Publications by Year: 2026

BACKGROUND & AIMS: Geography and ethnicity may influence disease phenotypic expression in the global emergence of inflammatory bowel disease (IBD). We performed this systematic review and meta-analysis to update the transethnic and migration impact on IBD epidemiology and phenotype.

METHODS: We included all population-based cohort data examining phenotype and/or outcomes of patients with Crohn's disease (CD) or ulcerative colitis (UC) published through December 2024. Pooled estimates of demographics, phenotypes, and outcomes across ethnic groups were compared across included cohorts. Within the cohort of those of Asian origin, we separately compared phenotype across different regions within Asia, and by immigrant status.

RESULTS: Our final analysis included a cohort of 237 population-based studies reporting outcomes of 1,251,682 patients with IBD. Among patients with CD, we observed higher rates of perianal disease (24%) in Asian individuals when compared with White individuals (14%) and those of Hispanic ethnicity (13%) (P < .01). On the contrary, no similar differences were observed in patients with UC. Among those of Asian descent, a family history of IBD was significantly more common among Middle Eastern individuals (12%) than South Asian individuals (3%) (P < .01) and was more notable among immigrants than native residents (12% vs 4%; P < .01). There were more males among Whites (51%) and Asians (60%), but females predominated in Blacks (55%, P < .01).

CONCLUSIONS: This global, transethnic meta-analysis revealed persistent differences in IBD phenotype and outcomes across ethnic groups. Future studies integrating multi-omic measurements in ethnically diverse populations are essential to elucidate the biologic basis of these variations.

PURPOSE: Traditional open approaches for matrix-induced chondrogenesis (AMIC®) carry significant morbidity risks. The purpose of this study is to evaluate the effectiveness of the as all-arthroscopic Autologous Matrix-Induced Chondrogenesis (AT-AMIC®) technique in treating osteochondral lesions of the talus (OLT), with a focus on mid-term functional outcomes and complications rates.

METHODS: In this retrospective, multicentric case series, we analyzed 64 patients (39 men, 25 women; age range, 18-71 years) with symptomatic OLTs, confirmed by Magnetic Resonance Imaging (MRI), who were treated with the AT-AMIC technique. The intervention included lesion debridement, subchondral bone microfracture, autologous cancellous bone grafting when needed, and the implantation of a porcine collagen bilayer matrix (Chondro-Gide®). Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, with a mean follow-up of 44 months (range, 31-62 months). Statistical analysis was performed using the Wilcoxon test, with the significance level set at 5% (p < 0.05).

RESULTS: The average size of the OLTs was 112 mm², with the most common location being Raikin zone 4 (54.68%). The average preoperative AOFAS score was 51.58, which significantly improved to 89.64 at the final follow-up (p < 0.0001). Seven patients (11%) experienced treatment failure due to complications such as membrane detachment, membrane hypertrophy, or recurrence of lesions. No significant correlation was found between lesion size or symptom duration and clinical outcomes.

CONCLUSION: The AT-AMIC® technique is a reproducible method of treatment for OLTs that resulted in a statistically strong clinical improvement in the mid-term. Further comparative studies are needed to confirm its long-term efficacy.

PURPOSE: To evaluate safety, hypertrophy, and kinetic growth rate (KGR) of future liver remnant following yttrium-90 radiation lobectomy (RL-90Y) in liver cancer using resin microspheres.

MATERIALS AND METHODS: This was a retrospective, single-center study. Patients with primary liver cancer who underwent RL-90Y transarterial radioembolization (TARE) from November 2015 to December 2022 were reviewed. Twenty-eight patients (68% with HCC and 36% with iCCA) were included. The right lobe was treated in 18 of 28 patients (64%). Single-compartment dosimetry model was used. Total liver parenchymal volume (TLPV), treated parenchymal volume, and future liver remnant volume (FLRV) were recorded at baseline and after treatment at 0-4 months (T1) and >4 months (T2). Hypertrophy, FLRV/TLPV ratio, and KGR were calculated. Treatment response was categorized by modified Response Evaluation Criteria in Solid Tumors (RECIST) for hepatocellular carcinoma (HCC) and RECIST for intrahepatic cholangiocarcinoma (iCCA). Primary outcomes included safety profile, hypertrophy, and KGR. Secondary outcomes included disease response and proportion of patients bridged to surgery.

RESULTS: The hypertrophy and KGR at T1 were 16% (interquartile range [IQR], 4%-28%) and 1.5% per week (IQR, 0.6%-2.3%) with increase in FLRV (P < .001) and FLRV/TLPV ratio (P < .001). KGR was higher at T1 than at T2 (1.3% vs 0.6%, P = .034). Treatment response (n = 27) was complete, partial, stable, and progressive in 53%, 24%, 6%, and 18% for HCC and 0%, 20%, 50%, and 30% for iCCA. Seven patients (25%) were bridged to resection at 2.5 months (IQR, 1.9-4.7 months). No differences were noted in atrophy, hypertrophy, and KGR at both time points (T1 and T2) when stratified on type of cancer, cirrhosis, portal vein thrombosis, or prescribed tumor dose.

CONCLUSIONS: RL-90Y TARE using single-compartment dosimetry with resin microspheres can safely be performed in patients with primary liver cancer with KGR of 1.5% per week.

BACKGROUND: Platelets amplify lung type 2 inflammation (T2I), but the underlying mechanisms remain incompletely understood.

OBJECTIVE: We elucidated the platelet-driven T2I mechanisms, particularly the role of platelet-derived leukotriene C4 (LTC4).

METHODS: We assessed lung T2I to Alternaria alternata extract in vivo using mice with targeted deletions of Ltc4s in platelets, macrophages (Macs), or mast cells (MCs); Il33 in Macs, hematopoietic cells, or alveolar type 2 (AT2) cells; and cysteinyl leukotriene receptors. Exogenous administration of LTC4 and IL-33 in naïve mice complemented the genetic models. Sex- and age-matched mice were randomly assigned, and histopathologic evaluations were performed under blinded conditions.

RESULTS: Platelets promoted IL-33 expression in perivascular Macs and induced transcellular LTC4 synthesis. Although platelet Ltc4s was not needed to induce IL-33+ Macs, it promoted both IL-33+ AT2 cell and group 2 innate lymphoid cell expansions in a sex-biased manner. Platelet depletion abrogated A alternata-induced increases in IL-33 and AT2 cell expansion. Platelet-adherent Macs expressed higher IL-33 than no-adherent counterparts. Platelet-specific Ltc4s deletion reduced eosinophil, group 2 innate lymphoid cell, and AT2 cell expansion in female animals in a delayed manner. Mac-specific Il33 deletion eliminated platelet-driven IL-33 increases and attenuated AT2 cell expansion selectively in female animals. Exogenous LTC4 and IL-33 synergistically induced IL-33+ Macs and expanded AT2 cells.

CONCLUSION: Adherent platelets rapidly upregulate IL-33-expressing Macs, and platelet-derived LTC4 sustains IL-33-driven expansion of AT2 cells and group 2 innate lymphoid cells, driving sex-biased amplification of T2I. This platelet-Mac axis may contribute to sex differences in type 2 inflammatory airway diseases such as asthma.

BACKGROUND: Suicide attempts in young people in India are a major public health concern but the reasons for these remain unclear. The aim of this study was to explore factors associated with suicide attempts in persons aged 15–29 years in India.

METHODS: We conducted a matched case–control study at a public hospital in the urban region of Pimpri-Chinchward, Pune, between 2019 and 2023. 15–29-year-olds who were admitted to the hospital following a suicide attempt (cases) were compared with 151 outpatients who presented at the general medicine department of the same hospital (controls). We administered a comprehensive semi-structured interview to participants in both groups and analysed the data using cox regression models.

RESULTS: There were eight factors independently associated with suicide attempts. At the individual-level, these were: clinically significant depressive or anxiety symptoms over the last two weeks, previous suicide attempt, impulsivity, and low SES; alcohol use was significant only for males. Among the social factors, lack of exposure to suicide-related information in the last month, lack of social interactions over the last 12 months, and presence of interpersonal negative life events involving partners or family in the last 12 months were associated with suicide attempts. Descriptive data on life events revealed several relationship adversities, and the importance of acute interpersonal stressors in precipitating suicide attempts.

CONCLUSION: A range of factors are associated with suicide attempts in young people in India which calls for a multifactorial approach towards suicide prevention.

CLINICAL TRIAL NUMBER: Not applicable.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07680-9.

OBJECTIVE: We describe the origin, program design, and evaluation activities of Partners in Contraception Choice and Knowledge (PICCK), a statewide contraceptive access and quality initiative in Massachusetts, United States from 2018 to 2023.

METHODS: PICCK primarily worked to improve contraceptive care at the state's birth hospitals and their affiliated outpatient practices using a champion model. In addition to hospital-level quality improvement activities, PICCK implemented statewide programming to engage audiences beyond the partnered sites, including a webinar series, annual conference, and resource development.

RESULTS: Champions at each hospital led coordination and implementation of customized programming for their site with support from PICCK staff. We conducted presentations and trainings by videoconference when in-person activities were restricted during the COVID-19 pandemic. Implementation periods ranged from 56 to 1323 days (average = 517.5 days). At the statewide level, we conducted 31 webinars, hosted three virtual annual conferences, and created 97 patient- and clinician-facing resources.

CONCLUSION: PICCK was innovative in our dual approach to implementation, with both hospital-based and statewide activities. The structure of PICCK could be adapted to implement other public health quality improvement programs in clinical settings or statewide, given the adaptability and broad reach of the program.

BACKGROUND: We aimed to conduct a qualitative prospective preference assessment (PPA) to assess participants’ willingness to enroll in a planned randomized controlled trial (RCT). The planned RCT would enroll participants with meniscal tear with persistent knee pain following a course of physical therapy (PT) and would compare outcomes of arthroscopic partial meniscectomy (APM) vs. enhanced conservative care.

METHODS: We identified participants 45–85 years old with suspected meniscal tear who were referred to PT. After 10 weeks of PT, participants were sent a questionnaire that assessed knee pain. We asked participants reporting persistent knee pain to participate in a follow-up interview. We conducted semi-structured interviews and coded and analyzed transcripts to identify themes related to enrollment in our planned RCT.

RESULTS: We analyzed transcripts from twenty participants (mean age (SD): 61.6 (6.16); 60% male, 100% White). 70% said they would participate in the trial. Willingness to enroll was associated with participants’ preferences for treatment modality and most were willing to continue PT, despite reporting persistent pain. Of those unwilling to enroll, all were averse to surgery or did not believe they needed surgery. Others had concerns about oral medications and injections, but these were not “dealbreakers” for willingness to enroll. Provider trust was a dominant decision-making factor in respondents’ willingness to enroll.

CONCLUSION: These findings suggest that investigators should consider additional education for participants regarding the benefits and risks of all treatment options at the time of enrollment invitation. Additionally, the trial should be introduced by a trusted provider.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-026-09521-6.

MOTIVATION: Genome-wide association studies (GWAS) at biobank scale are computationally intensive, especially for admixed populations requiring robust statistical models. SAIGE is a widely used method for generalized linear mixed-model GWAS but is limited by its CPU-based implementation, making phenome-wide association studies impractical for many research groups.

RESULTS: We developed SAIGE-GPU, a GPU-accelerated version of SAIGE that replaces CPU-intensive matrix operations with GPU-optimized kernels. The core innovation is distributing genetic relationship matrix calculations across GPUs and communication layers. Applied to 2068 phenotypes from 635 969 participants in the Million Veteran Program, including diverse and admixed populations, SAIGE-GPU achieved a 5-fold speedup in mixed model fitting on supercomputing infrastructure and cloud platforms. We further optimized the variant association testing step through multi-core and multi-trait parallelization. Deployed on Google Cloud Platform and Azure, the method provided substantial cost and time savings.

AVAILABILITY AND IMPLEMENTATION: Source code and binaries are available for download at https://github.com/saigegit/SAIGE/tree/SAIGE-GPU-1.3.3. A code snapshot is archived at Zenodo for reproducibility (DOI: [10.5281/zenodo.17642591]). SAIGE-GPU is available in a containerized format for use across HPC and cloud environments and is implemented in R/C++ and runs on Linux systems.