Study shows people overestimate hill steepness based on their eye level

People’s perceptions of the world are easily impacted by the angle at which they view objects in it, suggests a new study.

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Did you walk or cycle to school as a child? Your children are likely to follow in your footsteps

If you used physically active modes of commuting to school, your children are likely to do the same. A study published in the European Journal of Public Health by the University of Jyväskylä, Finland, reveals an intergenerational link between parents’ and their children’s school commuting habits. The researchers emphasize that active commuting to school is a simple and practical way to incorporate more physical activity into daily life.

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User-friendly tool streamlines transcriptomic data analysis for precision medicine applications

The Barcelona Institute for Global Health (ISGlobal) has launched HTGAnalyzer, a new, easy-to-use, fast and reproducible bioinformatics tool for advanced transcriptomic data analysis. Designed within the R statistical environment, this package simplifies complex analytical processes, making them accessible to professionals without specific expertise in bioinformatics.

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Report ties to child mental health crisis to immigration enforcement

Aggressive immigration practices—such as detention, deportation, and workplace raids—are contributing to widespread emotional trauma among both immigrant and U.S.-born children living in mixed-status households, according to a report published by a team of mental health professionals in the School of Medicine at the University of California, Riverside.

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CGM Metrics Strongly Predict 5-Year Mortality Risk in Diabetes, Study Shows

USA: A new long-term analysis published in Diabetes Care has highlighted the potential of continuous glucose monitoring (CGM) metrics to predict the risk of death among individuals with type 1 or type 2 diabetes. The study, led by Tomoki Okuno from the Department of Biostatistics at the University of California, Los Angeles, in collaboration with colleagues, suggests that CGM data may provide a more nuanced assessment of risk than traditional HbA1c measurements.

The research examined 2,752 adults aged 21 years or older with diabetes, 65% of whom had type 2 diabetes, from the Veterans Affairs Healthcare System. All participants had used Dexcom CGM devices between 2015 and 2020 and had at least 10 days of CGM data within landmark periods of 14 days, three months, or six months. These glucose readings were linked with electronic health records, and participants were followed for up to five years from the start of CGM use to assess all-cause mortality.

At the time of CGM initiation, the average age of participants was 64 years, and the median duration of CGM use was almost three years. Over the follow-up period, 407 participants died. The analysis evaluated multiple CGM-derived metrics—mean glucose (MG), time in range (TIR), time above range (TAR), coefficient of variation (CV), and glycemic risk index (GRI)—using multivariable Cox models adjusted for known mortality risk factors.

The study led to the following findings:

  • Higher mean glucose (MG), time above range (TAR), coefficient of variation (CV), and glycemic risk index (GRI) during the six-month observation period were significantly associated with an increased risk of death over the following five years.
  • Spending more time in the target glucose range (TIR) was linked to a lower mortality risk.
  • Hazard ratios were MG (1.18), TAR (1.20), CV (1.18), GRI (1.23), and TIR (0.83), all with P-values ≤ 0.01.
  • These associations remained significant even after adjusting for HbA1c levels recorded during the same period.
  • The link between glucose variability (CV) and mortality persisted independently of other CGM metrics, with the strongest association seen in individuals with lower HbA1c levels.
  • Similar associations were observed with shorter CGM observation periods, supporting the consistency of the results.

The researchers noted that while HbA1c remains a cornerstone in diabetes management, it provides an average glucose estimate and does not reflect fluctuations or the duration of hypo- and hyperglycemic episodes. CGM-derived data, on the other hand, offer a more dynamic picture of glycemic control, potentially enabling clinicians to identify high-risk individuals who might be missed using HbA1c alone.

Overall, the study emphasizes the importance of incorporating CGM metrics—particularly mean glucose, time in range, and measures of glucose variability—into clinical practice for long-term risk assessment. The authors suggest that this approach could pave the way for more targeted interventions aimed at reducing mortality in people with diabetes.

Reference:

Tomoki Okuno, Sharon A. Macwan, Gregory J. Norman, Donald R. Miller, Peter D. Reaven, Jin J. Zhou; Continuous Glucose Monitoring Metrics Predict All-Cause Mortality in Diabetes: A Real-world Long-term Study. Diabetes Care 2025; dc250716. https://doi.org/10.2337/dc25-0716

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SGLT2 Inhibitors Fail to Impact MI Severity or Outcomes in T2DM Patients: Study

Germany: A retrospective cohort study has found that prior use of SGLT2 inhibitors in type 2 diabetes mellitus (T2DM) patients did not reduce myocardial infarction (MI) size or decrease adverse events during hospitalization for MI treated with percutaneous coronary intervention (PCI).

The study, published in BMC Cardiovascular Disorders by Istvan Bojti and colleagues from the Department of Cardiology and Angiology, University Heart Center Freiburg – Bad Krozingen, examined whether ongoing SGLT2 inhibitor therapy influences infarct size and short-term outcomes in T2DM patients experiencing MI.

The research included 681 patients with T2DM who were admitted for MI and underwent PCI between November 2015 and December 2023. Among them, 105 were on SGLT2 inhibitors, while 576 were using other glucose-lowering medications at admission. The primary parameter assessed was infarct size, measured using peak high-sensitive troponin T (hs-TnT) normalized to the endangered myocardial area (EMA).

The analysis revealed the following findings:

  • Analysis showed no significant difference in infarct size between patients on SGLT2 inhibitors and those using other glucose-lowering therapies.
  • Median high-sensitive troponin T (hs-TnT) levels were similar in both groups.
  • Adjusted statistical models indicated that ongoing SGLT2 inhibitor therapy was not associated with a reduction in MI size.
  • Evaluation of in-hospital secondary outcomes, including major adverse events and ICU stay duration, showed no significant benefit linked to SGLT2 inhibitor use.

The authors hypothesize that any potential protective effect of SGLT2 inhibitors may have been offset by more severe coexisting cardiovascular conditions and poorer glycemic control observed in the SGLT2 inhibitor group. They also noted that the evolving prescription patterns during the study period, especially following the positive outcomes of SGLT2 inhibitors in heart failure patients, may have resulted in a higher proportion of patients with advanced cardiovascular disease in the SGLT2 inhibitor cohort.

The study’s real-world design was highlighted as a strength, as it included patients with multiple comorbidities who are often excluded from randomized clinical trials, such as those with prior coronary artery bypass grafting, significant renal impairment, or those on insulin therapy. However, the authors acknowledged several limitations, including the study’s retrospective nature, the absence of data on therapy duration or adherence, and the lack of detailed diabetes-related complications that could influence outcomes. They also emphasized that the method used for estimating infarct size may not be as accurate as cardiac MRI, which is considered the gold standard.

The authors note that while the findings do not demonstrate a significant relationship between ongoing SGLT2 inhibitor therapy and reduced infarct size or adverse in-hospital outcomes, they recommend further prospective studies, ideally incorporating cardiac MRI and diverse patient populations.

“Such investigations are needed to clarify whether SGLT2 inhibitors exert any protective effects in the setting of myocardial infarction, both in patients with and without T2DM,” the researchers concluded.

Reference:

Bojti, I., Bojti, F., Hartikainen, T. et al. SGLT2-inhibition and myocardial infarction size in patients with type 2 diabetes mellitus– Insights from an acute cardiovascular care center. BMC Cardiovasc Disord 25, 566 (2025). https://doi.org/10.1186/s12872-025-04981-5

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DMARD Use and Rheumatoid Arthritis Raise Mortality in Bronchiectasis Patients: Study Shows

South Korea: A large-scale study from South Korea has found that individuals living with both bronchiectasis and rheumatoid arthritis face more than double the risk of death compared to those with bronchiectasis alone. The research, published in Therapeutic Advances in Respiratory Disease, also indicates that RA seropositivity and the use of disease-modifying anti-rheumatic drugs may further heighten this risk.  

The study, led by Dr. Hayoung Choi from the Division of Pulmonary, Allergy, and Critical Care Medicine at Hallym University Kangnam Sacred Heart Hospital, analysed data from the Korean National Health Insurance Service covering the years 2010 to 2017. It included 3,355 patients diagnosed with both bronchiectasis and RA — of whom 2,632 were seropositive and 723 were seronegative — and compared them with 16,240 age- and sex-matched individuals who had bronchiectasis but not RA. Participants were followed for a median period of 5.8 years, beginning one year after RA diagnosis or a corresponding index date for the control group.

The study revealed the following findings:

  • Patients with bronchiectasis–RA overlap syndrome (BROS) had a 2.09-fold higher mortality risk compared to those with bronchiectasis alone, even after adjusting for other health factors.
  • Mortality risk was 2.34 times higher in patients with seropositive RA and 1.29 times higher in those with seronegative RA, compared to the bronchiectasis-only group.
  • Individuals with seropositive RA showed a poorer prognosis, indicating that persistent systemic inflammation may play a major role in worsening lung health and speeding up disease progression in this population.
  • Use of disease-modifying anti-rheumatic drugs (DMARDs) was linked to higher mortality in patients with BROS.
  • Although causality was not established, DMARDs—by suppressing immune function—may heighten vulnerability to respiratory infections, a significant concern for people with bronchiectasis.

One of the major strengths of the study is its size, making it one of the most comprehensive investigations into the link between RA and bronchiectasis-related mortality. The authors also emphasise its novel exploration of both RA seropositivity and DMARD exposure. However, they acknowledge limitations, including the reliance on diagnostic codes, which may lead to over- or under-diagnosis, and the absence of detailed clinical data such as lung infection rates, hospitalisation history, microbiological findings, RA disease activity measures, or the presence of RA-associated interstitial lung disease. Additionally, the number of patients on DMARDs was relatively small, which restricted the analysis of drug-related outcomes.

The findings emphasize the need for careful monitoring and tailored treatment approaches for patients with both bronchiectasis and RA, particularly those who are seropositive. The study’s authors call for further research to clarify the role of DMARDs in this context and to develop strategies that can help reduce mortality and improve long-term outcomes for this high-risk group.

Reference:

Choi, H., Han, K., Jung, J. H., Soyza, A. D., Kim, H., Shin, D. W., & Lee, H. (2025). Impact of rheumatoid arthritis, seropositivity and disease-modifying anti-rheumatic drugs on mortality risk in bronchiectasis. Therapeutic Advances in Respiratory Disease. https://doi.org/10.1177_17534666251360071

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Low vitamin B12 levels associated with primary monosymptomatic nocturnal enuresis: Study

A new study published in the Journal of Pediatric Urology found that children who have low or borderline vitamin B12 levels are more prone to experience primary monosymptomatic nocturnal enuresis (PMNE).

Urinary control systems may be impacted by micronutrient deficits, especially those involving vitamin B12. The most prevalent voiding issue in the pediatric population is PMNE, which is defined as involuntary nighttime urination in children past the age at which bladder control would typically be expected. Over the past few decades, nocturnal enuresis has continued to be the subject of substantial scientific inquiry due to its high incidence. Despite much discussion, the etiology of PNE is still not fully known.

Although their precise functions in both healthy and diseased settings are not entirely understood, vitamin B12 and folate are crucial for the metabolism, growth, and maturation of the nervous system. Despite a great deal of study on PNE, there are still a lot of concerns about its precise pathogenesis. Thus, this study wanted to determine whether vitamin B12 insufficiency is a possible risk factor for the development of enuresis and to examine the association between children’s blood vitamin B12 levels and PMNE.

A total of 167 age- and sex-matched healthy controls and 184 children with enuresis, ages 5 to 15, were included in this prospective case-control research. Vitamin B12 levels, age, gender, and family history of enuresis were noted for each participant. Serum B12 levels were classified as “normal” (>300 pg/mL), “deficiency” (<200 pg/mL), and “borderline deficiency” (200-300 pg/mL). 

Almost, 12.5% of the enuresis group had a B12 shortage, 41.3% had a borderline deficiency, and 46.2% had normal levels. These rates were 9.6%, 29.3%, and 61.1% in the control group, respectively (p<0.05). Multivariate analysis revealed that PMNE was strongly correlated with B12 deficiency (OR: 2.05; 95% CI: 1.01-4.08; p=0.049) and family history of enuresis (OR: 8.62; 95% CI: 4.61-16.13; p<0.001).

Overall, these findings suggest a statistically significant correlation between PMNE and vitamin B12 levels. When compared to healthy controls, B12 deficiency or borderline B12 levels were more prevalent. In addition to a family history of enuresis, a B12 deficiency quadrupled the risk of PMNE. The inclusion of vitamin B12 evaluation in clinical judgment for kids with enuresis is supported by this data.

Reference:

Gülyüz, A. (2025). Relationship between serum vitamin B12 levels and primary monosymptomatic nocturnal enuresis: A prospective case-control study. Journal of Pediatric Urology. https://doi.org/10.1016/j.jpurol.2025.07.032

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Pain Meets Peace: Study Evaluates Dexmedetomidine in Chronic Pain with Anxiety and Depression

Chronic pain frequently coexists with anxiety and depression, complicating treatment outcomes and exacerbating patients’ suffering. Dexmedetomidine (DEX), a selective α2-adrenoreceptor agonist used primarily in perioperative settings, has shown promise in alleviating these co-occurring symptoms due to its analgesic and anxiolytic properties. However, its application in chronic pain patients who also suffer from anxiety and depression remains under-researched. To investigate this, a recent retrospective cohort study evaluated patients who received intravenous DEX during interventional pain management procedures.

The study enrolled 306 chronic pain patients who exhibited no less than mild symptoms of anxiety and depression, as assessed by the GAD-7 and PHQ-9 questionnaires. Participants were divided into two groups: those receiving DEX (n=106) and those undergoing local analgesia (LA) (n=184). Propensity score matching ensured balanced characteristics between the DEX and LA groups, facilitating a robust comparison of outcomes.

Results

The findings demonstrated that at one-month follow-up, DEX administration was associated with significantly greater reductions in anxiety (GAD-7 score reduced by -4.43 for DEX vs. -2.42 for LA) and depressive symptoms (PHQ-9 score reduced by -6.19 for DEX vs. -3.92 for LA). Pain relief was also greater in the DEX cohort (-3.32 vs. -2.62 based on the NRS), indicating DEX’s effectiveness in managing both physical and psychological distress. Patient satisfaction scores were notably higher in the DEX group, reflecting improvements in anxiety management and overall procedural experiences. Sensitivity analyses reinforced these findings, particularly among patients exhibiting both anxiety and depression, and indicated that approximately 18-32% of anxiety and depression improvements could be directly attributed to pain alleviation. Despite these promising results, limitations included the retrospective design, single-center scope, and short follow-up duration, which may affect generalizability and long-term efficacy assessment. The research suggests DEX may serve as a dual-purpose treatment for chronic pain patients with anxiety and depressive symptoms, acting independently on mood regulation beyond analgesic effects. However, further randomized controlled trials are necessary to confirm DEX’s effectiveness, explore neurobiological mechanisms, and determine optimal dosing strategies to enhance outcomes in varied patient populations. Such efforts could lead to integrated approaches in managing chronic pain alongside psychological comorbidities, optimizing therapeutic strategies for multifaceted patient needs.

Key Points

– A retrospective cohort study evaluated the effects of intravenous dexmedetomidine (DEX) in 306 chronic pain patients with mild to moderate symptoms of anxiety and depression, assessing its potential benefits beyond standard local analgesia (LA).

– Participants were divided into two groups: those receiving DEX (n=106) and those receiving LA (n=184), with propensity score matching applied to ensure comparability in demographics and clinical characteristics between the groups.

– Results at one-month follow-up indicated that DEX treatment produced significantly greater reductions in anxiety (GAD-7 score: -4.43 for DEX vs. -2.42 for LA) and depressive symptoms (PHQ-9 score: -6.19 for DEX vs. -3.92 for LA), highlighting DEX’s multifaceted role in managing pain and psychological distress.

– The DEX cohort reported greater pain relief measured by the Numeric Rating Scale (NRS) (-3.32 for DEX vs. -2.62 for LA), along with higher patient satisfaction scores, which emphasized the therapeutic value of DEX in enhancing patient experiences during procedural interventions.

– Sensitivity analyses confirmed the robustness of these findings, especially among patients with concomitant anxiety and depression, revealing that 18-32% of the improvements in anxiety and depression could be attributed to pain relief obtained from DEX treatment.

– Limitations of the study include its retrospective design, the single-center nature of the research, and the relatively short follow-up period, which may restrict the generalizability of the results and necessitate further randomized controlled trials to validate DEX’s efficacy and explore underlying mechanisms in diverse patient populations.

Reference –

Yiting Ren et al. (2025). Dexmedetomidine For Chronic Pain Patients With Anxiety And Depression: A Propensity Score Matching Cohort Study. *BMC Anesthesiology*, 25. https://doi.org/10.1186/s12871-025-03087-x.

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Evidence gaps remain for AI eye imaging devices approved for patient care

Regulator-approved AI models used in eye care vary widely in providing evidence for clinical performance and lack transparency about training data, including details of gender, age and ethnicity, according to a new review led by researchers at UCL (University College London) and Moorfields Eye Hospital.

The analysis, published in the journal npj Digital Medicine, examined 36 regulator-approved “artificial intelligence as a medical device” (AIaMD) tools in Europe, Australia and the US, and found concerning trends.

Of the devices reviewed, 19% had no published peer-reviewed data on accuracy or outcomes. In evaluating the available evidence for the remainder, the researchers found that across 131 clinical evaluations, only 52% of studies reported patient age, 51% reported sex, and only 21% reported ethnicity. The review also highlights that most validation used archival image sets, with limited diversity or inadequate reporting of basic demographic characteristics and uneven geographical distributions.

Very few studies compared the AI tools head-to-head with each other (8%) or with the standard of care of human doctors (22%). Strikingly, only 11 of the 131 studies (8%) were interventional – the kind that test devices in real-life clinical settings and affect clinical care. This means real-world validation is still scarce.

More than two-thirds of the AI tools target diabetic retinopathy in a screening context, either singly or together with glaucoma and macular degeneration, while other common sight-threatening conditions and settings remain largely unaddressed.

Almost all the devices examined (97%) are approved in the European Union, but only 22% have Australian clearance with just 8% are authorised in the U.S. This uneven regulatory landscape means devices cleared on one continent may not meet standards elsewhere.

The authors argue these shortcomings must be addressed. They call for rigorous, transparent evidence and data that meets the FAIR principles of Findability, Accessibility, Interoperability, and Reusability, since lack of transparency can hide biases.

Lead author Dr Ariel Ong (UCL Institute of Ophthalmology and Moorfields Eye Hospital NHS Foundation Trust) said: “AI has the potential to help fill the global gap in eye care. In many parts of the world, there simply aren’t enough eye specialists, leading to delayed diagnoses and preventable vision loss. AI screening could help identify disease earlier and support clinical management, but only if the AI is built on solid foundations.

“We must hold AI tools to the same high standards of evidence as any medical test or drug. Facilitating greater transparency from manufacturers, validation across diverse populations, and high-quality interventional studies with implementation-focused outcomes are key steps towards building user confidence and supporting clinical integration.”

Senior author Jeffry Hogg, from the University of Birmingham, said: “Our review found that the evidence available to evaluate the effectiveness of individual AIaMDs is extremely variable, with limited data on how these devices work in the real world. Greater emphasis should be placed on accurate and transparent reporting of datasets. This is critical to ensuring devices work equally well for all people, as some populations may be underrepresented in the training data.”

In practical terms, the study suggests several next steps. The authors encourage manufacturers and regulators to adopt standardised reporting – for example, publishing detailed “model cards” or trial results at each stage of development. They note that regulatory frameworks for AIaMDs may benefit from a more standardised approach to evidence reporting, which would give clarity to both device developers and end users. The review also highlights new guidance, such as the EU AI Act, that could raise the bar for data diversity and real-world trials.

The researchers hope their work will inform policymakers and industry leaders to ensure that AI in eye care is both equitable and effective. Robust oversight, they argue, will help deliver on the promise of faster, more accurate eye disease detection—without leaving any patient group behind.

Reference:

Ong, A.Y., Taribagil, P., Sevgi, M. et al. A scoping review of artificial intelligence as a medical device for ophthalmic image analysis in Europe, Australia and America. npj Digit. Med. 8, 323 (2025). https://doi.org/10.1038/s41746-025-01726-8

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