Lancet Regional Health-Americas最新文献

{"title":"Sex differences in the association of vascular risk and APOE Genotype with cognitive decline and dementia: evidence from a U.S. longitudinal study","authors":"Longjian Liu ,&nbsp;Jintong Hou ,&nbsp;Saishi Cui ,&nbsp;Xiaopeng Zhao ,&nbsp;Zuolu Liu ,&nbsp;J. Craig Longenecker ,&nbsp;Nathalie S. May ,&nbsp;Jin Jun Luo ,&nbsp;Rose Ann DiMaria-Ghalili ,&nbsp;Howard J. Eisen","doi":"10.1016/j.lana.2025.101346","DOIUrl":"10.1016/j.lana.2025.101346","url":null,"abstract":"<div><h3>Background</h3><div>Sex differences in the association between vascular factors and cognitive outcomes remain unclear. We aimed to investigate the associations of blood pressure metrics (hypertension, systolic blood pressure [SBP), pulse pressure, ankle and brachial pressures, and ankle to brachial pressure index [ABI]) with the risk of cognitive decline and dementia.</div></div><div><h3>Methods</h3><div>We conducted a population-based longitudinal analysis using data from the Atherosclerosis Risk in Communities (ARIC) study (begun in 1987–1989) in the United States. We analyzed a total of 12,268 participants aged 45–64 years who had validated exposure measurements, cognitive function tests (first administrated 1990–1992), and followed up for incidence of dementia through December 2019. Cognitive function was assessed using the Digit Symbol Substitution Test, the Delayed Word Recall Test, and the Word Fluency Test. Dementia cases were identified through a standardized clinical evaluation process, mostly adjudicated by expert reviewers. We performed sex-stratified analyses to examine the associations of blood pressure metrics and APOE ε4 allele with the risk of cognitive decline and dementia.</div></div><div><h3>Findings</h3><div>Over a median follow-up of 26.4 years, 2698 participants developed dementia. Women aged 55–64 had a significantly higher incidence of dementia than men aged 55–64 (14.8 vs. 11.8 per 1000 person-years; p &lt; <em>0.0001</em>). After adjusting for key covariates, SBP, pulse pressure, ankle and brachial pressures were significantly associated with cognitive decline in women (p &lt; 0.05). In men, pulse pressure and ankle pressure showed a significant association. In longitudinal analyses, baseline hypertension and elevated brachial pressure were significantly associated with increased dementia risk in women, whereas in men, elevated brachial pressure and decreased ABI were significantly associated with dementia risk. Individuals with APOE ε4 allele had significantly higher risk of dementia in both sexes. A joint effect of APOE ε4 allele and elevated blood pressure metrics conferred a greater relative excess risk of dementia in women vs. men.</div></div><div><h3>Interpretation</h3><div>These findings highlight notable sex differences in the association between vascular factors and cognitive decline and dementia risk. Women appear more vulnerable to both genetic and vascular risk factors, emphasizing the need for sex-specific approaches in research, prevention, and intervention strategies for cognitive impairment.</div></div><div><h3>Funding</h3><div><span>NIH</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101346"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From detecting abnormalities to diagnosing cancer: how can lay anal examinations be refined?","authors":"Ming Wang,&nbsp;Yanru Cao,&nbsp;Qing Zhu","doi":"10.1016/j.lana.2026.101380","DOIUrl":"10.1016/j.lana.2026.101380","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101380"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to our 2025 reviewers","authors":"","doi":"10.1016/j.lana.2026.101421","DOIUrl":"10.1016/j.lana.2026.101421","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101421"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of eggs on Maya child development and growth: the Saqmolo’ Project randomized clinical trial","authors":"Gabriela Montenegro-Bethancourt ,&nbsp;Gabriela V. Proaño ,&nbsp;Elizabeth Yakes Jimenez ,&nbsp;Taylor C. Wallace ,&nbsp;Alison Steiber ,&nbsp;Xingya Ma ,&nbsp;Ming Ji ,&nbsp;Peter Rohloff","doi":"10.1016/j.lana.2025.101339","DOIUrl":"10.1016/j.lana.2025.101339","url":null,"abstract":"<div><h3>Background</h3><div>There is worldwide interest in determining whether frequent egg provision during complementary feeding enhances child development and growth in low-resource settings. We evaluated effects of adding one whole egg per day to local standard nutrition care on infant outcomes.</div></div><div><h3>Methods</h3><div>The Saqmolo’ Project individually randomized, partially blinded, comparative effectiveness clinical trial was conducted in rural Guatemala from 2021 to 2023. Maya infants aged 6–9 months were randomized to standard nutrition care alone (growth monitoring, complementary and responsive feeding education, deworming medication, multiple micronutrient powders, and referrals for medical care) versus standard care plus one whole egg per day for 6 months. Mixed linear or logistic regression models were used to estimate between-group differences in primary (global development score) and secondary (growth, anemia status, and diet quality) outcomes.</div></div><div><h3>Findings</h3><div>This trial included 1200 Maya infants (51.3% male). After adjustment for baseline values and participant characteristics, there was no significant between-group difference in global development score (β −0.08 points [95% CI −0.22 to 0.06]). There were also no significant between-group differences for most secondary outcomes. Intervention participants did have significantly higher odds of stunting (odds ratio [OR] 1.42 [95% CI 1.10–1.82]; p = 0.007) and of meeting minimum dietary diversity (OR 1.41 [95% CI 1.20–1.65]; p &lt; 0.001) and minimum adequate diet (OR 1.44 [95% CI 1.26–1.64]; p &lt; 0.001) benchmarks than standard care participants.</div></div><div><h3>Interpretation</h3><div>Provision of one whole egg per day in addition to standard care improved diet quality but did not benefit development, growth, or anemia status among Maya infants.</div></div><div><h3>Funding</h3><div><span>Academy of Nutrition and Dietetics Foundation</span> via an <span>Egg Nutrition Center investigator-initiated research</span> grant.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101339"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"US emergency department visits by women due to assault (2018–2021): a retrospective cross-sectional analysis","authors":"Summer Chavez ,&nbsp;Irma Ugalde ,&nbsp;Michael Ulrich ,&nbsp;Omolola Adepoju ,&nbsp;Tonghui Xu ,&nbsp;Winston Liaw","doi":"10.1016/j.lana.2025.101343","DOIUrl":"10.1016/j.lana.2025.101343","url":null,"abstract":"<div><h3>Background</h3><div>Domestic violence has played a key role in linking firearms and homicide amongst female individuals. Combined with the increase of reports of violence against women during the COVID-19 pandemic, a rise in emergency department (ED) visits may be witnessed. Our aim was to estimate the changes in prevalence and risk factors associated with assault and firearm-related emergency department (ED) visits by female patients following the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>We performed a retrospective cross-sectional study of female patients presenting to EDs due to assault from the National Emergency Department Sample (NEDS) from 2018 to 2021. Independent variables included age, race, mortality, ED disposition, primary payer, location, mean total ED chargers, quartile ZIP income, and mechanism and intent of injury. The adjusted association between independent variables and ED visits among patients injured by firearms compared to those injured by other assaults was examined.</div></div><div><h3>Findings</h3><div>The analytic sample represented an estimated 1,575,543 ED weighted records of female assault cases out of a total weighted sample of 537,133,200 observations (0.29%). While year-over-year ED encounters decreased, firearm injuries and the proportion of patients admitted and dying in the hospital increased. Female patients who were injured by firearms had 89 times higher risk of dying in the ED (RR = 88.82; 95% CI 6 = 72.38–97.06) compared to female patients injured by non-firearm injury mechanisms. Racial disparities were prevalent, with Native American women experiencing the greatest risk of being assaulted (RR = 2.81; 95% CI 2.67–2.97). Victims of firearm related assaults had nearly 4.12 times the risk of identifying as Black compared with those assaulted without firearms (95% CI 3.75–4.52). Female patients seeking care for assault had higher risk of being uninsured (95% CI 2.70–2.77).</div></div><div><h3>Interpretation</h3><div>While year-over-year ED encounters due to assault decreased, lockdowns and restrictions associated with the observed COVID-19 pandemic may not fully reflect changes in abuse rates in this time period. The strong connection between firearm presence and female homicide and continuations of assault and firearm-related ED visits among vulnerable demographic groups highlights the need for effective strategies to reduce violence.</div></div><div><h3>Funding</h3><div>Unfunded.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101343"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Impact of strategic public health interventions to reduce tuberculosis incidence in Brazil: a Bayesian structural time-series scenario analysis” - The Lancet Regional Health – Americas 2025; Volume 41: 100963; DOI: 10.1016/j.lana.2024.100963","authors":"Klauss Villalva-Serra ,&nbsp;Beatriz Barreto-Duarte ,&nbsp;Moreno M. Rodrigues ,&nbsp;Artur T.L. Queiroz ,&nbsp;Leonardo Martinez ,&nbsp;Julio Croda ,&nbsp;Valeria C. Rolla ,&nbsp;Afrânio L. Kritski ,&nbsp;Marcelo Cordeiro-Santos ,&nbsp;Timothy R. Sterling ,&nbsp;Mariana Araújo-Pereir ,&nbsp;Bruno B. Andrade","doi":"10.1016/j.lana.2026.101381","DOIUrl":"10.1016/j.lana.2026.101381","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101381"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors’ reply to: Todd et al., prenatal and intrapartum antibiotic exposure and childhood infections: considerations and complexities","authors":"Sarah A. Coggins ,&nbsp;Sagori Mukhopadhyay","doi":"10.1016/j.lana.2025.101369","DOIUrl":"10.1016/j.lana.2025.101369","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101369"},"PeriodicalIF":7.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145920762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique role of the prospective cohort incident-tumor biobank method in etiological research","authors":"Shuji Ogino ,&nbsp;Alpa V. Patel ,&nbsp;Satoko Ugai ,&nbsp;Marios Giannakis ,&nbsp;Tomotaka Ugai","doi":"10.1016/j.lana.2025.101290","DOIUrl":"10.1016/j.lana.2025.101290","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101290"},"PeriodicalIF":7.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and economic burden of insomnia medications among older Americans: findings from the future elderly model","authors":"Christopher N. Kaufmann ,&nbsp;Adam P. Spira ,&nbsp;Chien-Yu Tseng ,&nbsp;Emerson M. Wickwire","doi":"10.1016/j.lana.2025.101333","DOIUrl":"10.1016/j.lana.2025.101333","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101333"},"PeriodicalIF":7.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide-related outcomes in veterans with post-traumatic headache: a retrospective cohort study","authors":"Sarah E. Anthony ,&nbsp;Manali A. Phadke ,&nbsp;Richard B. Lipton ,&nbsp;Daniel G. Rogers ,&nbsp;Lisa A. Brenner ,&nbsp;John P. Ney ,&nbsp;Hamada H. Altalib ,&nbsp;X. Michelle Androulakis ,&nbsp;Amy S. Grinberg ,&nbsp;Melissa Skanderson ,&nbsp;Hung-Mo Lin ,&nbsp;Joel D. Scholten ,&nbsp;Brenda T. Fenton ,&nbsp;Elizabeth K. Seng ,&nbsp;Jason J. Sico","doi":"10.1016/j.lana.2025.101299","DOIUrl":"10.1016/j.lana.2025.101299","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic headache (PTH) is a common sequela of traumatic brain injury (TBI). Although there is a known association between TBI and suicide risk in veterans, the association between PTH and suicide-related outcomes in veterans with TBI is relatively unknown. We aimed to evaluate the association between PTH and suicide-related outcomes in veterans compared to matched controls diagnosed with TBI but no history of headaches.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted with Veterans Health Administration and Department of Defense electronic health record data from fiscal years 2008 through 2020. Veterans with PTH were matched to a control group who had TBI and no headache disorders. Relative risk was estimated using propensity score-weighted log-binomial models that evaluated differences in suicidal ideation, suicide attempts, and suicide death.</div></div><div><h3>Findings</h3><div>Of the 95,224 veterans included in the total sample, 85,730 were male (90.0%) and 9,949 were female (10.0%). The average age of the sample was 45.9 years (SD = 16.6). 73,500 (77.2%) were White, Non-Hispanic, 17,256 (18.1%) were Black, Non-Hispanic, and 4,468 (4.7%) were classified as other or mixed race. Of the 47,612 veterans diagnosed with PTH, 4,618 (9.7%) reported suicidal ideation or suicide attempts compared to 3,162 (6.6%) in the control group. Veterans with PTH had increased risk of suicidal ideation (RR, 1.45; 95% CI, 1.39–1.51) and suicide attempts (RR, 1.66; 95% CI, 1.50–1.83) compared to matched controls. Using inverse probability weighting to adjust for confounding, these results remained significant. When adjusting for potential confounders, as well as prior suicidal ideation or suicide attempts, there was no significant difference in risk of suicide death in veterans with PTH (RR, 0.83; 95% CI, 0.67–1.02) compared to those with TBI without headache.</div></div><div><h3>Interpretation</h3><div>Veterans with PTH have an increased risk of suicidal ideation and suicide attempts compared to veterans with TBI and without headache. There was no difference in suicide mortality between the two groups. Clinicians should be aware of heightened suicide risk among veterans with PTH and be especially diligent in terms of screening for suicide risk and related medical and mental health comorbidities that contribute to increased risk.</div></div><div><h3>Funding</h3><div>This study was supported by the United States <span>Department of Veterans Affairs</span> special purpose medical service funding (SP80DPE.1-0160).</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"53 ","pages":"Article 101299"},"PeriodicalIF":7.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}