BMC Medicine最新文献

{"title":"Excessive iron accumulation in the striatum associated with addictive behaviors of medication-overuse headache: a prospective study.","authors":"Xun Pei, Xiaoyan Bai, Xue Zhang, Zhangxuan Hu, Wei Wang, Xueyan Zhang, Yingkui Zhang, Hefei Tang, Yaqing Zhang, Xueying Yu, Ziyu Yuan, Peng Zhang, Tong Chen, Yuanbin Zhao, Xiuqin Jia, Qi Yang, Yonggang Wang, Binbin Sui","doi":"10.1186/s12916-025-04125-8","DOIUrl":"https://doi.org/10.1186/s12916-025-04125-8","url":null,"abstract":"<p><strong>Background: </strong>Abnormal iron deposition may be a biomarker for a disrupted central antinociceptive neuronal network, and the relationship between iron deposition and the pathophysiological mechanisms of chronic migraine (CM) with medication overuse (MOH) remains unclear. We investigated iron deposition in the deep gray matter (DGM) of the brain in CM patients with and without MOH using quantitative susceptibility mapping (QSM).</p><p><strong>Methods: </strong>Forty-eight healthy controls (HCs) and 69 CM patients (36 with MOH; 33 without MOH) were recruited. QSM data were acquired using a 3.0 T Magnetic resonance imaging (MRI). Regions of interest (ROI) in the DGM, including the bilateral caudate, putamen, globus pallidus (GP), hippocampus, nucleus accumbens, and amygdala, were segmented from the T1-weighted images (T1WI) of the whole brain of each individual patient using FreeSurfer. QSM images were registered to T1WI. QSM values within each ROI were extracted and compared between CM and HCs, as well as between CM with MOH and CM without MOH. Correlations between QSM values and clinical assessment scale scores were calculated. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic performance of QSM values in these DGM for detecting CM and CM with MOH.</p><p><strong>Results: </strong>Compared to HCs, CM patients exhibited increased iron deposition in the caudate (p = 0.013) and putamen (p < 0.001). In the CM without MOH group, headache duration correlated positively with iron deposition in the caudate (r = 0.502, p = 0.010) and putamen (r = 0.514, p = 0.009). CM with MOH patients showed greater iron deposition in the caudate (p < 0.001), putamen (p < 0.001), and GP (p = 0.049) than those without MOH, with medication use frequency correlating positively with iron deposition in the caudate (r = 0.427, p = 0.023) and putamen (r = 0.445, p = 0.018). ROC curve analysis indicated that the caudate (AUC = 0.736) and putamen (AUC = 0.729) exhibited high sensitivity and specificity in diagnosing CM with MOH.</p><p><strong>Conclusions: </strong>CM patients with MOH had excessive iron deposition in basal ganglia regions, including the caudate, putamen, and GP, which may be related to the medication overuse behavior. Iron deposition in the caudate and putamen may be a potential biomarker for CM with MOH. These findings provide insight into the common pathophysiological mechanisms underlying MOH and potential addiction.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"300"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widening gap in life expectancy between patients with heart failure living in most and least deprived areas: a longitudinal cohort study.","authors":"O I Brown, M Drozd, H MacGowan, M McGinlay, R Burgess, S Straw, A D Simms, V K Gatenby, A Sengupta, A M N Walker, C Saunderson, M F Paton, K I Bridge, J Gierula, K K Witte, R M Cubbon, M T Kearney","doi":"10.1186/s12916-025-04137-4","DOIUrl":"https://doi.org/10.1186/s12916-025-04137-4","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic deprivation is associated with adverse clinical outcomes in patients with heart failure (HF). However, in the context of improved medical and device therapy for HF, it is unknown whether the influence of socioeconomic deprivation on HF outcomes is changing over time, especially in relation to evolving life expectancy patterns in the general population. Therefore, we aimed to describe temporal trends in the association of socioeconomic deprivation with loss of actuarially predicted life expectancy amongst ambulatory patients with HF.</p><p><strong>Methods: </strong>Between 2006 and 2014, 1802 patients (73.2% male, mean age 69.6 years) with HF and left ventricular ejection fraction ≤ 45% were consecutively recruited across four hospitals in the United Kingdom (UK). Patients were stratified into socioeconomic deprivation tertiles defined by the UK Index of Multiple Deprivation (IMD) score with IMD tertile 1 denoting the least deprived and IMD tertile 3 the most deprived. The primary outcome was all-cause mortality, and relative survival predictions-in relation to age- and sex-matched background mortality rates-were calculated using UK National Life Tables. Relative survival was illustrated in terms of excess mortality risk and years of life expectancy lost. Recruitment period was split into 3-year intervals (2006-2008, 2009-2011 and 2012-2014).</p><p><strong>Results: </strong>During a median follow-up of 5.0 years, 1302 participants (72.3%) died. Unadjusted mortality rate was highest in tertile 2. However, adjusted to the age-sex matched UK population, a stepwise increase in excess mortality risk was observed across tertiles, with tertile 1 experiencing an excess mortality risk of 11.1% (95% CI: 6.1-16.1%) and tertile 3 24.2% (95% CI: 19.4-28.0%). This corresponded to a loss of life expectancy of 1.76 years (95% CI: 1.50-2.03) for tertile 1 and 2.30 years (95% CI: 2.03-2.57) for tertile 3 over a 10-year period. We observed disparity in actuarial survival between tertiles over time, with participants in tertile 1 losing less life expectancy at 10 years compared to those in tertiles 2 and 3. However this was only statistically significant for those recruited between 2012 and 2014 (p < 0.05).</p><p><strong>Conclusions: </strong>The impact of socioeconomic deprivation on HF outcomes in an unselected diverse UK population appears to have worsened over time.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"303"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A matters arising: discussion on urokinase dosing and individualized treatment strategies in the TRUST trial.","authors":"Yue Qiao, Xunming Ji, Wenbo Zhao","doi":"10.1186/s12916-025-04151-6","DOIUrl":"https://doi.org/10.1186/s12916-025-04151-6","url":null,"abstract":"<p><p>This matters arising addresses the recently published article in BMC Medicine by Tao Y et al., entitled \"Effect of intravenous urokinase vs best medicine treatment on functional outcome for patients with acute minor stroke (TRUST): a randomized controlled trial.\" While appreciating the rigorous methodology and important findings of the TRUST trial, we raise several points regarding optimizing urokinase dosing and treatment strategies. Specifically, we discuss the potential for optimizing urokinase dosing based on emerging evidence. Given China's extensive clinical experience with urokinase and associated cost considerations, we advocate for further research, including trials evaluating weight-based dosing strategies, to optimize urokinase thrombolytic therapy for patients with acute ischemic stroke. Such research is crucial for optimizing urokinase thrombolysis and establishing its role as a cost-effective treatment option, especially in resource-limited settings.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"309"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of risk model-based lung cancer screening in smokers and nonsmokers in China.","authors":"Tiantian Zhang, Yue Wang, Xuechen Chen, Xueer Yang, Leyao Zhang, Nagham Bazzi, Ling Bai, Aaron Finley, Jie Jiang, Jianxing He, Wenhua Liang","doi":"10.1186/s12916-025-04065-3","DOIUrl":"https://doi.org/10.1186/s12916-025-04065-3","url":null,"abstract":"<p><strong>Background: </strong>China bears the largest global burden of lung cancer, with a striking 40% of cases occurring in individuals who have never smoked. While the mortality-reducing benefits of low-dose computed tomography (LDCT) for lung cancer screening are established, the quest for an optimal screening strategy continues, considering the potential adverse effects of LDCT. The Chinese NCC-LCm2021 model was developed based on a nationwide population to identify at-risk individuals among smokers and nonsmokers. However, the cost-effectiveness of this model has yet to be determined.</p><p><strong>Methods: </strong>The cost-effectiveness analysis simulates a Chinese birth cohort using a calibrated Markov model based on individual data from a prospective cohort of the Guangzhou Lung Cancer Screening Program. Health utility was extracted from the literature. Cost parameters were obtained from the price of basic medical services in public medical institutions. Our analysis evaluated 236 distinct screening strategies, varying by screening initiation age, risk thresholds, and smoking status. The primary outcomes were quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).</p><p><strong>Results: </strong>For smokers, four strategies on the efficiency frontier yielded incremental QALYs ranging from 0.011 to 0.039 compared to no screening, with ICERs ranging from $21,874 to $55,038 when compared to the previous efficient strategies. The optimal strategy was annual screening of smokers aged 45 years and older with a 3-year risk of lung cancer incidence of 0.55%, offering the largest gain in QALYs at a willingness-to-pay (WTP) threshold of $38,224 (three times GDP per capita). This optimal strategy dominated the 2023 Chinese guideline-recommended strategy. For nonsmokers, the strategies on the efficiency frontier yielded incremental QALYs ranging from 0.006 to 0.041 compared to no screening, with ICERs ranging from $26,517 to $37,994 when compared to the previous efficient strategies. Correspondingly, the optimal strategy is annual screening of nonsmokers aged 45 years and older with a 3-year risk of lung cancer incidence of 0.20%.</p><p><strong>Conclusions: </strong>This economic evaluation found that lung cancer screening strategies based on the Chinese NCC-LC_m2021 model were cost-effective for both smokers and non-smokers in China. Furthermore, tailoring risk thresholds to smokers and nonsmokers can enhance the cost-effectiveness of lung cancer screening.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"315"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling the divergent causal pathways underlying the association between body mass index and bone mineral density: a comprehensive Mendelian randomization study.","authors":"Xunying Zhao, Lin He, Xueyao Wu, Li Zhang, Jinyu Xiao, Changfeng Xiao, Yang Qu, Jingwei Zhu, Chenjiarui Qin, Deqin Huang, Pengyue Shen, Tao Han, Mengyu Fan, Jiayuan Li, Stephen Burgess, Xia Jiang","doi":"10.1186/s12916-025-04139-2","DOIUrl":"https://doi.org/10.1186/s12916-025-04139-2","url":null,"abstract":"<p><strong>Background: </strong>While the protective role of body mass index (BMI) in bone mass has been well-documented, the divergent associations between BMI and estimated bone mineral density (eBMD), attributed to its highly heterogeneous nature, remain insufficiently understood.</p><p><strong>Methods: </strong>Leveraging the hitherto largest genome-wide summary statistics, we conducted a two-sample Mendelian randomization (MR) to re-evaluate the effect of genetically predicted BMI on eBMD. Then, MR-Clust was applied to examine the potential presence of distinct causal pathways underlying the BMI-eBMD link. Utilizing tissue-partitioned MR, we estimated the distinct effects of separated tissue-specific subcomponents of BMI on eBMD, further supplemented by multivariable MR of body composition phenotypes on eBMD.</p><p><strong>Results: </strong>We reconfirmed the significant positive association between genetically predicted BMI and eBMD (β_IVW = 0.13, P value = 1.28 × 10^-34). Potential distinct causal pathways contributing to the observed total effect were identified by MR-Clust, with some exerting a protective effect while others leading to its deterioration. Tissue-partitioned MR suggested a marginally independent protective association between skeletal muscle-tissue instrumented BMI and eBMD (β_IVW = 0.14, P value = 4.98 × 10^-2) after accounting for adipose-tissue instrumented BMI, which was supported by the independent association between genetically predicted lean mass and eBMD after accounting for other body composition phenotypes.</p><p><strong>Conclusions: </strong>Our results shed preliminary insights into the intricate relationship between obesity and bone mass, highlighting divergent causal pathways underlying the association between BMI and eBMD. Our findings emphasize the potential importance of precision obesity management over merely a general indicator as BMI in future public health strategies for osteoporosis prevention.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"305"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the associations between weekend catch-up sleep and insulin resistance: NHANES cross-sectional study.","authors":"Xianling Liu, Aihui Chu, Xiahao Ding","doi":"10.1186/s12916-025-04154-3","DOIUrl":"https://doi.org/10.1186/s12916-025-04154-3","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is a precursor to metabolic syndrome. Weekend catch-up sleep (WCS) is practiced to compensate for insufficient weekday sleep, but its impact on IR remains unclear. This study investigated associations between WCS and severe IR risk.</p><p><strong>Methods: </strong>Data from 1,903 adults participating in the National Health and Nutrition Examination Survey 2017-2020 were analyzed. IR was assessed using the Homeostatic Model Assessment for IR (HOMA-IR) and Metabolic Score for IR (METS-IR), with severe IR defined as the highest quartile. WCS was calculated by subtracting weekday sleep duration from weekend sleep duration and was categorized into five groups. Weighted logistic regression and restricted cubic spline analyses were performed to examine associations between WCS patterns and severe IR risk. Percentages reported were weighted to account for sampling design and population distribution.</p><p><strong>Results: </strong>The majority of participants were under 60 yrs (75.2%, n = 1,344) and had a body mass index below 30 kg/m² (59.2%, n = 1,082). Slightly more than half of the participants were female (51.3%, n = 990). A U-shaped relationship between WCS duration and severe IR risk was observed, with the lowest risk at approximately 0.7-1.0 h of WCS. Short WCS durations (0 < WCS ≤ 1 h) were associated with a significantly reduced risk of severe IR as defined by HOMA-IR (OR = 0.63, 95% CI: 0.41-0.97, P = 0.037) compared to stable sleep pattern (WCS = 0). Long WCS durations (WCS ≥ 2 h) were associated with an increased risk of severe IR as defined by METS-IR (OR = 1.88, 95% CI: 1.13-3.14, P = 0.018). Sensitivity analyses showed that the reduction in severe IR risk associated with short WCS durations was more significant in individuals with weekday sleep durations of seven hours or less.</p><p><strong>Conclusions: </strong>WCS duration exhibits a U-shaped association with severe IR risk, with approximately 0.7-1.0 h of WCS linked to the lowest risk. Both insufficient and excessive WCS are associated with increased severe IR risk, emphasizing the importance of optimal sleep patterns for metabolic health.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"311"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A highly scalable deep learning language model for common risks prediction among psychiatric inpatients.","authors":"Enzhao Zhu, Jiayi Wang, Guoquan Zhou, Chunbo Li, Fazhan Chen, Kang Ju, Liangliang Chen, Yichao Yin, Yi Chen, Yanping Zhang, Xu Zhang, Xinlin Zhou, Zongyuan Wang, Jianping Qiu, Hui Wang, Weizhong Shi, Feng Wang, Dong Wang, Zhihao Chen, Jiaojiao Hou, Hui Li, Zisheng Ai","doi":"10.1186/s12916-025-04150-7","DOIUrl":"https://doi.org/10.1186/s12916-025-04150-7","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of studies exploring the performance of Transformers-based language models in common risks assessment among psychiatric inpatients. We aim to develop a scalable risk assessment model using multidimensional textualized data and test the stability, robustness, and benefit of this approach.</p><p><strong>Methods: </strong>In this real-world cohort study, a deep learning language model was developed and validated using first hospitalized cases diagnosed with schizophrenia, bipolar disorder, and depressive disorder between January 2016 and March 2023 in three hospitals. The algorithm was externally validated on an independent testing cohort comprising 1180 patients. A total of 140 features, including first medical records (FMR), laboratory examinations, medical orders, and psychological scales, were assessed for analysis. The outcomes were short- and long-term impulsivity (STI and LTI), risk of suicide (STSS and LTSS), and need of physical restraint (STPR and LTPR) assessed by qualified nurses or clinicians. Analysis was carried out between August 2024 and June 2024. Models with different architectures and input settings were compared with each other. The area under the receiver operating characteristic curve (AUROC) was used to assess the primary performance of models. The clinical utility was determined by the net benefit under Youden's threshold.</p><p><strong>Results: </strong>Of 7451 patients included in this study, 2982 (47.6%) were male, and the median (interquartile range) age was 42 (28-57) years. The overall incidence of outcomes was 635 (8.5%), 728 (10.5%), 659 (8.8%), 803 (10.8%), 588 (7.9%), and 728 (9.8%) for STPR, LTPR, STSS, LTSS, STI, and LTI, respectively. The multitask semi-structured Transformers-based language (SSTL) model showed more promising AUROCs (STPR: 0.915; LTPR: 0.844; STSS: 0.867; LTSS: 0.879; STI: 0.899; LTI: 0.894) in the prediction of these outcomes than single-tasked or multimodal language models and traditional structured data models. Combining FMR with other data from electronic health records led to significant improvements in the performance and clinical utility of SSTL models based on demographic, diagnosis, laboratory tests, treatment, and psychological scales.</p><p><strong>Conclusions: </strong>The SSTL model shows potential advantages in prognostic evaluation. FMR is a strong predictor for common risks prediction and may benefit other tasks in psychiatry with minimum requirements for data and data processing.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"308"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal pemetrexed efficacy and cerebrospinal fluid tumor marker response in refractory leptomeningeal metastasis of non-small-cell lung cancer: a single-arm phase II trial.","authors":"Qingsheng Xu, Kaiyuan Huang, Luqing Tong, Danfang Yan, Yilei Zhao, Hanjin Yang, Weili Jin, Luyuan Zhang, Jinquan Cai, Qun Chen","doi":"10.1186/s12916-025-04134-7","DOIUrl":"https://doi.org/10.1186/s12916-025-04134-7","url":null,"abstract":"<p><strong>Background: </strong>The treatments for refractory leptomeningeal metastasis (RLM) of non-small cell lung cancer (NSCLC) are limited, and response assessment is complex and challenging. This clinical trial aimed to evaluate the efficacy of intrathecal pemetrexed (IP) and response assessment using cerebrospinal fluid (CSF) tumor marker in RLM.</p><p><strong>Methods: </strong>This was a single-center, single-arm, phase II adaptive clinical trial. Patients with RLM of NSCLC were eligible for inclusion. Patients were assigned to receive 30 mg of IP every 3 weeks for a total of 6 cycles. The primary endpoint was overall survival (OS). The secondary endpoints included progression-free survival (PFS) evaluated according to EANO-ESMO response assessment, disease control rate, the concordance of CSF tumor marker response with EANO-ESMO response assessment, and safety.</p><p><strong>Results: </strong>A total of 29 patients were enrolled in the trial. The median PFS was 10.03 months (95% CI, 6.42-13.64), and the median OS was 20.37 months (95% CI, 14.86-25.88), respectively. A ± 35% threshold for CSF tumor marker level change (TML) yielded the optimal predictive performance, with AUCs of 0.890 (95% CI, 0.833-0.947), 0.911 (95% CI, 0.870-0.951), and 0.784 (95% CI, 0.717-0.850) for EANO-ESMO response, progression, and stable, respectively. Most patients (93.1%) experienced grade 1-2 treatment-related adverse events.</p><p><strong>Conclusions: </strong>Our therapeutic regimen of IP provided a practical, survival-extending, and tolerant option for RLM patients. CSF tumor marker response was correlated with EANO-ESMO response assessment, offering an effective tool for response monitoring of RLM.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Register (ChiCTR) ChiCTR2200057235. Registered on March 1, 2022. Date of the first patient enrollment: April 29, 2022.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"301"},"PeriodicalIF":7.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Gender-affirming hormonal therapy induces a gender-concordant fecal metagenome transition in transgender individuals.","authors":"Timur Liwinski, Matthias K Auer, Johanna Schröder, Ina Pieknik, Christian Casar, Dorothee Schwinge, Lara Henze, Günter K Stalla, Undine E Lang, Alina von Klitzing, Peer Briken, Thomas Hildebrandt, Jeanne C Desbuleux, Sarah V Biedermann, Paul-Martin Holterhus, Corinna Bang, Christoph Schramm, Johannes Fuss","doi":"10.1186/s12916-025-04144-5","DOIUrl":"10.1186/s12916-025-04144-5","url":null,"abstract":"","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"295"},"PeriodicalIF":7.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartwatch-monitored physical activity and myopia in children: a 2-year prospective cohort study.","authors":"Daixi Chen, Jingjing Wang, Jun Chen, Meng Lu, Yuchen Du, Ziyan Zhu, Padmaja Sankaridurg, Zhuoting Zhu, Bo Zhang, Linlin Du, Jinliuxing Yang, Xiangui He, Xun Xu","doi":"10.1186/s12916-025-04136-5","DOIUrl":"10.1186/s12916-025-04136-5","url":null,"abstract":"<p><strong>Background: </strong>While outdoor time's protective role against myopia is established, the relationship between physical activity (PA) and myopia development remains unclear. This study aimed to determine the impact of PA on myopia in children.</p><p><strong>Methods: </strong>In this prospective, school-based cohort study conducted in Shanghai from 2016-2018, children aged 6-9 years from 24 primary schools wore smartwatches for 1 year to record activity intensity and environmental status (indoor/outdoor). Activity load was calculated as a weighted sum of time spent in light (1 ×), moderate (2 ×), and vigorous (3 ×) activities. Myopia shift was measured by 2-year changes in spherical equivalent (SE) and axial length (AL). Limited myopia progression was defined as myopic shift ≤ -0.50 D over 2 years.</p><p><strong>Results: </strong>Among 4306 participants (mean age 7.3 ± 0.6 years; 47.1% girls), mean daily activity times indoors were 134.26 ± 31.99, 9.05 ± 3.34, and 2.63 ± 2.71 min for light, moderate, and vigorous activities respectively, with corresponding outdoor times of 59.10 ± 17.71, 12.64 ± 4.79, and 2.21 ± 1.11 min. Activity load showed protective associations in both environments, stronger outdoors (β = 0.18; 95% CI, 0.10-0.27; p < 0.001) than indoors (β = 0.06; 95% CI, 0.003-0.12; p = 0.037). Children in the highest quartile of indoor activity (≥ 3.02 weighted hours/day) showed 22% higher odds of limited myopia progression (adjusted OR = 1.22; 95% CI, 1.00-1.50; p for trend = 0.048), while those with outdoor activity ≥ 1.47 weighted hours/day demonstrated 34-77% higher odds (adjusted OR: Q3 = 1.34, 95% CI 1.01-1.80; Q4 = 1.77, 95% CI 1.32-2.36; p for trend < 0.001). Outdoor activity load was particularly protective in non-myopic children (β = 0.15; 95% CI, 0.07-0.23; p < 0.001) and those with daily outdoor time < 120 min (β = 0.22; 95% CI, 0.11-0.33; p < 0.001), while indoor activity load was protective in Grade 2 students (β = 0.11; 95% CI, 0.03-0.20; p = 0.009) and children with ≥ 120 min of outdoor time (β = 0.23; 95% CI, 0.07-0.39; p = 0.006).</p><p><strong>Conclusions: </strong>Activity load, integrating both time and intensity of PA, shows significant protective associations with myopic shift in both indoor and outdoor environments. This protective effect exists independent of light exposure, suggesting that PA might offer additional benefits for myopia prevention beyond the known effects of outdoor time.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"294"},"PeriodicalIF":7.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118911","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}