ウィルソン病

Neighborhood factors, encompassing social, built, and natural environments, may explain geographic differences in the impact of COVID-19 pandemic on populations. Data from pre-existing national, population-based cohorts could be leveraged to better understand how pre-existing conditions (both individual and neighborhood) contribute to risk factor development and disease progression. We catalogued spatial and neighborhood data in the Collaborative Cohort of Cohorts for COVID-19 Research (C4R), comprising 14 diverse US cohorts (>50,000 participants). The C4R sample is generally spatially and socially representative of the overall nation, with C4R's calculated spatial coverage representing 28% of US land area and 52% of the total US population. However, C4R (vs. non C4R) areas were more urban, wealthy, with more foreign-born residents, and less car-dependent with lower proportion employed and green. Twelve cohorts collected neighborhood characteristics - most commonly social environment data on neighborhood socioeconomic status- based on participants' addresses. The most common built environment measures were related to food access, followed by other destination-based measures such as walkability. Natural environment data were available in the fewest cohorts, with emphasis on air quality or greenspace. This work provides clarity on available neighborhood and spatial data and facilitates future harmonization of data from C4R cohorts. Ultimately, this may enable future longitudinal and comparative analyses of neighborhood influences on COVID-19.

BACKGROUND: The Lancet Oncology Commission on Global Cancer Surgery recommended that access to and the quality of surgical care be improved. This study aimed to understand differences in surgical quality between emergency and elective resection among patients with potentially curative colorectal cancer. METHODS: This preplanned secondary analysis included patients undergoing only curative-intent surgery for colorectal cancer from three contemporary global prospective cohort studies (GlobalSurg-3, 5506 patients; CovidSurg-Cancer, 6719 patients; APOLLO, 876 patients) registered from 2018 to 2023. Hierarchical multilevel logistic regression models quantified associations between the urgency of surgery (elective versus emergency) and surgical quality, measured by margin-positive resection, adjusting for patient, disease, and health system factors. Bootstrap multivariable simulations evaluated effect modification by country income level, cancer stage, and location. RESULTS: Of the 45 699 patients registered, 13 101 across 95 countries were included in this analysis. Overall, 678 patients (5.4%) had margin-positive resections, with higher rates in the emergency than elective surgery group (13.7 versus 4.5%; P < 0.0001). In adjusted multilevel models, emergency surgery was associated with increased odds of margin-positive resections (adjusted odds ratio 2.45, 95% confidence interval (c.i.) 1.86 to 3.22), consistent across all country income groups and robust to alternative health system indicators. Bootstrap-derived absolute risk differences revealed the greatest disparities in patients with stage III-IV rectal cancers, with absolute differences of 12.6% (95% c.i. 10.2 to 15.7) in high-income countries, 19.0% (95% c.i. 13.6 to 23.9) in upper middle-income countries, and 14.1% (95% c.i. 10.9 to 16.5) in lower middle- and low-income countries. Variance decomposition demonstrated that hospital- and country-level factors accounted for 76% of the explained variation in surgical quality. CONCLUSION: Emergency surgery was associated with a two- to threefold increase in the risk of margin-positive resections globally, independent of resource availability, highlighting a neglected area of global surgical practice. These findings challenge the assumption that poorer outcomes after emergency surgery are due to advanced disease stage. For patients presenting as an emergency with potentially curative resection, enhanced decision-making around resectability, ensuring specialist surgeon availability, and developing bridge-to-surgery pathways represent immediate, low-cost strategies to improve global cancer outcomes.

AIMS: This research aimed to gain an understanding of rheumatic fever related echocardiography experiences from Indigenous Maaori and Pacific children, adolescents and their whaanau (family members) in the Counties Manukau region of Aotearoa New Zealand to improve these services. METHOD: The study used qualitative Indigenous Kaupapa Maaori consistent and Kakala methodologies. The research was based in the Counties Manukau region of Auckland, New Zealand. Data was collected through interviews with Maaori and Pacific children and adolescents with rheumatic fever or rheumatic heart disease who had recently had echocardiograms and their whaanau. Data was analysed using a general inductive thematic analysis. RESULTS: Seventeen Participants Were Included in the Study. Four Themes Were Identified in the General Inductive Analysis: (1) Communication; (2) Engagement; (3) Access; (4) Kaiaawhina. CONCLUSION: By identifying barriers and facilitators of echocardiography services for rheumatic fever, this research provided knowledge and insights that can assist in developing child, adolescent and whaanau-focused models of care that have the potential to improve patient experience and echocardiography services in Aotearoa New Zealand.

OBJECTIVE: To summarize and compare current pharmacologic treatment options for metabolic dysfunction-associated steatotic liver disease (MASLD). DATA SOURCES: PubMed was searched for English-language articles published from January 1, 2000, to May 1, 2026. Search terms included MASLD, metabolic dysfunction-associated steatohepatitis (MASH), nonalcoholic fatty liver disease, nonalcoholic steatohepatitis (NASH), pioglitazone, semaglutide, liraglutide, sodium-glucose cotransporter 2 (SGLT2) inhibitors, dapagliflozin, empagliflozin, treatment, and management. STUDY SELECTION AND DATA EXTRACTION: Eighteen publications, including randomized controlled trials, review articles, and practice guidelines, were included in this narrative review article. These articles were included to evaluate the efficacy, safety, and accessibility of the treatment options. DATA SYNTHESIS: Five primary treatment options were reviewed: resmetirom, semaglutide, empagliflozin, dapagliflozin, and pioglitazone. Semaglutide and resmetirom demonstrated the most consistent evidence for MASH improvement including statistically significant improvement in fibrosis (reduction of at least 1 fibrosis stage). Pioglitazone showed improvement in several histologic features; however, findings for fibrosis improvement and placebo-adjusted benefit were inconsistent. Evidence for SGLT2 inhibitors remains promising but limited. CONCLUSIONS: Semaglutide and resmetirom have the strongest evidence for histologic improvement in MASLD/MASH. Pioglitazone and SGLT2 inhibitors may offer benefits in patients with specific comorbidities, but additional research is needed.

Rice kernel smut, caused by the fungus Tilletia horrida Tak., is an emerging disease of rice. The pathogen infects germ cells at the early flowering stage, yet the plant remains asymptomatic until maturity. The rice plant may recognize it as a stress-inducible factor, triggering the expression of various stress-responsive genes and pathways. However, researchers are attempting to identify kernel smut-resistant genes in cell-surface proteins (elicitors), secretory proteins, glycoside hydrolase family proteins, and effector proteins. Based on annotated effector proteins and integrated analyses of available gene-expression datasets, this study aims to identify allelic variation in a putative candidate gene to develop a functional marker for marker-assisted identification of both resistant and susceptible rice lines. The gene OsLAC11 was found to be strongly associated with kernel smut resistance and is expressed on the first day of flowering in rice, which aligns with the infection window and supports its role in resistance. Sanger sequencing of the OsLAC11 gene across ten rice germplasms with varying levels of kernel smut resistance identified two single nucleotide polymorphisms (SNPs) in intronic regions. The first SNP (G/T allele) was used to develop a functional marker using Polymerase Chain Reaction (PCR) with the Confronting Two-Pair Primers (CTPP). This marker effectively differentiated kernel smut-resistant rice lines from susceptible ones and was validated through phenotypic disease ratings. The molecular marker developed in this study represents a significant advancement in breeding for kernel smut resistance, providing a robust tool to accelerate genetic gains and streamline marker-assisted selection in rice improvement programs.