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Slippery dopamine-fluoropolymer hybrid surface for improving biliary stent longevity

Wed, 01 Jul 2026 00:00:00 GMT

Title: Slippery dopamine-fluoropolymer hybrid surface for improving biliary stent longevity Authors: Kim, Tae Young; Lee, Won-Jong; Lee, Yurim; Kim, Seo Jung; Min, Sungjin; Chung, Seyong; Kim, Soo A.; Yook, Keun-Young; Moon, Chang-Hwan; Lee, Yeontaek; Park, Kijun; Kim, Dae-Hyun; Seo, Jungmok Abstract: Biliary obstruction leads to bile retention and triggers a cascade of pathological events. Bile accumulation induces cholestasis and inflammation, progressing to hepatocellular injury, fibrosis, and ultimately liver failure. To restore bile flow, biliary stents are a necessary option due to their immediate patency. However, their high susceptibility to foreign body reaction (FBR) associated fibrosis, biofilm formation, and biliary sludge accumulation leads to frequent occlusion. To address this limitation, we developed the Enhanced Longevity by antifouling Functional coating for Stent (ELFS), a lubricant-infused coating that prevents stent occlusion. ELFS can be readily fabricated via a simple dip-coating solution process and employ a polydopamine (PDA) adhesion layer. Intravital imaging in mice confirmed that ELFS suppressed the FBR by blocking early neutrophil adhesion, which in turn prevented downstream immune-fibrotic cascades. At 3 h, neutrophil recruitment in the non-coated group was >20-fold higher than in ELFS-coated groups. Additionally, ELFS-coated stents remained free of biofilm for over six months in mice and maintained full open for two months in a rabbit common bile duct model. In contrast, non-coated stents resulted in complete occlusion, bile duct dilation (over 4 times), hepatomegaly (over 2 times), and fibrosis.

Association between epilepsy duration and glymphatic dysfunction assessed by DTI-ALPS: A systematic review and meta-analysis

Wed, 01 Jul 2026 00:00:00 GMT

Title: Association between epilepsy duration and glymphatic dysfunction assessed by DTI-ALPS: A systematic review and meta-analysis Authors: Lee, Su Ji; Cho, Soomi; Shin, Hui Jin; Lee, Hyunji; Cho, Minjae; 신희진 Abstract: Objective: To systematically evaluate whether epilepsy duration is associated with glymphatic dysfunction as measured by diffusion tensor image analysis along the perivascular space (DTI-ALPS). Methods: A systematic review and correlation-based meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Embase, Scopus, Web of Science, and Google Scholar were searched from inception through January 20, 2026, for observational studies reporting correlations between epilepsy duration and DTI-ALPS values. Correlation coefficients were pooled using random-effects models after Fisher's z transformation. Subgroup analyses and meta-regression were performed to explore heterogeneity. Results: Ten observational studies comprising 449 patients with epilepsy were included. Pooled analysis demonstrated a significant negative association between epilepsy duration and the DTI-ALPS index (r = -0.37, 95% confidence interval [CI]: -0.53 to -0.19), indicating lower glymphatic function with longer disease duration. A significant association persisted in temporal lobe epilepsy (r = -0.30, 95% CI: -0.54 to -0.02) and was stronger in late-onset epilepsy (r = -0.68, 95% CI: -0.79 to -0.54). Meta-regression identified age as a significant moderator of effect size, whereas mean disease duration did not significantly explain variability. Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected. Conclusion: Longer epilepsy duration is associated with greater glymphatic dysfunction as measured by DTIALPS. Age significantly modulates this relationship, suggesting that seizure chronicity and aging-related vulnerability may synergistically influence perivascular clearance pathways. These findings support DTI-ALPS as a promising non-invasive marker of cumulative glymphatic burden in epilepsy and provide a quantitative framework for future longitudinal studies.

Risk of all-cause and cause-specific mortality, and suicide attempt in people with anxiety and stress-related disorders: a systematic review, meta-analysis and meta-regression analysis of 165 studies

Mon, 01 Jun 2026 00:00:00 GMT

Title: Risk of all-cause and cause-specific mortality, and suicide attempt in people with anxiety and stress-related disorders: a systematic review, meta-analysis and meta-regression analysis of 165 studies Authors: Wagner, Elias; Mortazavi, Matin; Poddighe, Laura; Baldwin, David S.; Masdrakis, Vasileios; Castle, David J.; Serretti, Alessandro; Oliva, Vincenzo; Fanelli, Giuseppe; Fornaro, Michele; Shin, Jae Il; Colman, Ian; Semchishen, Seana N.; Anderson, Kelly K.; Wang, Jian Li; Brietzke, Elisa; Sabe, Michel; Cortese, Samuele; Domschke, Katharina; Hasan, Alkomiet; Chang, Wing Chung; Myran, Daniel T.; Correll, Christoph U.; Connor Gorber, Sarah; Hojlund, Mikkel; Solmi, Marco Abstract: Anxiety disorders are the most prevalent mental health conditions worldwide. While their burden in terms of excess mortality is known to be high, a quantitative systematic evaluation of all-cause and cause-specific mortality and suicide attempt risks in people with anxiety or stress-related disorders is lacking. We performed a systematic review and random effects meta-analysis, in which co-primary outcomes were risk ratios (RRs) for all-cause and suicide-related mortality, and secondary outcomes were natural-cause mortality, other cause-specific mortality, and risk of suicide attempt. Sensitivity and meta-regression analyses were conducted. Overall, 165 studies encompassing 7,395,722 people with any anxiety or stress-related disorder and 135,059,023 controls, from 27 different countries across all continents, were included. Compared with the general population, a higher risk of all-cause mortality was associated with any anxiety or stress-related disorder (n=42, RR=1.54, 95% CI: 1.14-2.08, p=0.005), generalized anxiety disorder (n=9, RR=1.48, 95% CI: 1.23-1.78, p<0.001), and post-traumatic stress disorder (PTSD) and other stress-related disorders (n=21, RR=1.39, 95% CI: 1.15-1.67, p<0.001), but not with panic disorder, phobias, and mixed anxiety or stress-related disorders. Suicide mortality was increased in people with any anxiety or stress-related disorder (n=39, RR=2.88, 95% CI: 2.13-3.89, p<0.001), panic disorder (n=3, RR=3.58, 95% CI: 1.39-9.25, p<0.008), mixed anxiety or stress-related disorders (n=27, RR=2.77, 95% CI: 1.89-4.07, p<0.001), PTSD and other stress-related disorders (n=11, RR=3.13, 95% CI: 1.85-5.28, p<0.001), and generalized anxiety disorder (n=3, RR=1.93, 95% CI: 1.17-3.17, p<0.01). Suicide attempt risk was higher than in the general population in people with all anxiety or stress-related disorders, ranging from RR=6.33 (95% CI: 4.08-9.82, n=5) in panic disorder to RR=2.74 (95% CI: 1.72-4.35, n=5) in phobias. Natural-cause mortality was increased in any anxiety or stress-related disorder (n=19, RR=1.25, 95% CI: 1.09-1.44, p=0.002), generalized anxiety disorder (n=5, RR=1.55, 95% CI: 1.19-2.02, p=0.001), mixed anxiety or stress-related disorders (n=8, RR=1.26, 95% CI: 1.02-1.56, p=0.033), and PTSD and other stress-related disorders (n=9, RR=1.17, 95% CI: 1.03-1.33, p=0.019), but not in panic disorder. Cardiovascular-related deaths were increased in any and mixed anxiety or stress-related disorders and in generalized anxiety disorder, while cancer mortality was increased only in generalized anxiety disorder. When analyzing people with vs. without anxiety disorders with samples being matched by comorbid physical or mental disorders, results remained significant for all-cause mortality in generalized anxiety disorder and panic disorder, but not in any or mixed anxiety or stress-related disorders, and in PTSD and stress-related disorders. When compared with other mental disorders, no difference in co-primary outcomes emerged from more than two studies. Publication bias was present across several analyses, but sensitivity analyses largely confirmed the main findings. In meta-regression analyses, more recent data collection mitigated all-cause mortality, while schizophrenia-spectrum and bipolar disorder comorbidity mitigated suicide mortality risk, possibly driven by underlying treatment. This meta-analysis documents a higher all-cause, suicide and natural-cause mortality, and a higher risk of suicide attempt, in people with anxiety or stress-related disorders compared to the general population. Given the high prevalence and the recognized global treatment gap for these disorders, this finding is of great public health concern, and calls for appropriate prevention, screening and treatment strategies. More studies are needed to fill the publication bias gap and to identify modifiable risk or mitigating factors.

Real-world comprehensive care of people living with schizophrenia: recommendations across different settings and clinical stages

Mon, 01 Jun 2026 00:00:00 GMT

Title: Real-world comprehensive care of people living with schizophrenia: recommendations across different settings and clinical stages Authors: Fusar-Poli, Paolo; Pillinger, Toby; McCutcheon, Robert A.; Rangaswamy, Thara; Asmal, Laila; Singh, Swaran P.; Oliver, Dominic; Stefanelli, Riccardo; Crossley, Nicolas A.; Gadelha, Ary; Lopez-Jaramillo, Carlos; Mutamba, Byamah B.; Cheour, Majda; Valencia, Marcelo; Asher, Laura; Aymerich, Claudia; Catalan, Ana; Yon, Dong Keon; Shin, Jae Il; Solmi, Marco; Lawrie, Stephen M.; Kulisewa, Kazione; Karpenko, Olga; Ben-Zeev, Dror; Cortese, Samuele; Lund, Crick; Howes, Oliver; Keri, Peter; Sunkel, Charlene; Bonoldi, Ilaria; Damiani, Stefano; Fusar-Poli, Laura; McGorry, Patrick D.; Kane, John M.; Correll, Christoph U. Abstract: The clinical management of a complex disorder such as schizophrenia remains a significant challenge worldwide. This disorder requires a comprehensive, integrated and personalized care that blends multiple approaches, and the real-world availability of multiple resources. We present here the first recommendations addressing the real-world comprehensive care for people with schizophrenia-spectrum psychoses across different approaches, clinical stages, and levels of available resources. The recommendations are based on a critical review of the scientific literature and a collaborative appraisal by numerous clinical academics actively treating people with schizophrenia worldwide, representing various countries and clinical settings, including those in the Global South. Experts by experience were also involved. Our recommendations indicate that the comprehensive care of schizophrenia should involve: a) early detection; b) measurement-based monitoring; c) pharmacological treatments; d) psychological interventions; e) psychosocial interventions (including supported employment, housing and education); f) management of somatic conditions; g) community care; h) inpatient care; i) peer support, self-help, and alternative healing methods; j) population-level prevention, and l) societal-level support. The overarching core recommendation is to implement evidence-based care that addresses disparities across high- to middle/low-resource settings, emphasizing early intervention (and prevention when possible), culturally-sensitive paradigms that leverage the local existing resources, and task-sharing models that involve non-professional health care workers and, if possible, traditional healers. In the future, we expect that scalable and resource-saving, evidence-based digital solutions will help extend and improve care quality and efficiency across all resource settings. However, none of this can be achieved without adequately focusing on and strengthening mental health funding, improving access to care, addressing social determinants of health, and recognizing that care for people at risk for or living with schizophrenia is uneven and in need of improvement across all settings.