Antipsychotic-induced weight gain (AIWG) is a major clinical concern, affecting approximately 30% of patients. Clinical predictors explain only part of AIWG risk. Genetic and molecular variations are hypothesized to contribute to susceptibility. The purpose of this review is to summarize recent results to identify replicated and novel findings.

Applying PRISMA guidelines, we searched MEDLINE, Embase, and PsycINFO (May 2018-May 2026) for studies on genetic and molecular associations with AIWG, extending our prior review. Reviews, editorials, and conference abstracts were excluded. We extracted study characteristics (design, diagnosis, antipsychotic exposure, sample size, ancestry, genetic variants, and AIWG outcomes) (e.g., ≥7% weight gain, BMI change).

Fifty-three studies met inclusion criteria. In candidate gene studies, the most consistently replicated genes associated with AIWG were observed for DRD2, HTR2C, and MC4R. Multiple novel associations were identified by genome-wide association studies (GWAS) (e.g., MAP2K1, ZDBF2, PEPD), polygenic risk scores (PRS) (e.g., body mass index PRS), gene expression (e.g., CYP3A4, EP300), and epigenetic analyses (e.g., cg12034943 at CRTC1).

Polymorphisms in candidate genes related to neurotransmission and appetite regulation continue to be investigated for associations with AIWG, while novel findings have emerged from GWAS, gene expression, and epigenetic studies. Evidence remains inconsistent due to limited replication, methodological variability, sparse ancestry data, and geographical underrepresentation. No single genetic variant is ready for clinical use, and multi-omic and multi-ancestry models are needed to improve prediction and clinical utility.

To design a structured Return-to-Competition (RTC) protocol for judo athletes by adapting the 2023 Amsterdam International Consensus Statement on Concussion in Sport to judo-specific biomechanics and training demands.

We searched PubMed for English-language publications from January 1, 2010, to January 1, 2025 (search conducted February 1, 2025). Keywords included brain concussion, return to sport, martial arts, and judo. We identified additional sources by screening reference lists and retrieving consensus statements and federation protocols.

We integrated evidence on concussion recognition, acute assessment, and graded exertion with judo-specific technical demands to construct a staged RTC pathway. The protocol adapts general return-to-sport principles by introducing judo-specific substages progressing from symptom-limited activity and graded aerobic exercise to noncontact technical drills (tandoku-renshu) and structured reacquisition of key judo competencies, including breakfall skills (ukemi). Controlled partner drills (uchikomi) and sparring (randori) are reintroduced only after clinical recovery and symptom stability within defined progression and regression criteria (including symptom "flare" thresholds), with medical clearance required before full-contact training. The protocol was refined through consultation with a sports medicine physician experienced in judo.

This judo-specific RTC protocol translates international consensus recommendations into tatami-relevant stages with explicit progression criteria. Implementation provides clinicians and coaches with a structured framework that may reduce premature return-to-competition and recurrent injury risk in judo athletes. Prospective validation in judo settings is warranted.

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, with an overall survival now surpassing 90% in developed countries. However, treatments are not without adverse effects. In this study, we apply the severe toxicity-free survival (STFS) framework to determine the prevalence of 21 physician-defined severe toxicities following ALL treatment.

Retrospective cohort study.

(i) pediatric patients (0-18 years), (ii) treated for ALL at the Royal Children's Hospital, Melbourne, Australia, (iii) treated prior to December 2019, and (iv) >5 years since diagnosis (Dx).

(i) pediatric patients with ALL but did not receive treatment, (ii) <5 years since ALL Dx. Toxicity data were captured following review of the patients electronic medical record (EMR) using a list of 21 defined unacceptable toxicities.

We identified 345 patients who received primary ALL treatment at the Royal Children's Hospital, meeting the inclusion criteria of this study. The median age at Dx was 4 years (QR 3-9), and 161 patients (46.7%) were female. A total of 78 patients (22.6%) were identified as having a severe toxicity associated with their ALL treatment. The most common toxicities observed are mental health concerns (9.6%), osteonecrosis (6.7%), and paralytic, neuropathic, myopathic, and movement disorders (4.1%).

Our study reveals that 22.6% of patients with ALL experienced severe toxicities according to the STFS endpoint. The prominence of mental health concerns, osteonecrosis, and various movement disorders highlights the diverse nature of these toxicities. Given their severity and breadth, ongoing surveillance and intervention should be incorporated into standard care.

Subjective cognitive decline (SCD) is an at-risk condition for future cognitive decline, making its early identification crucial. We examined whether two widely used screening tools, the Addenbrooke's Cognitive Examination-Revised (ACE-R) and the Mini Mental State Examination (MMSE), can distinguish SCD individuals from healthy elderly (HS) and from individuals with objective cognitive impairment. 110 participants were recruited: 22 HS, 25 SCD, 31 amnestic mild cognitive impairment (aMCI), and 32 Alzheimer's disease (AD) patients. All participants underwent an extensive neuropsychological battery and the ACE-R, which incorporates the MMSE. Partial ACE-R (ACER_P) scores were derived. Between-group comparisons were performed and discriminant analyses were run to evaluate sensitivity, specificity, and accuracy of total ACE-R (ACER_TOT), ACER_P, and MMSE. Despite no screening test significantly distinguishing SCD from HS, a progressive downward trend emerged across groups, with AD performing worst, followed by aMCI, then SCD and HS. Discriminant analyses indicated ACER_TOT had the highest sensitivity for AD (84.4%), with overall accuracy of 59.1%. Sensitivity for HS (68.2%) and aMCI (51.6%) was good but weaker. ACER_P and MMSE yielded similar or lower accuracy. Importantly, all measures poorly detected SCD, with sensitivity below 30%, leading to frequent misclassification as HS or aMCI. Although ACE-R and MMSE are moderately effective for identifying AD, HS and aMCI, they fail to distinguish SCD from other groups. Given the higher risk of SCD of being in AD continuum, such misclassification may prevent appropriate clinical follow-up. More sensitive screening instruments are needed to capture subtle cognitive changes and support early intervention strategies.

Monoamine neurotransmitters, including catecholamines (i.e., norepinephrine, epinephrine, and dopamine), and the indolamine serotonin play important roles in signaling in the central and peripheral nervous systems. Alterations in neurotransmission may be suggestive of neuroendocrine or psychiatric disorders, may reflect therapeutic responses, and are often considered relevant to mental health. Monoamine modulators and their metabolites are detectable in saliva, suggesting that saliva could represent an attractive, non-invasive, and cost-effective matrix for identifying and monitoring conditions in both healthy and diseased individuals. Accordingly, measuring salivary monoamine neurotransmitters may have scientific and possible clinical relevance. In this review, we summarize and critically evaluate current evidence on salivary dopamine, norepinephrine, epinephrine, serotonin and their respective metabolites. Although further research is required to clarify their biological significance and clinical applicability, existing findings suggest that salivary monoamine measurement may hold potential, albeit with important limitations.

This study aimed to establish new morphometric reference values for the styloid process of the temporal bone, with particular emphasis on age- and sex-related differences and standardized 3-dimensional spatial orientation.

A retrospective analysis of CT angiographies of the supra-aortic vessels from 339 patients (678 styloid processes) was performed. Patient age and sex were documented. Measurements included styloid process length and diameter, angular orientation in 2 orthogonal planes, distance to the lesser horn of the hyoid bone, and ossification of the stylohyoid ligament. Statistical evaluation was conducted.

CT angiographies of 176 male (51.9%) and 163 female (48.1%) patients were analyzed. The mean styloid length was 26.1±10.4 mm (left) and 26.5±11.9 mm (right). Length increased with age in both sexes and was consistently greater in males. The mean anterior-posterior angle was 70.4°±5.63° (left) and 70.3°±5.9° (right); increasing length correlated with a decreasing AP angle, indicating medial displacement of the tip. The mean lateral angle was 64.2°±6.45° (left) and 64.2°±6.32° (right); increasing length correlated with increasing lateral angle, corresponding to dorsal displacement. The mean diameter measured 3.81±1.09 mm (left) and 3.87±1.16 mm (right), with age-related enlargement.

This study provides new morphometric reference values for the styloid process, demonstrating age-related elongation and thickening accompanied by dorsomedial deviation of the tip toward the adjacent neurovascular structures.In summary, CTA‑based morphometry of the stylohyoid complex provides a shared quantitative framework linking anatomical variation to clinical presentation in Eagle syndrome. Incorporating these standardized reference values into routine imaging reports may facilitate more consistent recognition of clinically relevant stylohyoid pathology and support targeted treatment decisions.

We present a novel framework (TS+TT) to nest a target study (TS) within a target trial (TT) for evaluating the effects of interventions on disparities. The target study component grounds the measurement of disparity in ethical assumptions, based on the concept of allowability, and anchors it to an explicit population within calendar time. It specifies an enrollment plan of stratified sampling of eligible persons to yield a sample where social groups are distributionally similar on covariates deemed allowable for measuring disparity. Within this enrolled sample, the target trial component specifies randomization of intervention strategies within each social group. Because social groups are similarly situated on allowable covariates at baseline, and because assigned intervention arms are exchangeable within social groups, TS+TT reflects a meaningful causal estimand for evaluating how interventions impact disparity. We describe the framework's key components, its emulation, and demonstrate its application to evaluate how hypothetical interventions on pulse oximeter bias affect disparities in treatment receipt in clinical care. We also extend semiparametric G-computation to accommodate continuous stochastic interventions and estimate counterfactual disparities in time-to-event outcomes. The TS+TT framework offers a versatile and policy-relevant approach for generating ethically informed causal evidence to reduce disparities and avoid exacerbating disparities.

Sleep health is associated with health-related quality of life (HRQOL) in the general population and may be a modifiable factor in entry-level Marines engaged in training. Entry-level Marines commonly experience pain during training and is a factor that affects both sleep and HRQOL. Since poor sleep health is deleterious to warfighter performance and operational readiness, identifying these relationships may help to inform the policies and practices needed to improve, prevent, and treat disordered sleep and pain. Therefore, the purpose of this research was to determine the relationship between sleep health, pain, and HRQOL in entry-level Marines and the moderating effects of pain on the relationship.

A cross-sectional analysis of data collected in a larger longitudinal study was performed. All participants completed a demographics and medical history form, the Pittsburgh Sleep Quality Index Questionnaire, the Defense and Veterans Pain Rating Scale, and the PROMIS Physical and Mental Health Short Form at enrollment. Separate multivariate regression models, one for each outcome (physical HRQOL and mental HRQOL), were performed. Each regression model included age and months of service as covariates. Partial eta-squared effect size estimates were calculated for each predictor.

A total of 785 entry-level Marines (73.4% male; mean age: 19.96 ± 2.39; mean months in service: 4.88 ± 3.13) were included in this analysis. The participants endorsed some degree of sleep difficulty (mean ± SD: 4.81 ± 2.85) and pain (mean ± SD: 0.82 ± 1.22). Greater sleep difficulty was associated with worse physical (B = -1.76, P < .001, ηp2 = .06) and mental HRQOL (B = -2.85, P < .001, ηp2 = .10). Although pain intensity did not moderate either relationship, pain interference emerged as a moderating variable between sleep health and HRQOL. Entry-level Marines who had greater pain interference and sleep difficulty had worse physical (B = -0.50, P = .03, ηp2 = .01) and mental HRQOL (B = -0.65, P = .03, ηp2 = .01).

These results suggest that early education related to sleep health and pain interference are mechanisms to enhance both physical and mental HRQOL in entry-level Marines.

Left-truncation is an unrecorded interval between multiple sclerosis (MS) onset and initial data in observational studies. This delay may bias estimates of disease-modifying therapy (DMT) effectiveness, especially when determined by patient or disease characteristics.

To examine whether causal effect estimates of DMTs over the full disease course can be reliably derived from left-truncated registry data.

We analysed data from MSBase (144 centres, 41 countries) to assess the impact of left-truncation on causal treatment effect estimates. Cox marginal structural models (MSMs) estimated hazard ratios (HRs) for relapses, disability worsening and improvement, considering left-truncation at random and not-at-random. Fixed-time truncation and multivariable adjustment were applied to remediate bias.

The study included 5588 patients tracked from true MS onset. The null model, without left-truncation, estimated the DMT effect on relapse risk (HR = 0.64; 95% confidence interval (CI) = 0.54-0.77). Left-truncation inflated this estimate. Shorter random truncation (1 year) produced greater bias (HR = 0.34), decreasing with longer durations (3-year HR = 0.48). Truncation not-at-random biased relapse estimates (HR = 0.37). Disability outcomes were less sensitive.

MSMs can reliably estimate DMT effectiveness in left-truncated MS registry data, although accuracy depends on truncation mechanism and duration. Both random and not-at-random truncation impact relapse estimates. Disability outcomes appear less sensitive. Fixed-time truncation and covariate adjustment mitigated bias.