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Association between pro-inflammatory proteins and neurofilament in plasma from persons with epilepsy. 癫痫患者血浆中促炎蛋白与神经丝的关系。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-13 DOI: 10.1186/s12916-025-04425-z
Mayuresh Sarangdhar, Sarah Akel, Saman Hosseini Ashtiani, Markus Axelsson, Johan Zelano
{"title":"Association between pro-inflammatory proteins and neurofilament in plasma from persons with epilepsy.","authors":"Mayuresh Sarangdhar, Sarah Akel, Saman Hosseini Ashtiani, Markus Axelsson, Johan Zelano","doi":"10.1186/s12916-025-04425-z","DOIUrl":"10.1186/s12916-025-04425-z","url":null,"abstract":"<p><strong>Background: </strong>Inflammation and neurodegeneration are emerging as pathophysiological processes of interest in epilepsy. Seizures can both arise from and induce inflammation and difficult-to-treat epilepsy is linked to brain atrophy. However, the interplay between inflammation and neurodegeneration remains poorly understood in epilepsy. This study investigates the association between inflammatory proteins and plasma neurofilament light chain (NEFL or NfL), a known marker of neurodegeneration, particularly in relation to active epilepsy.</p><p><strong>Methods: </strong>We performed Olink proteomics on plasma from 176 epilepsy patients aged between 18 and 50 years. To assess systemic inflammation, a composite pro-inflammatory score was derived from the expression of 12 pro-inflammatory proteins. Patients were stratified based on pro-inflammatory score and NEFL and correlation between them was analyzed. Seizure frequency and drug resistance were assessed across patient subgroups.</p><p><strong>Results: </strong>Pro-inflammatory score and NEFL showed weak positive correlation (r = 0.1); not all patients with high levels of inflammation had high levels of NEFL. In the small proportion of patients (11%, n = 19) with high inflammation and elevated NEFL, seizures (Kruskal-Wallis test H = 9.68, p = 0.02) and drug-resistant epilepsy (χ<sup>2</sup> = 13.47, p = 0.036, df = 6) were more common, whereas patients with low inflammation and normal NEFL (31.8%, n = 56) tended to have well-controlled epilepsy. Moreover, patients with high inflammation and abnormal NEFL showed protein changes suggestive of potential blood-brain barrier disruption and leukocyte migration.</p><p><strong>Conclusions: </strong>Inflammation and neurodegeneration are not necessarily linked in all epilepsy patients, but both are more likely to exist in the subset of cases with many seizures. Conversely, absence of both processes indicates well-controlled epilepsy. The combination of plasma NEFL with inflammatory markers could improve seizure prediction and provide novel insights for personalized epilepsy management.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"554"},"PeriodicalIF":8.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285530","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}
引用次数: 0
Beyond one-size-fits-all: addressing sex differences and promoting inclusive leadership in cardiovascular research and healthcare. 超越一刀切:解决性别差异,促进心血管研究和医疗保健的包容性领导。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-13 DOI: 10.1186/s12916-025-04373-8
Jie V Zhao, Samantha Sartori
{"title":"Beyond one-size-fits-all: addressing sex differences and promoting inclusive leadership in cardiovascular research and healthcare.","authors":"Jie V Zhao, Samantha Sartori","doi":"10.1186/s12916-025-04373-8","DOIUrl":"10.1186/s12916-025-04373-8","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with men and women experiencing distinct differences in risk, symptom presentation, and health outcomes. Despite established evidence of these differences, women remain underrepresented in cardiovascular research, leading to persistent disparities in clinical care and outcomes.</p><p><strong>Main body: </strong>Important sex differences in CVD risk and risk factors exist. For example, women face a disproportionately higher CVD risk from metabolic disorders such as diabetes. However, the underlying reasons have not been fully explained. Women are also more likely to present with atypical or non-classic CVD symptoms, resulting in under-recognition, diagnostic delays, and less intensive management. Despite this, most current research findings and guidelines are based predominantly on males, limiting their relevance for women. The lack of sex-specific evidence extends to risk prediction models and treatment approaches. Existing models have not considered women's specific risk factors. Prevention and treatment strategies often rely on \"one-size-fits-all\" standards that fail to address women's unique needs. Addressing these gaps requires clinical research intentionally designed to incorporate sex differences at every stage, from participant recruitment and risk stratification to the development of tailored prediction tools and therapies, and prioritize sex-specific questions. Increasing women's representation as both participants and principal investigators in clinical trials is essential; evidence shows that studies led by women are more likely to enroll female participants. Promoting women's leadership can help ensure that women's perspectives and needs are fully integrated into cardiovascular research and healthcare.</p><p><strong>Conclusions: </strong>Achieving equity in cardiovascular health requires the integration of sex-specific perspectives across research, risk assessment, prevention, treatment, and leadership. These efforts are essential to close persistent knowledge gaps and improve the quality and equity of cardiovascular care for all.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"556"},"PeriodicalIF":8.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285531","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}
引用次数: 0
Additive effects of depression and abdominal obesity on cognitive function in middle-aged and older population: evidence from multinational cohorts. 抑郁症和腹部肥胖对中老年人群认知功能的累加效应:来自多国队列的证据
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-13 DOI: 10.1186/s12916-025-04298-2
Ruiqi Wang, Yalin Chen, Kayla M Teopiz, Roger S McIntyre, Bing Cao
{"title":"Additive effects of depression and abdominal obesity on cognitive function in middle-aged and older population: evidence from multinational cohorts.","authors":"Ruiqi Wang, Yalin Chen, Kayla M Teopiz, Roger S McIntyre, Bing Cao","doi":"10.1186/s12916-025-04298-2","DOIUrl":"10.1186/s12916-025-04298-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the joint trajectories of obesity/abdominal obesity and depression, and their association with cognitive function among four nationally representative cohorts.</p><p><strong>Methods: </strong>We used data from four nationally representative cohorts (China, UK, USA, and Mexico) in adults over the age of 45, which included a total of 114,633 participants. Kml3D clustering algorithm was conducted to identify the potential joint trajectories of obesity/abdominal obesity and depression of homogeneous groups. Generalized Estimating Equations (GEE) were performed to examine the joint trajectory of obesity/abdominal obesity and depression in relation to cognitive function.</p><p><strong>Results: </strong>In all cohorts, the baseline \"Comorbidity\" (with both depression and obesity/abdominal obesity) exhibited significantly poorer performance on subsequent cognitive assessments compared to the \"Neither condition\" group (neither depression nor obesity). Cluster analysis and GEE revealed that when Body Mass Index (BMI) was used as an obesity indicator, individuals in the joint trajectory groups with depression trajectories (regardless of obesity trajectories) across four cohorts exhibited poorer cognitive performance compared to the Normal weight and No depressed group (CHARLS: β =  - 0.35, 95% CI - 0.42 to - 0.28; ELSA: β =  - 0.32, 95% CI - 0.44 to - 0.20; HRS: β =  - 0.20, 95% CI - 0.27 to - 0.13, MHAS: β =  - 0.15, 95% CI - 0.19 to - 0.10; all P < 0.001). Conversely, associations between the joint trajectory groups with obesity trajectories (regardless of depression trajectories) and cognitive function demonstrated significant heterogeneity across cohorts. Abdominal obesity measures indicated that the abdominal obesity or higher waist-to-height ratio (WHtR) and Depression group significantly contributed to cognitive decline compared to those in the No abdominal obesity and No depression group (CHARLS: β =  - 0.31, 95% CI - 0.39 to - 0.23; ELSA: β =  - 0.20, 95% CI 0.29 to - 0.12; HRS: β =  - 0.20, 95% CI - 0.27 to - 0.14, all P < 0.001).</p><p><strong>Conclusions: </strong>Abdominal obesity and depression exert independent additive and fluctuating effects on measures of cognition in middle-aged and older persons. Strategies that broadly aim to decrease excess fat, notably abdominal obesity, represent near-term interventions that may beneficially influence aspects of cognition in depression.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"555"},"PeriodicalIF":8.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285529","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}
引用次数: 0
VEGFA sex-specific signature is associated to long COVID symptom persistence. VEGFA性别特异性特征与COVID症状持续时间长有关。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-10 DOI: 10.1186/s12916-025-04402-6
Xavier Farré, Natalia Blay, Susana Iraola-Guzmán, Francisco Fernández-Jiménez, Sayoa Alzate-Piñol, Laia Llucià-Carol, Ana Espinosa, Gemma Castaño-Vinyals, Carlota Dobaño, Gemma Moncunill, Marianna Karachaliou, Judith Garcia-Aymerich, Manolis Kogevinas, Carles Barceló, Israel Cadenas, Rafael de Cid
{"title":"VEGFA sex-specific signature is associated to long COVID symptom persistence.","authors":"Xavier Farré, Natalia Blay, Susana Iraola-Guzmán, Francisco Fernández-Jiménez, Sayoa Alzate-Piñol, Laia Llucià-Carol, Ana Espinosa, Gemma Castaño-Vinyals, Carlota Dobaño, Gemma Moncunill, Marianna Karachaliou, Judith Garcia-Aymerich, Manolis Kogevinas, Carles Barceló, Israel Cadenas, Rafael de Cid","doi":"10.1186/s12916-025-04402-6","DOIUrl":"10.1186/s12916-025-04402-6","url":null,"abstract":"<p><strong>Background: </strong>Long COVID involves persistent symptoms after COVID-19 recovery, affecting multiple organ systems for months or years. Risk factors include female sex, prior chronic conditions, severe SARS-CoV-2 infection, reinfections, and lack of vaccination. As a major public health concern, ongoing research continues to investigate its causes, mechanisms, and long-term effects.</p><p><strong>Methods: </strong>Proteomic expression analysis of 171 individuals, in two time points, with confirmed SARS-CoV-2 infection, including 133 long COVID patients from the deeply characterized COVICAT cohort, assessed 1395 protein biomarkers using Olink® technology. Statistical analyses with linear mixed models examined protein expression changes, long COVID status, and sex-specific differences. Functional analysis included gene set enrichment analysis and protein-protein interaction networks.</p><p><strong>Results: </strong>Findings revealed VEGFA overexpression in long COVID patients (effect size 0.322, SE = 0.098, p = 0.0013), along with sex-specific expression patterns and the influence of sex-hormonal status in females, with significant overexpression of circulating VEGFA levels specifically in postmenopausal women (Mann-Whitney U test p value = 8.55 × 10<sup>-3</sup>). Network analysis identified 109 nodes and 274 edges, with VEGFA ranking highest in centrality. Dysregulated chemokine signaling, complement activation, and viral reactivation were also confirmed, consistent with prior studies.</p><p><strong>Conclusions: </strong>Using high-throughput proteomic profiling in a population-based cohort, we observed that vascular dysfunction, particularly involving VEGFA, is a key feature of long COVID, especially in milder cases, with significant overexpression of VEGFA in postmenopausal women. Sex-specific proteomic patterns suggest distinct recovery mechanisms, highlighting the need to consider sex, vascular health, and disease severity in the pathogenesis and management of long COVID.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"552"},"PeriodicalIF":8.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273707","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}
引用次数: 0
Early detection of non-small cell lung cancer: an electronic health record data-driven approach. 非小细胞肺癌的早期检测:电子健康记录数据驱动的方法。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-10 DOI: 10.1186/s12916-025-04289-3
Xiudi Li, Erin Y Yuan, Stephen J Kuperberg, Clara-Lea Bonzel, Mary I Jeffway, Tianrun Cai, Katherine P Liao, Raquel Aguiar-Ibáñez, Yu-Han Kao, Melissa L Santorelli, David C Christiani, Tianxi Cai, Rui Duan
{"title":"Early detection of non-small cell lung cancer: an electronic health record data-driven approach.","authors":"Xiudi Li, Erin Y Yuan, Stephen J Kuperberg, Clara-Lea Bonzel, Mary I Jeffway, Tianrun Cai, Katherine P Liao, Raquel Aguiar-Ibáñez, Yu-Han Kao, Melissa L Santorelli, David C Christiani, Tianxi Cai, Rui Duan","doi":"10.1186/s12916-025-04289-3","DOIUrl":"10.1186/s12916-025-04289-3","url":null,"abstract":"<p><strong>Background: </strong>Specific patient characteristics increase the risk of cancer, necessitating personalized healthcare approaches. For high-risk individuals, tailored clinical management ensures proactive monitoring and timely interventions. Electronic health record (EHR) data are crucial for supporting these personalized approaches, improving cancer prevention and early diagnosis. We leverage EHR data and build a prediction model for early detection of non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>We utilize data from Mass General Brigham's EHR and implement a three-stage ensemble learning approach. Initially, we generate risk scores using multivariate logistic regression in a self-control and case-control design to distinguish between cases and controls. Subsequently, these risk scores are integrated and calibrated using a prospective Cox model to develop the risk prediction model.</p><p><strong>Results: </strong>We identified 127 EHR-derived features predictive for early detection of NSCLC. The highly predictive features include smoking, relevant lab test results, and chronic lung diseases. The predictive model reached area under the receiver operating characteristic (ROC) curve (area under the curve, AUC) of 0.801 (positive predictive value (PPV) 0.0173 with specificity 0.02) for predicting 1-year NSCLC risk in a population aged 18 and above, and AUC of 0.757 (PPV 0.0196 with specificity 0.02) in a population aged 40 and above.</p><p><strong>Conclusions: </strong>This study identified EHR-derived features which are predictive of early NSCLC diagnosis. The developed risk prediction model exhibits superior performance for early detection of NSCLC compared to a baseline model that only relies on demographic and smoking information, demonstrating the potential of incorporating EHR-derived features for personalized cancer screening recommendations and early detection.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"551"},"PeriodicalIF":8.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273773","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}
引用次数: 0
Association between daily dietary intake trajectory and depressive symptom onset and transition among young adults: a longitudinal study. 年轻人每日饮食摄入轨迹与抑郁症状发生和转变之间的关系:一项纵向研究。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-10 DOI: 10.1186/s12916-025-04401-7
Hao Chen, Yi Zeng, Jie Qian, Weiqiang Zhou, Jingyun Ding, Hong Peng, Zhu Ai, Haihong Qian, Yingnan Jia
{"title":"Association between daily dietary intake trajectory and depressive symptom onset and transition among young adults: a longitudinal study.","authors":"Hao Chen, Yi Zeng, Jie Qian, Weiqiang Zhou, Jingyun Ding, Hong Peng, Zhu Ai, Haihong Qian, Yingnan Jia","doi":"10.1186/s12916-025-04401-7","DOIUrl":"10.1186/s12916-025-04401-7","url":null,"abstract":"<p><strong>Background: </strong>Little information is available on long-term dietary monitoring among young adults. We examined the associations between 28-month dietary intake trajectories and depressive symptom onset and transition.</p><p><strong>Methods: </strong>Using complete daily dining records from Shanghai's Intelligent Ordering System (IOS) (September 2021-December 2023; n = 6,447), we prospectively assessed dietary exposures prior to measuring depressive symptoms through two Beck Depression Inventory-II (BDI-II) administrations at 24-month intervals (2022 and 2024) in young adults aged 18-40 years. Group-based multi-trajectory models (GBMTs) identified monthly dietary trajectories (classified as Chronic Recommended, Chronic High/Low, or Fluctuating) for 28 nutrients and 15 food components. Multivariable logistic regression assessed associations with depressive symptom onset/transition.</p><p><strong>Results: </strong>Among 6447 young adults, depressive symptom incidence was 9.7%, whereas depressive symptom improvement and progression incidences were 59.1% and 12.52%, respectively. Certain nutrient and food component trajectories were associated with lower depressive symptom onset risk, including chronic higher intake of carbohydrates, protein, sodium, oil, and sauce, and chronic lower intake of saturated fatty acids (SFAs). In contrast, non-recommended trajectories of zinc, refined grains, and light-colored vegetables were linked to higher onset risk. Notably, some trajectories (e.g., high fat, potassium) showed dual associations: they correlated with higher chances of depressive symptom improvement but also elevated progression risk.</p><p><strong>Conclusions: </strong>Certain nutrients and dietary patterns showed protective effects against depressive symptom onset, while non-recommended trajectories increased the risk. Some patterns improved symptoms but increased progression risk. The nutritional medicine approach may be beneficial for preventing and promoting depression in young adults.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"553"},"PeriodicalIF":8.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273730","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}
引用次数: 0
Adiposity, mortality, and disease risk: insights from bioimpedance analysis and magnetic resonance imaging. 肥胖、死亡率和疾病风险:来自生物阻抗分析和磁共振成像的见解。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-10 DOI: 10.1186/s12916-025-04356-9
Quan Gan, Heinz Freisling, Laia Peruchet-Noray, Emma Fontvieille, Komodo Matta, Yue Zhai, Patricia Bohmann, Anja Sedlmeier, Amina Amadou, Béatrice Fervers, Michael J Stein, Reynalda Córdova, Hansjörg Baurecht, Pietro Ferrari, Vivian Viallon
{"title":"Adiposity, mortality, and disease risk: insights from bioimpedance analysis and magnetic resonance imaging.","authors":"Quan Gan, Heinz Freisling, Laia Peruchet-Noray, Emma Fontvieille, Komodo Matta, Yue Zhai, Patricia Bohmann, Anja Sedlmeier, Amina Amadou, Béatrice Fervers, Michael J Stein, Reynalda Córdova, Hansjörg Baurecht, Pietro Ferrari, Vivian Viallon","doi":"10.1186/s12916-025-04356-9","DOIUrl":"10.1186/s12916-025-04356-9","url":null,"abstract":"<p><strong>Background: </strong>Basic anthropometric (BA) indicators of adiposity, such as body mass index, may not fully capture disease risk. Whether more advanced anthropometric measurements derived from bioimpedance analysis (BIA) or magnetic resonance imaging (MRI) enhance our understanding of the relationship between adiposity and health-related outcomes is debated.</p><p><strong>Methods: </strong>We used data from 40,338 participants from the UK Biobank imaging sub-study with anthropometric measurements derived from BIA and abdominal MRI, in addition to BA indicators, to evaluate their discriminatory performance. We studied the relationship between these adiposity indicators and all-cause mortality, risks of cardiovascular diseases (CVDs), obesity-related cancer, overall cancer, and type 2 diabetes (T2D) using Cox models adjusted for established risk factors. For each health-related outcome, relevant anthropometric indicators were selected using a stepwise approach, and the discriminatory power of each model was evaluated with cross-validated C-indexes.</p><p><strong>Results: </strong>MRI-derived organ morphometry indicators moderately improved risk discrimination for T2D (cross-validated C-index increased from 0.83 [95% CI: 0.81, 0.84] to 0.85 [0.83, 0.86]; adjusted p = 4.05E - 6) and obesity-related cancers (from 0.59 [0.57, 0.62] to 0.61 [0.59, 0.64]), albeit with borderline significance (adjusted p = 0.053). Although improved discrimination was also observed for overall cancer and all-cause mortality compared to BA alone, differences were not statistically significant (all adjusted p > 0.200). Conversely, the inclusion of BIA indicators generally did not lead to improved discriminatory power.</p><p><strong>Conclusions: </strong>MRI-derived organ morphometry indicators may provide information beyond BA indicators for the assessment of adiposity and its association with risk of some health-related outcomes.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"550"},"PeriodicalIF":8.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273791","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}
引用次数: 0
STI testing and diagnosis rates among patients with Mpox in 2 populous US cities, 2022. 2022年美国两个人口稠密城市m痘患者的性传播感染检测和诊断率。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-09 DOI: 10.1186/s12916-025-04396-1
Shauna H Gunaratne, Karen J Vigil, Simian Huang, Nina Kumenda, Jacob McLean, Clare DeLaurentis, Delivette Castor, Jason Zucker
{"title":"STI testing and diagnosis rates among patients with Mpox in 2 populous US cities, 2022.","authors":"Shauna H Gunaratne, Karen J Vigil, Simian Huang, Nina Kumenda, Jacob McLean, Clare DeLaurentis, Delivette Castor, Jason Zucker","doi":"10.1186/s12916-025-04396-1","DOIUrl":"10.1186/s12916-025-04396-1","url":null,"abstract":"<p><strong>Background: </strong>Mpox is recognized as a sexually transmitted infection, and the 2022 epidemic and 2024 resurgence of mpox cases through sexual transmission highlighted the need for sexually transmitted infection (STI) testing. Our objective was to observe rates of STI testing and STI diagnoses in patients with confirmed mpox in Houston, Texas and New York City, New York (NY).</p><p><strong>Methods: </strong>This was a retrospective cohort study involving manual review of confirmed mpox cases at three large clinical centers in Houston, Texas and New York City, NY. Descriptive statistics were calculated for rates of STI testing and new diagnoses of syphilis, chlamydia and gonorrhea.</p><p><strong>Results: </strong>There were 404 patients in the cohort from the three different clinical sites. The median age was 33 years. 66% underwent STI testing within two weeks of their mpox diagnosis. Among those who were tested, there were 71 patients with a new STI. Syphilis was the most newly diagnosed STI with 31 new cases. Most of the chlamydia and gonorrhea cases were extragenital (81%). Rates of chlamydia and gonorrhea tended to be higher in patients reporting site-specific symptoms (ex. pharyngitis, urethritis) than in asymptomatic patients. However, rates of STI testing were still low even in patients reporting site-specific symptoms. 63.6% of those reporting urinary symptoms, 51.9% of those reporting rectal symptoms and 47.4% reporting pharyngitis symptoms were tested for site-specific chlamydia and gonorrhea.</p><p><strong>Conclusions: </strong>Our findings highlight a gap in STI testing even in patients at high risk presenting with mpox, a sexually transmitted infection.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"548"},"PeriodicalIF":8.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257472","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}
引用次数: 0
Prediction models for self-harm and suicide: a systematic review and critical appraisal. 自我伤害和自杀的预测模型:系统回顾和批判性评价。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-09 DOI: 10.1186/s12916-025-04367-6
Aida Seyedsalehi, James Bailey, Maya G T Ogonah, Thomas R Fanshawe, Seena Fazel
{"title":"Prediction models for self-harm and suicide: a systematic review and critical appraisal.","authors":"Aida Seyedsalehi, James Bailey, Maya G T Ogonah, Thomas R Fanshawe, Seena Fazel","doi":"10.1186/s12916-025-04367-6","DOIUrl":"10.1186/s12916-025-04367-6","url":null,"abstract":"<p><strong>Background: </strong>The number of prediction models for self-harm and suicide has grown substantially in recent years. However, their potential role in improving assessment of suicide risk is debated. In this systematic review, we provide an overview and critical appraisal of the predictive performance and methodological quality of prognostic risk models for self-harm and suicide.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Global Health from inception to 30/11/2021. The search was updated on 25/10/2024 to include new external validations. We included studies describing the development and/or external validation of statistical models for predicting risk of non-fatal self-harm and/or death by suicide. Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST).</p><p><strong>Results: </strong>We included 91 articles describing the development of 167 models and 29 external validations. Most models predicted risk of self-harm (76 models), followed by suicide (51 models), and the composite outcome of suicide or non-fatal self-harm (40 models). Only 8% of developed models (14/167) were externally validated, and 17% (28/167) were presented in a format enabling validation or use by others. The reported C indices ranged from 0.61 to 0.97 (median 0.82) in development studies and from 0.60 to 0.86 (median 0.81) in external validations. Calibration was assessed for 9% of models (15/167) in development studies and 31% of external validations (9/29). Of these, the OxMIS and Simon models showed adequate discrimination and calibration performance in external validation. All model development studies, and all but two external validations, were at high risk of bias. This was mainly driven by inappropriate or incomplete evaluation of predictive performance (180/196, 92%), insufficient sample sizes (151/196, 77%), inappropriate handling of missing data (129/196, 66%), and not adequately accounting for overfitting and optimism during model development (106/167, 63%).</p><p><strong>Conclusions: </strong>Despite skepticism about the feasibility and accuracy of self-harm and suicide risk prediction and assessment, we have identified five models with good predictive performance in external validation. Avoidable sources of research waste include an oversupply of unvalidated prediction models addressing similar research questions, and shortcomings in study design, conduct, and statistical analysis. To address these, new research must prioritise methodological rigour and focus on external validation and updating existing models. Complete, transparent, and accurate reporting is essential, with model presentation in a format that enables independent validation.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"549"},"PeriodicalIF":8.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257411","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}
引用次数: 0
The protective effect of breastfeeding on infant inflammation: a mediation analysis of the plasma lipidome and metabolome. 母乳喂养对婴儿炎症的保护作用:血浆脂质组和代谢组的中介分析。
IF 8.3 1区 医学
BMC Medicine Pub Date : 2025-10-08 DOI: 10.1186/s12916-025-04343-0
Satvika Burugupalli, Toby Mansell, Tingting Wang, Alexandra D George, Sudip Paul, Richard Saffery, Mimi L K Tang, Thomas W McDade, Habtamu B Beyene, Thy Duong, Peter Vuillermin, Anne-Louise Ponsonby, David P Burgner, Peter J Meikle
{"title":"The protective effect of breastfeeding on infant inflammation: a mediation analysis of the plasma lipidome and metabolome.","authors":"Satvika Burugupalli, Toby Mansell, Tingting Wang, Alexandra D George, Sudip Paul, Richard Saffery, Mimi L K Tang, Thomas W McDade, Habtamu B Beyene, Thy Duong, Peter Vuillermin, Anne-Louise Ponsonby, David P Burgner, Peter J Meikle","doi":"10.1186/s12916-025-04343-0","DOIUrl":"10.1186/s12916-025-04343-0","url":null,"abstract":"<p><strong>Background: </strong>Inflammation has long-term health impacts across the life course. Breastfeeding substantially reduces inflammation risk, but key pathways, including the extent that this is due to protection against early life infection, are poorly understood. We aimed to investigate the relationships between breastfeeding, inflammation, and infection burden, and to determine the extent to which metabolomic and lipidomic profiles associated with breastfeeding mediate these health outcomes.</p><p><strong>Methods: </strong>We utilised data from the Barwon Infant Study (BIS), a longitudinal birth cohort in Victoria, Australia. Infants (n = 889) with available breastfeeding (categorised as yes/no) clinical, metabolomic, and Lipidomic data at 6 and/or 12 months were included (n = 793 at 6 months, n = 734 at 12 months). Inflammation, measured via glycoprotein acetyls (GlycA), at 6 and 12 months and infection burden, including parent-reported and medically attended infections assessed through standardised 3-monthly questionnaires were used as outcomes.</p><p><strong>Results: </strong>Any breastfeeding, regardless of supplementary feeding, was associated with lower inflammation, fewer infections, and significant, potentially beneficial changes in metabolomic and lipidomic markers, particularly plasmalogens. There was evidence of bidirectional mediation: metabolomic biomarkers and lipids mediated breastfeeding's effects on inflammation, while inflammation partly mediated breastfeeding's impact on certain metabolites and lipids.  CONCLUSIONS: These findings highlight pathways through which breastfeeding reduces inflammation and infection burden, identifying potential targets for optimising infant feeding.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"531"},"PeriodicalIF":8.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243713","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}
引用次数: 0
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