Search Results (3,408)

Background: Mobile health interventions offer a potential solution to adherence challenges, yet evidence regarding their collective efficacy in schizophrenia spectrum disorders has not been formally synthesized. This systematic review evaluates the impact of mobile health (mHealth) interventions on medication adherence as a primary outcome and on daily functioning and psychotic symptoms as secondary outcomes in individuals with schizophrenia spectrum disorders. Methods: Using the Population, Intervention, Comparison, Outcome (PICO) framework, a systematic search was conducted across multiple databases to identify relevant randomized controlled trials (RCTs) evaluating mHealth strategies for medication adherence in adults with schizophrenia spectrum disorders. The PubMed, CINAHL, PsycINFO, EMBASE, and JBI databases were searched from inception until 24 February 2026, using combinations of search terms such as “Schizo” OR “Psychos” AND “mHealth” OR “Digital Health” AND “Medication Adherence”. Data extraction was conducted using a standardized data extraction table and narratively synthesized. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ensuring structured and comprehensive reporting of the findings. Results: Fourteen randomized controlled trials (RCTs) with 1717 participants were included in this review. Four studies evaluated text messaging interventions, four employed phone call interventions, three used electronic medication monitoring systems, and three used mobile applications. Nine of the fourteen studies reported statistically significant improvements in medication adherence. For secondary outcomes, the results were highly inconsistent: only three studies demonstrated significant reductions in psychotic symptoms, and none showed benefits for daily functioning. While various theoretical frameworks, such as the Health Belief Model and Cognitive Behavioral Therapy and intervention modalities, were utilized, the overall evidence was limited by high clinical heterogeneity and a lack of robust long-term data. Conclusions: mHealth interventions, particularly text messaging and mobile applications, demonstrate clear potential to improve medication adherence in individuals with schizophrenia spectrum disorders. Given the high heterogeneity and lack of long-term evidence, future research should prioritize standardized outcome measurements, rigorous designs, and extended follow-up periods to confirm clinical utility. Full article

Osteonecrosis can cause significant and chronic musculoskeletal morbidity in children and adolescents with sickle cell disease (SCD). Although the femoral head is most frequently affected, lesions can also occur in the humeral head, vertebral bodies, knees, and other joints. Progressive joint damage can result in chronic pain, impaired mobility, loss of function, and the need for surgical intervention at a young age. As survival continues to improve in SCD, the long-term burden of osteonecrosis is becoming increasingly important. This narrative review summarizes the current understanding of osteonecrosis in pediatric and adolescent SCD. We review its epidemiology, pathophysiology, clinical presentation, imaging findings, and management. Disease burden increases with age and is closely linked to markers of severe SCD, including frequent vaso-occlusive crises and acute chest syndrome. Full article

Autophagy is a highly conserved degradation and recycling process in eukaryotic cells that plays a critical role in maintaining cellular homeostasis and responding to external stress. During viral infection, autophagy exhibits a classic “double-edged sword” effect—it can act as a host defense mechanism by directly degrading viral components, but it can also be hijacked by viruses to promote their own replication. Porcine epidemic diarrhea virus (PEDV), an important enteric coronavirus that severely affects the global swine industry, engages in a complex and sophisticated interplay with the host autophagy system. This review systematically dissects the dual regulatory mechanisms of autophagy during PEDV infection and reveals two intertwined functional axes. On one hand, PEDV utilizes multiple viral proteins to cooperatively manipulate the autophagic pathway—inducing mitophagy to suppress innate immune responses, utilizing autophagic membranes to construct replication platforms, and blocking autophagic flux to evade degradation—thereby establishing a multi-level pro-viral network. On the other hand, host cells deploy a unified molecular axis of “ubiquitination–autophagy receptor–lysosome” by mobilizing a broad array of restriction factors to target and degrade viral proteins, forming a coordinated defense system. These two axes converge at the oxidative stress–endoplasmic reticulum stress–autophagy hub, where PEDV NSP1 and NSP2 synergistically inhibit the NRF2 antioxidant system to trigger this cascade, while host factors such as DDX6 and ACE2 finely regulate the process. Based on this mechanistic framework, we discuss the therapeutic implications of targeting autophagy for PEDV intervention, with particular emphasis on the development of selective autophagy modulators as potential antiviral agents. We also identify key knowledge gaps and propose future research directions to translate these mechanistic insights into clinical or field applications. This review synthesizes the peer-reviewed literature published between 2013 and 2026, identified through systematic searches of PubMed, Web of Science, and Scopus databases. Notably, the majority of mechanistic findings discussed are derived from in vitro cell culture models, and their translation to in vivo settings remains a significant challenge. Bridging this gap will require validation in physiologically relevant models, such as porcine intestinal organoids and controlled piglet challenge studies, to assess the efficacy and safety of autophagy-targeting interventions in the context of intestinal homeostasis and mucosal immunity. Full article

The integration of digital therapeutics (DTx), wearable electronic devices, and artificial intelligence (AI) represents a significant advancement in personalized healthcare. The primary purpose of this structured narrative review is to evaluate the convergence of these technologies, providing a consolidated framework that bridges the gap between raw biometric data acquisition and actionable, AI-driven clinical insights. This paper synthesizes the latest literature on the intersection of mobile health (mHealth), machine learning (ML), and physiological tracking, with a primary focus on heart rate variability (HRV) and associated biochemical markers, such as cortisol, salivary alpha-amylase, and interleukins. Instead of viewing wearable outputs simply as raw data, we critically evaluate the technical verification and clinical validation required to define them as true “digital biomarkers.” By evaluating multimodal sensor technologies and advanced predictive algorithms, this paper outlines the clinical utility of digital biomarkers in diagnosing and proactively managing cardiovascular, neurological, metabolic, and psychiatric conditions, noting classification accuracies frequently exceeding 85% in controlled settings. However, we strongly caution that internally validated performance in controlled settings does not inherently demonstrate external clinical utility. The clinical relevance of this study lies in its holistic approach to identifying how continuous monitoring can broaden healthcare accessibility while improving precision medicine. Furthermore, it deeply addresses the technical challenges of highly variable ambulatory data quality, the necessity for robust artifact reduction (e.g., via LSTM and GAN architectures), and the limitations of small, homogeneous training datasets. We highlight the essential need for demographic-aware algorithmic models, external validation, and decentralized privacy-preserving models (e.g., federated learning) in diverse populations to ensure the safe, equitable clinical translation of DTx, mHealth, ML, and AI technologies. Full article

Aging frailty is a multifactorial geriatric syndrome characterized by reduced physiological reserve across multiple interrelated systems, leading to increased vulnerability to adverse health outcomes. Mesenchymal stem cells (MSCs) have emerged as a potential therapeutic intervention due to their immunomodulatory and regenerative properties. This systematic review aimed to evaluate the available clinical evidence regarding the safety and efficacy of MSC administration in individuals with aging frailty. A systematic literature search was conducted in PubMed, Scopus, and the Cochrane Library from database inception to 15 April 2026. Only randomized controlled trials (RCTs) were eligible. Data were extracted according to study design, participants’ characteristics, MSC source and dosing, safety outcomes, functional performance measures, quality of life (QoL) indices, and inflammatory, immune, and vascular biomarkers. Three RCTs met the inclusion criteria, comprising a total of approximately 208 participants. MSC administration was well-tolerated, with no treatment-related serious adverse events reported. Signals of improvement were reported in mobility-related and physical performance outcomes, although the magnitude and consistency of the response varied across studies. A dose-dependent increase in 6 min walk distance was observed at nine months in one trial, while improvements in SPPB, TUG, and grip strength were reported in the other studies. Additionally, MSC therapy was associated with QoL improvement and reduction in circulating pro-inflammatory cytokine concentrations. MSC administration was also associated with changes in immune-cell activation and a dose-dependent reduction in circulating sTIE2. Because of substantial clinical and methodological heterogeneity among the included trials, a quantitative meta-analysis was not performed. Current randomized evidence remains limited but suggests that intravenous MSC therapy is generally well tolerated in older adults with aging frailty and may produce clinically relevant signals of improvement in mobility-related functional outcomes, quality of life, and selected inflammatory, immune, and vascular biomarkers. However, the small number of trials, heterogeneity in MSC source, dose, endpoints, and follow-up duration, and the exploratory nature of much of the evidence preclude definitive conclusions regarding efficacy. Larger, adequately powered trials with standardized frailty endpoints are required, while future trials specifically targeting sarcopenia should apply consensus diagnostic criteria and direct measures of muscle quantity, strength, and physical performance. Full article

Adhesive capsulitis is characterized by shoulder pain, stiffness, and limited range of motion. Although multimodal rehabilitation is commonly used, it is unclear which combination of physiotherapy interventions is optimal. The aim of this exploratory study was to compare the short-term effects of TECAR therapy combined with proprioceptive neuromuscular facilitation (PNF) with those of standard physiotherapy in women with stage II adhesive capsulitis. This was a prospective, longitudinal, non-randomized, and exploratory study in which participants were assigned either the TECAR + PNF group or the standard physiotherapy group. Both intervention groups were given treatment three times a week for four weeks. Pain intensity and upper-limb disability were measured using the Visual Analog Scale (VAS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Shoulder flexion, abduction, internal rotation and external rotation were measured using goniometry. Within-group changes were analyzed with the Wilcoxon signed-rank test, and exploratory baseline-adjusted analyses were conducted with ANCOVA. Both groups showed statistically significant improvements in pain and disability as a result of treatment. The median reduction on the VAS was about 5.00 points in the TECAR + PNF group and 2.00 points in the standard physiotherapy group. The median DASH scores fell by about 43.25 points and 16.00 points, respectively. Exploratory ANCOVA models showed that the TECAR + PNF group had more favourable adjusted VAS and DASH scores after treatment. Nevertheless, the groups differed at baseline in abduction, internal rotation, and external rotation, and a full pre–post analysis of changes in range of motion was not available. Therefore, the mobility results cannot be regarded as providing evidence of treatment superiority. We can conclude that in this small, non-randomised pilot study, the combination of TECAR and PNF led to greater short-term reductions in pain and upper-limb disability compared with standard physiotherapy. Nevertheless, these findings are still only preliminary and hypothesis-generating, and it is essential to carry out larger, adequately powered randomised controlled trials with concealed allocation, balanced baseline characteristics, complete analyses of changes in range of motion, and longer follow-up periods in order to confirm their clinical relevance and determine their comparative effectiveness. Full article

Background: Dengue has expanded rapidly beyond traditional tropical and subtropical regions, driven by climate change, urbanization, population mobility, and the spread of competent Aedes vectors. Vaccination is an increasingly important component of dengue prevention, but development has been complicated by four viral serotypes, antibody-dependent enhancement, variable baseline serostatus, and the need for balanced and durable tetravalent immunity. Methods: We conducted a narrative review of PubMed/MEDLINE, Google Scholar, ClinicalTrials.gov, and relevant public health and regulatory sources. Evidence on dengue epidemiology, immunopathogenesis, licensed vaccines, advanced candidates, efficacy, immunogenicity, safety, durability, and implementation was critically evaluated. Priority was given to randomized trials, long-term follow-up studies, regulatory assessments, and surveillance data. Evidence was synthesized descriptively without formal meta-analysis or risk-of-bias assessment. Results: CYD-TDV was the first licensed dengue vaccine but is restricted to individuals with documented previous infection because seronegative recipients may experience an increased risk of severe dengue. TAK-003 has demonstrated overall efficacy against virologically confirmed dengue and dengue-related hospitalization in both baseline-seropositive and baseline-seronegative populations. However, protection is heterogeneous by serotype, and evidence remains limited or uncertain for some serotype-by-serostatus strata. Butantan-DV offers a promising single-dose strategy, but broader use requires additional long-term safety, effectiveness, and serotype-specific data. Inactivated, DNA, viral-vectored, virus-like particle, and mRNA vaccines remain investigational. Conclusions: Dengue vaccination should be integrated with surveillance, vector control, clinical preparedness, and risk communication. Population-based vaccination is most appropriate in high-transmission settings, whereas selective, risk-based strategies are preferable in temperate regions. Continued pharmacovigilance and effectiveness monitoring are essential to guide safe and equitable implementation. Full article

Background: Mobile phones are widely used by healthcare students during clinical training and may act as potential reservoirs for pathogenic microorganisms. Objectives: This study aimed to investigate and evaluate the role of mobile phones as epidemiological factors in the transmission of microorganisms in medical and dental practice. Methods: A cross-sectional epidemiological and microbiological study was conducted between September 2025 and April 2026. A total of 125 mobile phones belonging to fourth-year dental students and fifth-year medical students were examined. Samples were collected from the entire phone surface and cultured on blood agar, eosin–methylene blue agar, and Candida chromogenic agar. Participants also completed a structured questionnaire assessing demographic characteristics, clinical experience, hand hygiene practices, and mobile phone use and cleaning habits. Results: No microbial growth was detected in 52.8% of samples on blood agar, while 44.8% showed growth below 10⁵ CFU of coagulase-negative staphylococci and 2.4% showed growth ≥10⁵ CFU. Minimal growth was detected on eosin–methylene blue agar (0.8%). Fungal contamination was identified in 2.4% of samples, exclusively among students who reported touching their phones with contaminated gloves. Statistically significant associations were observed between microbiological growth and students’ specialty, duration of clinical experience, and contact with mobile phones while wearing contaminated gloves (p < 0.05). Conclusions: Touching mobile phones with contaminated gloves was significantly associated with microbial growth. These findings emphasize the need for targeted infection control education and stricter guidelines regarding mobile device use during clinical training. Full article

Point-of-care ultrasound (POCUS) is a dynamic imaging modality that can diagnose musculoskeletal and tendon injuries to facilitate appropriate orthopedic care and improve patient outcomes. This manuscript illustrates the value of dynamic POCUS to distinguish between complete and partial tendon injuries at the patient’s bedside, which is important for management and disposition planning in emergency department (ED) or clinic patients with acute trauma. In this case, a healthy 34-year-old male presented with acute left knee pain and swelling after a fall. He had a deformity superior to his patella and could not actively extend his left knee. Left knee X-ray was negative for fracture. POCUS demonstrated a disrupted left distal quadriceps tendon with anechoic fluid, tendon enlargement, and proximal tendon retraction. Importantly, a dynamic POCUS video cine loop revealed no contiguous tendon mobility with passive extension of the left knee (when movement is performed by the physician), confirming that this was a complete and not partial tendon tear. The patient was discharged in an extension knee brace. Outpatient magnetic resonance imaging confirmed the complete left quadriceps tendon rupture, and he underwent orthopedic surgery with good outcomes. Thus, early dynamic musculoskeletal POCUS confirmed a complete tendon injury, guiding expedited surgical treatment to prevent permanent damage and disability. Full article

Background: Effective postoperative pain control after cesarean delivery is essential for facilitating early mobilization and reducing analgesic requirements. Ultrasound-guided fascial plane blocks, such as the transversus abdominis plane (TAP) and transversalis fascia plane (TFP) blocks, are increasingly used as components of multimodal analgesia; however, direct comparative data between these techniques remain limited. Methods: In this prospective observational study, 90 patients undergoing repeat cesarean deliveries under spinal anesthesia were administered either a bilateral ultrasound-guided transversus abdominis plane (TAP) block or a transversus fascia plane (TFP) block in accordance with standard clinical practice. The intensity of postoperative pain, assessed both at rest and during movement, was determined using VAS scores at 3, 6, 12, and 24 h after surgery. The time until first ambulation and additional postoperative analgesic consumption beyond the standardized baseline analgesic regimen over the first 24 postoperative hours were also evaluated. Results: The patients who were administered a TFP block had diminished postoperative pain levels, reduced additional postoperative analgesic requirements, and expedited mobilization relative to those administered a TAP block. The TFP group had considerably lower movement-related pain levels within the first 24 h following surgery. Opioid-related adverse effects were comparable between groups. Conclusions: After a repeat cesarean delivery, applying a TFP block was linked to better postoperative analgesia and fewer analgesic requirements than applying a TAP block. These findings suggest that TFP blocks may represent an effective component of multimodal analgesia in obstetric anesthesia. Full article

Class imbalance in clinical electrocardiogram (ECG) datasets limits the diagnostic sensitivity of automated arrhythmia classifiers, particularly for rare but clinically significant beat types. We propose a three-stage hybrid generative pipeline that combines a spectral-guided conditional variational autoencoder (cVAE), a class-conditional latent denoising diffusion probabilistic model (DDPM), and a Quantum Latent Refinement (QLR) module built on parameterized quantum circuits, implemented and evaluated using a classical quantum-circuit simulator, to augment minority arrhythmia classes, and present results based on the MIT-BIH Arrhythmia Database. The QLR module applies a bounded residual correction guided by Maximum Mean Discrepancy minimization to align synthetic latent distributions with real class-specific latent banks. A lightweight 1D MobileNetV2 classifier evaluated over ten independent random seeds and four augmentation ratios serves as the downstream benchmark. Our findings establish latent diffusion augmentation as an effective strategy for imbalanced ECG classification. To our knowledge, the proposed QLR module is the first use of a parameterized quantum circuit as a distributional refiner within a generative augmentation pipeline. While its performance is comparable to that of the classical latent diffusion framework under the present experimental conditions, the proposed approach demonstrates the feasibility of integrating quantum latent operators into generative medical AI pipelines and provides a foundation for future investigations on quantum-enhanced representation learning and data augmentation. Full article

Background: Canine otitis externa caused by Pseudomonas aeruginosa is frequently chronic and treatment refractory, yet integrated historical phenotype–genotype data remain limited. We characterized an archival Hungarian collection obtained in 2010 and 2017. Methods: Broth microdilution minimum inhibitory concentrations (MICs) were determined for 67 isolates against 13 antimicrobial agents and chlorhexidine, and 59 isolates had matched long-read whole-genome assemblies. Resistance-associated determinants were identified using the Comprehensive Antibiotic Resistance Database, and their predicted proximity to mobile genetic elements and plasmid-like contigs was evaluated. Results: Current canine Clinical and Laboratory Standards Institute breakpoints classified 59/67 isolates (88.1%) as enrofloxacin resistant and 43/67 (64.2%) as marbofloxacin resistant. European Committee on Antimicrobial Susceptibility Testing epidemiological cut-off values identified non-wild-type subsets for ciprofloxacin (7/67), tobramycin (4/67), imipenem (1/67), and piperacillin–tazobactam (51/67), whereas all isolates remained within the available wild-type distributions for ceftazidime, gentamicin, and amikacin. No continuous MIC distribution changed significantly between sampling years after false-discovery-rate correction, although categorical marbofloxacin resistance decreased from 87.5% in 2010 to 42.9% in 2017. Resistance-gene screening identified 64 unique determinants, including near-universal efflux-system components, PDC and OXA-50-like β-lactamases, APH(3′)-IIb, arnA, and basS. The fluoroquinolone-associated determinant crpP occurred in 37/59 genomes and was located on plasmid-predicted contigs in six isolates. No determinant–MIC association remained significant after correction for multiple testing. Conclusions: The discordance between conserved resistance-gene repertoires and heterogeneous MICs demonstrates that sequence-based detection alone is insufficient for therapeutic inference. Integrated phenotypic and genomic surveillance is therefore required to support evidence-based antimicrobial stewardship in canine pseudomonal otitis. Full article

Background/Objectives: Although proximal first metatarsal osteotomy is a common treatment for hallux valgus (HV), its effect on dynamic first tarsometatarsal (TMT) joint mobility remains unclear. Previous assessments have largely relied on static radiographic parameters, which may not capture functional joint kinematics. The aim of this study was to evaluate changes in first TMT joint mobility during the stance phase of gait using a synchronized ultrasound and three-dimensional motion capture system after combined hallux valgus surgery incorporating proximal first metatarsal osteotomy. Methods: We prospectively studied 23 feet of 21 female patients with symptomatic HV undergoing combined hallux valgus surgery incorporating proximal closing-wedge osteotomy. We also evaluated 11 feet of 11 healthy female volunteers as controls. Per clinical indications, additional concomitant procedures were performed for 21 of the 23 feet. Vertical displacement of the first metatarsal and medial cuneiform as well as the first TMT joint gap was measured throughout the stance phase of gait using a synchronized ultrasound and motion capture system. Pre- and postoperative kinematics (>1 year follow-up) were compared with those in the control group using one-dimensional statistical parametric mapping (SPM). Results: Radiographically, the HV and intermetatarsal angles significantly improved, while sagittal plane parameters showed no significant changes. SPM analysis revealed no significant differences in the first TMT joint gap or first metatarsal displacement among groups. Preoperatively, compared with the controls, HV feet exhibited significantly greater plantar displacement of the medial cuneiform during late terminal stance. Postoperatively, this abnormal displacement was significantly decreased, with no significant difference between groups. Conclusions: Combined hallux valgus surgery incorporating proximal first metatarsal osteotomy was associated with reduced dynamic medial column hypermobility, specifically shifting vertical displacement of the medial cuneiform towards patterns observed in healthy controls during the terminal stance phase. These functional improvements occurred despite minimal changes in static sagittal radiographic alignment. The findings highlight the importance of dynamic assessment for evaluation of postoperative medial column biomechanics. Full article

Background/Objectives: Periodontitis is a multifactorial chronic inflammatory disease influenced by behavioral, metabolic, and lifestyle-related factors. This study aimed to examine the associations of selected dietary habits, body mass index (BMI), physical activity, smoking, and oral hygiene behaviors with clinical periodontal parameters in a clinical sample of adults with periodontitis from northwestern Romania. Methods: This cross-sectional study included 204 adults with clinically diagnosed periodontitis. Sociodemographic characteristics, smoking status, physical activity, toothbrushing frequency, tooth mobility, and selected dietary habits were assessed using a structured questionnaire. Periodontal status was clinically evaluated using periodontal probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP), while BMI was calculated from anthropometric measurements. Descriptive and inferential statistical analyses were performed to evaluate associations between the investigated factors and periodontal parameters. Multivariable linear regression models were constructed separately for PPD, CAL, and BOP, simultaneously including age, sex, BMI, smoking status, physical activity frequency, toothbrushing frequency, tooth mobility, education level, and the assessed dietary habits. Results: In the fully adjusted multivariable analyses, fish consumption 1–3 times/week was independently associated with lower PPD, whereas sweets consumption 1–3 times/week was independently associated with higher PPD. Carbonated beverage and sweets consumption 1–3 times/week were independently associated with higher BOP. Although the multivariable model for CAL was statistically significant overall, none of the individual predictors included in the model reached statistical significance. BMI and physical activity frequency were not independently associated with PPD, CAL, or BOP after simultaneous adjustment for the other variables. Age group was significantly associated with CAL category (χ²(2) = 13.28, p = 0.001, Cramér’s V = 0.255), while educational level was significantly associated with toothbrushing frequency (χ² = 62.26, p < 0.001, Cramér’s V = 0.39). Conclusions: Selected dietary habits were independently associated with PPD and BOP after adjustment for demographic, anthropometric, lifestyle, and oral hygiene factors, whereas no individual predictor was independently associated with CAL in the fully adjusted model. BMI and physical activity were not independently associated with the periodontal parameters examined. These findings emphasize the multifactorial nature of periodontal status and suggest that specific dietary habits may be associated with different clinical dimensions of periodontal disease. However, causal relationships cannot be established due to the cross-sectional design of the study. Prospective studies using validated dietary assessment methods are needed to confirm these associations. Full article

Background/Objectives: Low parathyroid hormone (PTH) levels in maintenance hemodialysis may reflect malnutrition, inflammation, reduced functional reserve, or low bone turnover rather than optimal CKD-MBD control. We evaluated associations of longitudinal PTH burden with nutritional-inflammatory and functional-dependence profiles, hospitalization, and mortality. Methods: This retrospective cohort included 188 adults receiving maintenance hemodialysis. Serial PTH measurements were summarized using time-weighted mean PTH. Associations with nutritional-inflammatory biomarkers, functional-dependence measures, and hospitalization were assessed using regression models. Mortality was primarily evaluated using a joint longitudinal–survival model linking repeated log2-transformed PTH measurements with time to death and adjusting for age, sex, dialysis vintage, and dialysis access. A 6-month landmark analysis was performed as a complementary sensitivity analysis. Results: Median time-weighted mean PTH was 292 pg/mL. Lower longitudinal PTH burden was associated with lower albumin, cholesterol, and transferrin and higher C-reactive protein and ferritin. Higher PTH was associated with lower odds of worse mobility and dependence in dressing, bathing, toileting, and continence after adjustment. Hospitalization was not significantly associated with PTH. During follow-up, 62 patients died. In the joint model, each twofold higher estimated current PTH level was associated with a lower observed mortality hazard (adjusted hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.46–0.73; p < 0.001). The 6-month landmark analysis included 159 patients and 44 subsequent deaths. Each twofold higher PTH level was associated with lower subsequent mortality hazard (HR 0.69, 95% CI 0.51–0.95; p = 0.021), while PTH < 150 pg/mL was associated with higher mortality than PTH 300–600 pg/mL (HR 2.84, 95% CI 1.22–6.63). Conclusions: Low time-weighted PTH was associated with adverse nutritional-inflammatory and functional profiles, and lower estimated current PTH with higher mortality. Findings were consistent in the 6-month landmark analysis, do not establish causality, and support interpreting PTH in the broader clinical context. Full article