Medical research archives最新文献

{"title":"A single center cross-sectional study examining the prevalence of inpatient postpartum anxiety and post-traumatic stress symptoms using the State-Trait Anxiety Inventory and Post-Traumatic Stress Disorder Checklist for DSM-5.","authors":"Claudia Lucia Sotillo, Guillermina Michel, Sana Shah, Margaret Smith, Sarah Ciechanowicz, Z Bekemeyer, Aleesha Jasmin Jethwa, Brendan Carvalho, Nan Guo, Michael Joshua Ostacher, Debra Lee Kaysen, Danielle Mari Panelli, Pervez Sultan","doi":"10.18103/mra.2026.0452","DOIUrl":"https://doi.org/10.18103/mra.2026.0452","url":null,"abstract":"<p><strong>Background: </strong>Mental health conditions are now the leading cause of maternal mortality in the United States, prompting calls for universal postpartum anxiety and post-traumatic stress disorder screening. However, standardized guidelines for screening implementation remain deficient. This cross-sectional study evaluated the prevalence of inpatient postpartum anxiety and post-traumatic stress disorder while exploring associated risk factors.</p><p><strong>Objectives: </strong>Over a three-week period, we prospectively assessed adult postpartum patients following all delivery modes (vaginal and cesarean, live and stillbirth) at a single academic institution in the US. Screening was performed within 36 hours of delivery using the State-Trait Anxiety Inventory (score cut off ≥80) and post-traumatic stress disorder checklist for DSM-5 (score cut off ≥28). Data collection included demographic, medical, anesthesia, obstetric and neonatal variables, with assessments conducted in-person or via telephone for any spoken language.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Results: </strong>Among 275 eligible patients, 263 (95.6%) completed the screening measures. The prevalence of positive postpartum anxiety and post-traumatic stress disorder screening was 12.5% and 4.9% respectively, with 3.8% of patients screening positive for both conditions. Worse State-Trait Anxiety Inventory scores were associated with ASA ≥3, pre-term birth and neonatal Apgar scores at 5 minutes <7. Worse post-traumatic stress disorder scores were associated with ASA ≥3, primiparity, spontaneous vaginal delivery, pre-eclampsia, pre-term birth, blood transfusion, Apgar score <7 and neonatal intensive care unit admission. Factors after adjustment associated with positive anxiety screening were a psychiatric history or medication use. No factors after adjustment were associated with positive PTSD screening.</p><p><strong>Conclusions: </strong>Positive screening for inpatient postpartum anxiety was two and a half times more prevalent than for post-traumatic stress disorder. Positive anxiety screening was independently associated with psychiatric history or medication use. Targeted screening for post-traumatic stress disorder may be more appropriate, particularly among patients with pre-existing psychiatric conditions, complicated pregnancies or neonatal morbidity. Future research should focus on determining optimal screening parameters and timing, and intervention guidelines to better support high-risk obstetric populations.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Implementation of a New Set of Anthropomorphic Phantoms for Dosimetry of the Japanese Atomic Bomb Survivors.","authors":"Harry M Cullings, Sachiyo Funamoto, Keith T Griffin, Shota Shimizu, Sean J Domal, Camilo M Correa-Alfonso, Tatsuhiko Sato, Choonsik Lee, Stephen D Egbert, Akira Endo, Wesley E Bolch","doi":"10.18103/mra.2026.0407","DOIUrl":"10.18103/mra.2026.0407","url":null,"abstract":"<p><p>For many years, the dose estimates calculated at the Radiation Effects Research Foundation for the Japanese atomic bomb survivors in Hiroshima and Nagasaki have relied on models of the human body (phantoms) developed in the 1980s. These phantoms are used to calculate doses that specific organs of a survivor received from the gamma rays and neutrons emanating from the bombs. The phantoms from the 1980s are based on primitive geometrical shapes such as rods and cones and offer only three models to represent all age ranges from newborn to adult. These models included male and female sex organs (hermaphroditic in design) with no body differences by sex. Furthermore, no specific model of the female with a fetus was available to use for survivors who were exposed during pregnancy at the time of a bombing. A binational working group has recently developed a modern set of phantoms with more realistic shapes, six age ranges, and phantoms for pregnant women at four gestational ages, denoted the \"J45\" phantoms to indicate their bodily dimensions being based on the Japanese population of 1945. We discuss here the changes in the phantoms and the corresponding differences in body transmission factors which quantify body self-shielding for gamma rays and neutrons from the bombs for some important example organs. Results are presented as ratios of the body transmission factors for new vs. old phantoms. We discuss how the use of the new phantoms may change the dose estimates for the survivor population that are used in radiation epidemiology, including population average changes by distance, given survivor distributions by age and sex. Dose estimates for the new phantoms are not much more than 10% different from the old ones for gamma rays, the main source of dose, but are substantially larger for neutrons, a lesser source of dose. We also discuss additional implementation work, including issues related to the dependence of body transmission factors on survivor orientation (direction facing vis-à-vis the direction to the bomb) and on bodily position (standing, kneeling, lying down) and the related need to calculate averaged body transmission factors for survivors without those data. We also discuss remaining issues such as the use of the same phantom, i.e., the same body size and shape, for each combination of sex and age group, although body size varied among survivors and individual body size data are available for a large part of the cohort.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient outcomes following positive depression screening in a postpartum clinic: A single center retrospective cohort study.","authors":"Aleesha Jasmin Jethwa, Nan Guo, Natasha Harrison, Dipro Chakraborty, Kimberly Mendoza, Natsumi Kii, Brendan Carvalho, Danielle Mari Panelli, Pervez Sultan","doi":"10.18103/mra.2026.0389","DOIUrl":"10.18103/mra.2026.0389","url":null,"abstract":"<p><strong>Background: </strong>Depression screening using the Edinburgh Postnatal Depression Scale is commonly performed at the 6-week postpartum visit, yet subsequent referral patterns and clinical outcomes are incompletely characterized.</p><p><strong>Methods: </strong>A single center cohort study was conducted using electronic health records of patients with a completed depression screen at the 6-week postpartum clinic between 2014-2023. Exposure was categorized as screen negative (Edinburgh Postnatal Depression Scale 0-9) or screen positive (Edinburgh Postnatal Depression Scale ≥10) for depressive symptoms. Primary outcome: the proportion of new mental health referrals made (to social work and/or psychiatry services) following the 6-week postpartum depression screen up to 1 year after childbirth. Secondary outcomes: the proportion of patients referred to each specialty after 6 weeks and during the peripartum period (antenatal to 1 year postpartum); patient variables associated with specialty referral from 6 weeks to 1 year postpartum using a multivariable logistic regression model; timing of postpartum referrals after 6-week depression screening; and psychiatric (medications, hospitalizations, mental health diagnoses) and infant associated outcomes within 1 year of childbirth.</p><p><strong>Results: </strong>Of 41,790 deliveries, 8,155 patients met inclusion criteria. 12.6% received a new mental health referral following 6-week postpartum depression screening up to 1 year after childbirth. After screening, social work and psychiatry referrals occurred in 4.7% and 3.7% of negative-screened patients and 37.1% and 19.5% of positive-screened patients, respectively. Across the peripartum period, social work and psychiatry referrals occurred in 8.6% and 17.5% of negative-screened patients, and 42.0% and 42.5% of positive-screened patients, respectively. Variables associated with referrals (6 weeks to 1 year postpartum) included divorced, separated and widowed marital status, ASA grade ≥3, delivery of a non-viable fetus, neonatal intensive care hospitalization, psychiatric diagnosis, and medication use. Referrals within 2 months postpartum were more frequent following positive screening compared to negative screening; Social Work (84% vs 49%); Psychiatry (53% vs 32%). Psychiatric medications, hospitalizations, mental health diagnoses and infant associated outcomes were more frequent following positive screening.</p><p><strong>Conclusion: </strong>Positive postpartum depression screening was associated with increased referrals to social work and psychiatry services; however, a critical gap persists between positive screening and specialty referral, diagnosis, and initiation of treatment. Findings support longitudinal mental health screening across the peripartum period.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achilles Tendinopathy: Comorbidity Profile and Incidence From the TriNetX Network.","authors":"Haiyin Li, David Ciufo, Edward Schwarz, Chike Cao","doi":"10.18103/mra.2026.0372","DOIUrl":"10.18103/mra.2026.0372","url":null,"abstract":"<p><strong>Background: </strong>Contemporary population-level estimates of Achilles tendinopathy incidence across age, sex, and race remain limited, and the comorbidity burden associated with clinically diagnosed Achilles tendinopathy is incompletely characterized.</p><p><strong>Aims: </strong>To describe the epidemiology of clinically diagnosed Achilles tendinopathy in a large, predominantly United States electronic health record network, including baseline patient characteristics, age-specific incidence, race-specific incidence, and sex- and race-related differences in age-specific incidence.</p><p><strong>Methods: </strong>Achilles tendinopathy was identified in the TriNetX Research Network using ICD-10-CM codes M65.27, M76.6, and M77.5. Baseline characteristics were summarized for patients with Achilles tendinopathy recorded through October 31, 2025, and compared with individuals without tendinopathy at any anatomic location. Annual incidence rates per 100,000 person-years were estimated within single calendar-year cohorts from 2015, 2019, 2020, 2023, and 2024 using 5-year age bands. Sex- and race-stratified age-specific incidence was assessed in 2024.</p><p><strong>Results: </strong>Patients with Achilles tendinopathy had a greater overall comorbidity burden than individuals without tendinopathy. Across study years, age-specific incidence followed a consistent bell-shaped distribution, peaking at ages 50-54 years at approximately 191-261 cases per 100,000 person-years before declining at older ages. Overall annual incidence was lower in 2020 during the COVID-19 pandemic and higher in 2024 than in 2015, with rates of 110, 147, and 128 per 100,000 person-years, respectively. In 2024, race-specific annual incidence was highest among White patients, at 174 per 100,000 person-years, and lower among African American patients, at 160 per 100,000 person-years, and Asian patients, at 108 per 100,000 person-years. Sex-specific incidence curves showed higher incidence among males at younger ages and higher incidence among females in midlife. The male-to-female crossover occurred at ages 45-49 years overall, earlier among African American patients, at 35-39 years, and later among Asian patients, at 55-59 years.</p><p><strong>Conclusion: </strong>In a large electronic health record network, Achilles tendinopathy was associated with increased comorbidity burden and showed a consistent midlife peak in incidence. Incidence declined during 2020 and subsequently rebounded, with distinct race-specific and sex-specific age patterns in 2024. These findings provide contemporary clinical benchmarks for risk stratification, prevention, and future etiologic studies.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amyloid precursor protein dosage normalization rescues neurogenesis and Alzheimer's Disease phenotypes associated with Down Syndrome.","authors":"Deepika Patel, Karen Rakowiecki, Orly Lazarov","doi":"10.18103/mra.2026.0302","DOIUrl":"10.18103/mra.2026.0302","url":null,"abstract":"<p><p>Down Syndrome (DS) is the most abundant genetic form of mental retardation. It is caused by the triplication of partial or complete human chromosome 21 (HSA21). The molecular mechanisms of DS are not fully understood. Amyloid precursor protein (APP) resides on HSA21 and is triplicated in DS. While it is not thought to be a part of the \"Down syndrome Critical Region\", APP plays a role in developmental and post-natal neurogenesis and synaptic plasticity, thus, its triplication may affect cortical development in DS. Further, mutations in APP cause familial Alzheimer's disease (AD). However, whether APP overdose is sufficient or required for the development of Alzheimer's disease in DS is not fully elucidated. Here, we addressed the role of APP overdose in neuronal development and AD pathology. Using DS patient-derived induced pluripotent stem cells in which one copy of APP was silenced using CRISPR-Cas9, we examined developmenta neurogenesis, AD-related pathology and the expression levels of genes on HSA21 that are implicated in DS, neurodegeneration and inflammation. Amyloid precursor protein triplication, in DS induced pluripotent stem cells, led to reduced stem cell proliferation, enhanced differentiation into neurons, increased amyloid pathology, and altered protein levels of selected genes on HSA21. Correction of APP gene dosage rescued the altered neurogenesis phenotype and reduced pathological amyloidogenic processing. These data highlight APP dosage as a key regulator of neuronal maturation and AD pathology in DS, suggesting therapeutic value in targeting APP expression to mitigate neurodevelopmental and neurodegenerative features of the disorder.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arsenic Exposure During Pregnancy: Impacts to Maternal and Offspring Cardiovascular Health.","authors":"Morgan Steiner, Marsha Wills-Karp, Mark Kohr","doi":"10.18103/mra.2026.0269","DOIUrl":"10.18103/mra.2026.0269","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is the leading cause of pregnancy-related deaths, with rates continuing to rise. While older maternal age and preexisting conditions such as obesity, diabetes and hypertension contribute to this trend, they do not fully account for it, suggesting a critical role for environmental factors. A major environmental concern is inorganic arsenic (iAs), which contaminates the food and water supply of over 140 million people worldwide. Exposure to iAs has been linked to a number of chronic diseases including cancer, neurodegenerative disorders and heart disease. During pregnancy, gestational iAs exposure poses a substantial threat to maternal and fetal health. It is linked with a higher risk of maternal hypertension, preeclampsia, and structural heart changes during and after pregnancy. Concurrently, it drives fetal complications including pre-term delivery, congenital heart defects and low birth weight. Furthermore, these early-life exposures predispose offspring to lifelong CVD. Herein, we summarize current evidence regarding the adverse impacts of prenatal iAs exposure on the cardiovascular health of mothers and their offspring. We underscore the need to elucidate the underlying biological mechanisms to inform targeted preventive strategies, therapeutics, and public health policies aimed at combating the rising global maternal mortality.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexpramipexole alleviates chronic allodynia from sciatic neuropathy and reduces spinal interferon-γ and other proinflammatory cytokines in spinal cord and dorsal root ganglia in mice.","authors":"Noah A Castro, Clara J Tomicek, Melody S Sun, Justine R Zimmerly, Annette K Fernandez-Oropeza, Sammy D Gomez-Medina, Zarena M Dominguez, Shahani Noor, Jessie R Maxwell, Erin D Milligan","doi":"10.18103/mra.v14i5.7499","DOIUrl":"10.18103/mra.v14i5.7499","url":null,"abstract":"<p><p>Dexpramipexole is a small molecule compound with properties previously shown to block the voltage-gated sodium channel, Nav_1.8 on nociceptors. It additionally has anti-inflammatory properties in immune cells. In addition to clinical trials investigating the therapeutic efficacy of dexpramipexole to control eosinophilic asthma, dexpramipexole is effective in alleviating peripheral neuropathies in preclinical mouse models such as sciatic nerve chronic constriction injury, which reverses pathological sensitivity to light touch (i.e. allodynia). Pain signals are further processed in limbic areas of the brain that serve to regulate stress. Such overlapping regulation elicits increases in hypothalamic efferent sympathetic activity, which engages the spleen and adrenal glands in response to stress; organs critical in regulating immune responses and producing catecholaminergic norepinephrine, respectively. Thus, the current study evaluated the action of dexpramipexole (1) on the full timecourse of peripheral (intravenous) dexpramipexole and the acute timecourse of spinal (intrathecal) dexpramipexole on established allodynia from chronic constriction injury, and (2) characterized spinal and limbic proinflammatory cytokine protein expression following the spinal intrathecal dexpramipexole application in female mice. Splenic cytokine mRNA expression and adrenal norepinephrine levels were measured, as chronic constriction injury-induced neuropathy elicits elevated sympathetic nervous activity. Hindpaw sensitivity was assessed using the von Frey method. After intrathecal dexpramipexole and hindpaw reassessment at 1hr, the anterior cingulate cortex, amygdala, hypothalamus, dorsal lumbar spinal cord, lumbar dorsal root ganglia, spleen and adrenal glands were collected. Intravenous dexpramipexole, resulted in profound allodynic reversal within 1hr through 24hr, that returned by 48hr occurred. Intrathecal dexpramipexole, resulted in full reversal of allodynia by 1hr occurred. Chronic constriction injury-induced elevations in spinal interferon-γ protein was significantly suppressed from intrathecal dexpramipexole-treated mice that also demonstrated allodynia reversal, whereas trends for reduced spinal interleukin-1β and tumor necrosis factor-α were observed. Lumbar dorsal root ganglia from allodynic reversed mice given intrathecal dexpramipexole revealed reduced interleukin-1β and tumor necrosis factor-α, as was observed in the hypothalamus. Intrathecal dexpramipexole did not reliably alter splenic cytokine mRNA expression nor adrenal norepinephrine. These data suggest dexpramipexole may control allodynia by decreasing spinal interferon-γ and sensory ganglia interleukin-1β and tumor necrosis factor-α, which may serve as a potential pain therapeutic in addition to its action at Nav_1.8.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scalable dissemination model for training faculty in mentor development and networking.","authors":"Akshay Sood, Beth Tigges, Deborah Helitzer","doi":"10.18103/mra.v14i5.7423","DOIUrl":"10.18103/mra.v14i5.7423","url":null,"abstract":"<p><p>Faculty success in academia depends on effective mentoring and developmental networks, yet shortages in trained mentors, limited networking skills and inconsistent mentoring quality impact career advancement. While structured mentor development programs improve mentor competency and curriculum-based training improves networking self-efficacy, these programs are widely unavailable and/or underutilized. To address this gap, we evaluated scalable, evidence-based faculty training programs disseminated to academic institutions across the United States using the Project ECHO (Extension of Community Health Outcomes) telementoring model. Two interventions-Mentor Development and Mentoring Networks-were implemented from 2023 to 2025. Participation, demographics and reach were tracked, while surveys assessed knowledge, content relevance, intent to apply knowledge, communication, barriers and perceived impact. Knowledge gains were measured by comparing retrospective pre/post- test scores on a Likert scale. A total of 821 Mentor Development and 556 Mentoring Networks attendances were recorded, with mean attendance of 20.5 and 15.4 unique individuals, respectively. Both programs showed significant increases in knowledge (p<0.001; Cohen's d = 1.3 and 1.7, respectively). Participants reported strong intentions to apply the content (means = 4.6, 4.6), high relevance (means = 4.0, 3.9), and improved communication and collaboration within teams (means = 4.2, 4.4). Reported impacts included improved knowledge (84-94%), skills (59-61%), and performance (32-36%), with limited time and resources as the most common barriers. The Project ECHO model is a feasible, scalable approach for disseminating mentor development and networking training to strengthen academic workforce capacity and reduce inequities across diverse, real-world academic settings.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Relationship Between Dolutegravir and Diabetes Using Routine Data of Patients on Anti-Retroviral Treatment in a High HIV Prevalence Setting.","authors":"Samson Haumba, Thokozani Maseko, Fezokuhle Khumalo, Nakekelo Mndzebele, Clara Nyapokoto, Sylvia Ojoo","doi":"10.18103/mra.v14i2.7309","DOIUrl":"10.18103/mra.v14i2.7309","url":null,"abstract":"<p><strong>Background: </strong>Dolutegravir has been associated with excessive weight gain and type 2 diabetes mellitus (T2DM) The study aimed to describe the incidence and prevalence of type 2 diabetes mellitus in a cohort of patients exposed and non-exposed to dolutegravir containing antiretroviral therapy in Eswatini.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using routinely collected data from electronic medical records for adults aged ≥25years active on antiretroviral therapy in two of the country's regions between 01 October 2018 and 31 August 2025. Included patients were adults (≥25 years) active on antiretroviral therapy with no prior diagnosis of diabetes mellitus. The primary outcome was a documented diagnosis of type 2 diabetes mellitus among dolutegravir initiators- patients who started antiretroviral therapy on a dolutegravir-based regimen; dolutegravir transitioners- patients previously on a non-dolutegravir regimen who transitioned to a dolutegravir-based regimen; and non- dolutegravir users- patients that were never exposed to dolutegravir. Multiple imputation was used to handle missing data in body mass index and antiretroviral therapy duration. Descriptive statistics were used to describe patient characteristics, and Poisson log link regression was used to compute incidence risk ratios.</p><p><strong>Results: </strong>A total of 102330 patients were analyzed (21938 in dolutegravir initiators group, 73967 in dolutegravir transitioners group and 6425 in non-dolutegravir users group). The participant mean age was 43.7±11.7years, the mean duration on antiretroviral therapy was 9.4±3.9years and mean body mass index (BMI) was 27.5±6.2 kg/m². The overall prevalence of type 2 diabetes was 2.0% (1.2% among dolutegravir initiators; 2.3% among dolutegravir transitioners and 1.4% among non-dolutegravir users) and the overall incidence rate was 3.6 cases per 1000person-years [Non-dolutegravir Users-6.2 per 1000person-years), Dolutegravir Transitioners (3.6 per 1000person-years) and Dolutegravir Initiators (2.9 per 1000person-years)]. After adjusting for age, BMI, and duration on antiretroviral therapy, Dolutegravir Initiators (aIRR=0.4) and Dolutegravir Transitioners (aIRR=0.4) had a lower risk than Non-Dolutegravir Users.</p><p><strong>Conclusion: </strong>There was a protective relationship for developing type 2 diabetes mellitus for patients on dolutegravir-based regimens in comparison to non-dolutegravir regimens. All patients commencing antiretroviral therapy should have baseline and ongoing blood glucose monitoring as a critical component in the management of HIV.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 2","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13606507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the Primate Perirhinal Cortex in Memory and Emotional Regulation: Ontogeny and Early Insults.","authors":"Jocelyne Bachevalier, Alison R Weiss","doi":"10.18103/mra.v14i2.7272","DOIUrl":"10.18103/mra.v14i2.7272","url":null,"abstract":"<p><p>The perirhinal cortex, a small strip of the anterior medial temporal cortex, first came into prominence through studies of memory. While examining patients with damage to the medial temporal lobe as well as animals with similar regional damage, findings showed that combined damage to the hippocampus, amygdala, and adjacent cortical areas, including the perirhinal cortex, were responsible for the profound memory loss observed. Later, however, the evidence demonstrated that the accompanying damage to the underlying medial temporal cortical areas were largely responsible for the memory deficit that had been attributed to the combined hippocampal and amygdala lesions. The perirhinal cortex has become appreciated as a critical structure supporting familiarity judgement, recognition memory, flexible executive control and behavioral regulation. The objective of this article is first to review the anatomy of the perirhinal cortex and its interactions with other medial temporal structures as well as the neocortex. A series of neurosurgical ablation studies in nonhuman primates will provide evidence for its role in memory and behavioral regulation in adulthood. The next section will highlight the functional maturation of the perirhinal from infancy through adulthood and will show that its role in support of recognition memory emerges in early infancy. The findings will also show that the neonatal perirhinal dysfunction results in functional compensation of recognition and working memory in adulthood but impacts higher-order executive processes such as cognitive control and flexibility. Interestingly, the discovery of the role of perirhinal cortex in familiarity judgements instead of recollection, which is mediated by the hippocampus, is now well documented in several clinical neurodevelopmental disorders (epilepsy, Alzheimer's disease, schizophrenia), providing valuable markers in the prodromal phase of the diseases for early diagnosis and treatment.</p>","PeriodicalId":94137,"journal":{"name":"Medical research archives","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}