BMC Medicine最新文献

{"title":"The PCOS Phenotypes in Unselected Populations (P-PUP) study: participant clinical features and data harmonization on analysis of individual participant data.","authors":"Asmamaw Demis Bizuneh, Sylvia Kiconco, Arul Earnest, Mahnaz Bahri Khomami, Raja Ram Dhungana, Ricardo Azziz, Larisa V Suturina, Xiaomiao Zhao, Alessandra Gambineri, Fahimeh Ramezani Tehrani, Bulent O Yildiz, Jin Ju Kim, Liangzhi Xu, Christian Chigozie Makwe, Helena J Teede, Anju E Joham, Chau Thien Tay","doi":"10.1186/s12916-025-04221-9","DOIUrl":"10.1186/s12916-025-04221-9","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a multifaceted condition with diagnostic challenges and clinical heterogeneity across populations. Research priorities include enhanced accuracy in defining cut-offs for diagnostic features. Here, we aim to describe participant clinical features and data harmonization in the international PCOS Phenotype in Unselected Populations (P-PUP) study.</p><p><strong>Methods: </strong>We searched EMBASE and Medline (Ovid) from 1990 to October 2, 2020, in population-based, medically unbiased study cohorts. Included studies had ≥ 300 participants, directly assessed PCOS-related features, and provided Individual Participant Data (IPD). Risk of bias was assessed using the AXIS tool. Data integrity was ensured via cross-referencing, identifying outliers/implausible data, and variable harmonization. Reporting follows PRISMA-IPD guidelines, summarizing findings with frequencies and proportions.</p><p><strong>Results: </strong>The study included 9979 reproductive-age women from 12 studies across eight countries (China, Iran, Italy, Nigeria, Russia, South Korea, Turkey, and the USA), representing 11 ethnicities. Ovulatory dysfunction was variably recorded, from mean menstrual cycle length, minimum or maximum cycle length, number of cycles per year, or urinary progesterone measurements. Clinical hyperandrogenism was assessed via modified Ferriman-Gallwey (mFG) scores, with a few also including acne and alopecia. Biochemical hyperandrogenism thresholds varied (95th, 97.5th, or 98th percentile of healthy controls). Polycystic ovary morphology was assessed via transvaginal, transabdominal, or transrectal approaches. Harmonization adhered to International PCOS Guidelines for ovulatory dysfunction, ethnicity-specific cut-offs for hirsutism (via k-means clustering), and 95th percentile thresholds for biochemical hyperandrogenism. PCOS prevalence ranged from 3.3 to 19.8% in the original studies and was 11.0% overall after harmonization.</p><p><strong>Conclusions: </strong>The P-PUP study offers an unprecedented, ethnically diverse, medically unbiased population-based cohort, an extraordinarily valuable tool to enhance knowledge and research in PCOS. However, variability in data collection methods and definitions of PCOS diagnostic features across studies limited the ability to fully integrate data for analysis. Despite these limitations, we optimized harmonization in this IPD, and the findings provided valuable insights into the challenges of data harmonization and established a foundation for future collaborative research. Future research should focus on standardizing data collection, establishing normative cut-offs based on true natural groupings, and linking diagnostic clusters to outcomes in diverse populations.</p><p><strong>Protocol registration: </strong>CRD42021267847.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"420"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636188","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}

{"title":"Cardiac magnetic resonance markers of pre-clinical hypertrophic and dilated cardiomyopathy in genetic variant carriers.","authors":"Philip M Croon, Marion van Vugt, Cornelis P Allaart, Bram Ruijsink, Perry M Elliott, Folkert W Asselbergs, Rohan Khera, Connie R Bezzina, Michiel Winter, A Floriaan Schmidt","doi":"10.1186/s12916-025-04226-4","DOIUrl":"10.1186/s12916-025-04226-4","url":null,"abstract":"<p><strong>Background: </strong>Patients with hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM) exhibit structural and functional cardiac abnormalities. We aimed to identify imaging biomarkers for pre-clinical cardiomyopathy in healthy participants carrying cardiomyopathy-associated variants (G +).</p><p><strong>Methods: </strong>We included 40,169 UK Biobank participants free of cardiac disease at the time of cardiac magnetic resonance imaging (CMR) and with whole exome sequencing. We validated 22 CMR measurements by associating them with incident atrial fibrillation (AF) or heart failure (HF). We subsequently assessed associations of these CMR measurements with HCM G+, DCM G + , or specific genes, utilising generalised linear models conditional on cardiac risk factors.</p><p><strong>Results: </strong>Thirteen CMR measurements were associated with incident AF and 15 with HF. These included left ventricular (LV) ejection fraction (EF; hazard ratio [HR] 0.61, 95% confidence interval [95%CI] 0.54; 0.69) for HF and indexed maximum left atrial volume (LAVi max; HR 1.47, 95%CI 1.29; 1.67) for AF. Five measurements associated with HCM G + , amongst which right ventricular (RV) end-systolic volume (RV-ESV; odds ratio [OR] 0.62, 95%CI 0.53; 0.74), RV-EF (OR 1.36, 95%CI 1.19; 1.55), and right atrial (RA) EF (OR 1.22, 95%CI 1.08; 1.39). Associations overlapping with incident disease and HCM G + had opposite effect directions, such as RV-ESV with HF (HR 1.22, 95%CI 1.07; 1.40). Two CMR measurements associated with DCM G + : LV-ESVi (OR 1.35, 95%CI 1.15; 1.58) and LV-EF (OR 0.75, 95%CI 0.64; 0.88). We observed significant associations with individual cardiomyopathy genes, finding that mitral annular plane systolic excursion associated with TTN and TNNT2, and LA pump volume and RA-EF associated with MYH7.</p><p><strong>Conclusions: </strong>We identified right-heart CMR measurements associated with HCM G + in healthy individuals, indicating early compensation of cardiac function. LV measurements associated with DCM G + , where CMR associations varied across individual DCM genes, suggesting distinct early pathophysiology.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"421"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636184","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}

{"title":"Mpox stigma in the UK and implications for future outbreak control: a cross-sectional mixed methods study.","authors":"Amy Paterson, Ashleigh Cheyne, Harun Tulunay, Chloe Orkin, Will Nutland, Jake Dunning, Jeni Stolow, Nina Gobat, Piero Olliaro, Amanda Rojek","doi":"10.1186/s12916-025-04243-3","DOIUrl":"10.1186/s12916-025-04243-3","url":null,"abstract":"<p><strong>Background: </strong>Stigma emerged as a prominent public health challenge in the global mpox outbreak that began in 2022, impeding outbreak control efforts and the well-being of affected individuals. Addressing stigma is important for improving infection prevention and control. Despite frequent mention in public and policy discourse, robust assessment of mpox stigma is lacking. This study investigated the causes, manifestations, and impacts of mpox-related stigma in the UK, focusing on anticipated stigma among directly and indirectly affected communities.</p><p><strong>Methods: </strong>We conducted an online, mixed-methods cross-sectional survey to assess mpox stigma. We developed and content validated a new tool, the Stigma Survey and Community-based Assessment for New and Re-emerging outbreaks (Stigma-SCANR) for this purpose. Through quota sampling, the survey targeted populations most affected by mpox at the time of data collection (March-July 2024), including gay, bisexual, and other men who have sex with men (GBMSM), and healthcare workers. The survey primarily explored anticipated stigma. Respondents with previous mpox diagnoses were asked about personal experiences of stigma.</p><p><strong>Results: </strong>Of 479 respondents who initiated the survey, 437 (91%) were included in analyses. In modules related to drivers of stigma, pre-existing prejudices towards associated groups such as GBMSM and migrants were emphasised, alongside fear and misinformation. On average, respondents anticipated higher levels of negative judgement and unwarranted avoidance compared to other forms of social stigma, particularly from casual partners and the public. Among the 13 respondents who reported a previous mpox diagnosis, 11 (85%) had experienced mpox-related stigma. Nearly a quarter of respondents (24%) said they would not, or were unlikely to, tell a recent sexual partner about an mpox diagnosis. Feelings of shame were considered the most common barrier to care-seeking (299 respondents, 68%).</p><p><strong>Conclusions: </strong>This analysis of mpox stigma in the UK offers insights for international outbreak response, particularly in countries with similarly affected communities. Lessons learnt may also be transferable to other disease outbreaks. We propose practical recommendations for reducing stigma in future outbreaks, including peer support initiatives, distributing accessible information about safe timelines for returning to socialising and work or school, and co-designing public communications and contact tracing programmes with affected community members.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"422"},"PeriodicalIF":7.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636186","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}

{"title":"Sexual identity inequalities in the co-occurrence of poor mental health and health risk behaviours-a national cross-sectional study.","authors":"Amal R Khanolkar, Alexis Karamanos, Laia Becares","doi":"10.1186/s12916-025-04236-2","DOIUrl":"10.1186/s12916-025-04236-2","url":null,"abstract":"<p><strong>Background: </strong>Mental health problems (MHP, like depression/anxiety) and health and risk behaviours (HRBs) are more common among sexual minority adolescents (SMA) than in heterosexual peers. Limited studies have examined the co-occurrence of poor mental health and HRBs, if co-occurrence differs by sexual identity, and associated risks for self-harm and attempted suicide in adolescents.</p><p><strong>Methods: </strong>This study included 10,233 adolescents aged 17 years (51% female/11% sexual minority) from the UK-wide Millennium Cohort Study. Sexual identity, MHP, seven HRBs (like regular smoking, drug use and sexual risk behaviour), self-harm and attempted suicide were self-reported. MHP were assessed using the strengths and difficulties questionnaire [SDQ] emotional symptoms subscale for depression/anxiety. We assessed associations between sexual identity and co-occurrence of MHP and HRBs using multinomial logistic regression. We estimated predicted probabilities for self-harm or attempted suicide based on sexual identity and MHP-HRB co-occurrence status using logistic regression models with appropriate interaction terms (between sexual identity and MHP-HRB co-occurrence status variables).</p><p><strong>Results: </strong>MHP prevalence was higher in gay/lesbian (48%) and bisexual (49%) adolescents compared to heterosexual peers (19%). Self-harm (bisexual, 64%; gay/lesbian, 53%; heterosexual, 19%) and attempted suicide (bisexual, 24%; gay/lesbian, 17%; heterosexual, 6%) prevalence were higher in SMA compared to heterosexual peers. Gay/lesbian and bisexual adolescents consistently had higher probability for MHP-HRB co-occurrence compared to heterosexual peers (example, for gay/lesbian individuals: RRR 3.16 [95% CI 2.1-4.68] for MHP-1HRB, RRR 3.54 [95% CI 2.06-6.08] for MHP- ≥ 3HRB, for bisexual adolescents: RRR 2.44 [95% CI 1.85-3.20] for MHP-1HRB, RRR 4.11 [95% CI 2.99-5.66] for MHP- ≥ 3HRB). MHP-HRB co-occurrence and sexual minority identity were independently associated with greater odds for self-harm or attempted suicide. SMA had higher probabilities of reporting self-harm than heterosexual peers with the same level of MHP-HRB co-occurrence. For example, 37.2% of heterosexual adolescents with MHP-1HRB reported self-harm. Corresponding numbers were twice as high in bisexual (75.7%) and gay/lesbian (77.9%) individuals. Similarly, 58.3% of heterosexual adolescents with MHP- ≥ 3HRBs reported self-harm, increasing to 84.6% in bisexual and 83.8% in gay/lesbian peers.</p><p><strong>Conclusions: </strong>SMA are more likely to experience MHP-HRB co-occurrence, which is associated with substantially higher risks for self-harm and attempted suicide compared to heterosexual peers. Findings highlight the need for better public health policies to address MHP and associated comorbidities to reduce sexual identity-related health inequities in adolescence.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"417"},"PeriodicalIF":7.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590455","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}

{"title":"Sjögren's syndrome is associated with a reduction in the surface area of the right caudal anterior cingulate gyrus.","authors":"Ping Wang, Yunpeng Tai, Xiaofang Zhu, Xinyi Wan, An Sun, Jiajia Wang, Hui Cheng, Jingwei Hong, Yi Zhang, Xiaobing Wang","doi":"10.1186/s12916-025-04205-9","DOIUrl":"10.1186/s12916-025-04205-9","url":null,"abstract":"<p><strong>Background: </strong>Sjögren's syndrome (SS) is a common chronic autoimmune disease. Neurological involvement in SS represents one of the more severe and challenging aspects, with complications affecting the central system leading to cognitive dysfunction, sensory neuropathy, and multifocal sensorimotor neuropathies among other cortical function abnormalities. The relationship between cerebral cortex structure and neurological pathologies is well-documented, yet the impact of SS on cerebral cortex structure remains unclear.</p><p><strong>Methods: </strong>A two-sample Mendelian randomization (MR) analysis was conducted using four single-nucleotide polymorphisms (SNPs) associated with SS. Summary data from genome-wide association studies (GWAS) on SS and brain cortical structure were analyzed using inverse-variance weighted (IVW), MR-Egger, and weighted median (WM) methods. Sensitivity analyses were performed to ensure reliability. Brain magnetic resonance imaging (MRI) scanning of a group of established but treatment-naïve SS patients were performed and assessed for validation. For TWAS (transcriptome-wide association studies), we used the RNA sequencing expression data from the Genotype-Tissue Expression version 8 (GTEx v8) for the cerebral cortex as a reference dataset and predicted the mRNA expression levels of cis-regulated genes in the cerebral cortex using linear models based on expression quantitative trait loci (eQTLs). We also used CELLECT to leverage genome-wide association study (GWAS) and single-cell RNA sequencing (scRNA-seq) data to identify pathogenic cell types.</p><p><strong>Results: </strong>The MR analysis revealed a negative genetic causal relationship between SS and brain structure (entorhinal: IVW: beta = - 3.4398, SE = 1.6954, P = 0.0425; caudal anterior cingulate gyrus: IVW: beta = - 4.2947, SE = 2.0593, P = 0.0370). Brain MRI of SS patients confirmed a reduction in the surface area of the right caudal anterior cingulate. TWAS identified genes associated with SS in the major histocompatibility complex (MHC) region and identified PRTFDC1 in the caudal anterior cingulate gyrus. Cell-type enrichment analysis indicated that excitatory glutamatergic cells are primarily involved in the brain changes associated with SS.</p><p><strong>Conclusions: </strong>This study suggests that SS is a risk factor for changes in brain cortical structure, with a reduction in the surface area of the right caudal anterior cingulate gyrus. The identified genes and cell types provide insights into the mechanisms underlying the effects of SS on brain structure.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"415"},"PeriodicalIF":7.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590456","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}

{"title":"Health insurance status and severe mpox disease outcomes among sexual minority men in NYC: a retrospective cohort study.","authors":"Ofole Mgbako, Cecilia Castellano, Kathryn Jano, Anthony Lo Piccolo, Madeline A DiLorenzo, Dorothy Knutsen, Yusra Shah, Joyce C Pressley, Dustin T Duncan, Jason Felder, Dana Mazo","doi":"10.1186/s12916-025-04252-2","DOIUrl":"10.1186/s12916-025-04252-2","url":null,"abstract":"<p><strong>Background: </strong>The 2022-2023 global mpox outbreak predominantly affected sexual minority men, with notable racial/ethnic disparities in the USA. While the current literature has established the clinical predictors of severe mpox disease, little is known about the role of insurance status on clinical outcomes. We sought to characterize patients diagnosed with mpox in New York City (NYC) and examine associations between insurance status and mpox severity score (mpox-SS).</p><p><strong>Methods: </strong>We included 143 patients aged 18 years and older between May 1, 2022, and December 31, 2023, with confirmed mpox identified through the electronic medical record. Demographics and clinical characteristics were summarized. Linear regression was performed to examine associations between insurance status and mpox-SS, controlling for race/ethnicity, high-risk condition (e.g., HIV with CD4 < 350 cells/mm³), prior vaccination with JYNNEOS or a smallpox vaccine, presence of a sexually transmitted infection (STI), and CDC Social Vulnerability Index.</p><p><strong>Results: </strong>The mean age (SD) was 38.3 (10.2) years with 53 (37.1%) identifying as non-Hispanic White, 44 (30.8%) as Hispanic/Latino, and 30 (20.9%) as non-Hispanic Black. Over 90% were male sex at birth or identified as cisgender men and approximately 80% were sexual minority men. Ninety-six (67.1%) had private insurance, 6 (4.2%) Medicare, 35 (24.5%) Medicaid, and 4 were (2.8%) uninsured. Sixty-three (44.1%) had a confirmed HIV diagnosis, 25 (17.4%) patients had prior JYNNEOS vaccination, and 31 (21.7%) had a high-risk condition. Thirty-eight (26.6%) patients received tecovirimat; 21 (14.7%) patients were hospitalized, with 4 (2.8%) of those admitted to the ICU. The mean (SD) mpox-SS was 6.85 (3.36). In univariate analysis, lack of insurance or Medicaid status was associated significantly with more severe mpox-SS. Insurance status remained significant (p = 0.03) in multivariable models.</p><p><strong>Conclusions: </strong>Being uninsured or on Medicaid was significantly associated with a higher mpox-SS in this diverse cohort of predominantly cisgender sexual minority men in NYC. High-risk status and lack of prior vaccination were associated with higher mpox-SS. Further studies are needed to assess the relationship between insurance, delays in access to care, or other socioeconomic inequities with severe mpox to understand the inequities beyond insurance access to prevent disparities in future outbreaks.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"418"},"PeriodicalIF":7.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590443","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}

{"title":"Baseline functional connectivity of the basal forebrain-cortical circuit predict taVNS treatment response in primary insomnia: a randomized controlled trial and fMRI study.","authors":"Meng Qi, Yiting Huang, Runru Mai, Zhaoxian Yan, Biyun Xu, Bo Liu, Yue Zhang","doi":"10.1186/s12916-025-04126-7","DOIUrl":"10.1186/s12916-025-04126-7","url":null,"abstract":"<p><strong>Background: </strong>Dysfunctional basal forebrain (BF) connectivity contributes to primary insomnia (PI). This study investigated whether transcutaneous auricular vagus nerve stimulation (taVNS) modulates BF functional connectivity (FC) in patients with PI and whether baseline FC predicts taVNS treatment response.</p><p><strong>Methods: </strong>Seventy patients with PI were randomized to real or sham taVNS for 4 weeks. Clinical assessments-including Pittsburgh Sleep Quality Index (PSQI], Insomnia Severity Index (ISI] and Zung's Self-Rating Anxiety (SAS], and Depression Scale (SDS)-and resting-state fMRI data were collected at baseline and after treatment. FC of the bilateral BF subregions (Ch_123, Ch_4) was analyzed, and pre-to-post intervention changes in FC and clinical scores were compared between groups. Baseline FC was used to predict treatment response using a support vector regression (SVR) model, validated on an independent dataset.</p><p><strong>Results: </strong>Sixty-seven patients completed the study (33 real taVNS, 34 sham taVNS). Changes in clinical outcomes showed that real taVNS significantly reduce PSQI, ISI, and SAS scores compared to sham. FC analysis revealed reduced connectivity between bilateral BF and areas involved in visual (superior occipital gyrus, SOG; middle occipital gyrus, MOG; fusiform gyrus, FFG), somatosensory (supplementary motor area, SMA) cortex and medial prefrontal cortex (mPFC) after taVNS treatment. Reduced FC between bilateral BF and left MOG correlated positively with ISI improvement (r = 0.490, p = 0.008, Bonferroni correction). The SVR model effectively predicted treatment response based on BF-visual circuit connectivity (r = 0.520, p = 0.0014, 5000 permutation test) and generalized well to an independent dataset (r = 0.443, p = 0.0354, 5000 permutation test).</p><p><strong>Conclusions: </strong>Our findings suggest that taVNS may alleviate symptoms of primary insomnia through modulation of basal forebrain connectivity with visual, sensorimotor, and medial prefrontal cortical regions. Preliminary investigations indicate that baseline functional connectivity in the BF-visual circuit could represent a candidate biomarker for taVNS response, potentially informing personalized treatment strategies.</p><p><strong>Trial registration: </strong>The study was registered with the China Clinical Trial Registry (Clinical Trial No. ChiCTR1900022535).</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"412"},"PeriodicalIF":7.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590441","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}

{"title":"Obsessive-compulsive disorder in the World Mental Health surveys.","authors":"Dan J Stein, Ayelet Meron Ruscio, Yasmin Altwaijri, Wai Tat Chiu, Nancy A Sampson, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Stephanie Chardoul, Oye Gureje, Chiyi Hu, Elie G Karam, John J McGrath, Fernando Navarro-Mateu, Kate M Scott, Juan Carlos Stagnaro, Yolanda Torres, Cristian Vladescu, Jacek Wciórka, Miguel Xavier, Ronald C Kessler","doi":"10.1186/s12916-025-04209-5","DOIUrl":"10.1186/s12916-025-04209-5","url":null,"abstract":"<p><strong>Background: </strong>National surveys have suggested that obsessive-compulsive disorder (OCD) is a prevalent and impairing condition. However, there are few cross-national data on OCD, with data particularly scarce in low- and middle-income countries. Here we employ data from the World Mental Health surveys to characterize the onset, course, severity, and treatment of OCD across a range of countries in different geographic regions of the world.</p><p><strong>Methods: </strong>Data came from general population surveys carried out in 10 countries (Argentina, Australia, Colombia, Iraq, Poland, People's Republic of China, Portugal, Romania, Saudi Arabia, Spain) using a consistent research protocol and interview. A total of 26,136 adults were assessed for OCD in face-to-face interviews and were included in the present analyses. We examined lifetime and 12-month prevalence as well as age of onset, persistence, severity, and treatment of DSM-IV OCD in six high-income countries (HICs) and four low- or middle-income countries (LMICs). We also investigated socio-demographic variables and temporally prior mental disorders as predictors of OCD onset, persistence, severity, and treatment.</p><p><strong>Results: </strong>Across the 10 countries surveyed, OCD has a combined lifetime prevalence of 4.1%. The 12-month prevalence (3.0%) is nearly as high, suggesting a highly persistent course of illness. Age of onset is early, with more than 80% of OCD cases beginning by early adulthood. Most OCD cases in the community are mild (47.0%) or very mild (27.5%), with a smaller percentage designated as moderate (22.9%) or severe (2.7%) by the Yale-Brown Obsessive-Compulsive Scale. Only 19.8% of respondents with OCD received any mental health treatment in the past year, with treatment rates much higher in HICs (40.5%) than LMICs (7.0%). Cross-nationally, OCD commonly emerges in adolescence or early adulthood against a backdrop of earlier-occurring mental disorders. With few exceptions (e.g., prior social phobia), the socio-demographic and psychopathological risk factors for OCD onset, persistence, severity, and treatment are distinct.</p><p><strong>Conclusions: </strong>These cross-national data underscore clinical lessons regarding the importance of early diagnosis of OCD and comprehensive evaluation of comorbidity; draw attention to OCD as an undertreated disorder, particularly in LMIC contexts; and emphasize the public health significance of this often-overlooked condition.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"416"},"PeriodicalIF":7.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590445","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}

{"title":"Increased prevalence of cardio-cerebrovascular risk factors during the COVID-19 pandemic lockdown: a large, single center, cross-sectional study.","authors":"Jinjing Lu, Yanyan Shen, Xiaoying Liu, Yuqiang Mao, Li Jing, Zhiyong Yang, Dongmei Pei, Weiwei Dong","doi":"10.1186/s12916-025-04193-w","DOIUrl":"10.1186/s12916-025-04193-w","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic prompted over 170 countries to implement lockdowns, significantly altering lifestyles and potentially impacting cardio-cerebrovascular risk factors (CCVRFs). This study evaluates changes in CCVRFs before, during, and after the lockdown, stratified by population subgroups. We aim to mitigate the lockdown's impact on CCVRFs, address knowledge gaps, and inform future health management strategies.</p><p><strong>Methods: </strong>This cross-sectional study analyzed preventive health assessment data of individuals at the Health Management Center of Shengjing Hospital, China Medical University. The study covers three timeframes: pre-pandemic (January 1, 2017, to December 31, 2019), during the pandemic lockdown (January 1, 2020, to December 31, 2022), and after the pandemic lockdown (January 1, 2023, to December 31, 2023). The primary outcome was the change in prevalence of hypertension, dyslipidemia, diabetes mellitus, systemic inflammation index, and insulin resistance index before, during, and after the COVID-19 pandemic lockdown. Additionally, multivariate linear or logistic regression analysis the association between changes in CCVRFs and the COVID-19 pandemic lockdown.</p><p><strong>Results: </strong>This study included 46,958 participants: 21,062 pre-pandemic, 18,164 during lockdown, and 7732 post-lockdown. Compared to pre- and post-lockdown periods, diabetes mellitus incidence significantly increased during lockdown. Systemic immune indicators (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune-inflammation index [SII]) and insulin resistance markers (triglyceride-glucose index [TyG], TyG-body mass index [TyG-BMI]) also increased significantly. Subgroup analyses revealed more pronounced changes in CCVRFs among individuals over 60 during lockdown. Multivariate analysis showed a significant association between lockdown and CCVRFs, with adjusted odds ratios (OR) and β values (95% confidence intervals) as follows: diabetes mellitus 1.37 (1.28-1.47), PLR 5.44 (4.77-6.11), NLR 0.05 (0.04-0.06), SII 5.28 (1.91-8.65), TyG 0.03 (0.02-0.05), and TyG-BMI 4.16 (3.47-4.84).</p><p><strong>Conclusions: </strong>In this cross-sectional study, the prevalence of diabetes mellitus, systemic inflammation index, and insulin resistance index increased during the COVID-19 pandemic lockdown, highlighting the importance of proactively managing CCVRFs during and after the pandemic lockdowns.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"414"},"PeriodicalIF":7.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590444","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}

{"title":"Firesorb bioresorbable scaffold for de novo coronary artery disease: 1-year clinical outcomes.","authors":"Jun Jiang, Changling Li, Delong Chen, Lei Song, Zhanqian Cui, Ping Li, Lijun Gan, Yundai Chen, Hui Li, Shaobin Jia, Shenghu He, Wen Lu, Runlin Gao, Jianan Wang","doi":"10.1186/s12916-025-04254-0","DOIUrl":"10.1186/s12916-025-04254-0","url":null,"abstract":"<p><strong>Background: </strong>The first-generation bioresorbable scaffolds (BRS) have been associated with higher rates of device-related adverse outcomes in comparison to everolimus-eluting stents. We aimed to evaluate the efficacy and safety of the thinner-strut (100/125 μm) poly-L-lactic acid-based sirolimus-eluting Firesorb BRS in patients with de novo coronary lesions.</p><p><strong>Methods: </strong>Patient-level data derived from 1205 patients in the FUTURE-II RCT (n = 215) and FUTURE-III registry (n = 990) were prospectively collected, pooled, and analyzed. The primary endpoint of 1-year target lesion failure (TLF) was defined as a composite of cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization. The patient-oriented composite endpoint (POCE) of all-cause death, any myocardial infarction, or any revascularization was also analyzed.</p><p><strong>Results: </strong>At 1-year follow-up, the cumulative rate of TLF was 1.67%, with an upper 95% confidence interval of 2.57%, significantly lower than the objective performance criterion goal of 6.6% (P < 0.001). The rate of single TLF components was 0.42% for cardiac death, 0.92% for target vessel myocardial infarction, and 0.42% for ischemia-driven target lesion revascularization. The cumulative rate of POCE at 1 year was 3.34%. No patient experienced definite or probable device thrombosis during 1-year follow-up.</p><p><strong>Conclusions: </strong>This pooled, patient-level analysis indicates that the thinner strut Firesorb BRS exhibits promising 1-year efficacy and safety profiles with regard to TLF. However, our findings are only applicable to non-complex lesions; large-scale randomized clinical trials powered to assess clinical endpoints are necessary to evaluate the strategy of Firesorb BRS compared to drug-eluting stents.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02890160 and NCT03660202.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"419"},"PeriodicalIF":7.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590442","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}