{"title":"Is <i>Hamnet</i> the pandemic story we needed?","authors":"Lakshmi Krishnan","doi":"10.1136/bmj.s241","DOIUrl":"https://doi.org/10.1136/bmj.s241","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s241"},"PeriodicalIF":42.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Israel accepts Gaza death toll of 70 000, but experts say true number is much higher.","authors":"Elisabeth Mahase","doi":"10.1136/bmj.s239","DOIUrl":"https://doi.org/10.1136/bmj.s239","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s239"},"PeriodicalIF":42.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Noise pollution affects health inside the hospital.","authors":"Rachael Collins, Thomas Hampton","doi":"10.1136/bmj.s230","DOIUrl":"https://doi.org/10.1136/bmj.s230","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s230"},"PeriodicalIF":42.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Royal Colleges of Physicians and General Practitioners join the X exodus-why medical leaders are refusing to tweet.","authors":"Chris Stokel-Walker","doi":"10.1136/bmj.s206","DOIUrl":"https://doi.org/10.1136/bmj.s206","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s206"},"PeriodicalIF":42.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cancer: Three quarters of patients in England will survive by at least five years by 2035, government promises.","authors":"Adrian O'Dowd","doi":"10.1136/bmj.s237","DOIUrl":"https://doi.org/10.1136/bmj.s237","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s237"},"PeriodicalIF":42.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline Fyfe, Henric Winell, Joseph Dougherty, David H Gutmann, Alexander Kolevzon, Natasha Marrus, Kristina Tedroff, Tychele N Turner, Lauren A Weiss, Benjamin H K Yip, Weiyao Yin, Sven Sandin
Objectives: To examine changes in the male to female ratio in diagnoses of autism spectrum disorder (ASD) over a 35 year period, providing temporal trends in diagnosis (incidence rate), the male to female ratio, and the age-cohort specific cumulative male to female ratio (cMFR).
Design: Population based, prospectively collected birth cohort study.
Participants: 2 756 779 liveborn children recorded in the Swedish medical birth register between 1985 and 2020.
Setting: Sweden.
Main outcome measure: Age-period cohort analysis investigating associations between ASD and age at diagnosis, calendar period, birth cohort, and sex, quantified by incidence rate ratios and associated two sided 95% confidence intervals.
Results: Among 2 756 779 individuals born in Sweden between 1985 and 2020, ASD was diagnosed in 78 522 (2.8%) by the end of follow-up (2022). The incidence rate for ASD increased with each five year age interval throughout childhood, peaking at 645.5 (per 100 000 person years) for the male cohort at age 10-14 years and 602.6 for the female cohort at age 15-19 years in 2020-2022, and then decreased. Age specific incidence of ASD increased for each calendar period and birth cohort between 1985 and 2020. The male to female ratio decreased with increasing age at diagnosis and, for those older than 10 years, by calendar period. For the final year of follow-up in 2022, the cumulative male to female ratio for incidence of ASD was 1.2 by age 20 years. Further projection of these trends suggested that the cumulative male to female ratio would reach parity at age 20 years by 2024.
Conclusion: Findings indicate that the male to female ratio for ASD has decreased over time and with increasing age at diagnosis. This male to female ratio may therefore be substantially lower than previously thought, to the extent that, in Sweden, it may no longer be distinguishable by adulthood. This finding highlights a need to investigate why girls and women receive diagnoses of ASD later than boys and men.
{"title":"Time trends in the male to female ratio for autism incidence: population based, prospectively collected, birth cohort study.","authors":"Caroline Fyfe, Henric Winell, Joseph Dougherty, David H Gutmann, Alexander Kolevzon, Natasha Marrus, Kristina Tedroff, Tychele N Turner, Lauren A Weiss, Benjamin H K Yip, Weiyao Yin, Sven Sandin","doi":"10.1136/bmj-2025-084164","DOIUrl":"https://doi.org/10.1136/bmj-2025-084164","url":null,"abstract":"<p><strong>Objectives: </strong>To examine changes in the male to female ratio in diagnoses of autism spectrum disorder (ASD) over a 35 year period, providing temporal trends in diagnosis (incidence rate), the male to female ratio, and the age-cohort specific cumulative male to female ratio (cMFR).</p><p><strong>Design: </strong>Population based, prospectively collected birth cohort study.</p><p><strong>Participants: </strong>2 756 779 liveborn children recorded in the Swedish medical birth register between 1985 and 2020.</p><p><strong>Setting: </strong>Sweden.</p><p><strong>Main outcome measure: </strong>Age-period cohort analysis investigating associations between ASD and age at diagnosis, calendar period, birth cohort, and sex, quantified by incidence rate ratios and associated two sided 95% confidence intervals.</p><p><strong>Results: </strong>Among 2 756 779 individuals born in Sweden between 1985 and 2020, ASD was diagnosed in 78 522 (2.8%) by the end of follow-up (2022). The incidence rate for ASD increased with each five year age interval throughout childhood, peaking at 645.5 (per 100 000 person years) for the male cohort at age 10-14 years and 602.6 for the female cohort at age 15-19 years in 2020-2022, and then decreased. Age specific incidence of ASD increased for each calendar period and birth cohort between 1985 and 2020. The male to female ratio decreased with increasing age at diagnosis and, for those older than 10 years, by calendar period. For the final year of follow-up in 2022, the cumulative male to female ratio for incidence of ASD was 1.2 by age 20 years. Further projection of these trends suggested that the cumulative male to female ratio would reach parity at age 20 years by 2024.</p><p><strong>Conclusion: </strong>Findings indicate that the male to female ratio for ASD has decreased over time and with increasing age at diagnosis. This male to female ratio may therefore be substantially lower than previously thought, to the extent that, in Sweden, it may no longer be distinguishable by adulthood. This finding highlights a need to investigate why girls and women receive diagnoses of ASD later than boys and men.</p>","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"e084164"},"PeriodicalIF":42.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inclusion in research: strategies to tackle implicit barriers for older people.","authors":"Emma Tenison","doi":"10.1136/bmj.s215","DOIUrl":"https://doi.org/10.1136/bmj.s215","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s215"},"PeriodicalIF":42.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Matt Morgan: What mermaids can teach us about misinformation.","authors":"Matt Morgan","doi":"10.1136/bmj.s123","DOIUrl":"https://doi.org/10.1136/bmj.s123","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s123"},"PeriodicalIF":42.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards the equal recognition of autism in girls and women.","authors":"Anne E Cary","doi":"10.1136/bmj.s120","DOIUrl":"https://doi.org/10.1136/bmj.s120","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"s120"},"PeriodicalIF":42.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To compare the diagnostic accuracy of minipad collected menstrual blood versus clinician collected cervical samples to test for human papillomavirus (HPV) in the detection of cervical intraepithelial neoplasia grade 2/3 or worse (CIN2+/CIN3+).
Design: Cross sectional population based study.
Setting: Four urban and three rural communities in Hubei Province, China.
Participants: 3068 women aged 20-54 years with regular menstrual cycles, enrolled between September 2021 and January 2025.
Interventions: HPV testing using minipad collected menstrual blood, clinician collected cervical samples, and ThinPrep cytology. Women who tested HPV positive by either collection method or by cytology (atypical squamous cells of undetermined significance or worse) were referred for colposcopy directed biopsy sampling.
Main outcome measure: Diagnostic accuracy for detecting CIN2+ and CIN3+.
Results: Among 3068 participants, minipad based HPV testing showed a sensitivity of 94.7% (95% confidence interval 80.9% to 99.1%) for CIN2+ detection, comparable to clinician based HPV testing (92.1%, 77.5% to 97.9%; P=1.00). Although minipad HPV testing showed a lower specificity than clinician HPV testing (89.1%, 88.0% to 90.2% v 90.0%, 88.9% to 91.1%; P=0.001), the negative predictive value matched that of clinician HPV testing (99.9%, 99.7% to 100.0% v 99.9%, 99.7% to 100.0%; P=1.00). Both collection methods had a similar positive predictive value (9.9%, 7.1% to 13.5% v 10.4%, 7.4% to 14.3%; P=0.82) and screening efficiency (10.1 v 9.6 referrals per CIN2+ detected; P=0.82).
Conclusions: Minipad collected menstrual blood showed comparable diagnostic accuracy to clinician collected cervical samples for HPV testing for detecting CIN2+ and CIN3+.
目的:比较迷你pad采集经血与临床采集宫颈标本检测人乳头瘤病毒(HPV)对宫颈上皮内瘤变2/3级及以上(CIN2+/CIN3+)的诊断准确性。设计:基于人群的横断面研究。地点:中国湖北省4个城市和3个农村社区。参与者:3068名年龄在20-54岁、月经周期正常的女性,于2021年9月至2025年1月登记。干预措施:使用迷你pad收集经血进行HPV检测,临床医生收集宫颈样本,并进行ThinPrep细胞学检查。通过收集方法或细胞学检测HPV阳性的妇女(不典型鳞状细胞的不确定意义或更糟)被转介进行阴道镜指导活检取样。主要观察指标:检测CIN2+和CIN3+的诊断准确性。结果:在3068名参与者中,基于迷你pad的HPV检测对CIN2+检测的敏感性为94.7%(95%置信区间为80.9%至99.1%),与基于临床医生的HPV检测(92.1%,77.5%至97.9%;P=1.00)相当。虽然minipad HPV检测的特异性低于临床HPV检测(89.1%,88.0% ~ 90.2% v 90.0%, 88.9% ~ 91.1%; P=0.001),但阴性预测值与临床HPV检测相匹配(99.9%,99.7% ~ 100.0% v 99.9%, 99.7% ~ 100.0%; P=1.00)。两种收集方法具有相似的阳性预测值(9.9%,7.1% ~ 13.5% v 10.4%, 7.4% ~ 14.3%, P=0.82)和筛选效率(10.1 v 9.6转诊/ CIN2+检测,P=0.82)。结论:Minipad采集经血与临床采集宫颈HPV检测CIN2+、CIN3+的诊断准确率相当。试验注册:ClinicalTrials.gov NCT06082765。
{"title":"Testing menstrual blood for human papillomavirus during cervical cancer screening in China: cross sectional population based study.","authors":"Xun Tian, Chen Cao, Lejing Wang, Jingjing Zhang, Ye Chen, Rui Tian, Bo Zhou, Lili Sun, Caixia Zhang, Lijuan Gan, Yu Jin, Jiahui Liu, Ting Wang, Yanqing Shen, Sisi Huang, Ling Zhang, Shenhua Zhang, Ping Chen, Chunli Tong, Jiaqi Kang, Hongli Fan, Guocheng Zhou, Liming Xiang, Yu Wen, Ruiliu Gan, Yong Chen, Xiaolan Li, Li Zhai, Qinghua Zhang, Ding Ma, Zhiqiang Han, Zheng Hu","doi":"10.1136/bmj-2025-084831","DOIUrl":"10.1136/bmj-2025-084831","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic accuracy of minipad collected menstrual blood versus clinician collected cervical samples to test for human papillomavirus (HPV) in the detection of cervical intraepithelial neoplasia grade 2/3 or worse (CIN2+/CIN3+).</p><p><strong>Design: </strong>Cross sectional population based study.</p><p><strong>Setting: </strong>Four urban and three rural communities in Hubei Province, China.</p><p><strong>Participants: </strong>3068 women aged 20-54 years with regular menstrual cycles, enrolled between September 2021 and January 2025.</p><p><strong>Interventions: </strong>HPV testing using minipad collected menstrual blood, clinician collected cervical samples, and ThinPrep cytology. Women who tested HPV positive by either collection method or by cytology (atypical squamous cells of undetermined significance or worse) were referred for colposcopy directed biopsy sampling.</p><p><strong>Main outcome measure: </strong>Diagnostic accuracy for detecting CIN2+ and CIN3+.</p><p><strong>Results: </strong>Among 3068 participants, minipad based HPV testing showed a sensitivity of 94.7% (95% confidence interval 80.9% to 99.1%) for CIN2+ detection, comparable to clinician based HPV testing (92.1%, 77.5% to 97.9%; P=1.00). Although minipad HPV testing showed a lower specificity than clinician HPV testing (89.1%, 88.0% to 90.2% <i>v</i> 90.0%, 88.9% to 91.1%; P=0.001), the negative predictive value matched that of clinician HPV testing (99.9%, 99.7% to 100.0% <i>v</i> 99.9%, 99.7% to 100.0%; P=1.00). Both collection methods had a similar positive predictive value (9.9%, 7.1% to 13.5% <i>v</i> 10.4%, 7.4% to 14.3%; P=0.82) and screening efficiency (10.1 <i>v</i> 9.6 referrals per CIN2+ detected; P=0.82).</p><p><strong>Conclusions: </strong>Minipad collected menstrual blood showed comparable diagnostic accuracy to clinician collected cervical samples for HPV testing for detecting CIN2+ and CIN3+.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06082765.</p>","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"392 ","pages":"e084831"},"PeriodicalIF":42.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}