Bin Cao, MD, from the Institute of Respiratory Medicine in the Chinese Academy of Medical Sciences in Beijing, and colleagues enrolled 1,208 patients at 35 sites in China with mild-to-moderate COVID-19 and onset of symptoms within the past three days to receive 750 mg of simnotrelvir plus 100 mg of ritonavir or placebo twice daily for five days (603 and 605 patients, respectively).

The researchers found that the time to sustained resolution of COVID-19 symptoms was significantly shorter in the simnotrelvir group than the placebo group (180.1 versus 216.0 hours) among patients in the modified intention-to-treat population. The decrease in viral load from baseline was greater in the simnotrelvir group than in the placebo group on day 5 (mean difference, −1.51 ± 0.14 log₁₀ copies/mL). A higher incidence of adverse events during treatment was seen in the simnotrelvir group versus placebo group (29.0 versus 21.6%); most of the adverse events were mild or moderate.

“Early administration of simnotrelvir plus ritonavir was effective in shortening the time to symptom resolution among adult patients with COVID-19, without evident safety concerns,” the authors write.

The study was funded by the Jiangsu Simcere Pharmaceutical Co., the manufacturer of simnotrelvir.

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Michelle Nguyen, from University of Toronto, and colleagues conducted a systematic literature review to identify studies evaluating 100% fruit juice consumption and body weight in children and adults.

Based on 17 eligible studies in children, the researchers found that each additional serving per day of 100% fruit juice was associated with a 0.03 higher body mass index change.

The researchers identified 25 studies in adults. Among studies that did not adjust for energy, there was an association with greater body weight gain (0.21 kg) compared with studies that did adjust for energy intake (−0.08 kg). There was no significant association of assignment to 100% fruit juice with body weight among randomized clinical trials involving adults. 

“Our findings support guidance to limit consumption of fruit juice to prevent intake of excess calories and weight gain,” the authors write. “Further trials of 100% fruit juice and body weight are desirable.”

Several authors disclosed financial ties to various medical organizations.

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Su Hwan Kim, PhD, from Seoul National University Hospital in South Korea, and colleagues examined the association between exposure to OALAN and the risk for incident EAMD. The analysis included 4,078 individuals (aged 50 years and older) with newly diagnosed EAMD (2010 through 2011) and matched controls (1:30).

The researchers found that in fully adjusted models, an interquartile range (IRQ; 55.8 nW/cm²/sr) increase in OALAN level was associated with a higher risk for incident EAMD (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.56 to 1.78). The exposure-response curve showed a nonlinear, concave upward slope, which became more pronounced at higher levels of light exposure (at approximately 110 nW/cm²/sr). In urban areas, an interquartile range increase in OALAN was associated with an increased risk for incident EAMD (HR, 1.46; 95% CI, 1.33 to 1.61), but this finding was not seen in rural areas (HR, 1.01; 95% CI, 0.84 to 1.22).

“Further studies incorporating comprehensive information on exposure, individual adaptive behaviors, and potential mediators are recommended to deepen our understanding in this area,” the authors write.

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Anjali Gupta and Tomi Akinyemiju, PhD, from the Duke University School of Medicine in Durham, NC, used publicly available data from the National Center for Health Statistics to estimate age-adjusted cancer mortality rates for Black and white individuals for each year between January 2000 and December 2020.

The researchers found that age-adjusted mortality rates were 251.7 and 199.7 per 100,000 population among Black and white individuals, respectively, in 2000, significantly decreasing to 166.8 and 149.3 per 100,000 population in 2020 (average annual percentage changes, −2.04 and −1.44%, respectively). For both groups, declines in cancer mortality were seen for each cancer type between 2000 and 2020. For all cancers except female lung and bronchus, Black individuals consistently experienced higher mortality than white individuals. There was a decrease in the overall cancer mortality rate ratio between Black and white individuals from 1.26 to 1.12, with a corresponding decline in absolute rate differences (51.99 to 17.54 per 100,000). For female breast cancer and male colorectal cancer, the rate ratio increased (1.31 to 1.37 and 1.44 to 1.45, respectively). Across the study period, considerable disparities remained for prostate, male lung and bronchus, and female colorectal cancer.

“Our results underscore the importance of sustained, focused efforts to reduce cancer burden among Black patients across the continuum of cancer care,” the authors write.

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Although not meant to be used as a primary screening tool, the technology further evaluates skin lesions that doctors have already flagged as suspicious, the FDA noted in an agency news release.  

The handheld device uses AI-powered spectroscopy to assess the characteristics of lesions at both the cellular level and beneath the skin’s surface.

“We are entering the golden age of predictive and generative artificial intelligence in healthcare, and these capabilities are being paired with novel types of technology, like spectroscopy and genetic sequencing, to optimize disease detection and care,” DermaSensor Inc. co-founder and CEO Cody Simmons said in a company news release. “Equipping PCPs [primary care physicians], the most abundant clinicians in the country, to better evaluate the most common cancer in the country has been a major, long-standing unmet need in medicine.”

The device, also called DermaSensor, provides real-time results using an algorithm based on data culled from more than 4,000 malignant and benign lesions, according to the company.

“The device should be used in conjunction with the totality of clinically relevant information from the clinical assessment, including visual analysis of the lesion, by physicians who are not dermatologists,” the FDA said, adding that DermaSensor is for use in patients ages 40 and up.

Along with helping to spot melanoma, the most deadly form of skin cancer, the device can also assess moles for basal cell carcinoma and squamous cell carcinoma.

One in five Americans will have developed a form of skin cancer by the age of 70, according to the American Academy of Dermatology, which puts the cost of treatment in the United States at more than $8 billion. Most skin cancers are curable if detected early.

The FDA added that it is requiring additional validation testing in patients from representative demographic groups, including those who are at lower risk of skin cancer.

More information

The Skin Cancer Foundation has more on skin cancer.

SOURCE: US Food and Drug Administration, news release, Jan. 16, 2024; DermaSensor Inc., news release, Jan. 17, 2024

Masha Remskar, from the University of Bath in the United Kingdom, and colleagues conducted a systematic literature review to examine the impact of interventions that combined physical activity and mindfulness on mental health and well-being outcomes.

Based on 35 included studies, the researchers found that most studies had pilot or feasibility designs (19 studies; 54%) or small sample sizes. Compared with passive controls, combined interventions were feasible to deliver and improved psychological health (25 of 33 outcome comparisons reported across trials). Compared with active controls, the effects on psychological health outcomes were mixed. Twelve of 38 comparisons favored combination over physical activity only, while five of 18 favored combination over mindfulness only.

“Although research into the combined impact of these behaviors is in its infancy, the evidence base offers promise that such interventions are feasible to administer and evaluate, are well adhered to, and point to favorable psychological health outcomes,” the authors write.

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Arch G. Mainous III, PhD, from the University of Florida in Gainesville, and colleagues examined whether there is a synergistic effect of the presence of inflammation and poverty on the 15-year risk for all-cause, heart disease and cancer mortality among US adults. The authors evaluated data from the National Health and Nutrition Examination Survey (1999 to 2002) with linked records to the National Death Index through Dec. 31, 2019. The 15-year mortality risk was assessed among adults aged 40 years and older.

The researchers found that the risk for 15-year adjusted, all-cause mortality was increased for individuals with elevated C-reactive protein (CRP) at 1.0 mg/dL and poverty compared with those with low CRP and above poverty (hazard ratio, 2.45). The mortality risk was essentially the same for those with one at-risk characteristic (hazard ratios, 1.58 and 1.59 for low inflammation/poverty and inflammation/above poverty, respectively); these risks were substantially lower than those seen for adults with both inflammation and poverty. The 15-year heart disease mortality risk was elevated by 127 percent and 15-year cancer mortality was elevated by 196% for individuals with both elevated inflammation and living in poverty.

“Inflammation and poverty are well known risk factors for mortality, but when both exist simultaneously and CRP is >1.0 mg/dL, they have the potential to increase mortality more than one would expect from an additive effect,” the authors write. “This is particularly concerning in socially disadvantaged patients who are already a medically vulnerable population.”

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Julia Mueller, PhD, from the University of Cambridge in the United Kingdom, and colleagues assessed how small fluctuations in mental well-being within individuals predict bodyweight over short time periods. The analysis included 2,133 adults who completed monthly mental health and weight measurements using a mobile app during a period of six to nine months.

The researchers found that within-individual variation in depressive symptoms predicted subsequent weight (0.045 kg per unit of depressive symptom severity). Baseline body mass index (BMI) had a moderation effect on the association between within-individual fluctuation in depressive symptoms and subsequent weight, with the association only apparent in those with overweight/obesity (BMI <25 kg/m²: 0.011 kg per unit of depressive symptom severity; BMI 25 to 29.9 kg/m²: 0.052 kg per unit of depressive symptom severity; BMI ≥30 kg/m²: 0.071 kg per unit of depressive symptom severity). There were no associations seen for stress and anxiety with weight.

“Our findings suggest weight management interventions may benefit by monitoring for small fluctuations in depressive symptoms and providing additional emotional support when needed,” the authors write.

Several authors disclosed ties to various institutions.

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Marnina B. Stimmel, PhD, from Albert Einstein College of Medicine in New York City, and colleagues examined the utility and discriminative validity of the Spanish and English MoCA versions to identify cognitive impairment among diverse community-dwelling older adults. The analysis included 231 older adults (aged 65 years and older; 43% Hispanic and 39% Black/African American) with cognitive concerns attending outpatient primary care.

The researchers found that neuropsychological assessment identified 90 participants as cognitively normal with subjective cognitive concerns (average MoCA, 19.9), 133 with MCI (average MoCA, 16.6), and eight with dementia (average MoCA, 10.6). The mean English MoCA average was 18.6 versus 16.7 for Spanish. There was a high false-positive rate using the published cutpoint ≤23 for MCI (79%). Using the English MoCA, ≤18.5 was identified as the score to identify MCI or dementia (65% sensitivity; 77% specificity) and ≤16.5 for the Spanish MoCA (64% sensitivity; 73 percent specificity).

“Lower Spanish and English MoCA cutpoints may improve diagnostic accuracy for identifying cognitive impairment in this group, highlighting the need for the creation and validation of accurate cognitive screeners for ethnoculturally and linguistically diverse older adults,” the authors write.

One author disclosed ties to MedRhythms.

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Evan L. Reynolds, PhD, from the University of Michigan in Ann Arbor, and colleagues examined the effect of surgical weight loss on cognition in individuals with class II/III obesity. The analysis included 113 participants who completed baseline assessments and 87 who completed two-year follow-up assessments.

The researchers found that the primary outcome, the NIH Toolbox Cognitive Battery (NIHTB-CB) composite score, was stable following bariatric surgery (−0.4). For secondary outcomes following surgery, the NIHTB-CB dimensional card sorting test (executive function assessment), improved (+6.5), while the Rey Auditory Verbal Learning Test (AVLT) delayed recall test (memory assessment) declined (−0.24). There was no association between improvements in metabolic risk factors and diabetes complications with improvements in the NIHTB-CB composite score. At follow-up, the other four NIHTB-CB subtests and Rey AVLT assessments of auditory learning and recognition were unchanged.

“Since individuals with obesity experience more rapid cognitive decline than those without, stable cognition two years after bariatric surgery may be considered a success against historical trends, yet future controlled trials are needed to test this,” Reynolds said in a statement.

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