Search Results (9,767)

Background: Long-acting monoclonal antibodies have become an important strategy for preventing respiratory syncytial virus (RSV) disease in infants. Nirsevimab is the first product for which substantial post-licensure implementation data are available, whereas real-world evidence on clesrovimab remains limited. Although nirsevimab has demonstrated high efficacy, its uptake varies considerably across countries, healthcare systems, delivery settings, and population subgroups. This World Association for Infectious Diseases and Immunological Disorders (WAidid) consensus document examines the policy, organizational, economic, and equity-related determinants that shape real-world implementation of long-acting monoclonal antibodies for infant RSV prevention. Methods: This study was conducted as a structured narrative review and WAidid expert consensus document. A structured literature search was performed in PubMed and Embase for English-language publications relevant to nirsevimab uptake and implementation, complemented by targeted review of surveillance reports, policy documents, and public health guidance from the ECDC, UKHSA, and CDC, as well as reference lists of selected publications. Eligible sources included observational and real-world implementation studies, systematic reviews and meta-analyses, economic evaluations, guidelines, policy statements, surveillance reports, and relevant narrative reviews. Evidence was synthesized qualitatively according to policy frameworks, financing and reimbursement, delivery pathways, demographic and socioeconomic determinants, and healthcare-system factors influencing uptake. No statistical software was used because no quantitative re-analysis or meta-analysis was performed. Results: Nirsevimab uptake was strongly influenced by national RSV prevention policies, particularly whether countries adopted universal infant monoclonal antibody programs, maternal RSV vaccination strategies, dual maternal–infant approaches, or targeted risk-based models. Universal, publicly funded programs integrated into neonatal care achieved the highest and most homogeneous coverage, especially when administration occurred before hospital discharge and was supported by registry-based recall systems for infants born outside the RSV season. In contrast, fragmented, outpatient-only, insurance-dependent, or partially reimbursed models were associated with lower, delayed, or more variable uptake. Additional determinants included product cost, reimbursement pathways, provider practices, caregiver awareness and health literacy, insurance status, income, race and ethnicity, geographic deprivation, and access to primary pediatric care. Most available evidence comes from high-income countries, limiting generalizability to low- and middle-income settings, where RSV burden is greatest and implementation constraints may differ. Conclusions: Successful implementation of long-acting monoclonal antibodies for infant RSV prevention requires more than regulatory approval and demonstrated efficacy. Equitable uptake depends on clear national recommendations, sustainable public financing, reliable product supply, integration into neonatal and primary pediatric care, proactive identification and recall of eligible infants, and targeted strategies to reduce socioeconomic and geographic disparities. Although many determinants identified in high-income settings are likely relevant globally, their feasibility, relative importance, and impact require dedicated evaluation in low- and middle-income countries. Full article

Background/Objectives: Diet is a key modifiable determinant of mental health; however, the prospective association between dietary patterns and new-onset suicidal ideation remains poorly elucidated. Methods: We enrolled 7480 participants from demolition resettlement communities in Jining, Zoucheng, and Weifang in Shandong Province, China, during 2021–2023. Data were used from two waves (baseline and 1-year follow-up) in this study. Dietary patterns were determined using principal component analysis based on food frequency questionnaire data. Incident suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Multivariable logistic regression, stratified analysis, and sensitivity analysis were used to examine associations of different dietary patterns with the risk of incident suicidal ideation. Results: Among participants, 193 (2.58%) reported incident suicidal ideation. After full multivariable adjustment, the livestock–poultry–seafood dietary pattern was significantly inversely associated with incident suicidal ideation (Q3 vs. Q1; odds ratio = 0.67; 95% confidence interval: 0.45–0.97), whereas no significant association was identified when the pattern score was modelled continuously (OR = 0.92; 95% CI: 0.79–1.06; p = 0.239). Stratified analyses revealed stronger inverse associations among men, older adults, overweight individuals, and participants who did not use dietary supplements, but all interaction p-values exceeded 0.05, with no statistically confirmed subgroup disparities. After excluding participants with baseline depression, participants with baseline anxiety, and individuals with missing covariates in sensitivity analysis, the inverse association remained statistically stable. Conclusions: Our findings suggested a modest inverse association between higher adherence to the livestock–poultry–seafood dietary pattern and new-onset suicidal ideation in this observational cohort. Full article

Background: Nudix hydrolases (NHs), characterized by the conserved Nudix motif (GX₅EX₇REUXEEXGU), hydrolyze nucleoside diphosphate derivatives and play vital roles in plant stress responses and cellular homeostasis. However, the NH gene family has not been systematically characterized in maize (Zea mays L.). Methods: We performed a genome-wide analysis of ZmNH (Nudix hydrolase) genes using a maize pan-genome encompassing 26 high-quality genomes. Results: A total of 73 ZmNH members were identified, comprising 22 core genes (present in all 26 lines), 28 dispensable genes (present in 2–25 lines), and 23 private genes (present in only one line). Phylogenetic analysis clustered them into three subgroups (Type-I, -II, and -III), with Type-III being the largest (28 members). Gene structure and motif analyses revealed conserved exon–intron architectures and 10 conserved motifs. Nonsynonymous/synonymous substitution ratio (Ka/Ks) calculations across the 26 inbred lines indicated that most ZmNH genes were under purifying selection (Ka/Ks < 1), whereas ZmNH2 and ZmNH12 showed evidence of positive selection in some lines. Expression profiling under four stress conditions—Fusarium graminearum, Cercospora zeina, Exserohilum turcicum, and Ostrinia furnacalis—identified 20 differentially expressed ZmNH genes. Notably, ZmNH9 was consistently responsive across multiple pathogen treatments, suggesting a potential role in broad-spectrum disease resistance. Conclusions: These findings provide a foundation for future functional studies of the maize NH gene family. Full article

Background: Depression-like phenotypes in animal models often show graded behavioral variation rather than uniform group-wise changes, yet treatment effects are still commonly evaluated using categorical comparisons. In particular, it remains difficult to determine whether treated animals retain model-like behavioral features or shift toward a more control-like state. Here, we developed a continuous behavioral phenotyping framework based on multidimensional open-field-test (OFT) features to quantify model-like behavioral states and treatment-associated behavioral shifts. Methods: In the present dataset, untreated CUMS- and LPS-induced mice jointly defined a shared model-like behavioral state characterized by reduced locomotor activity and altered spatial exploration. By integrating principal component analysis with k-nearest-neighbor-based behavioral inference, we derived two complementary indices: Δd, representing the relative distance of an animal from the model-like versus control-like behavioral centroids, and p_depression, a kNN-derived score representing similarity to the untreated model-like reference state. These indices were used to position individual animals along a spectrum between control-like and model-like behavioral states. Results: Higher p_depression and lower Δd indicated OFT phenotypes more similar to untreated model mice. Using this framework, NSC-treated animals showed treatment-associated shifts away from model-like behavioral patterns and toward more control-like states, while preserving substantial inter-individual variability. Behavioral scores also showed group-level correspondence with neuroinflammatory markers, suggesting preliminary biological relevance. Because the primary model-specific biological comparisons were based on a limited subgroup size (n = 4 per group), the observed NSC-associated treatment effects should be regarded as exploratory and require confirmation in larger, prospectively powered cohorts. Conclusions: Together, these findings support continuous OFT-based behavioral phenotyping as a promising exploratory approach for evaluating treatment-associated behavioral change and phenotypic heterogeneity in preclinical depression research. Full article

Oral squamous cell carcinoma (OSCC) prognosis remains limited by TNM staging alone. We conducted a systematic review and meta-analysis to evaluate preoperative neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) and lymphocyte-to-monocyte (LMR) ratios as prognostic markers. We searched PubMed/MEDLINE, Scopus, Base, Google Scholar and ScienceDirect from inception to 30 May 2026. Eligible studies reported preoperative ratios and survival outcomes, namely, overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS), in surgically treated OSCC. Risk of bias was assessed with the QUIPS tool. Random-effects meta-analyses of multivariate hazard ratios (HRs) were primary; univariate data, heterogeneity, prediction intervals, sensitivity and subgroup analyses were also performed. Thirty-nine studies (12,153 patients; mostly East Asian retrospective cohorts) were included. Elevated NLR predicted worse overall survival (HR 1.51, 95% CI 1.32–1.73) and disease-specific survival (HR 2.00, 1.58–2.54). NLR also showed a significant association with DFS (HR = 1.47, 95% CI: 1.21–1.78), though the prediction interval crossed unity. PLR and LMR showed weaker, less consistent associations. Evidence was limited by predominant retrospective design, geographic concentration and variable cut-offs. Preoperative NLR is a reproducible, inexpensive prognostic biomarker that may complement TNM staging; standardized thresholds require prospective validation. The review was registered in PROSPERO; no specific funding was received. Full article

Background: Assessment of lymph node involvement was incorporated into the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system as a critical determinant of patient management and prognostication. This study aims to validate the prognostic significance of metastatic lymph node characteristics and their correlation with molecular classification. Methods: We conducted a retrospective analysis of 131 patients with stage IIIC endometrial carcinoma who underwent surgical intervention at the Tianjin Medical University Cancer Institute and Hospital from 2010 to 2025. The patients were stratified based on various characteristics of metastatic lymph nodes. Progression-free survival (PFS) was estimated using Kaplan–Meier curves, and group comparisons were performed using the log-rank test. Univariate Cox proportional hazards regression was conducted to identify independent prognostic factors for PFS. Results: In accordance with the 2023 FIGO staging system, within the stage IIIC cohort, patients with concurrent pelvic and para-aortic lymph node metastases and those in the stage IIIC1 cohort with macrometastasis demonstrated decreased PFS (HR = 2.748; 95% CI = 1.227–6.151; p = 0.011, and HR = 4.039; 95% CI = 1.232–13.240; p = 0.021, respectively). Furthermore, patients with lymph nodes showing extracapsular extension had significantly reduced PFS in the stage IIIC, stage IIIC1, and stage IIIC1ii cohorts (HR = 10.12; 95% CI = 2.38–42.99; p < 0.001; HR = 3.58; 95% CI = 1.242–10.31; p = 0.011; and HR = 2.32; 95% CI = 0.83–6.71; p = 0.037, respectively). The number of involved lymph nodes, the largest diameter of metastatic foci in lymph nodes, and the presence or absence of extracapsular extension of metastatic lymph nodes were significantly different among the NSMP, MMRd, and p53abn molecular classifications (p = 0.033, p < 0.001, and p = 0.002, respectively). Patients with extracapsular extension of metastatic lymph nodes had worse PFS than those without in the MMRd group (p = 0.018). Conclusions: Extracapsular extension (ECE) of metastatic lymph nodes is the strongest predictor of worse progression-free survival in stage IIIC endometrial carcinoma, especially in the IIIC1 and MMRd subgroups, supporting its value for risk stratification and prognostic assessment. Full article

Background: Metastatic melanoma in East Asian populations is enriched for acral and mucosal subtypes and harbors a distinct molecular landscape compared with Western cutaneous melanoma. However, data on the efficacy of first-line immune checkpoint inhibitor (ICI) therapy and on the impact of molecular characteristics on treatment effect in this population remain limited. We aimed to characterize the genomic landscape of an East Asian metastatic melanoma cohort and to evaluate the predictive values of molecular markers for first-line ICI therapy. Methods: This study included 135 patients with metastatic melanoma who received first-line ICI at Samsung Medical Center between January 2022 and December 2025. Of these, 108 with paired next-generation sequencing (NGS) data were included in the molecular analysis. Survival outcomes were estimated by the Kaplan–Meier method, and the prognostic value of molecular subtype was assessed using univariable and multivariable Cox proportional hazards models. Results: Mucosal melanoma was the most common primary site (58, 43.0%), followed by acral melanoma (31, 23.0%) and cutaneous melanoma (25, 18.5%); 4 (3.0%) had uveal melanoma and 17 (12.6%) had melanoma of other or unknown primary origin. The overall objective response rate to first-line ICI was 37.8% (51 of 135), and median progression-free survival (PFS) was 6.2 months (95% confidence interval [CI] 4.0–9.6). Using the hierarchical classification, 108 patients were classified into five molecular subtypes: BRAF-altered (n = 17, 15.7%), RAS-altered (n = 17, 15.7%), KIT-altered (n = 15, 13.9%), and NF1-altered (n = 7, 6.5%), and quadruple–wild-type (n = 52, 48.1%). TMB-high status (10.2%) showed no significant association with outcomes. Molecular subtype was significantly associated with PFS (log-rank p = 0.009). After multivariable adjustment, BRAF fusion (hazard ratio [HR] 5.05, 95% CI 1.70–14.98, p = 0.003) and KIT-altered status (HR 2.91, 95% CI 1.46–5.77, p = 0.002) emerged as independent adverse prognostic factors, whereas BRAF V600 single-nucleotide variants did not differ significantly from quadruple–wild-type. Conclusions: In this East Asian metastatic melanoma cohort, BRAF fusion and KIT alterations were independent adverse prognostic factors for first-line ICI. These findings suggest that BRAF fusion and KIT-altered tumors may represent distinct subgroups that warrant further investigation. Full article

Objectives: The endometrium and cervix share a common Müllerian origin and may exhibit overlapping biological responses to oncogenic stimuli. However, the clinical significance of preoperative cervical cytology in patients with endometrial cancer remains unclear. This study aimed to investigate the association between preoperative cervical smear cytology and clinicopathologic characteristics, with particular emphasis on advanced FIGO stage (III–IV) as the primary outcome. Methods: This retrospective cohort study included 154 patients who underwent primary surgery for histologically confirmed endometrial cancer. Preoperative cervical smear cytology was classified according to the Bethesda System into four categories: normal, low-grade, high-grade, and malignant. For subgroup analyses, low-grade, high-grade, and malignant cytology results were combined and compared with normal cytology. FIGO stage was analyzed both as individual stages (IA–IV) and as early-stage (I–II) versus advanced-stage (III–IV) disease, where appropriate. Continuous variables were summarized as mean ± standard deviation or median (interquartile range), while categorical variables were expressed as n (%). Group comparisons were performed using the Pearson chi-square test or Fisher’s exact test, as appropriate, and a two-sided p value < 0.05 was considered statistically significant. Results: A total of 154 patients with endometrial cancer were included in the analysis. Preoperative cervical smear cytology was normal in 140 patients (90.9%), low-grade in 6 (3.9%), high-grade in 3 (1.9%), and malignant in 5 (3.2%). Comparison across cytology categories demonstrated a significant association between smear cytology and FIGO stage (p < 0.001), with high-grade and malignant cytology occurring more frequently in patients with advanced-stage disease. Vaginal cuff involvement was also significantly associated with smear cytology (p = 0.001), whereas no significant associations were observed for myometrial invasion, lymphovascular space invasion, cervical stromal involvement, tubo-ovarian involvement, omental involvement, or lymph node metastasis. Subgroup analysis comparing normal and abnormal cytology yielded similar findings, confirming significant associations with FIGO stage (p < 0.001) and vaginal cuff involvement (p = 0.002). In a multivariable model additionally including cervical cytology, LVSI and deep myometrial invasion were independent predictors of advanced stage (AUC = 0.888), whereas cytology was not statistically significant after adjustment (OR 4.51, p = 0.076) and showed poor standalone diagnostic performance (AUC = 0.564, sensitivity 19.4%, specificity 93.5%). All patients with vaginal cuff involvement had advanced-stage disease (Fisher’s exact p < 0.001). The cytology–FIGO stage association was not significant in postmenopausal (p = 0.065) or endometrioid-only (p = 1.00) subgroup analyses. Conclusions: Abnormal preoperative cervical smear cytology was significantly associated with advanced FIGO stage and vaginal cuff involvement in patients with endometrial cancer. These findings suggest that cervical cytological abnormalities may reflect overall disease extent rather than individual histopathological risk factors. Given the retrospective design and the limited number of patients with abnormal cytology, these findings should be interpreted cautiously and validated in larger prospective studies. However, cytology was not an independent predictor of advanced stage after multivariable adjustment and performed poorly as a standalone diagnostic marker, suggesting it should not be used alone to assess disease extent. Full article

Sex differences in intensive care unit (ICU) admission and treatment are reflected in the underrepresentation of women, poorer outcomes, and higher mortality risk. Historical exclusion from clinical trials has limited evidence for providing sex-specific care. This study aims to examine demographic and admission data from MIMIC-IV electronic health records to understand sex differences in ICU admissions, treatments, and outcomes, addressing critical gaps in care. Using the MIMIC-IV database of de-identified electronic health records, multiple correspondence analysis (MCA) was applied as an exploratory method to identify patterns and associations across categorical variables, including ICU type and demographic factors, for both heart failure (HF) and myocardial infarction (MI) patients. The study aimed to determine whether demographic or socioeconomic factors influenced assignment to specialty cardiac ICUs, and to evaluate differences in critical care delivery among patients with HF and MI. We observed that women were associated with admission to non-specialty ICUs, whereas men were admitted to specialty cardiac ICUs. MCA uncovered subgroup patterns showing that admission to cardiac ICUs is not uniform across sex, race, insurance, age, or marital status. There were also racial discrepancies noted in assignments to specialty ICUs, with minority groups being underrepresented in specialty ICUs. Marital status was a factor in admissions: widowed and single people were more frequently admitted to non-specialty ICUs. Length of stay (LOS) was comparable between HF and MI patients; however, chi-square analysis showed LOS being significantly associated with sex, age and marital status in HF, and with insurance status in the MI cohort. This data exploration illustrates systemic inequities in ICU allocation based on sex, race, and socioeconomic factors. Evidence of sex-based bias in the medical community highlights the need to address these inequalities in treatments and critical care to achieve better outcomes in the future. Full article

The APOA1 rs670 (−75 G>A) polymorphism has been implicated in lipid metabolism and susceptibility to metabolic syndrome (MetS). However, individual studies have reported inconsistent associations with circulating apolipoprotein A1 (Apo A1) and lipid parameters, and no meta-analysis has comprehensively evaluated these associations stratified by metabolic disorder status. We therefore quantified the associations between APOA1 rs670 and serum Apo A1 and lipid parameters, and determined whether these associations are modified by metabolic disorder status. PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched from inception to March 2026. Eligible studies reported APOA1 rs670 genotype data with quantitative lipid measurements. Forty studies involving 22,175 participants met the inclusion criteria. Pooled effect sizes were estimated as standardized mean differences (SMDs) with 95% confidence intervals (CIs) using random-effects models. This review was registered in PROSPERO (CRD420261333145). A allele carriers had significantly higher serum Apo A1 (SMD, 0.20; p < 0.001) and HDL-C levels (SMD, 0.14; p < 0.001) than GG homozygotes. Subgroup analyses stratified by metabolic disorder status revealed that the associations with Apo A1 (SMD, 0.53 vs. 0.11) and HDL-C (SMD, 0.23 vs. 0.08) were substantially stronger among individuals with metabolic disorders than among metabolically healthy individuals. No significant associations were observed for LDL-C or triglyceride levels. The APOA1 rs670 polymorphism is associated with higher circulating Apo A1 and HDL-C levels, with stronger associations in individuals with metabolic disorders. These findings suggest that metabolic status modifies the phenotypic effects of rs670 on the Apo A1–HDL pathway. Full article

As automated technology advances rapidly, human employees’ fear of being replaced (i.e., technology-induced job insecurity) has become a widespread stress in today’s workplace. It is crucial for organizations to recognize this new technological challenge and address its impact appropriately. Therefore, to systematically understand its impacts and explore potential buffering factors, the present research conducts a systematic review and meta-analysis of 96 studies (N = 43,104 individuals). Drawing on the tripartite response model, we classify their outcome variables into three broad categories encompassing nine subgroups. Furthermore, integrating stress appraisal theory and threat-rigidity theory, we examine two critical moderators reflecting specific coping capability against technological threats. Our findings indicate that technology-induced job insecurity is systematically associated with employees’ cognition, affection, and behavior. Notably, the moderation analysis highlights distinct boundary conditions under which these associations vary across different outcomes, emphasizing the complexity of these effects. Specifically, low threat proximity—providing a crucial time buffer before the actual threat happens—is associated with weaker negative attitudes toward the organization, and lower withdrawal and resistance behaviors. Individuals’ high learning ability—reflecting strong adaptive flexibility—is associated with weaker negative appraisals of the job itself and more sustained proactive behaviors. In summary, the present research contributes to a systematic understanding of how technology-induced job insecurity is related to human psychology and behaviors at work, thereby offering valuable insights to inspire future research and management practice. Full article

Human sarcocystosis is a neglected zoonotic infection caused by protozoa of the genus Sarcocystis. Although sporadic cases and outbreaks have been reported worldwide, the global burden of human infections has not been comprehensively synthesized. This study aimed to estimate the pooled prevalence and global distribution of Sarcocystis infections in humans. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251159944). PubMed, Scopus, Web of Science, Ovid, Nursing & Allied Health Premium, and Google Scholar were used for retrieving relevant studies. Observational studies published from 2000 onward reporting human Sarcocystis infections confirmed by microscopic and/or molecular methods were included. A random-effects model was used to estimate pooled prevalence. Heterogeneity was assessed using the I² statistic. Subgroup analyses and meta-regression were performed to explore sources of heterogeneity. Seventeen studies comprising 66,329 participants met the inclusion criteria. The pooled prevalence of human Sarcocystis infection was 0.85% (95% confidence interval [CI]: 0.33–2.19), with substantial heterogeneity (I² = 98.2%). Prevalence estimates showed marked variation across continents, countries, participant groups, diagnostic methods, Sarcocystis species, and clinical forms of sarcocystosis. Although human Sarcocystis infection appears relatively rare, its prevalence is geographically heterogeneous across studies published between 2000 and 2024. The robustness of the pooled prevalence estimate is limited by the small number of studies, uneven geographical coverage, and substantial heterogeneity. Differences in diagnostic approaches, study populations, infecting species, and disease phenotypes likely contributed to this variability. Enhanced surveillance and standardized application of sensitive molecular diagnostics are essential to better define the epidemiology, burden, and public health significance of human sarcocystosis. Full article

Glycoside hydrolase family 1 (GH1) β-glucosidases (BGLUs) play diverse roles in plant development and stress responses. However, a comprehensive pan-genomic characterization of this gene family across diverse Brassica rapa accessions is still lacking. Here, we conducted a pan-genome-wide analysis of BGLU genes across 21 B. rapa accessions. A total of 1840 BGLU genes were identified and clustered into 57 orthologous gene groups (OGGs), comprising 22 core, 19 dispensable, and 16 private groups. Phylogenetic reconstruction assigned these OGGs to five subgroups, and duplication analysis revealed whole-genome duplication as the predominant driver of family expansion, accounting for 47.51% of duplicated genes. Expression profiling identified two core genes, BrBGLU10 and BrBGLU56, as specifically expressed in fertile floral buds and differentially regulated between fertile and sterile lines. CRISPR/Cas9-mediated knockout of BrBGLU10 resulted in approximately 36% pollen abortion and drastically reduced seed set upon self-pollination, supporting its important role in pollen development. Collectively, these findings establish BrBGLU10 as an important regulator of pollen development and a potential target for fertility-related applications via gene editing in B. rapa and related Brassica crops. Full article

(1) Background/Objectives: Blood-based biomarkers have emerged as practical tools for identifying Alzheimer’s disease (AD) pathology in patients with mild cognitive impairment (MCI). Among them, plasma phosphorylated Tau217 (p-Tau217) demonstrates strong associations with cerebral amyloid deposition. In parallel, the easy Z-score Imaging System (eZIS), a quantitative brain perfusion SPECT analysis tool, has been widely used to detect characteristic AD-related hypoperfusion patterns. Although both measures reflect distinct AD processes, the relationship between plasma p-Tau217 and eZIS in MCI remains unclear. (2) Methods: This retrospective study included 62 patients with MCI who underwent plasma p-Tau217 testing and brain perfusion SPECT with eZIS analysis. Associations between plasma p-Tau217 and the three eZIS indices (severity, extent, and ratio) were evaluated. Exploratory subgroup analyses were performed using a previously reported plasma p-Tau217 threshold of 0.63 pg/mL. In addition, a validation sub-cohort of 21 participants who underwent plasma p-Tau217 testing, eZIS, and amyloid PET was analyzed to assess concordance with cerebral amyloid pathology. (3) Results: Among the three eZIS indices, severity demonstrated the highest sensitivity relative to elevated plasma p-Tau217 levels. However, all eZIS indices showed limited discriminative performance. Optimal eZIS cutoff values derived from the present cohort were higher than previously reported thresholds. In the amyloid PET-validated sub-cohort, plasma p-Tau217 demonstrated closer concordance with amyloid positivity than any individual eZIS parameter. The reduced performance of eZIS appeared to be associated with advanced age, substantial vascular burden, white matter lesions, and cerebral atrophy. (4) Conclusions: Plasma p-Tau217 showed a stronger association with cerebral amyloid pathology than eZIS indices in this elderly MCI cohort. Nevertheless, eZIS may provide complementary information regarding downstream neurodegenerative and cerebrovascular processes that are not directly captured by plasma biomarkers. This integrated approach highlights plasma p-Tau217 as a primary screening tool for amyloid pathology to guide disease-modifying therapies (DMTs), alongside eZIS for tracking follow-up mixed co-pathologies. Full article

Background: The rotator cable is thought to contribute to load transmission and preservation of shoulder function in rotator cuff tears; however, its detectability on arthroscopy and magnetic resonance imaging (MRI), agreement between these modalities, and clinical relevance remain incompletely defined. This study evaluated rotator cable visibility on arthroscopy and MRI, factors associated with arthroscopic cable visibility, and its relationship with preoperative active shoulder motion. Methods: This retrospective cross-sectional study included 128 patients who underwent shoulder arthroscopy for supraspinatus tears between January 2019 and February 2023. Arthroscopic video recordings were reviewed for rotator cable visibility. Standardized preoperative MRI review was available in 58 patients. Agreement between MRI and arthroscopic visualization was assessed using Cohen’s kappa and percentage agreement measures. Multivariable binary logistic regression was performed to identify factors independently associated with arthroscopic cable non-visibility. Results: The rotator cable was visible arthroscopically in 79 of 128 patients (61.7%) and on MRI in 38 of 58 patients (65.5%). Overall agreement between MRI and arthroscopy was 67.2% (95% CI, 53.7–79.0%), with a Cohen’s kappa of 0.315 (95% CI, 0.090–0.540; p = 0.011), indicating fair agreement. Positive and negative percent agreement were 78.8% and 52.0%, respectively. Although increasing age was associated with cable non-visibility in univariable analysis, this association did not remain statistically significant after multivariable adjustment. Higher Lafosse grade was independently associated with cable non-visibility in the overall cohort (adjusted OR, 1.43 per grade; 95% CI, 1.04–1.97; p = 0.028), whereas increasing tear size was independently associated with cable non-visibility among patients with full-thickness tears (adjusted OR, 2.78 per category; 95% CI, 1.19–6.52; p = 0.019). The unadjusted association between massive tear size and reduced MRI cable visibility did not remain significant after false discovery rate adjustment (q = 0.276). No statistically significant associations were detected between cable visibility or MRI-measured cable dimensions and preoperative active abduction or forward elevation. Conclusions: MRI and arthroscopy demonstrated fair agreement in the assessment of rotator cable visibility. After multivariable adjustment, cable non-visibility was more closely associated with tear-related characteristics than with patient age. No statistically significant associations were detected between cable characteristics and the assessed preoperative range-of-motion measures; however, smaller or moderate associations cannot be excluded, particularly within the MRI subgroup. Rotator cable visibility should primarily be interpreted as a marker of detectability and tear morphology rather than as a direct surrogate for structural integrity or shoulder function. Full article