Du Hospital, Vietnam, between January 2019 and December 2020. All patients diagnosed with molar pregnancy were analyzed retrospectively based on serial serum beta-human chorionic gonadotropin levels following uterine evacuation. Post-evacuation outcomes, including relapsed molar pregnancy and gestational trophoblastic neoplasia, were also monitored.ResultsWe enrolled 560 patients with molar pregnancy, including 298 with complete hydatidiform mole and 262 with partial hydatidiform mole. Severe symptoms were more common in those with complete hydatidiform mole. Over the follow-up period, 97 cases of gestational trophoblastic neoplasia were noted. The data show that the median time to gestational trophoblastic neoplasia diagnosis was 8.75 ± 4.41 (4-26) weeks. In terms of variations in the serum beta-human chorionic gonadotropin levels, the generalized estimating equation model showed a faster decline in the complete hydatidiform mole group than in the partial hydatidiform mole group. Similarly, regression in serum beta-human chorionic gonadotropin levels was significantly more rapid in patients who progressed to gestational trophoblastic neoplasia than in those with relapsed molar pregnancy (-11,593 vs. -20,651.22 and -12,946.26 vs. -46,329.23 mUI/mL, <i>p</i> < 0.001).ConclusionsSurveillance of serum beta-human chorionic gonadotropin levels remains essential for gestational trophoblastic neoplasia monitoring in patients with molar pregnancy following surgical evacuation. The post-evacuation serum beta-human chorionic gonadotropin level regression curve helps distinguish gestational trophoblastic neoplasia from hydatidiform moles. Further evidence is required to strengthen these findings.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261472724"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865295","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":"Genetically predicted <i>GLP-1R</i> expression and idiopathic pulmonary fibrosis: A Mendelian randomization mediation study of <i>JAKMIP3</i> and pulmonary function.","authors":"Gaofeng Liang, Dongchen Tian, Keyun Zhu, Yingxi Li, Jing Zeng, Yan Shen, Zhaohui Chen, Yao Tian","doi":"10.1177/03000605261488118","DOIUrl":"https://doi.org/10.1177/03000605261488118","url":null,"abstract":"<p><p>ObjectiveTo evaluate the association between genetically predicted <i>GLP-1R</i> expression and idiopathic pulmonary fibrosis and to explore potential mediation through <i>JAKMIP3</i> and pulmonary-function traits using Mendelian randomization.MethodsWe conducted a two-sample drug-target cis-Mendelian randomization study using Genotype-Tissue Expression lung cis-expression quantitative trait locus summary data as genetic proxies for <i>GLP-1R</i> expression and FinnGen R5 summary data (1028 cases and 196,986 controls; n = 198,014) for idiopathic pulmonary fibrosis. Type 2 diabetes mellitus served as a positive control, and a targeted panel of circulating molecular and pulmonary-function traits was evaluated using two-step Mendelian randomization. Primary estimates were obtained using inverse-variance weighting, with complementary estimators and sensitivity analyses. For the European-ancestry pulmonary function analyses, we used measured forced expiratory volume in 1 s (GCST90691840), forced vital capacity (GCST90691839), and peak expiratory flow (GCST90691841) genome-wide association studies, each including 383,471 participants.ResultsHigher genetically predicted <i>GLP-1R</i> expression was associated with a lower risk of idiopathic pulmonary fibrosis on inverse-variance weighted analysis (odds ratio = 0.740, 95% confidence interval: 0.632-0.866, <i>p</i> = 1.83 × 10^-4). The positive-control analysis supported the biological coherence of the <i>GLP1R</i> expression proxy (type 2 diabetes mellitus, odds ratio = 0.630). <i>JAKMIP3</i> was identified as a candidate circulating protein mediator, with a mediation proportion of 9.8%. In the European-ancestry pulmonary function analyses, forced expiratory volume in 1 s, forced vital capacity, and peak expiratory flow showed mediation proportions of 14.2%, 22.6%, and 11.8%, respectively, with the largest estimate observed for forced vital capacity.ConclusionsThe findings support an association between genetically predicted higher <i>GLP-1R</i> expression and lower risk of idiopathic pulmonary fibrosis and identify <i>JAKMIP3</i> and pulmonary-function traits as candidate intermediates. These results provide a rationale for mechanistic and clinical studies evaluating glucagon-like peptide-1 receptor-related pathways in idiopathic pulmonary fibrosis.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261488118"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001976","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 retrospective, real-world study on serious infection risk in a multiracial rheumatoid arthritis population on advanced therapies.","authors":"Joanna Janice Tan, Say Lee Pok, Pui Li Wong, Ahmad Rafizi Hariz Ramli, Fariz Yahya","doi":"10.1177/03000605261491008","DOIUrl":"https://doi.org/10.1177/03000605261491008","url":null,"abstract":"<p><p>ObjectiveAdvanced therapies have revolutionized the treatment landscape for rheumatoid arthritis. However, concerns exist regarding the risk of serious infections among patients receiving these therapies. This study aimed to determine the incidence of serious infections and identify predictive factors associated with serious infections in patients with rheumatoid arthritis receiving advanced therapies.MethodsThis single-center retrospective cohort study reviewed patients with rheumatoid arthritis who attended the rheumatology clinic and/or ward at Universiti Malaya Medical Centre between January 2006 and December 2023. Patient demographic and clinical data, as well as data on treatment with advanced therapies, were collected. Logistic regression analyses were used to identify predictors of serious infections.ResultsOf the 423 patients with rheumatoid arthritis identified, 87% were female. The mean age was 61.0 (SD: 13.8) years, and 80 (18.9%) received at least one advanced therapy. Sixteen (20%) patients developed serious infections, with a total of 23 serious infection episodes reported. The overall incidence rate of serious infections was 3.75 per 100 patient-years. Respiratory infections were the most common (52.2%), and tumor necrosis factor inhibitors had the highest incidence rate (4.25/100 patient-years) among the various classes of advanced therapies. Diabetes mellitus (odds ratio = 4.508, 95% confidence interval: 1.246-16.316; p = 0.022) and lung disease (odds ratio = 4.554, 95% confidence interval: 1.056-19.637; p = 0.042) were independent predictors of serious infections.ConclusionSerious infections may develop among patients with rheumatoid arthritis receiving advanced therapy, with lung disease and diabetes mellitus identified as independent risk factors. This study may help improve clinicians' awareness of the real-world risks associated with initiating advanced therapy. Future studies with a larger sample size are warranted to expand upon these findings.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261491008"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069689","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}