Aim: Population-level evidence linking animal protein supply with dementia incidence remains limited. This study examined global associations between national animal protein supply and dementia incidence within an ecological framework of nutritional and epidemiological transition.Materials & methods: Harmonized population-level data from the Food and Agriculture Organization of the United Nations statistical database (FAOSTAT), the Institute for Health Metrics and Evaluation (IHME), the World Bank, the World Health Organization (WHO) and United Nations data platforms were analyzed for up to 204 populations. Animal protein supply was examined in relation to total dementia incidence and female–male differences in dementia incidence using correlation analysis, partial correlation, polynomial modeling, principal component analysis, multivariable regression and stratified analyses by income, development and regional groupings.Results: Animal protein supply was positively associated with total dementia incidence. Associations were non-linear, with steeper increases at low-to-moderate supply levels and attenuation at the highest levels. Associations were stronger in low- and middle-income and developing settings than in high-income or developed contexts. Animal protein supply remained positively associated with female–male incidence differences after adjustment; independence from total incidence and mediation through it were not directly tested.Conclusion: Animal protein supply may operate as an ecological marker of nutritional and epidemiological transition rather than as an isolated dietary exposure. These findings support context-sensitive interpretation of diet–dementia associations in global cognitive ageing research.
Introduction Pregnancy-related physiologic and metabolic changes influence drug exposure and response. Yet therapeutic decisions often lack individualized biologic guidance. Obstetric pharmacometabolomics uses endogenous metabolic signatures to investigate and potentially predict and monitor drug response in pregnancy.Areas covered PubMed/MEDLINE and Google Scholar were searched from inception through October 12, 2026, using terms related to metabolomics, pharmacometabolomics, medication exposure, treatment response, maternal–placental-fetal metabolism, pharmacokinetics, pharmacodynamics, and obstetric medications. Human pregnancy studies, longitudinal investigations, drug-perturbation experiments, and mechanistic preclinical studies were prioritized. This review examines pregnancy-specific metabolic adaptations, analytical approaches, and potential applications involving aspirin, antihypertensives, antidiabetic therapies, antiretrovirals, antimicrobials, corticosteroids, and psychiatric medications. It also considers pharmacometabolic approaches to preeclampsia, gestational diabetes mellitus, preterm birth, fetal growth disorders, obesity, and HIV-associated pregnancy.Expert opinion Obstetric pharmacometabolomics offers a promising framework for individualized therapeutics, but clinical implementation requires longitudinal studies, standardized biospecimen collection, rigorous exposure assessment, validated biomarkers, and diverse populations. Integration with pharmacogenomics, pharmacomicrobiomics, pharmacoproteomics, and model-informed drug development can improve therapeutic precision, provided that clinical utility is demonstrated.
Aims: To evaluate postoperative C-reactive protein (CRP) for ruling out anastomotic leakage (AL) after digestive resection in a cohort including several anastomotic sites.Patients & methods: Prospective single-centre diagnostic accuracy study (STARD 2015) of 82 consecutive patients with an unprotected digestive anastomosis (January 2024–August 2025). CRP was measured on postoperative days (POD) 1, 3 and 5. No analysis was formally prespecified. The primary analysis excluded leaks diagnosed on or before POD 5; a strict analysis also excluded four leaks with an undated diagnosis.Results: AL occurred in 12 patients (14.6%). CRP discriminated on POD 3 (area under the curve [AUC] 0.83; 95% CI: 0.71–0.95) and POD 5 (AUC 0.88; 0.78–0.98) but not on POD 1 in the 71 patients with an available value (AUC 0.59). In the primary pre-diagnosis analysis (79 patients, 9 leaks), an exploratory, data-derived POD 5 cutoff of 127 mg/L had a sensitivity of 77.8% (40.0–97.2) and a negative predictive value of 96.4% (87.7–99.6); in the strict analysis (75 patients, 5 leaks), sensitivity was 80.0% and NPV 98.2%. In the full cohort, sensitivity was 83.3% (apparent) and 76.5% (optimism-corrected). Both false negatives followed gastric resection.Conclusion: A low POD 5 CRP makes AL unlikely, particularly after non-gastric resection, but these data-derived thresholds are exploratory, do not support any change in discharge practice and require external validation.
Aim This study aims to assess the efficacy of Virtual Reality (VR) during painful procedures and chemotherapy (CT) in reducing pain and anxiety for patients with hematologic malignancies.Materials and methods A crossover design with an external control group was carried out. Participants were assigned to two groups: an intervention group, with a crossover design (n patients/procedures = 112), where patients underwent the procedure with standard care only, followed by washout period, then underwent the same procedure with VR. An external control group (n patients = 94, n procedures = 101) was matched to the intervention group based on age and procedure type. Pain and anxiety were assessed subjectively before and after the procedure, with intra-individual and intergroups comparisons. Side effects were captured objectively.Results A total of 206 participants were included in this study, with a total of 213 invasive procedures. Anxiety and pain decreased more during VR period than the without VR period and external control group. VR was effective in anxiety and pain reduction during all procedure, except pain during CT (p > 0.05). Two side effects (1.8%) related to intervention were reported.Conclusion VR effectiveness was demonstrated in reducing pain and anxiety during painful procedures. It was effective in reducing anxiety during CT.Clinical trial registration [ClinicalTrials.gov] identifier is [NCT07085065]
Aims Translocase of Outer Mitochondrial Membrane 5 (TOMM5), a mitochondrial outer membrane translocase subunit implicated in tumorigenesis, remains unexplored in oral cancer. Herein, we aimed to decipher the role of TOMM5 in oral cancer.Methods This study comprehensively explored the expression profile, clinical significance, and functional roles of TOMM5 in oral carcinogenesis with global RNA-seq and microarray datasets. In vitro experiments were performed for evaluating the impact of TOMM5 knockdown on the biological functions of oral cancer cells. Distribution heterogeneity of TOMM5 expression and related cellular trajectory was analyzed through scRNA-seq. The therapeutic implications of TOMM5 for oral cancer were analyzed through drug sensitivity prediction and tumor immune dysfunction and exclusion (TIDE) scoring.Results TOMM5 was significantly overexpressed in oral cancer tissues and demonstrated moderate diagnostic accuracy. TOMM5 knockdown significantly suppressed aggressive biological behaviors of oral cancer cells. ScRNA-seq data revealed predominant TOMM5 expression in B cells, decreasing with differentiation, and linked distinct pathway activities to specific cellular compartments. High TOMM5 expression was linked to reduced immune cell infiltration and sensitivity to Paclitaxel/Vincristine.Conclusions Overexpressed TOMM5 shows potential as a biomarker in oral cancer, correlating with tumor progression and immune infiltration.
