2f:I[703058,["/_next/static/immutable/chunks/01paypqginy0h.js","/_next/static/immutable/chunks/1thp5uf9zr3zl.js","/_next/static/immutable/chunks/18st_ghz-9_12.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/31nozh34lrzg9.js","/_next/static/immutable/chunks/1wwib9tz7-gtq.js","/_next/static/immutable/chunks/0t-245yo8v_7x.js","/_next/static/immutable/chunks/0r4zly9oj045f.js","/_next/static/immutable/chunks/18zpky__xcemv.js","/_next/static/immutable/chunks/316o2u2mp21uq.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/00pb_zlp7vf18.js"],"PaperListPageClient"] 30:T8f3,The goal of this study was to identify symptoms that occur in children post-SARS-CoV-2 infection, their trajectory over the first-year post-enrollment, and relationship to age. Longitudinal comparison of infected and uninfected cohorts. Participants (0-21 years) with laboratory-confirmed SARS-CoV-2 infection were enrolled as infected. The uninfected cohort was individuals without laboratory evidence of SARS-CoV-2 infection. Primary outcome was presence or absence of symptoms. 852 participants (705 infected, 147 uninfected) completed baseline visits. Of those, 558 infected subjects completed a 12-month post-enrollment visit. Twenty symptoms were identified as more common in infected participants compared to uninfected, at either baseline or 12-months, with symptoms varying by age. Some symptoms in the infected were more frequent at baseline (e.g. fever, weight loss), whereas many symptoms persisted through 12-months. Several symptoms were more frequent at 12-months (e.g. dysmenorrhea, persistent headache). Presence of symptoms at 12-months was not significantly associated with the wave of circulating virus at original infection. Interim analysis at one-year post-enrollment identifies 20 symptoms that infected participants were more likely to report post SARS-CoV-2 infection compared to uninfected, at either visit. Type of symptoms varies by age. Ongoing longitudinal data up to 3-years post-enrollment will increase understanding of long-term symptoms of SARS-CoV-2 infection in children and their trajectory. NCT04830852. Although most children recover fully from SARS-CoV-2 infection, some children experience a variety of prolonged symptoms following infection. Many studies attempting to characterize these symptoms and trajectory are not prospective nor longitudinal and lack comparison to uninfected controls. This longitudinal analysis identifies and characterizes post-COVID symptoms in children and adolescents and their trajectory through the first-year post enrollment compared to an uninfected cohort. 20 post-infection symptoms were identified as occurring more frequently in the infected as compared to uninfected cohort. Age played a critical role in the type and frequency of symptoms after SARS-CoV-2 infection. Gastrointestinal symptoms were prominent.31:T740,Estrogens underlie puberty in girls, but the steroid metabolome may also regulate pubertal timing in response to elevated stress and increasing body mass index (BMI). Our objective was to identify steroid metabolome patterns linked to accelerated puberty and test whether BMI and stress markers modify this relationship. From the LEGACY Girls Study, a longitudinal cohort followed for 6 years, we selected 327 girls aged 5 to 13 years at baseline to measure 36 steroid metabolites of glucocorticoids, androgens, progesterone, and estrogens in 2 urine samples collected before and during puberty. Parents reported the age at onset of breast development (thelarche), which had a high correlation in the subset with clinically assessed Tanner. Study staff measured height and weight and administered questionnaires, including the Internalizing Composite Scale, a parental proxy of child stress. We estimated hazard ratios (HRs) for the association between doubled steroid metabolites and ages at thelarche, pubarche, and menarche using Weibull survival models, testing interactions with stress and BMI z-scores. Accelerated thelarche was associated with higher prepubertal urinary metabolites of glucocorticoids (HR = 1.9, 95% CI: 1.5-2.5), androgens (HR = 3.9, 95% CI: 2.7-5.6), and progesterone (HR = 6.7, 95% CI: 4.1-10.9). Girls with high glucocorticoid metabolites combined with high BMI and stress reached thelarche 7 months earlier than their counterparts with low measures in these parameters. Elevated metabolites of glucocorticoids, androgens, and progesterone are associated with accelerated pubertal onset, and BMI and stress modify this association. Previous studies have focused on estrogens, menarche, and BMI; our results suggest that androgens and stress impact the timing of thelarche as well, explaining secular declines in pubertal timing.32:Ta50,Abstract Context Estrogens underlie puberty in girls, but the steroid metabolome may also regulate pubertal timing in response to elevated stress and increasing body mass index (BMI). Objective Our objective was to identify steroid metabolome patterns linked to accelerated puberty and test whether BMI and stress markers modify this relationship. Methods From the LEGACY Girls Study, a longitudinal cohort followed for 6 years, we selected 327 girls aged 5 to 13 years at baseline to measure 36 steroid metabolites of glucocorticoids, androgens, progesterone, and estrogens in 2 urine samples collected before and during puberty. Parents reported the age at onset of breast development (thelarche), which had a high correlation in the subset with clinically assessed Tanner. Study staff measured height and weight and administered questionnaires, including the Internalizing Composite Scale, a parental proxy of child stress. We estimated hazard ratios (HRs) for the association between doubled steroid metabolites and ages at thelarche, pubarche, and menarche using Weibull survival models, testing interactions with stress and BMI z-scores. Results Accelerated thelarche was associated with higher prepubertal urinary metabolites of glucocorticoids (HR = 1.9, 95% CI: 1.5-2.5), androgens (HR = 3.9, 95% CI: 2.7-5.6), and progesterone (HR = 6.7, 95% CI: 4.1-10.9). Girls with high glucocorticoid metabolites combined with high BMI and stress reached thelarche 7 months earlier than their counterparts with low measures in these parameters. Conclusion Elevated metabolites of glucocorticoids, androgens, and progesterone are associated with accelerated pubertal onset, and BMI and stress modify this association. Previous studies have focused on estrogens, menarche, and BMI; our results suggest that androgens and stress impact the timing of thelarche as well, explaining secular declines in pubertal timing. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Prospective Longitudinal Cohort Study: Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Prospective Longitudinal Cohort Study (study design). Clinician-written summaries and actionable practice insights. 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Child ADHD diagnosis—not parental ADHD—drove conduct problems at follow-up (OR = 2.62) and their persistence (OR = 6.84). Paternal ADHD symptoms were not significantly associated with any child outcome.","limitations":"The ADHD + Autism subgroup was very small (n = 13), limiting reliability of those comparisons. Selection bias is possible at follow-up because not all children without psychological risk were reassessed. Parenting style and parent-child relationship quality were not measured, leaving the mediating mechanisms unexplored.","practice_takeaway":"Clinicians assessing children with ADHD should routinely screen mothers for ADHD symptoms and psychological difficulties, as both independently predict persistent emotional problems and poorer QoL in children. Family-focused interventions that address maternal mental health alongside child treatment may improve long-term outcomes for both."}},{"doi":"10.1136/gutjnl-2026-339115","pmid":"42749361","title":"Longitudinal gut microbiome dynamics during immunotherapy identify microbial features of clinical benefit in advanced primary liver cancer","journal_title":"Gut","journal_issn":"0017-5749","published_at":"2026-09-16T00:00:00.000Z","url":"https://doi.org/10.1136/gutjnl-2026-339115","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-21T23:14:52.668Z","updated_at":"2026-09-21T23:14:52.668Z","tags":[{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"condition","value":"Primary Liver Cancer","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"sample_size","value":"n=315","value_numeric":315},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"warning","value":"No specific ICI agents (brand or generic names) were mentioned in the abstract; drug-level tags could not be assigned.","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"warning","value":"The external validation cohorts (n=1,204 across 9 studies) cover multiple cancer types, but the discovery cohort is limited to primary liver cancer — cross-tumour generalisation should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-339115","tag_type":"warning","value":"The 'level_of_evidence' tag is set to 2 based on a large prospective cohort with external validation; however, absence of randomisation means it does not reach Level 1.","value_numeric":null}],"summaries":{"what_studied":"A prospective longitudinal shotgun metagenomic study evaluated gut microbiome trajectories during immune checkpoint inhibitor (ICI) therapy in 315 patients with advanced primary liver cancer, profiling 777 serial stool metagenomes at baseline and ~3-month intervals, to determine whether on-treatment microbial states improve pretreatment biomarker signatures.","key_result":"Responders (durable clinical benefit ≥6 months) had higher baseline alpha diversity and distinct community structure. A 16-species panel discovered via on-treatment sampling at ~6 months yielded a baseline model that stratified overall survival (HR 0.49) and progression-free survival (HR 0.44) in the discovery cohort, and generalised across all nine external ICI cohorts (n=1,204).","limitations":"Single-disease cohort (primary liver cancer) limits direct generalisation to other tumour types. Responder definition (≥6 months durable benefit) may not align with other clinical trial endpoints. External validation cohorts were public datasets with potentially heterogeneous treatment regimens and stool collection protocols.","practice_takeaway":"Baseline gut microbiome scoring derived from on-treatment feature discovery may help stratify liver cancer patients before starting ICI therapy. Clinicians should consider that on-treatment sampling windows enrich the signal used to build pretreatment predictive models, supporting future microbiome-guided patient selection tools."}},{"doi":"10.1136/gutjnl-2026-338976","pmid":"42749360","title":"Divergent microbial preludes to necrotising enterocolitis defined by gut phages and bacterial resistomes","journal_title":"Gut","journal_issn":"0017-5749","published_at":"2026-09-16T00:00:00.000Z","url":"https://doi.org/10.1136/gutjnl-2026-338976","source_score":56,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-21T23:14:52.343Z","updated_at":"2026-09-21T23:14:52.343Z","tags":[{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"age_group","value":"neonate","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"condition","value":"Necrotising Enterocolitis","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"modality","value":"Gut Microbiome / Virome Profiling","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"modality","value":"Machine Learning","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"sample_size","value":"n=129","value_numeric":129},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"warning","value":"Sample size for NEC cases is modest (n=43), which may limit the robustness of machine learning model performance metrics. External validation was not reported.","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"warning","value":"The impact_flag 'practice_changing' reflects the novelty of the findings (phage/resistome-based NEC risk stratification); clinical implementation tools do not yet exist based on this study alone.","value_numeric":null},{"paper_doi":"10.1136/gutjnl-2026-338976","tag_type":"warning","value":"The study design is observational; causal roles of phages or resistome elements in NEC pathogenesis remain to be established.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated whether gut prophageome (phage) profiles and antibacterial resistome signatures could predict necrotising enterocolitis (NEC) in preterm infants, using integrated metagenomics, metatranscriptomics, and machine learning on 1,825 longitudinal stool samples from 43 NEC cases and 86 matched controls across three US hospitals.","key_result":"Early-onset NEC (≤40 days) was best predicted by phage-bacterial interaction signatures (75% accuracy, 81% sensitivity); late-onset NEC (>40 days) was best predicted by antibacterial resistome profiles (83% accuracy). Metatranscriptomics showed high phage DNA abundance with low gene expression, suggesting a lysogenic lifestyle that may stabilise pathobionts.","limitations":"Observational design limits causal inference; relatively small NEC case group (n=43) may affect generalisability; machine learning models were not externally validated beyond the three study hospitals.","practice_takeaway":"Clinicians caring for preterm infants should be aware that early- and late-onset NEC appear to have distinct microbial drivers — phage-bacterial interactions vs. antibiotic resistome — suggesting future risk stratification tools may need to differentiate by disease timing. Microbiome-targeted surveillance strategies informed by gut phage and resistome profiling may one day enable earlier NEC detection before symptoms emerge."}},{"doi":"10.1097/j.pain.0000000000004107","pmid":"42751721","title":"Temporal associations between pain intensity and disturbed body perception after total knee arthroplasty: a random-intercept cross-lagged panel model analysis","journal_title":"Pain","journal_issn":"0304-3959","published_at":"2026-09-10T00:00:00.000Z","url":"https://doi.org/10.1097/j.pain.0000000000004107","source_score":20,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-25T13:51:00.529Z","updated_at":"2026-09-25T13:51:00.529Z","tags":[{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"condition","value":"Chronic Musculoskeletal Pain","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"condition","value":"Post-Surgical Pain","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"modality","value":"Total Knee Arthroplasty","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"sample_size","value":"n=285","value_numeric":285},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"warning","value":"RMSEA values exceeded recommended thresholds in both RI-CLPMs, indicating uncertain model fit and that findings should be interpreted with caution","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"warning","value":"Sex of participants was not reported in the abstract, limiting assessment of generalizability across sexes","value_numeric":null},{"paper_doi":"10.1097/j.pain.0000000000004107","tag_type":"warning","value":"The 6-month body perception finding is based on a single observational cohort; replication in diverse TKA populations is needed before clinical translation","value_numeric":null}],"summaries":{"what_studied":"Whether within-person changes in knee-specific body perception (measured by the Fremantle Knee Awareness Questionnaire, FreKAQ) prospectively predict pain intensity (movement and resting) after total knee arthroplasty (TKA) across 5 time points over 1 year (preoperative, 1, 3, 6, and 12 months), using random-intercept cross-lagged panel models (RI-CLPMs) in 285 patients.","key_result":"Higher FreKAQ scores (worse body perception) at 6 months predicted greater pain at 1 year (pain during movement: β = 0.262, P = 0.004; resting pain: β = 0.359, P = 0.003); resting pain at 3 months also predicted worse body perception at 6 months (β = 0.179, P = 0.033), but no other pain-to-FreKAQ paths were significant.","limitations":"Model fit was mixed — RMSEA values exceeded recommended thresholds, raising concerns about model adequacy; the study is observational, so causality cannot be established; findings may not generalize beyond this single cohort of primary TKA patients.","practice_takeaway":"Clinicians should consider screening for disturbed body perception around 6 months post-TKA, as it may signal risk for persistent pain at 1 year. However, body-perception-focused rehabilitation cannot yet be recommended without further interventional evidence."}},{"doi":"10.1002/acr.80128","pmid":"42544859","title":"Optimizing Hydroxychloroquine Blood Levels and Long‐Term Hydroxychloroquine Intake Could Lower\n ASCVD\n Risk and Prevent Polypharmacy in Systemic Lupus Erythematosus","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-08-03T00:00:00.000Z","url":"https://doi.org/10.1002/acr.80128","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-11T13:26:06.971Z","updated_at":"2026-08-11T13:26:06.971Z","tags":[{"paper_doi":"10.1002/acr.80128","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"brand","value":"Plaquenil","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"condition","value":"Atherosclerotic Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"generic","value":"hydroxychloroquine","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"modality","value":"Antimalarial","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"sample_size","value":"n=248","value_numeric":248},{"paper_doi":"10.1002/acr.80128","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"warning","value":"Sex distribution of the cohort is not explicitly reported in the abstract; 'mixed' is assumed based on typical SLE demographics.","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — while the findings are clinically meaningful, the outcome is an estimated ASCVD risk score rather than a hard cardiovascular endpoint, which limits the strength of the claim.","value_numeric":null},{"paper_doi":"10.1002/acr.80128","tag_type":"warning","value":"The PREVENT calculator used for ASCVD risk estimation is relatively new; its validation in SLE populations is not discussed in the abstract.","value_numeric":null}],"summaries":{"what_studied":"This prospective longitudinal study evaluated how hydroxychloroquine (HCQ) blood levels and long-term intake (measured by proportion of days covered, PDC) relate to 10-year ASCVD risk at baseline and after 1 year in 248 adults with SLE from the Wisconsin cohort.","key_result":"Patients with very low HCQ blood levels (<200 ng/mL) AND low long-term intake (PDC <80%) had significantly higher baseline ASCVD risk (+2.1%, mean 6.6%). Those who stayed in or moved into low-exposure categories had the highest follow-up ASCVD risk (5.7%).","limitations":"Single-center cohort (Wisconsin) limits generalizability; ASCVD risk was estimated using the PREVENT calculator rather than measured hard outcomes; 1-year follow-up is short for a cardiovascular endpoint study.","practice_takeaway":"Monitor whole-blood HCQ levels and adherence (PDC) in SLE patients — those with levels <200 ng/mL and PDC <80% carry meaningfully higher cardiovascular risk. Supporting sustained HCQ adherence may reduce ASCVD risk and limit the need for additional preventive therapies."}},{"doi":"10.1542/peds.2025-074681","pmid":"42503419","title":"Symptoms Associated With Respiratory Pathogens in Young Children: 2019–2025","journal_title":"Pediatrics","journal_issn":"0031-4005","published_at":"2026-07-27T00:00:00.000Z","url":"https://doi.org/10.1542/peds.2025-074681","source_score":11,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:37:18.194Z","updated_at":"2026-07-31T13:37:18.194Z","tags":[{"paper_doi":"10.1542/peds.2025-074681","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"condition","value":"Acute Respiratory Illness","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"condition","value":"Human Metapneumovirus Infection","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"condition","value":"Influenza","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"condition","value":"Parainfluenza Virus Infection","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"condition","value":"Respiratory Syncytial Virus Infection","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"generic","value":"not applicable","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"modality","value":"Diagnostic / Surveillance","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"sample_size","value":"n=1223","value_numeric":1223},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"warning","value":"Study period spans pre- and post-COVID pandemic years (2019–2025), which may introduce secular trends in pathogen circulation and healthcare-seeking behavior that are not fully disentangled in the reported results.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"warning","value":"The 'generic' tag was not applicable here as no therapeutic intervention was studied; tag omitted from meaningful output.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-074681","tag_type":"warning","value":"The sample size of n=1,223 children generated 15,898 ARI episodes — the episode count is the analytic unit for most outcomes, not unique children; clinicians should interpret ORs in that context.","value_numeric":null}],"summaries":{"what_studied":"A US longitudinal birth cohort (n=1,223 infants and children, Cincinnati, OH) was followed from November 2019 to August 2025 with weekly nasal swabs and biweekly symptom surveys to characterize symptom profiles and medical outcomes across 15,898 acute respiratory illness (ARI) episodes caused by specific pathogens (influenza A/B, RSV A/B, hMPV, SARS-CoV-2, parainfluenza), excluding co-infections.","key_result":"Infants had significantly higher odds of respiratory distress/dyspnea vs. older children with influenza A (OR 4.73), SARS-CoV-2 (OR 3.99), RSV A (OR 2.52), RSV B (OR 2.22), and hMPV (OR 2.36); influenza A caused more fever (OR 2.77) and anorexia (OR 2.94) than influenza B; >75% of symptomatic episodes were managed at home; vomiting/diarrhea occurred in ~25% of RSV and ~33% of influenza episodes.","limitations":"Single US city cohort (Cincinnati) limits geographic generalizability; co-infections were excluded, which may underrepresent real-world mixed-pathogen illness severity; symptom data relied on biweekly caregiver surveys, introducing potential recall bias.","practice_takeaway":"Infants are at markedly higher risk for respiratory distress across most major viral pathogens — clinicians should maintain a lower threshold for assessment in this age group. The frequent occurrence of vomiting/diarrhea with RSV and influenza (up to one-third of cases) is a useful clinical reminder not to dismiss GI symptoms during respiratory illness season."}},{"doi":"10.1002/alz.71599","pmid":"42483984","title":"Prognostic value of plasma %p‐tau217 in cognitively unimpaired older adults","journal_title":"Alzheimer's & Dementia","journal_issn":"1552-5260","published_at":"2026-07-22T00:00:00.000Z","url":"https://doi.org/10.1002/alz.71599","source_score":17,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-01T13:21:46.872Z","updated_at":"2026-08-01T13:21:46.872Z","tags":[{"paper_doi":"10.1002/alz.71599","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"brand","value":"Lumipulse","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"brand","value":"PrecivityAD2","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"condition","value":"Dementia","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"condition","value":"Mild Cognitive Impairment","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"condition","value":"Preclinical Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"generic","value":"phosphorylated tau 217","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"modality","value":"Blood-Based Biomarker","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"modality","value":"Immunoassay","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"modality","value":"Mass Spectrometry","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"sample_size","value":"n=982","value_numeric":982},{"paper_doi":"10.1002/alz.71599","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"warning","value":"One author (Andreas Jeromin) is a co-founder of Tau Biosciences and a former ALZpath employee; other potential conflicts include consulting relationships. Readers should weigh industry links when interpreting assay comparisons.","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"warning","value":"Sample size tag reflects the primary Vallecas Project cohort (n=982); the replication AgeCoDe cohort (n=1204) uses a different immunoassay platform and older participants (mean age 83.7 vs 74.7), which limits direct cross-cohort comparisons.","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the robust 12-year prognostic data and strong NPVs, but clinical implementation is premature without PET/CSF validation studies and broader population diversity.","value_numeric":null},{"paper_doi":"10.1002/alz.71599","tag_type":"warning","value":"The study does not report overall survival data; high dropout rates of unknown cause may introduce survivorship bias in long-term progression estimates.","value_numeric":null}],"summaries":{"what_studied":"Baseline plasma %p-tau217 (ratio of phosphorylated to non-phosphorylated tau217, measured by LC-MS/MS) was evaluated as a prognostic biomarker in 982 cognitively unimpaired (CU) community-dwelling adults (age 69–85, 65% female) followed annually for up to 12 years, with replication in the same cohort using immunoassays and in an independent primary care cohort (AgeCoDe, n=1204, age >80).","key_result":"Participants with Elevated or High %p-tau217 had markedly increased risks of MCI (HR 6.0–12.6) and dementia (HR 9.9–21.3) vs. the Low group; the Low group had a 92.2% 10-year negative predictive value (NPV) for any clinical progression and 98.1% NPV for dementia. The High group had a 71.6% positive predictive value (PPV) for MCI/dementia at 10 years. Immunoassays (Fujirebio, ALZPath) showed comparable NPVs but lower PPVs and weaker high-risk stratification than mass spectrometry–based %p-tau217.","limitations":"- No amyloid or tau PET/CSF confirmation of pathological status, limiting ground-truth verification.\n- High dropout rates (reasons undetermined; may bias progression estimates toward survival) and up to 2-year follow-up gaps due to COVID-19.\n- Demographically narrow cohorts (predominantly Spanish and German, older adults), limiting generalizability to younger or more diverse populations.","practice_takeaway":"A low plasma %p-tau217 result can reassure most CU older adults of minimal dementia risk over 10 years (NPV >92%), making it a practical front-line screening tool. Immunoassay platforms offer similar reassurance for ruling out risk, but mass spectrometry–based %p-tau217 better identifies the highest-risk individuals for clinical trial enrichment or confirmatory workup."}},{"doi":"10.1080/15374416.2026.2697488","pmid":"42467884","title":"Patterns of Early Development in Children with ADHD","journal_title":"Journal of Clinical Child & Adolescent Psychology","journal_issn":"1537-4416","published_at":"2026-07-17T00:00:00.000Z","url":"https://doi.org/10.1080/15374416.2026.2697488","source_score":11,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-26T13:44:48.243Z","updated_at":"2026-07-26T13:44:48.243Z","tags":[{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"condition","value":"Attention-Deficit/Hyperactivity Disorder","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"modality","value":"Developmental Screening","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"sample_size","value":"n=185","value_numeric":185},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"warning","value":"ADHD outcomes were assigned at school age; it is unclear whether formal DSM-based diagnostic criteria were applied consistently across all three contributing studies.","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously: findings are observational and based on a select high-risk cohort, so prospective validation in general pediatric populations is needed before changing screening protocols.","value_numeric":null},{"paper_doi":"10.1080/15374416.2026.2697488","tag_type":"warning","value":"The sample was recruited from studies focused on autism family history risk, which may not represent the broader population of children with ADHD — clinicians should interpret generalizability with caution.","value_numeric":null}],"summaries":{"what_studied":"This study compared early developmental trajectories (cognitive/motor development and adaptive functioning) from 6 to 36 months between children later diagnosed with ADHD (n=62) and typically developing (TD) children (n=123), followed to school age (~6–16 years), using data from three prospective longitudinal studies of infants with/without a family history of autism.","key_result":"Children with ADHD had lower estimated raw scores on all Mullen Scales of Early Learning subscales and nearly all Vineland-II subscales compared to TD children; they also showed higher rates of early intervention service eligibility, especially in communication and socialization domains.","limitations":"- Sample was majority male, White, and non-Hispanic, limiting generalizability to more diverse populations.\n- Participants were drawn from studies of infants with a family history of autism, which may inflate neurodevelopmental risk and reduce applicability to the general ADHD population.\n- ADHD diagnosis was assigned at school age retrospectively, so early developmental data were not collected with ADHD as the primary outcome.","practice_takeaway":"Children who later develop ADHD show measurable cognitive, motor, and adaptive delays as early as 6 months — clinicians should consider increased developmental screening and early intervention referrals for infants at elevated neurodevelopmental risk, particularly in communication and socialization."}},{"doi":"10.1186/s12879-026-13950-y","pmid":"42426637","title":"The one-month impact of influenza infection on patient-reported symptom burden among symptomatic U.S. adults with a test-confirmed illness: a longitudinal study","journal_title":"BMC Infectious Diseases","journal_issn":"1471-2334","published_at":"2026-07-09T00:00:00.000Z","url":"https://doi.org/10.1186/s12879-026-13950-y","source_score":12,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-14T13:24:20.715Z","updated_at":"2026-07-14T13:24:20.715Z","tags":[{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"condition","value":"Influenza","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"modality","value":"Vaccine (Influenza)","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"sample_size","value":"n=724","value_numeric":724},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"warning","value":"Day 1 data included retrospective recall of worst symptoms since infection onset, which may introduce recall bias for early symptom severity estimates.","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"warning","value":"Participants were recruited exclusively from ambulatory care sites, so findings may not reflect influenza burden in hospitalized or asymptomatic/minimally symptomatic individuals.","value_numeric":null},{"paper_doi":"10.1186/s12879-026-13950-y","tag_type":"warning","value":"The cohort is 74.2% female, which is a notable imbalance and may limit generalizability across sexes.","value_numeric":null}],"summaries":{"what_studied":"Prospective longitudinal study of 724 U.S. adults (≥18 years) with test-confirmed influenza during the 2024–2025 season, tracking patient-reported severity of 12 symptoms daily from Day 1 through Week 4 post-enrollment using a 4-point composite score.","key_result":"Mean composite symptom score on Day 1 was 17.1 (SE: 0.3), with 8.7 total symptoms, 5.9 moderate-to-severe, and 2.5 severe symptoms. Severe symptoms persisted through Day 5; at Week 4, composite score, any-symptom count, and moderate-to-severe count remained slightly above pre-infection baseline (increases of +0.5, +0.3, and +0.2, respectively).","limitations":"74.2% of participants were female, limiting generalizability to broader populations. Participants were recruited only from ambulatory care sites, excluding hospitalized or non-care-seeking individuals. Nearly half (49.3%) were vaccinated, which may have modified symptom severity.","practice_takeaway":"Influenza causes a heavy symptom burden that peaks early but can persist at mild-to-moderate levels for at least four weeks — clinicians should set patient expectations accordingly. Vaccination and other preventive strategies remain key, given that even vaccinated patients in this cohort experienced substantial illness."}},{"doi":"10.1111/pai.70393","pmid":"42415534","title":"Prevalence of Avoidant/Restrictive Food Intake Disorder (ARFID) in children with and without food allergy","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-07-07T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70393","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-12T13:19:46.443Z","updated_at":"2026-07-12T13:19:46.443Z","tags":[{"paper_doi":"10.1111/pai.70393","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"condition","value":"Avoidant/Restrictive Food Intake Disorder","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"sample_size","value":"n=951","value_numeric":951},{"paper_doi":"10.1111/pai.70393","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"warning","value":"Attrition in the HealthNuts cohort resulted in over-representation of participants with allergic disease history by age 10, which may affect generalizability.","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"warning","value":"The ARFID-FAA definition is exploratory and not validated; the FAA cut-off was study-defined rather than clinically standardized.","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"warning","value":"The high overall possible ARFID rate (~21%) likely reflects removal of the underweight criterion to align with updated DSM-5 criteria; this may reduce specificity compared to older estimates.","value_numeric":null},{"paper_doi":"10.1111/pai.70393","tag_type":"warning","value":"The study reports 'possible ARFID' based on a screening tool (EDY-Q), not formal diagnostic interviews; true ARFID prevalence may differ.","value_numeric":null}],"summaries":{"what_studied":"This study examined the prevalence of possible ARFID in 10-year-old children with (n=102) and without (n=849) current IgE-mediated food allergy, using the EDY-Q screening tool within the population-based HealthNuts cohort (Melbourne, Australia). Food allergy anxiety (FAA) from the FAQLQ-PF was also incorporated as an ARFID variant to assess EDY-Q sensitivity.","key_result":"Possible ARFID prevalence was similar in children with vs. without current food allergy: 23% (95% CI 15–32) vs. 21% (95% CI 18–24; OR 1.09, 95% CI 0.67–1.80). When food allergy anxiety was added as an ARFID variant, an additional 10 children (10%) with food allergy met criteria, raising their ARFID prevalence to 32% (95% CI 24–42%).","limitations":"- The EDY-Q does not capture fear of allergic reactions, likely underdetecting ARFID in food-allergic children.\n- Removing the underweight requirement (to align with updated DSM-5 criteria) may reduce specificity, potentially overestimating prevalence.\n- FAA was parent-reported, not independently validated, and only measured in food-allergic children, preventing direct comparison with non-allergic peers.","practice_takeaway":"Clinicians in allergy settings should actively screen for ARFID symptoms in children with food allergy, since standard tools like the EDY-Q may miss fear-of-reaction-driven food avoidance. When a child with food allergy shows signs of disordered eating beyond routine allergy management, consider referral for formal ARFID assessment using newer tools that capture fear of allergic reactions."}},{"doi":"10.1016/j.eatbeh.2026.102110","pmid":"42413206","title":"Compulsive exercise in higher levels of eating disorder care: Trajectory of change over time among adolescents with anorexia nervosa","journal_title":"Eating Behaviors","journal_issn":"1471-0153","published_at":"2026-07-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.eatbeh.2026.102110","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-11T13:32:59.553Z","updated_at":"2026-07-11T13:32:59.553Z","tags":[{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"condition","value":"Anorexia Nervosa","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"condition","value":"Compulsive Exercise","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"sample_size","value":"n=443","value_numeric":443},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"warning","value":"Full text was not accessible (publisher captcha wall); summary is based solely on the abstract.","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"warning","value":"Sex/gender breakdown of the sample is not reported in the abstract; 'mixed' sex tag is an assumption given the clinical population context.","value_numeric":null},{"paper_doi":"10.1016/j.eatbeh.2026.102110","tag_type":"warning","value":"Study design is described as longitudinal with piecewise growth curve analysis but lacks randomization — labeled as prospective cohort; some ambiguity remains.","value_numeric":null}],"summaries":{"what_studied":"This study examined how compulsive exercise frequency changes across higher levels of eating disorder care (inpatient/residential → partial hospitalization → intensive outpatient) in 443 adolescents with anorexia nervosa, and whether weight restoration (% expected body weight) predicted compulsive exercise at discharge.","key_result":"Among the 58% (n=257) who endorsed compulsive exercise at admission, frequency dropped significantly from admission to stepdown (β = −0.21, p < .001), but did not change significantly from stepdown to discharge (β = −0.02, p = .080). Weight restoration was not associated with compulsive exercise frequency at discharge (IRR = 1.19, p = .941).","limitations":"- No control group or randomized design limits causal inference about exercise restriction.\n- No follow-up data beyond discharge; durability of improvement is unknown.\n- Compulsive exercise measured only by frequency (EDE-Q), without assessing motivation or compulsivity quality.","practice_takeaway":"Higher levels of care that restrict physical activity are linked to reduced compulsive exercise in adolescents with AN, independent of weight gain — but gains plateau as supervision decreases. Clinicians should address exercise motivation explicitly when stepping patients down, rather than relying on weight restoration alone."}},{"doi":"10.1002/alz.71616","pmid":"42340807","title":"Sleep fragmentation correlates with amyloid beta deposition at brain autopsy","journal_title":"Alzheimer's & Dementia","journal_issn":"1552-5260","published_at":"2026-06-24T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13293097/","source_score":14,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-03T13:38:40.835Z","updated_at":"2026-07-03T13:38:40.835Z","tags":[{"paper_doi":"10.1002/alz.71616","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"condition","value":"Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"condition","value":"Amyloid Beta Pathology","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"condition","value":"Sleep Fragmentation","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"modality","value":"Actigraphy","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"modality","value":"Brain Autopsy / Neuropathology","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"sample_size","value":"n=798","value_numeric":798},{"paper_doi":"10.1002/alz.71616","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"warning","value":"Level of evidence assigned as 3 (prospective cohort); no randomization or intervention was performed.","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"warning","value":"The kRA metric is specific to the Rush MAP methodology and may not directly map to standard clinical sleep parameters (e.g., sleep efficiency, WASO), limiting direct clinical translation.","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"warning","value":"The paradoxical inverse association between subjective PSQI scores and AD neuropathology is likely driven by recall bias and underreporting in cognitively impaired individuals, not a true protective effect of poor self-reported sleep.","value_numeric":null},{"paper_doi":"10.1002/alz.71616","tag_type":"warning","value":"The study is observational and cannot determine causality — whether sleep fragmentation drives amyloid accumulation or early amyloid deposition disrupts sleep remains unresolved.","value_numeric":null}],"summaries":{"what_studied":"This longitudinal autopsy-based cohort study (Rush Memory and Aging Project, n=798; mean age at baseline 81.72 years) examined whether objective actigraphy-derived sleep fragmentation (kRA) and subjective sleep quality (modified PSQI) correlated with quantitative AD neuropathology at brain autopsy, with a mean follow-up of 9.53 study years.","key_result":"Objective sleep fragmentation (mean kRA) was independently associated with greater cortical amyloid density (B=0.09; 95% CI 0.02–0.15; p=0.006), representing ~18% relative increase in Aβ-positive cortical area per 1 SD increase in kRA. This link was significant only in participants with **low AD neuropathologic change** (B=0.09; p=0.03) or **no/mild cognitive impairment** (B=0.11; p=0.01), not in those with intermediate/high burden or Alzheimer's dementia. Sleep fragmentation measured closest to death showed the strongest association (last-year kRA B=0.12; p<0.001). Paradoxically, higher subjective PSQI scores (worse self-reported sleep) were linked to *lower* amyloid density (B=−0.14; p<0.001) and lower burden across all other neuropathologic metrics.","limitations":"- Cohort is predominantly White, older adults from the Chicago area, limiting generalizability.\n- Time between last sleep assessment and autopsy was unavailable, preventing evaluation of late sleep changes.\n- kRA captures rest-activity fragmentation broadly and may not isolate sleep-specific disruption; chronic sleep medication use and cause of death were not accounted for.","practice_takeaway":"Actigraphy-measured sleep fragmentation—not self-reported sleep quality—tracks with amyloid burden at autopsy, and the association is strongest in early-stage disease. Clinicians should be cautious interpreting subjective sleep complaints as a proxy for objective sleep disruption in older adults at risk for AD, and consider objective measurement when evaluating sleep in this population."}},{"doi":"10.1001/jamanetworkopen.2026.19569","pmid":"42329650","title":"Youth Soccer Participation and Brain Health Outcomes in Adolescent Athletes","journal_title":"JAMA Network Open","journal_issn":"2574-3805","published_at":"2026-06-22T00:00:00.000Z","url":"https://doi.org/10.1001/jamanetworkopen.2026.19569","source_score":204,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-01T13:27:03.484Z","updated_at":"2026-07-01T13:27:03.484Z","tags":[{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"condition","value":"Repetitive Head Impacts","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"condition","value":"Sport-Related Brain Injury","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"modality","value":"Neuroimaging","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"modality","value":"Plasma Biomarker Assessment","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"sample_size","value":"n=129","value_numeric":129},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"warning","value":"Heading exposure was self-reported, which likely underestimates true repetitive head impact burden and may explain the null association with outcome changes.","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"warning","value":"The preseason group differences in biomarkers (tNAA, GFAP, NfL) could reflect pre-existing selection differences rather than sport-related exposure; causality cannot be established.","value_numeric":null},{"paper_doi":"10.1001/jamanetworkopen.2026.19569","tag_type":"warning","value":"The sample is exclusively male, so findings may not apply to female soccer players, who represent a large portion of youth participants globally.","value_numeric":null}],"summaries":{"what_studied":"This prospective longitudinal cohort study compared male adolescent soccer players (n=82, mean age 14.8 years) with noncontact sport athletes (n=47, mean age 14.7 years) across one competitive season at three European centers, assessing cognition, behavior, balance, brain MRI metrics, and plasma biomarkers at preseason, postseason, and 2 months later.","key_result":"No significant between-group differences were found in cognition, behavior, balance, cortical thickness, brain volumes, white-matter microstructure, or functional connectivity. However, soccer players had higher preseason tNAA, GFAP, and NfL than controls, and tNAA declined in soccer players while rising in controls (β=0.047, 95% CI 0.020–0.074, P=.001), converging by postseason. Heading exposure within soccer players was not significantly associated with any outcome change.","limitations":"- Single-season follow-up limits detection of cumulative, long-term RHI effects.\n- Male-only sample restricts generalizability to female athletes.\n- Self-reported heading exposure is an imprecise measure of actual RHI dose.","practice_takeaway":"One season of youth soccer was not associated with detectable deficits in cognition or brain structure, but subtle biomarker signals (GFAP, NfL, tNAA) warrant monitoring. Clinicians and coaches should be aware that current evidence supports continued play while underscoring the need for longer-term surveillance studies before drawing firm safety conclusions."}},{"doi":"10.1001/jamaneurol.2026.2112","pmid":"42268636","title":"Neurological Manifestations in Adult Survivors of Ebola Virus Disease","journal_title":"JAMA Neurology","journal_issn":"2168-6149","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1001/jamaneurol.2026.2112","source_score":48,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-14T13:34:43.826Z","updated_at":"2026-06-14T13:34:43.826Z","tags":[{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"condition","value":"Cognitive Dysfunction","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"condition","value":"Ebola Virus Disease","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"condition","value":"Post-Infectious Neurological Sequelae","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"sample_size","value":"n=229","value_numeric":229},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"warning","value":"The 'impact_flag' of practice_changing reflects the novel 7-year longitudinal data on EVD neurological sequelae, but no specific treatment intervention was tested; the takeaway is about surveillance, not therapy.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"warning","value":"The neurological examination scoring system (general neurological examination score and CNS score) was developed de novo for this study and has not been externally validated — comparisons with other cohorts should be made cautiously.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.2112","tag_type":"warning","value":"Total sample size of n=229 represents survivors + contacts combined; survivor-only N=148 and contact-only N=81.","value_numeric":null}],"summaries":{"what_studied":"Prospective longitudinal cohort study (PREVAIL III Neurology Study) in Liberia comparing neurological sequelae in 148 Ebola antibody-positive adult survivors vs. 81 antibody-negative contacts over more than 7 years (September 2015–March 2023), with biannual neurologist evaluations.","key_result":"Survivors had significantly higher rates of neurological sequelae than controls, including persistent headaches (66.2%), cognitive dysfunction (56.1%), depression (49.3%), and fatigue (51.1%). At final visit, memory loss (57.4% vs. 26.2%, P<.001), irritability (36.5% vs. 14.8%, P=.006), and trouble concentrating (29.6% vs. 9.8%, P=.002) remained significantly more common in survivors. Most neurological findings improved over 7 years, but some persisted long-term.","limitations":"Single-site study in Liberia may limit generalizability to other EVD outbreaks or settings. Relatively small sample size (148 survivors, 81 contacts). Neurological examination scoring system was developed specifically for this study and has not been externally validated.","practice_takeaway":"EVD survivors face a broad, long-lasting neurological burden — cognitive symptoms, headache, and mood disturbances can persist for years. Clinicians caring for EVD survivors should incorporate structured, long-term neurological follow-up into post-discharge care plans."}},{"doi":"10.1177/13872877261453034","pmid":"42199011","title":"Peripheral immune and vascular inflammatory signatures precede Alzheimer's disease onset: A serum proteomic study","journal_title":"Journal of Alzheimer’s Disease","journal_issn":"1387-2877","published_at":"2026-05-27T00:00:00.000Z","url":"https://doi.org/10.1177/13872877261453034","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-08T13:46:50.545Z","updated_at":"2026-06-08T13:46:50.545Z","tags":[{"paper_doi":"10.1177/13872877261453034","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"category","value":"Neurosciences","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"condition","value":"Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"condition","value":"Neuroinflammation","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"modality","value":"Serum Proteomics","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"warning","value":"Machine learning model instability (wide confidence intervals) limits conclusions about the discriminative serum protein subset.","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"warning","value":"No individual proteins reached FDR-corrected significance; pathway-level findings should be interpreted as hypothesis-generating only.","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"warning","value":"Sample size is not reported in the abstract; tags and summary reflect an unknown N.","value_numeric":null},{"paper_doi":"10.1177/13872877261453034","tag_type":"warning","value":"Sex breakdown of the study population is not reported in the abstract.","value_numeric":null}],"summaries":{"what_studied":"Baseline serum proteomic profiles from cognitively normal older adults in a population-based longitudinal cohort were analyzed to identify systemic immune and vascular changes preceding incident Alzheimer's disease over up to 5 years of follow-up.","key_result":"No individual proteins reached FDR-corrected significance, but pathway-level analyses showed downregulation of immune resolution, Fc receptor-mediated phagocytosis, endosomal trafficking, and vascular repair pathways, alongside upregulation of neutrophil activation and NET formation; a sparse ML model could partially discriminate future converters, though with wide confidence intervals.","limitations":"No individual biomarker reached FDR-corrected significance, limiting actionable single-protein findings; ML model confidence intervals indicated limited stability and generalizability; the study does not establish causality between peripheral immune changes and Alzheimer's disease onset.","practice_takeaway":"Systemic immune dysregulation and vascular inflammation may be detectable years before Alzheimer's disease onset, but no serum protein signature is yet ready for clinical use; these pathway-level findings can inform future biomarker and therapeutic target research."}},{"doi":"10.1177/10507256261454209","pmid":"42184216","title":"Prospective Evaluation of Follow-Up De-Escalation to Primary Care in Differentiated Thyroid Cancer with Excellent Response to Therapy","journal_title":"Thyroid®","journal_issn":"1050-7256","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1177/10507256261454209","source_score":11,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-30T13:22:50.983Z","updated_at":"2026-05-30T13:22:50.983Z","tags":[{"paper_doi":"10.1177/10507256261454209","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"condition","value":"Differentiated Thyroid Carcinoma","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"generic","value":"levothyroxine","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"modality","value":"Radioiodine Ablation","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"modality","value":"Thyroid Hormone Replacement","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"modality","value":"Total Thyroidectomy","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"sample_size","value":"n=154","value_numeric":154},{"paper_doi":"10.1177/10507256261454209","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"warning","value":"Age distribution of the cohort is not explicitly reported; 'adult' age group is inferred from study context.","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"warning","value":"Impact flag 'practice_changing' assigned because the study provides the first prospective evidence supporting discharge to primary care in DTC with excellent response, which directly challenges current specialist-led follow-up norms.","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"warning","value":"The patient-reported outcomes tool is study-specific and not validated, limiting interpretation of fear-of-recurrence data.","value_numeric":null},{"paper_doi":"10.1177/10507256261454209","tag_type":"warning","value":"The study is single-center and lacks a randomized comparator arm; generalizability may be limited.","value_numeric":null}],"summaries":{"what_studied":"This longitudinal cohort study prospectively evaluated 154 adults with differentiated thyroid carcinoma (DTC) who completed ≥5 years of specialist follow-up and were discharged to primary care (PC) after achieving an excellent response (ER) to therapy (total thyroidectomy ± radioiodine). A standardized reassessment was performed ≥5 years after discharge (mean 70.3 ± 10.6 months).","key_result":"Zero biochemical or structural recurrences were observed after discharge to PC. ER rates rose from 76.6% at 6 months to 96.1% at post-discharge reassessment. No patient deteriorated from ER; all non-ER findings at reassessment were confined to the 9 patients already classified as indeterminate at discharge. Despite this, 42.9% reported high fear of recurrence and 91.6% preferred continued specialist follow-up.","limitations":"- Single-center prospective cohort without a control arm, limiting causal inference.\n- A small subset (n=9) was discharged with an indeterminate response based on clinical judgment, introducing selection bias.\n- Patient-reported outcomes used a non-validated, study-specific questionnaire.","practice_takeaway":"DTC patients who achieve an excellent response after ≥5 years of specialist follow-up can be safely transitioned to primary care, where low-intensity surveillance (TSH monitoring and levothyroxine management) appears sufficient. Clinicians should proactively address fear of recurrence, as nearly half of patients reported high anxiety despite excellent outcomes."}},{"doi":"10.1038/s41390-026-05002-7","pmid":"42070008","title":"Pediatric SARS-CoV-2 outcomes study (PECOS): 12-month longitudinal analysis of post-COVID symptoms in infected versus uninfected participants","journal_title":"Pediatric Research","journal_issn":"0031-3998","published_at":"2026-05-03T00:00:00.000Z","url":"https://doi.org/10.1038/s41390-026-05002-7","source_score":49,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-07","doi":"10.1038/s41390-026-05002-7","days":"7","issn":"0031-3998","rank":"3","field":"Clinical Medicine","score":"49","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1038/s41390-026-05002-7","title":"Pediatric SARS-CoV-2 outcomes study (PECOS): 12-month longitudinal analysis of post-COVID symptoms in infected versus uninfected participants.","journal":"Pediatric research","methods":"","results":"852 participants (705 infected, 147 uninfected) completed baseline visits. Of those, 558 infected subjects completed a 12-month post-enrollment visit. Twenty symptoms were identified as more common in infected participants compared to uninfected, at either baseline or 12-months, with symptoms varying by age. Some symptoms in the infected were more frequent at baseline (e.g. fever, weight loss), whereas many symptoms persisted through 12-months. Several symptoms were more frequent at 12-months (e.g. dysmenorrhea, persistent headache). Presence of symptoms at 12-months was not significantly associated with the wave of circulating virus at original infection.","abstract":"$30","keywords":[],"pubmed_id":"42070008","conclusions":"","publication_date":"2026-05-03T00:00:00"},"crossref":{"DOI":"10.1038/s41390-026-05002-7","URL":"https://doi.org/10.1038/s41390-026-05002-7","ISSN":["0031-3998","1530-0447"],"link":[{"URL":"https://www.nature.com/articles/s41390-026-05002-7.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41390-026-05002-7","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://www.nature.com/articles/s41390-026-05002-7.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Pediatric SARS-CoV-2 outcomes study (PECOS): 12-month longitudinal analysis of post-COVID symptoms in infected versus uninfected participants"],"author":[{"given":"Gina A.","family":"Montealegre Sanchez","sequence":"first","affiliation":[]},{"given":"Alexandra B.","family":"Yonts","sequence":"additional","affiliation":[]},{"given":"Allyson","family":"Mateja","sequence":"additional","affiliation":[]},{"given":"Lauren E.","family":"Arrigoni","sequence":"additional","affiliation":[]},{"given":"Max T.","family":"Wolff","sequence":"additional","affiliation":[]},{"given":"Mallory C.","family":"Barrix","sequence":"additional","affiliation":[]},{"given":"Shera","family":"Weyers","sequence":"additional","affiliation":[]},{"given":"Maureen A.","family":"Edu","sequence":"additional","affiliation":[]},{"given":"Rachel L.","family":"Falik","sequence":"additional","affiliation":[]},{"given":"Monika L.","family":"Geslak","sequence":"additional","affiliation":[]},{"given":"Marcin","family":"Gierdalski","sequence":"additional","affiliation":[]},{"given":"Saira R.","family":"Huq","sequence":"additional","affiliation":[]},{"given":"Luigi D.","family":"Notarangelo","sequence":"additional","affiliation":[]},{"given":"James E.","family":"Bost","sequence":"additional","affiliation":[]},{"given":"C. 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Some symptoms (e.g., fever, weight loss) peaked at baseline; others (e.g., dysmenorrhea, persistent headache) were more frequent at 12 months. GI symptoms were prominent. Symptom burden at 12 months was not linked to the COVID-19 variant wave at time of infection. 558 of 705 infected participants completed the 12-month visit.","limitations":"- Only 558/705 (79%) infected participants completed the 12-month visit, raising risk of attrition bias.\n- Uninfected cohort was substantially smaller (n=147) and may not be fully comparable to the infected group.\n- This is an interim 1-year analysis; longer-term trajectories (up to 3 years) are still pending.","practice_takeaway":"Clinicians should screen children after SARS-CoV-2 infection for a broad range of symptoms—including GI complaints, persistent headache, and menstrual irregularities—as these can persist or even emerge at 12 months post-infection. Symptom type varies meaningfully by age, so assessments should be age-tailored."}},{"doi":"10.1016/j.brat.2026.105049","pmid":"42019098","title":"The association of short-term variability in suicidal ideation with subsequent suicidal thoughts and behaviours: Longitudinal cohort study","journal_title":"Behaviour Research and Therapy","journal_issn":"0005-7967","published_at":"2026-04-20T00:00:00.000Z","url":"https://doi.org/10.1016/j.brat.2026.105049","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:44.842Z","updated_at":"2026-05-08T13:23:44.842Z","tags":[{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Self-Harm","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"condition","value":"Suicide Attempt","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"sample_size","value":"n=831","value_numeric":831},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"Level of evidence is assigned as 2 (prospective cohort), but no randomised intervention was tested; this reflects the observational prognostic design.","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"The impact flag 'practice_changing' is applied cautiously — the study challenges the clinical utility of frequent SI monitoring, but this is a single cohort study and replication in acute/clinical settings is needed before changing monitoring protocols.","value_numeric":null},{"paper_doi":"10.1016/j.brat.2026.105049","tag_type":"warning","value":"The paper is dated April 2026 and references a 3-year prospective cohort (LifeTrack); only 12-month outcome data are reported here — longer-term predictive analyses may follow.","value_numeric":null}],"summaries":{"what_studied":"This prospective longitudinal cohort study (LifeTrack, n=831 adults with suicidal ideation, 66% women) examined whether short-term intraindividual variability in suicidal ideation — measured via daily assessments over 7 days — predicted suicide attempt, self-harm, and suicidal ideation severity over 12 months.","key_result":"Four SI trajectories were identified: low stable (55%), low increasing (7%), high stable (27%), and high decreasing (11%). Trajectories did not significantly predict suicide attempts (p=0.51); variability showed only a modest association with subsequent attempts (p=0.03) but explained minimal variance beyond baseline ideation severity, with no consistent link to self-harm or SI at 12 months.","limitations":"- Study relied on 7-day daily assessments to capture variability, which may not reflect longer-term fluctuation patterns.\n- The association between variability and suicide attempts, while statistically significant (p=0.03), explained minimal additional variance, limiting clinical interpretability.\n- The sample was drawn from a population-based cohort and may not generalise to acute clinical or inpatient settings.","practice_takeaway":"Frequent repeated measurement of suicidal ideation variability appears to add little predictive value beyond baseline ideation severity, suggesting intensive monitoring protocols may not improve risk stratification. Clinicians should instead prioritise addressing depression, distress, perceived burdensomeness, and social connection in patients with suicidal thoughts."}},{"doi":"10.1111/all.70342","pmid":"41998808","title":"Biphasic Effects on Allergen‐Specific Type 2 Memory B Cells Over 18 Months Sublingual Immunotherapy for House Dust Mite Allergy","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-04-17T00:00:00.000Z","url":"https://doi.org/10.1111/all.70342","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-10T13:20:43.885Z","updated_at":"2026-05-10T13:20:43.885Z","tags":[{"paper_doi":"10.1111/all.70342","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"condition","value":"House Dust Mite Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"generic","value":"house dust mite sublingual immunotherapy","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"modality","value":"Allergen Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"modality","value":"Sublingual Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"study_design","value":"Prospective Longitudinal Cohort Study","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"warning","value":"Age group defaulted to 'adult' based on context; the paper does not explicitly state the population's age range.","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"warning","value":"Sample size (total N) is not stated in the abstract or results sections; the sample_size tag could not be populated.","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"warning","value":"Study design is observational/longitudinal with a comparator group, but randomization is not confirmed — design label may warrant verification against full text.","value_numeric":null},{"paper_doi":"10.1111/all.70342","tag_type":"warning","value":"The specific HDM-SLIT product/brand used is not named in the abstract.","value_numeric":null}],"summaries":{"what_studied":"Longitudinal study of allergen-specific Type 2 memory B cells (Bmem) in HDM-allergic patients over 18 months, comparing those receiving sublingual HDM allergen immunotherapy (SLIT) vs. no AIT, with assessments at 0, 4, 12, and 18 months.","key_result":"SLIT produced clinical improvement (reduced medication use, improved lung function) alongside a **biphasic Bmem response**: allergen-specific Type 2 Bmem expanded with CD29 and IgG4 upregulation at 4 and 12 months, then declined at 18 months — the same timepoint associated with durable unresponsiveness.","limitations":"- Sample size and exact patient numbers are not reported in the abstract, limiting precision of effect estimates.\n- Observational/longitudinal design without randomization; confounding cannot be excluded.\n- Mechanistic causality between Type 2 Bmem deletion and clinical remission is inferred, not proven.","practice_takeaway":"Clinicians should counsel HDM-allergic patients that meaningful immunologic remodeling — specifically loss of pathogenic Type 2 memory B cells — may require a full **18 months** of SLIT before durable benefit is achieved. Strategies that accelerate Type 2 Bmem deletion could be a future target to shorten treatment duration."}},{"doi":"10.1210/clinem/dgag086","pmid":"41955216","title":"Steroids, stress, and body mass index interact to accelerate female pubertal development","journal_title":"The Journal of Clinical Endocrinology & Metabolism","journal_issn":"0021-972X","published_at":"2026-04-09T00:00:00.000Z","url":"https://doi.org/10.1210/clinem/dgag086","source_score":116,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-04-14","doi":"10.1210/clinem/dgag086","days":"30","issn":"0021-972X","rank":"8","field":"Clinical Medicine","score":"116","category":"Endocrinology & Metabolism","categories":["Endocrinology & Metabolism"],"_categories":["Endocrinology & Metabolism"]},"pubmed":{"doi":"10.1210/clinem/dgag086","title":"Steroids, stress, and body mass index interact to accelerate female pubertal development.","journal":"The Journal of clinical endocrinology and metabolism","methods":"","results":"Accelerated thelarche was associated with higher prepubertal urinary metabolites of glucocorticoids (HR = 1.9, 95% CI: 1.5-2.5), androgens (HR = 3.9, 95% CI: 2.7-5.6), and progesterone (HR = 6.7, 95% CI: 4.1-10.9). Girls with high glucocorticoid metabolites combined with high BMI and stress reached thelarche 7 months earlier than their counterparts with low measures in these parameters.","abstract":"$31","keywords":["BMI","breast cancer","puberty","steroid","stress"],"pubmed_id":"41955216","conclusions":"Elevated metabolites of glucocorticoids, androgens, and progesterone are associated with accelerated pubertal onset, and BMI and stress modify this association. Previous studies have focused on estrogens, menarche, and BMI; our results suggest that androgens and stress impact the timing of thelarche as well, explaining secular declines in pubertal timing.","publication_date":"2026-04-09T00:00:00"},"crossref":{"DOI":"10.1210/clinem/dgag086","URL":"https://doi.org/10.1210/clinem/dgag086","ISSN":["0021-972X","1945-7197"],"link":[{"URL":"https://academic.oup.com/jcem/advance-article-pdf/doi/10.1210/clinem/dgag086/67933895/dgag086.pdf","content-type":"application/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https://academic.oup.com/jcem/advance-article-pdf/doi/10.1210/clinem/dgag086/67933895/dgag086.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Steroids, stress, and body mass index interact to accelerate female pubertal development"],"author":[{"given":"Lauren C","family":"Houghton","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health , NewYork, NY 10032 ,"},{"name":"Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center , NewYork, NY 10032 ,"}]},{"given":"Eva","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health , NewYork, NY 10032 ,"}]},{"given":"Ying","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Columbia University Mailman School of Public Health , NewYork, NY 10032 ,"}]},{"given":"Stefan A","family":"Wudy","sequence":"additional","affiliation":[{"name":"Steroid Research and Mass Spectrometry Unit, Laboratory of Translational Hormone Analytics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University , Giessen 35392 ,"}]},{"given":"Michaela F","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Steroid Research and Mass Spectrometry Unit, Laboratory of Translational Hormone Analytics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University , Giessen 35392 ,"}]},{"given":"Frank","family":"Stanczyk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California , Los Angeles, CA 90033 ,"}]},{"given":"Julia A","family":"Knight","sequence":"additional","affiliation":[{"name":"Sinai Health, Lunenfeld-Tanenbaum Research Institute , Toronto, ON M5G 1X5 ,"},{"name":"Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto , Toronto, ON M5S 3E3 ,"}]},{"given":"Irene L","family":"Andrulis","sequence":"additional","affiliation":[{"name":"Sinai Health, Lunenfeld-Tanenbaum Research Institute , Toronto, ON M5G 1X5 ,"},{"name":"Department of Molecular Genetics, University of Toronto , Toronto, ON M5S 3K3 ,"}]},{"given":"Angela R","family":"Bradbury","sequence":"additional","affiliation":[{"name":"Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104 ,"},{"name":"Departments of Medicine, Hematology/Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19106 ,"}]},{"given":"Lisa","family":"Schwartz","sequence":"additional","affiliation":[{"name":"The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104 ,"}]},{"given":"Saundra S","family":"Buys","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Utah Health Sciences Center, Huntsman Cancer Institute , Salt Lake City, UT 84112 ,"}]},{"given":"Mary B","family":"Daly","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Fox Chase Cancer Center , Philadelphia, PA 19111 ,"}]},{"given":"Esther M","family":"John","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology and Population Health and of Medicine (Oncology) and Stanford Cancer Institute, Stanford University School of Medicine , Stanford, CA 94305 ,"}]},{"given":"Wendy K","family":"Chung","sequence":"additional","affiliation":[{"name":"Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center , NewYork, NY 10032 ,"},{"name":"Departments of Pediatrics and Medicine, Columbia University Medical Center , New York, NY 10032 ,"},{"name":"Department of Pediatrics, Boston Children's Hospital and Harvard Medical School , Boston, MA 02115, USA"}]},{"given":"Regina M","family":"Santella","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences, Columbia University Mailman School of Public Health , NewYork, NY 10032 ,"}]},{"given":"Russell D","family":"Romeo","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Behavior, Barnard College of Columbia University , NewYork, NY 10027 ,"}]},{"given":"Mary Beth","family":"Terry","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health , NewYork, NY 10032 ,"},{"name":"Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center , NewYork, NY 10032 ,"},{"name":"Silent Spring Institute , Newton, MA 02460 ,"}]}],"funder":[{"id":[{"id":"10.13039/501100021671","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/501100021671","name":"National Cancer Institute","award":["5K07CA21816603"],"award-info":[{"award-number":["5K07CA21816603"]}],"doi-asserted-by":"publisher"},{"id":[{"id":"10.13039/501100021671","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/501100021671","name":"National Cancer 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metabolites (glucocorticoids, androgens, progesterone, estrogens) interact with BMI z-scores and internalizing stress scores to affect timing of thelarche, pubarche, and menarche in 327 girls aged 5–13 at baseline.","key_result":"Higher prepubertal glucocorticoid metabolites (HR 1.9, 95% CI 1.5–2.5), androgen metabolites (HR 3.9, 95% CI 2.7–5.6), and progesterone metabolites (HR 6.7, 95% CI 4.1–10.9) each independently predicted earlier thelarche. Girls with high glucocorticoids, high BMI, and high stress reached thelarche **7 months earlier** than peers with low levels across all three measures.","limitations":"Thelarche onset was primarily parent-reported (not clinician-assessed for the full cohort), introducing potential recall or observation bias. The study is observational, limiting causal inference. The sample was drawn from a single longitudinal cohort, which may limit generalizability.","practice_takeaway":"Clinicians evaluating early puberty in girls should consider not just BMI and estrogen status, but also stress burden and androgen/glucocorticoid activity — especially in girls with high BMI and signs of chronic stress, who may reach breast development 7 months earlier. 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