European Journal of Medical Research最新文献

{"title":"Predictors, trends and outcomes associated with urinary tract infections in intracerebral hemorrhage: insights from a National Inpatient Sample Study (2010-2022).","authors":"Binbin Tian, Chunbo Chen, Junfen Cheng, Jian Wang, Junde Mo, Guorong Zhong, Qiongru Yuan","doi":"10.1186/s40001-025-03302-y","DOIUrl":"10.1186/s40001-025-03302-y","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are an important concomitant condition among patients with intracerebral hemorrhage (ICH). Data regarding predictors, outcomes and trends relating to UTIs in ICH are lacking.</p><p><strong>Methods: </strong>A retrospective analysis of data from the Nationwide Inpatient Sample (NIS) for the years January 1, 2010-December 31, 2022 was conducted, employing multivariable logistic regression to examine the associated factors and temporal trends of UTIs in patients with ICH.</p><p><strong>Results: </strong>Between 1 January 2010 and 31 December 2022, the NIS database contained an unweighted total of 311,581 hospitalizations (weighted estimate, 1,554,702) with ICH coded as either a primary or secondary diagnosis. Among these, 42,271 hospitalizations were combined with UTIs. Our analysis revealed a significant down-trend in the occurrence of UTIs among patients with ICH over the 12-year period, resulting in an overall occurrence rate of 13.6%. The identified associated factors for UTIs included advanced age (≥ 45), female individuals, Black individuals, Hispanic individuals, comorbidities (≥ 1), Charlson comorbidity index (CCI) ≥ 3, medium/large hospital and treatment in South regional hospital. Significant comorbidities that increased the odds of UTIs included deficiency anemia, depression, diabetes (with complications), congestive heart failure, fluid and electrolyte disorders, paralysis, psychoses, peptic ulcer disease excluding bleeding and weight loss. Patients who developed UTIs were associated with worse clinical outcomes, including more frequent conditions (pressure ulcer, pneumonia, transfusion, acute renal failure, deep vein thrombosis, delirium, malnutrition, sepsis), significantly longer hospitalization periods (median 10 vs. 5 days), and substantially increased healthcare expenditures (median $100,923 vs. $62,928). Interestingly, patients with UTIs were associated with lower in-hospital mortality (13.0% vs. 22.9%) (P < 0.001).</p><p><strong>Conclusions: </strong>There is an association between UTIs and increased healthcare utilization in the setting of ICH. This study revealed several predictors/associated factors of UTIs occurrence with ICH among a nationally representative sample in the United States. These data may assist physicians and healthcare providers in identifying patients at increased risk for UTIs in ICH and, hence, initiate timely interventions.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"974"},"PeriodicalIF":3.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive model of delayed union of tibial and fibular fractures based on PGC-1α, NOS, and Runx2.","authors":"Bin Wang, Zhiyuan Shi, Derong Li, Jinwei Yu","doi":"10.1186/s40001-025-03247-2","DOIUrl":"10.1186/s40001-025-03247-2","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the associations between the levels of Peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), Nitric oxide synthase (NOS), Runt-related transcription factor 2 (Runx2) and the delayed union of tibiofibular fractures, and to construct and validate a model for predicting the delayed union of tibiofibular fractures.</p><p><strong>Methods: </strong>A total of 351 patients with tibiofibular fractures who were treated in the hospital from January 2022 to June 2024 were selected as the study subjects. They were randomly divided into a training set (n = 246) and a validation set (n = 105) at a ratio of 7:3. Experimental techniques such as ELISA were used to accurately detect the serum of patients, and multiple clinical data of the patients were comprehensively collected. Key influencing factors were screened out by statistical methods, such as univariate analysis and multivariate logistic regression analysis. Plot a nomogram and construct a prediction model, and use evaluation indicators to comprehensively evaluate and validate the model.</p><p><strong>Results: </strong>In the training set, 72 cases (29.27%) had delayed union of tibiofibular fracture. Multivariate logistic analysis showed that fracture complexity, time from injury to surgery, levels of PGC-1α, NOS, Runx2, and OPG were independent influencing factors for the delayed union of tibiofibular fractures (all P < 0.05). In the training set and the validation set, the C-index of the nomogram model was 0.760 and 0.711, respectively. The calibration curve showed moderate agreement between the predicted values and the actual values. The results of the Hosmer-Lemeshow test were χ² = 5.277, P = 0.728 and χ² = 10.540, P = 0.229, respectively. The ROC curve showed that in the training set and the validation set, the AUC of the nomogram model for predicting the delayed union of tibiofibular fractures was 0.760 (95%CI 0.680-0.839) and 0.711 (95%CI 0.581-0.842), respectively, and the sensitivity and specificity were 0.796, 0.645 and 0.739, 0.500, respectively.</p><p><strong>Conclusions: </strong>This study provides a new perspective and method for the assessment of the delayed union of tibiofibular fractures, which is helpful for clinicians to potentially assist in risk stratification and closer follow-up for high-risk patients.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"978"},"PeriodicalIF":3.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic regulation by WTAPP1 promotes trophoblast dysfunction in gestational diabetes via CNR1/NF-κB activation.","authors":"Na Yang, Yuan Li, Jiefang Zhang, Xianghong Gao, Peng Zhang, Weiling Li","doi":"10.1186/s40001-025-03217-8","DOIUrl":"10.1186/s40001-025-03217-8","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) poses significant risks to maternal and fetal health, necessitating exploration of novel molecular mechanisms. Clinical data from placental tissues from 33 GDM patients and 30 controls revealed Wilms tumor 1 associated protein (WTAP) pseudogene 1 (WTAPP1) was significantly upregulated in GDM, correlating with fasting glucose levels. In vitro, high glucose (25 mM) triggered oxidative stress (manifested by increased MDA, reduced GSH/GSSG ratio, and decreased CAT and SOD activity), inflammation (evidenced by elevated secretion of IL-1β, IL-6, TNF-α, and MCP-1), and apoptosis (along with upregulated cleaved caspase-3 or Bax, and downregulated Bcl-2) in trophoblast cell HTR-8/Svneo, while WTAPP1 knockdown partially restored viability, reduced apoptosis, and mitigated inflammatory cytokines and oxidative markers. Mechanistically, WTAPP1 promoted cannabinoid receptor 1 (CNR1) expression via WTAP-mediated m6A methylation, stabilizing CNR1 mRNA and activating the NF-κB signaling, as evidenced by increased phosphorylated IkBα and nuclear p65. Rescue experiments confirmed that CNR1 overexpression reversed the protective effects of WTAPP1 knockdown on high-glucose-induced damage in HTR-8/Svneo cells, while NF-κB inhibition by BAY-11-7085 attenuated high glucose-induced damage. This study unveils a novel WTAPP1/WTAP-m6A-CNR1-NF-κB axis driving trophoblast cell injury in GDM, highlighting WTAPP1 as a potential therapeutic target for hyperglycemia-induced placental injury.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"975"},"PeriodicalIF":3.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The crosstalk between MicroRNAs and sirtuins: a bit unexpected therapeutic target for cardiovascular diseases.","authors":"Radin Kamvar, Amir Hossein Barjasteh, Mahyaar Omouri-Kharashtomi, Parvaneh Hamian Roumiani, Arman Beheshtirooy, Parisa Adib-Hajbagheri, Pouria Rezaei, Rahele Shokraei, Mohammad Hossein Pourhanifeh","doi":"10.1186/s40001-025-03235-6","DOIUrl":"10.1186/s40001-025-03235-6","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality globally, necessitating a deeper understanding of their underlying mechanisms. Sirtuins (SIRTs) are a family of NAD ± dependent deacetylases that play pivotal roles in various biological processes, including metabolism, oxidative stress response, and apoptosis. Evidence highlights the critical involvement of sirtuins in the pathophysiology of CVDs, with SIRT1 demonstrating cardioprotective effects by inhibiting cardiac hypertrophy and oxidative stress. At the same time, SIRT3 and SIRT6 also contribute to reducing oxidative stress and stabilizing atherosclerotic plaques. MicroRNAs (miRNAs), small non-coding RNA molecules, play a crucial role in regulating gene expression by degrading or inhibiting target mRNAs. They are implicated in various biological processes, including cellular stress responses, inflammation, and mitochondrial function. Recent studies have identified miRNAs as key biomarkers for various diseases, including Alzheimer's disease, diabetes, cancer, and CVDs. Our review summarizes the relationship between microRNAs and sirtuins in CVDs and explores their potential applications in clinical practice, emphasizing the therapeutic promise of targeting these molecular pathways.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"969"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sirt3-CD38 axis induces mitochondrial dysfunction in hypertrophied heart by regulating mitochondrial calcium overload.","authors":"Jia Liu, Ning Liu, Chao Qi, Delu Dong, Bin Liu","doi":"10.1186/s40001-025-03211-0","DOIUrl":"10.1186/s40001-025-03211-0","url":null,"abstract":"<p><p>Mitochondrial dysfunction driven by calcium overload is a hallmark of cardiac hypertrophy, yet the role of Sirtuin-3 (Sirt3) in regulating this process remains incompletely defined. Specifically, the mechanism by which CD38-mediated NAD depletion links Sirt3 deficiency to mitochondrial calcium dysregulation remains incompletely elucidated. Therefore, 12 week-old Sirt3-deficient mice were used as cardiac hypertrophy model. The morphological changes of cardiac muscle fibers and the ultra-structure changes of mitochondria were detected by hematoxylin and eosin (HE) staining and transmission electron microscopy (TEM). Then, multi-omics approach was used to analyze the differently expressed genes and different metabolites. Key genes and metabolites were scrutinized through Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG). Finally, in vitro studies examining the effects of Sirt3 knockdown on H9C2 cells, including intracelluler and mitochondrial reactive oxygen species (ROS) and calcium, and mitochondrial membrane potential (MMP). Western blot and qPCR were used to verify the differently expressed genes. The hearts of Sirt3-deficient mice increased myofiber thickness, and altered mitochondrial morphology. Sirt3 deficiency induced mitochondrial dysfunction was promoted by an inhibition of the translation of oxidative phosphorylation (OXPHOS) complex subunits. Multi-omics profiling implicated CD38 as a major NAD consumer and linked the metabolites of CD38 to cAMP signaling pathways. Furthermore, in vitro studies examining H9C2 Sirt3 knockdown showed an increase in intracellular and mitochondrial ROS levels, a decrease in MMP, and promoted MCU expression and mitochondrial calcium overload. However, CD38 inhibitors effectively attenuated Sirt3 knockdown-induced elevations in intracellular and mitochondrial ROS levels, dissipation of mitochondrial membrane potential, and mitochondrial calcium overload, thereby restoring mitochondrial function. In summary, the Sirt3-CD38 axis induces mitochondrial dysfunction in hypertrophied heart by regulating mitochondrial calcium overload. These findings will aid in providing new ideas for the prevention and treatment of age-related cardiac hypertrophy.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"967"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of biomarkers related to neutrophil extracellular traps and potential therapeutic drugs for rheumatoid arthritis using computational analysis.","authors":"Liyong Sheng, Xingliang Liu, Huixi Zhang, Xinyi Qian, Yangqin Gu, Wenli Zhu, Xiaoqi Gong","doi":"10.1186/s40001-025-03213-y","DOIUrl":"10.1186/s40001-025-03213-y","url":null,"abstract":"<p><strong>Background: </strong>Neutrophil extracellular traps (NETs) derived from neutrophils are implicated in the pathogenesis of rheumatoid arthritis (RA) pathogenicity, though the underlying mechanisms remain unclear.</p><p><strong>Methods: </strong>Data were obtained from Gene Expression Omnibus (GEO) database. First, Gene Set Variation Analysis (GSVA) was used to calculate NET scores, and ConsensusClusterPlus was employed to classify RA samples. Subsequently, weighted gene co-expression network analysis (WGCNA) was used to construct co-expression networks. Lasso regression and support vector machine recursive feature elimination (SVM-RFE) were then used to cross-screen biomarkers for RA, with predictive performance evaluated via the timeROC package. Immune infiltration in RA samples was assessed using ssGSEA and MCPcounter methods. Additionally, qRT-PCR was conducted to validate the expression of key genes. Finally, potential therapeutic drugs were predicted through Enrichr using the DSigDB database, and candidate compounds were preprocessed with PyMOL and ChemBioOffice before molecular docking with AutoDockTools.</p><p><strong>Results: </strong>RA patients had significantly higher NET scores than controls, and the samples were divided into C1 and C2. WGCNA combined with differential analysis identified eight key genes, and five biomarkers were screened by two machine learning algorithms, namely, ANGPTL1, CASP8, FNIP2, MEOX2, and ZNF780B. Both the training set and validation set showed an AUC > 0.7. Immunological analysis revealed an association with neutrophil infiltration, while drug prediction and molecular docking revealed that N-Acetyl-L-cysteine and Eckol exhibited favorable binding activity.</p><p><strong>Conclusion: </strong>This study provided novel insights into RA progression based on NETs, offering potential signature genes for the prognostic prediction of RA.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"965"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment options for young patients with asymptomatic severe aortic stenosis: a multicenter retrospective cohort study.","authors":"Yu Mao, Yang Liu, Mengen Zhai, Ping Jin, Fangyao Chen, Yuhui Yang, Gejun Zhang, Xiaoke Shang, Zhao Jian, Haibo Zhang, Lai Wei, Jian Liu, Yingqiang Guo, Xiangbin Pan, Yongjian Wu, Nicolo Piazza, Jian Yang","doi":"10.1186/s40001-025-03227-6","DOIUrl":"10.1186/s40001-025-03227-6","url":null,"abstract":"<p><strong>Background: </strong>The treatment of patients with asymptomatic severe aortic stenosis (SAS) with left ventricular ejection fraction (LVEF) retention remains controversial.</p><p><strong>Objective: </strong>The study aimed to evaluate the safety and efficacy of these three treatment modalities and to provide evidence for their clinical application and promotion.</p><p><strong>Methods: </strong>This multicenter retrospective study included asymptomatic patients with SAS who accepted treatment [defined as normal left ventricular function, aortic valve area ≤ 1.0 cm², peak velocity (V_max) ≥ 4.0 m/s or mean pressure gradient ≥ 40 mmHg]. Patients were divided into the transcatheter aortic valve replacement (TAVR) group, the surgical aortic valve replacement (SAVR) group, and the conservative treatment group. The primary end point was all-cause mortality during the follow-up period.</p><p><strong>Results: </strong>During follow-up of 66.5 (interquartile range: 63.1-69.2) months, the incidence of the primary end point was lower in the TAVR group than in the conservative treatment group (33.3% vs. 46.4%, P = 0.023), and the incidence of major adverse cardiovascular events was reduced in the SAVR group (12.8% vs. 22.3%, P = 0.047). The incidences of the primary end point (37.3% vs. 60.4%, P < 0.001) and stroke (19.0% vs. 40.7%, P < 0.001) were significantly lower in patients who converted to aortic valve replacement (AVR) compared with those who did not convert to AVR.</p><p><strong>Conclusions: </strong>Early AVR improved both primary and secondary end points compared with patients having conservative treatments. Conversion to AVR during conservative treatment was found to be more likely to bring net clinical benefits for such patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Protocol Registration System NCT02917980.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"966"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How accurate is preoperative MRI in assessing scaphoid vascularity in patients with scaphoid nonunion? A systematic review and meta-analysis.","authors":"Omid Mahmoudi Nasab, Farid Najd Mazhar, Ali Behmanesh, Azadeh Gharooee Ahangar, Laura Serrano Barrenechea, Roshanak Shams","doi":"10.1186/s40001-025-03099-w","DOIUrl":"10.1186/s40001-025-03099-w","url":null,"abstract":"<p><strong>Background: </strong>Scaphoid fractures are a prevalent and complex issue in orthopedic practice, particularly when they lead to complications, such as nonunion and avascular necrosis (AVN), especially in proximal pole fractures. Preoperative assessment of scaphoid vascularity using magnetic resonance imaging (MRI) has become increasingly important for guiding surgical interventions, including deciding on using avascular bone grafting or vascular grafting procedures. However, there is ongoing debate regarding the diagnostic accuracy of various MRI techniques in evaluating scaphoid vascularity. This study aims to analyze existing literature on the diagnostic efficacy of different preoperative MRI methods in assessing scaphoid viability in patients with nonunion.</p><p><strong>Materials and methods: </strong>This systematic review was designed based on the structure of the Preferred Checklist for Systematic Reviews and Meta-Analyses (PRISMA). The search strategy employed a combination of keywords and MeSH terms related to scaphoid nonunion, preoperative MRI, and vascularity assessment.</p><p><strong>Results: </strong>Across three databases yielded 431 articles, of which 14 were selected for meta-analysis. The diagnostic performance of these MRI techniques was evaluated, revealing pooled sensitivity and specificity values of 0.702 and 0.85, respectively. Specifically, unenhanced MRI demonstrated a pooled sensitivity of 0.63 and a specificity of 0.85, while enhanced MRI showed improved sensitivity and specificity at 0.77 and 0.87, respectively, with an area under the curve (AUC) of 0.83 (P < 0.0001).</p><p><strong>Conclusions: </strong>This meta-analysis indicates that contrast-enhanced preoperative MRI provides superior sensitivity, specificity and AUC to unenhanced MRI for detecting scaphoid vascularity. In addition, the study highlights that the detection of hypointensity is a more reliable predictor of AVN, whereas isointensity may not accurately reflect scaphoid viability. Given the significant heterogeneity among studies and the lack of large, randomized trials, further well-designed studies with adequate sample sizes are necessary to confirm the effectiveness of different MRI methods in preoperatively assessing scaphoid vascularity.</p><p><strong>Level of evidence: </strong> I.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"970"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the brain networks underlying creativity enhancement via aesthetic experience.","authors":"Chao Huo, Chenzhi Li, Ke Ding","doi":"10.1186/s40001-025-03155-5","DOIUrl":"10.1186/s40001-025-03155-5","url":null,"abstract":"<p><p>Aesthetic experience is widely believed to foster creativity, yet the neural mechanisms mediating this link remain poorly defined. Here, we propose five key brain networks that may support this process and systematically review the evidence. In the creative generation stage, immersive aesthetic stimuli first activate the default mode network (DMN), which supports memory retrieval and spontaneous divergent thinking. Concurrently, the executive control network (ECN) remains suppressed, enabling associative thinking and intuitive creativity, while the salience network (SN) monitors novel or emotionally salient features. During the creative evaluation stage, aesthetic processing synergistically engages the SN, DMN, and ECN. The SN flexibly modulates the coupling between the DMN and ECN. The DMN contributes to affective and interoceptive evaluation, retrieves prototypical events, and supports insight generation, whereas the ECN inhibits conventional ideas, facilitates mental set shifting, and promotes the formation of novel associations. In the creative expression stage, aesthetic experience recruits the sensorimotor network (SMN), enhancing creative output and improvisational capability. Across all three stages, the reward system (RS) plays a dual role in both initiating and sustaining creativity. Dopamine released in response to aesthetic pleasure increases cognitive flexibility and task persistence during the generation and evaluation stages. In the expression stage, it maintains high creative motivation, thereby driving creative implementation and reinforcing emotional resonance. Importantly, none of these stages is mediated by a single brain region or network; instead, creativity is supported by the dynamic reconfiguration of connections within and between these networks. Finally, the review addresses current challenges in the field and proposes promising future directions.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"968"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota and metabolism in systemic lupus erythematosus: from dysbiosis to targeted interventions.","authors":"Jing-He Zhu, Li-Pei Wu, Lin Deng, Su-Gang Zang, Xue-Bin Li, Xin Chen, Jian-Xiu Yu","doi":"10.1186/s40001-025-03264-1","DOIUrl":"10.1186/s40001-025-03264-1","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multiorgan involvement, with pathogenesis closely linked to that of gut dysbiosis and metabolic disturbances. Studies indicate that SLE patients exhibit significantly reduced gut microbial diversity, increased abundance of pathogenic bacteria, and decreased beneficial bacteria. Dysbiosis exacerbates disease progression by disrupting the intestinal barrier, triggering autoimmune responses, and promoting proinflammatory cytokine release. Metabolomic analyses further reveal that SLE is associated with dysregulated amino acid metabolism, reduced short-chain fatty acids, and disrupted lipid homeostasis, which correlate with disease activity, renal injury, and increased atherosclerosis risk. Emerging microbiota-targeted interventions, such as fecal microbiota transplantation (FMT), probiotics/prebiotics, phage therapy, and dietary modifications, demonstrate promising therapeutic potential by restoring microbial balance, enhancing immune regulation, and improving metabolic homeostasis. This review systematically summarizes the alterations in gut microbiota and metabolism in SLE, their critical roles in disease progression, diagnosis, and pathogenesis, and explores the clinical value of microbial-targeted strategies in improving SLE outcomes.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"971"},"PeriodicalIF":3.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}