BMC Medicine最新文献

{"title":"Influential drivers of the cost-effectiveness of respiratory syncytial virus vaccination in European older adults: a multi-country analysis.","authors":"Xiao Li, Lander Willem, Caroline Klint Johannesen, Arantxa Urchueguía-Fornes, Toni Lehtonen, Richard Osei-Yeboah, Heini Salo, Alejandro Orrico-Sánchez, Javier Díez-Domingo, Mark Jit, Joke Bilcke, Harish Nair, Philippe Beutels","doi":"10.1186/s12916-025-03970-x","DOIUrl":"10.1186/s12916-025-03970-x","url":null,"abstract":"<p><strong>Background: </strong>We aimed to identify influential drivers of the cost-effectiveness of older adult respiratory syncytial virus (RSV) vaccination in Denmark, Finland, the Netherlands and Valencia-Spain.</p><p><strong>Methods: </strong>A static multi-cohort model was parameterised using country- and age-specific hospitalisations using three approaches: (A) the International Classification of Diseases (ICD)-coded hospitalisations, (B) laboratory RSV-confirmed hospitalisations and (C) time-series modelling (TSM). Plausible hypothetical RSV vaccine characteristics were derived from two protein subunit vaccines for adults aged ≥60 years. A full incremental analysis was conducted by comparing three RSV vaccination strategies: (1) in adults aged ≥60 years (\"60y+\"); (2) in adults aged ≥65 years (\"65y+\"); (3) in adults aged ≥75 years (\"75y+\") to \"no intervention\" and to each other. Both costs and quality-adjusted life-years (QALYs) were discounted at country-specific discount rates and the analysis was conducted from both the healthcare payers' and societal perspectives. Value of information, probabilistic sensitivity and scenario analyses identified influential drivers.</p><p><strong>Results: </strong>Besides vaccine price, the hospitalisation estimates were most influential: (A) Using adjusted RSV-ICD-coded hospitalisations at a vaccine price of €150 per dose, no intervention was cost-effective up to willingness-to-pay (WTP) values of €150,000 per QALY gained in Denmark and the Netherlands, and up to €124,000 per QALY gained in Finland. (B) Using the adjusted RSV-confirmed dataset, the findings were consistent in Denmark and comparable in Finland. In Spain-Valencia, the 75y+ strategy became cost-effective at WTP >€55,000. (C) Using TSM-based estimates, the 75y+ strategy was cost-effective at WTP >€45,000, >€101,000, >€41,000 and >€114,000 in Denmark, Finland, the Netherlands and Spain-Valencia, respectively. Sensitivity analyses showed that the (in-hospital) case fatality ratio and the specification of its age dependency were both influential. Duration of protection was found more influential than a variety of plausible waning patterns over the duration of protection.</p><p><strong>Conclusions: </strong>Data gaps and uncertainties on the RSV-related burden in older adults persist and influence the cost-effectiveness of RSV vaccination. More refined age- and country-specific data on the RSV attributable burden are crucial to aid decision making.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"170"},"PeriodicalIF":7.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699656","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":"The risk associated with ultra-processed food intake on depressive symptoms and mental health in older adults: a target trial emulation.","authors":"Belayneh Mengist, Mojtaba Lotfaliany, Julie A Pasco, Bruno Agustini, Michael Berk, Malcolm Forbes, Melissa M Lane, Suzanne G Orchard, Joanne Ryan, Alice J Owen, Robyn L Woods, John J McNeil, Mohammadreza Mohebbi","doi":"10.1186/s12916-025-04002-4","DOIUrl":"10.1186/s12916-025-04002-4","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal cohort studies across the lifespan suggest an association between ultra-processed food (UPF) and depression. However, the effect of UPF on depression and mental health in older adults has not been determined. Therefore, this study investigated the effect of UPF on depressive symptoms and mental health in community-dwelling older adults.</p><p><strong>Methods: </strong>A pragmatic target trial was designed and emulated using the ASPirin in Reducing Events in the Elderly longitudinal data. Participants were community-dwelling older adults (≥ 70 years) in Australia. We specified and emulated the protocol of a two-arm randomised pragmatic clinical trial using the level of UPF consumption as the intervention. Greater than or equal to 4 servings of UPF per day was considered the intervention, with less than 4 servings per day the control. Dietary consumption was assessed using a mail-based diet screening questionnaire, and the level of food processing was classified based on the NOVA classification. The study outcomes were depressive symptoms, defined as a score of ≥ 8 on the Center for Epidemiological Studies Depression 10-item scale, and general mental health, defined by the mental component summary score of the Short Form-12. We applied inverse probability treatment weighting to balance confounders. Marginal structural models were employed to estimate the population-level average effect of intervention using generalised estimated equations.</p><p><strong>Results: </strong>A total of 11,192 participants (3415 intervention and 7777 control) were eligible for the emulation. High UPF consumption at time zero was associated with an increased risk of depressive symptoms at follow-ups (RR: 1.10; CI: 1.04-1.18). The finding was consistent with sensitivity analyses; after excluding participants on antidepressants at time zero, the risk of depressive symptoms in the intervention group was increased by 11% compared to the control (RR: 1.11; 95% CI: (1.04-1.20)). Consumption of UPF adversely affected the mental component quality of life (β: - 0.40; CI: - 0.65 to - 0.15).</p><p><strong>Conclusions: </strong>A higher level of UPF consumption was associated with a higher risk of depressive symptoms and adversely affected mental health among older adults.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"172"},"PeriodicalIF":7.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699697","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":"Designing novel \"Smell-Aids\" to improve olfactory function in post COVID-19 era.","authors":"Veronica L Formanek, Barak M Spector, Gabriela Zappitelli, Zhenxing Wu, Kai Zhao","doi":"10.1186/s12916-025-03999-y","DOIUrl":"10.1186/s12916-025-03999-y","url":null,"abstract":"<p><strong>Background: </strong>Eyeglasses, hearing aids, etc., all serve to enhance the sensory stimuli to enable patients to see or hear things that they would not otherwise be able to, but we have no equivalent technology for olfaction, a pressing issue in the post-COVID era.</p><p><strong>Methods: </strong>We attempt to invent \"Smell-Aids\" by non-invasively enhancing intranasal odorant delivery to the olfactory epithelium, using two prototypes: (a) a nasal foam plug with a diagonal channel embedded to direct air/odor flow upwards to the olfactory region; (b) a clip (similar to what synchronized swimmers use) pinching a critical nasal valve region that may intensify the nasal airflow vortex to the olfactory region.</p><p><strong>Results: </strong>We first tested these prototypes in counter-balanced orders on 58 healthy subjects, where their measured odor detection thresholds to phenylethyl alcohol significantly improved with both prototypes in subjects with normal smell function (baseline: 8-16.5, n = 30, 12.49 ± 2.8, plug: 14.42 ± 4.9, pinch: 14.73 ± 5.4, p < 0.05), but not in subjects with \"super\" sensitivity at baseline (> 16.5, n = 28). Next, we tested the prototypes on 54 patients with confirmed olfactory losses (age 21-80 years, median 54.5), the majority of whom (37/54 = 69%) were post-COVID long haulers (infected 12/15/2019 to 10/4/23; persisted 30 to 1260 days, median 22 months). The remaining non-COVID smell losses (n = 17) span significantly longer from 5 months to 27 years (median 8.5 years). The 9-item NIH toolbox odor identification score significantly improved after application of both smell aids (baseline: 4.30 ± 2.27, plug 5.11 ± 2.32, pinch 4.82 ± 2.06, mixed model p < 0.05), especially among the non-COVID cohort. For COVID long haulers, only the nasal plug remained effective (p < 0.05). Subgroup analysis was performed on patients who reported diminished (hyposmia/anosmia 38/54) vs distorted smell (parosmia/phantosmia 27/54, n = 11 reported both) and showed that the nasal plug remains effective for both cohorts (p < 0.05) while the pinch is only effective for the hypo/anosmia cohort (p < 0.05).</p><p><strong>Conclusions: </strong>These results preliminarily demonstrated the novelty of improving olfactory function through different peripheral mechanisms for different patient and normative cohorts and may one day lead to an effective over-the-counter smell aid. Enhancing olfactory functions in healthy and patient cohorts through improving intranasal air and odorant delivery.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05920330.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"169"},"PeriodicalIF":7.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699651","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":"Association of Life's Essential 8 with incidence of heart failure modified by depressive symptoms: a prospective cohort study from UK Biobank.","authors":"Wei Hu, Chun-Hua Zhao, Jia-Ning Wang, Zhen-Zhen Shen, Ge Tian, Yue-Qing Huang, Bao-Peng Liu, Cun-Xian Jia","doi":"10.1186/s12916-025-04011-3","DOIUrl":"10.1186/s12916-025-04011-3","url":null,"abstract":"<p><strong>Background: </strong>The Life's Essential 8 (LE8) proposed by the American Heart Association for assessing cardiovascular health (CVH) has been demonstrated to be associated with cardiovascular disease, but rarely includes heart failure (HF), and the role of psychological factors has not been considered. We aimed to prospectively investigate the independent, joint, and interactive associations of LE8 and depressive symptoms with HF incidence.</p><p><strong>Methods: </strong>A total of 336,939 participants recruited from UK Biobank without HF, coronary heart disease, and stroke were included in the cohort study. The LE8 score consisted of four behavioral (diet, physical activity, nicotine exposure, and sleep) and four biological factors (glucose, blood lipids, blood pressure, and body mass index) and was classified into three levels: low, moderate, and high CVH. Depressive symptoms at baseline were identified by self-report and linkage to medical records. Incident HF cases during follow-up were extracted through primary care, hospital admissions, self-reports, and death registrations. Cox proportional hazard models were conducted to examine the associations of LE8 and depressive symptoms with HF incidence, with findings presented as hazard ratios (HRs) (95% confidence interval, CI).</p><p><strong>Results: </strong>A total of 9379 (2.8%) participants developed HF during a median follow-up of 13.6 years. Compared with low-CVH individuals, the multivariate-adjusted HRs with 95% CI for incident HF were 0.596 (0.565-0.629) and 0.458 (0.408-0.514) in those with moderate and high CVH, respectively. Per standard deviation increment in LE8 was associated with a 25.5% (HR = 0.745; 95% CI: 0.729-0.762) lower risk of HF. The stratification analysis indicated that the detrimental effect of low CVH on HF was more pronounced in participants with depressive symptoms compared to those without, with a significant multiplicative interaction (P for multiplicative interaction = 0.016). The joint test showed that the lowest risk of HF was observed in participants with high CVH and no depressive symptoms (HR = 0.344; 95% CI: 0.295-0.401), which may be attributed to a significant additive interaction observed.</p><p><strong>Conclusions: </strong>The cohort study revealed that LE8-defined CVH not only could predict the incidence of HF, but also mitigate the increased risk of HF attributable to depressive symptoms. Achieving the high LE8 scores recommended by the AHA to improve CVH will be beneficial in reducing the population burden of HF, especially among patients with depressive symptoms.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"175"},"PeriodicalIF":7.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699650","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":"Association between urbanization levels and frailty among middle-aged and older adults in China: evidence from the CHARLS.","authors":"Xinlan Xie, Jiaqun Que, Linsu Sun, Tao Sun, Feng Yang","doi":"10.1186/s12916-025-03961-y","DOIUrl":"10.1186/s12916-025-03961-y","url":null,"abstract":"<p><strong>Background: </strong>Rapid urbanization is underway in China. However, the impact of urbanization on frailty remains unclear. This study aims to investigate the relationship between urbanization and frailty among middle-aged and older adults.</p><p><strong>Methods: </strong>We analyzed nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 to 2018. After applying inclusion and exclusion criteria, 10,758 non-frail individuals at baseline were analyzed. The exposure of interest was the comprehensive urbanization level. Urbanization level (0.072-0.689) was assessed using the entropy method. Frailty was assessed using the frailty index (FI), which ranges from 0 to 100. Frailty was defined as FI ≥ 25, and the urbanization-frailty association was assessed using - the restricted cubic spline (RCS) expressions and Cox proportional hazards models. Least absolute shrinkage and selection operator (LASSO) regression were employed to evaluate major factors associated with frailty.</p><p><strong>Results: </strong>The results revealed a U-shaped nonlinear association between urbanization level and frailty incidence, with a turning point at 0.3 (P_nonlinear < 0.001). In the Cox model, for urbanization scores below 0.3, each ten-percentile increase was associated with an HR of 0.871 (95% CI 0.843-0.900, P < 0.05). Conversely, scores at or above 0.3 had an HR of 1.178 (95% CI 1.053-1.319, P < 0.05) per ten-percentile increase. In the subgroup analysis of participants with urbanization scores below 0.3, there was a significant interaction between current work status and subgroups with dyslipidemia. LASSO regression showed that, for urbanization scores < 0.3, total retail sales (coefficient =  - 0.129) and per capita income (coefficient =  - 0.071) were most protective against frailty. For scores ≥ 0.3, key urbanization factors associated with increased frailty risk included the number of college students per 10,000 people (coefficient = 0.080) and the proportion of built-up land in the urban area (coefficient = 0.060).</p><p><strong>Conclusions: </strong>Urbanization level had U-shaped association with frailty incidence. Factors such as total retail sales of consumer goods per capita, per capita disposable income of urban residents, and the number of college students per 10,000 people may be key in formulating a strategy for frailty prevention.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"171"},"PeriodicalIF":7.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699649","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":"Correction: Assessing lung cancer progression and survival with infrared spectroscopy of blood serum.","authors":"Kosmas V Kepesidis, Mircea-Gabriel Stoleriu, Nico Feiler, Lea Gigou, Frank Fleischmann, Jacqueline Aschauer, Sabine Eiselen, Ina Koch, Niels Reinmuth, Amanda Tufman, Jürgen Behr, Mihaela Žigman","doi":"10.1186/s12916-025-03991-6","DOIUrl":"10.1186/s12916-025-03991-6","url":null,"abstract":"","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"168"},"PeriodicalIF":7.0,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691098","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":"Association of activity-based food environment index with obesity-related cancer mortality in the US.","authors":"Qinyun Lin, Xiang Chen, Xukun Xiang, Weixuan Lyu, Congcong Miao, Gaofei Zhang, Ran Xu","doi":"10.1186/s12916-025-03967-6","DOIUrl":"10.1186/s12916-025-03967-6","url":null,"abstract":"<p><strong>Background: </strong>Obesity and obesity-related cancers contribute to rising healthcare costs and declining life expectancy in the US and improving diet quality plays a crucial role in reversing such trends. Existing studies on the relationship between healthy food access and obesity-related cancer mortality present mixed findings, whereas food procurement activities are largely overlooked. The paper aims to construct a novel food environment index based on residents' food retailer visits, and then compare it with the location-based food environment index regarding the strength of associations with obesity-related cancer mortality rates.</p><p><strong>Methods: </strong>This cross-sectional ecologic study used business location data from InfoGroup and aggregated GPS-based food retailer visit data from SafeGraph in 2018-2019, and mortality data from the Centers for Disease Control and Prevention in 2015-2020. A total of 2925 counties or equivalents with complete information were included. Activity-based index was calculated as the percentage of visits to healthy food retailers out of total visits to all qualified food retailers for residents in each county. Location-based index was calculated as the percentage of healthy food retailers out of all qualified food retailers in each county. The main outcome is age-adjusted obesity-related cancer (13 types of cancer based on evidence from the International Agency for Research on Cancer) mortality rates, which were calculated for each county and counties were further categorized into high- and low-risk (≥ 60.2 and < 60.2 cases per 100,000 population) areas. Linear, non-linear, logistic, and spatial regression analyses were performed to examine the association between each food environment index and obesity-related cancer mortality rates.</p><p><strong>Results: </strong>The activity-based index demonstrated significant negative association with the 2015-2020 obesity-related cancer mortality rates (coefficient [95% CI]: - 0.980 [- 1.385, - 0.575], P < 0.001), and each standard deviation increase in the activity-based index was associated with an 18% decrease in the odds of being in a high-risk area (odds ratio [95% CI]: 0.821 [0.749, 0.900], P < 0.001), while the location-based index showed much weaker and non-significant effects.</p><p><strong>Conclusions: </strong>Our findings suggest that health policies and initiatives that combat obesity and obesity-related cancers should consider incorporating food retailer visits into policy formation.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"167"},"PeriodicalIF":7.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668913","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":"Reconsideration of lowering gestational weight gain guidelines in pregnant women diagnosed with gestational diabetes: evidence from a Belgian study.","authors":"Katrien Benhalima, Caro Minschart, Ina Geerts, Lieveke Ameye, Bart Van Der Schueren, Roland Devlieger, Annick Bogaerts, Chantal Mathieu","doi":"10.1186/s12916-025-03992-5","DOIUrl":"10.1186/s12916-025-03992-5","url":null,"abstract":"<p><strong>Background: </strong>The suitability of the United States National Academy of Medicine guidelines for gestational weight gain in women with gestational diabetes remains uncertain, raising global concerns. This study aimed to evaluate the association of gestational weight gain with pregnancy and birth outcomes and to determine optimal ranges for gestational weight gain per pre-pregnancy body mass index category in women with gestational diabetes.</p><p><strong>Methods: </strong>An epidemiological analysis between 2009-2018 analyzed a large Belgian cohort of singleton pregnancies with gestational diabetes and gestational age 38-40 weeks. Multivariate logistic regression assessed associations between gestational weight gain and relevant pregnancy and birth outcomes, with and without adjustment for confounding variables, including maternal age, origin, education, mode of conception, parity, gestational age at delivery, social deprivation, and year of delivery. Potential optimal weight gain ranges were calculated by minimizing the combined risk of small- and large-for-gestational-age infants (SGA, LGA).</p><p><strong>Results: </strong>A total of 13,060 women with gestational diabetes were included. Compared to recommended weight gain, gestational weight gain above guidelines occurred in 26.9% and was associated with an increased risk of gestational hypertension (aOR 1.41, 95% CI 1.20-1.66, p < 0.001), emergency caesarean section (aOR 1.45, 95% CI 1.25-1.69, p < 0.001), LGA infants (aOR 1.84, 95% CI 1.63-2.08, p < 0.001), and macrosomia (aOR 1.78, 95% CI 1.55-2.04, p < 0.001). Weight gain less than recommended (40.2%) was associated with a decreased risk of gestational hypertension (aOR 0.81, 95% CI 0.69-0.96, p = 0.015), LGA infants (aOR 0.58, 95% CI 0.50-0.66, p < 0.001), and macrosomia (aOR 0.57, 95% CI 0.49-0.65, p < 0.001), but at the expense of an increased risk of SGA infants (aOR 1.68, 95% CI 1.45-1.96, p < 0.001) and low birth weight (aOR 2.28, 95% CI 1.57-3.32, p < 0.001). Based on current analysis, the optimal ranges for gestational weight gain would be 9 to 14 kg for women with a normal weight, 1 to 9 kg for women with overweight, and -7 to 1 kg for women with obesity.</p><p><strong>Conclusions: </strong>This Belgian study suggests that optimal gestational weight gain for singleton at-term pregnancies complicated by gestational diabetes should be lower than current recommendations, highlighting the need to reevaluate gestational weight gain guidelines in this context.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"165"},"PeriodicalIF":7.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656199","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":"Denoised recurrence label-based deep learning for prediction of postoperative recurrence risk and sorafenib response in HCC.","authors":"Yixin Li, Ji Xiong, Zhiqiu Hu, Qimeng Chang, Ning Ren, Fan Zhong, Qiongzhu Dong, Lei Liu","doi":"10.1186/s12916-025-03977-4","DOIUrl":"10.1186/s12916-025-03977-4","url":null,"abstract":"<p><strong>Background: </strong>Pathological images of hepatocellular carcinoma (HCC) contain abundant tumor information that can be used to stratify patients. However, the links between histology images and the treatment response have not been fully unveiled.</p><p><strong>Methods: </strong>We trained and evaluated a model by predicting the prognosis of 287 non-treated HCC patients postoperatively, and further explored the model's treatment response predictive ability in 79 sorafenib-treated patients. Based on prognostic relevant pathological signatures (PPS) extracted from CNN-SASM, which was trained by denoised recurrence label (DRL) under different thresholds, the PPS-based prognostic model was formulated. A total of 78 HCC patients from TCGA-LIHC were used for the external validation.</p><p><strong>Results: </strong>We proposed the CNN-SASM based on tumor pathology and extracted PPS. Survival analysis revealed that the PPS-based prognostic model yielded the AUROC of 0.818 and 0.811 for predicting recurrence at 1 and 2 years after surgery, with an external validation reaching 0.713 and 0.707. Furthermore, the predictive ability of the PPS-based prognostic model was superior to clinical risk indicators, and it could stratify patients with significantly different prognoses. Importantly, our model can also stratify sorafenib-treated patients into two groups associated with significantly different survival situations, which could effectively predict survival benefits from sorafenib.</p><p><strong>Conclusions: </strong>Our prognostic model based on pathology deep learning provided a valuable means for predicting HCC patient recurrence condition, and it could also improve patient stratification to sorafenib treatment, which help clinical decision-making in HCC.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"162"},"PeriodicalIF":7.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656198","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":"Cellular sentinels: empowering survival and immune defense in hematopoietic stem cell transplantation through mesenchymal stem cells and T lymphocytes.","authors":"Tzong-Shyuan Tai, Yun-Hsiang Chen, Chao-Ling Yao, Jiun-Han Lin, Yu-Shao Yang, Jai-Wen Shi, Li-Wen Fang, Duen-Wei Hsu, Shu-Chen Kuo, Shu-Ching Hsu","doi":"10.1186/s12916-025-03987-2","DOIUrl":"10.1186/s12916-025-03987-2","url":null,"abstract":"<p><strong>Background: </strong>Hematopoietic stem cell transplantation (HSCT) is a critical treatment for hematologic disorders such as leukemia, lymphoma, and specific immune deficiencies. Despite its efficacy, challenges such as engraftment failure and delayed neutrophil regeneration remain significant barriers. These complications lead to prolonged cytopenia, increased risks of infections and other complications, and elevated morbidity and mortality rates. While mesenchymal stem cells (MSCs) are known to play essential roles in supporting hematopoiesis, the precise mechanisms and interactions between MSCs and other cellular components in HSCT require further investigation.</p><p><strong>Methods: </strong>To address these challenges, we explored the combined infusion of allotype-cord blood hematopoietic stem cells (HSCs) and activated T cells from the same donor along with third-party MSCs. The study assessed the effects of this triple-cell therapy on neutrophil differentiation and function ex vivo and in vivo. Using a respiratory infection model, we evaluated the accumulation of human neutrophils, cytokine secretion (IL-6 and IL-8), bacterial clearance, and overall survival compared to control groups.</p><p><strong>Results: </strong>The triple-cell therapy demonstrated a significant improvement in the differentiation of human HSCs into neutrophils both in ex vivo and in vivo. In the respiratory infection model, this approach resulted in enhanced accumulation of human neutrophils, increased secretion of IL-6 and IL-8, superior bacterial clearance, and reduced mortality rates compared to the control group. These findings highlight the synergistic interplay between allo-HSCs, MSCs, and activated T cells in promoting neutrophil production and function.</p><p><strong>Conclusions: </strong>Our study presents a novel therapeutic strategy combining allo-HSCs, activated T cells, and third-party MSCs to enhance neutrophil production and functionality post-transplantation. This approach not only accelerates neutrophil regeneration but also improves resistance to infections, offering a promising avenue to overcome engraftment challenges in HSCT.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"164"},"PeriodicalIF":7.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656197","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}