BMC Medicine最新文献

{"title":"Dynamics of contact behaviour by self-reported COVID-19 vaccination and infection status during the COVID-19 pandemic in Germany: an analysis of two large population-based studies.","authors":"Lena Böff, Antonia Bartz, Manuela Harries, André Karch, Annette Aigner, Veronika K Jaeger, Berit Lange","doi":"10.1186/s12916-025-04211-x","DOIUrl":"10.1186/s12916-025-04211-x","url":null,"abstract":"<p><strong>Background: </strong>Contact behaviour is crucial to assess and predict transmission of respiratory pathogens like SARS-CoV-2. Contact behaviour has traditionally been assessed in cross-sectional surveys and not as part of longitudinal population-based studies which simultaneously measure infection frequency and vaccination coverage. During the COVID-19 pandemic, several studies assessed contact behaviour over longer periods and correlated this to data on immunity. This can inform future dynamic modelling. Here, we assess how contact behaviour varied based on SARS-CoV-2 infection or vaccination status in two large population-based studies in Germany during 2021.</p><p><strong>Methods: </strong>We assessed direct encounters, separated into household and non-household contacts, in participants of MuSPAD (n = 12,641), a population-based cohort study, and COVIMOD (n = 31,260), a longitudinal contact survey. We calculated mean numbers of reported contacts and fitted negative binomial mixed-effects models to estimate the impact of immunity status, defined by vaccination or previous infection, on contact numbers; logistic mixed-effects models were used to examine the relationship between contact behaviour and seropositivity due to infection.</p><p><strong>Results: </strong>Contact numbers varied over the course of the pandemic from 7.6 to 10.8 per 24 h in MuSPAD and 2.1 to 3.1 per 24 h in COVIMOD. The number of non-household contacts was higher in participants who reported previous infections and vaccinations (contact ratio (CR) MuSPAD: 1.22 (95%CI 0.94-1.60); COVIMOD: 1.35 (CI 1.12-1.62)) compared to unvaccinated and uninfected individuals. Non-household contact numbers were also higher in fully vaccinated participants (MUSPAD: CR 1.15 (CI 1.05-1.26); COVIMOD: 1.43 (CI 1.32-1.56)) compared to unvaccinated individuals. Compared to individuals without household contacts, the odds for seropositivity due to infection were higher among MuSPAD individuals with three or more household contacts (odds ratio (OR) 1.54 (CI 1.12-2.13)) and eleven or more non-household contacts (OR 1.29 (CI 1.01-1.65)).</p><p><strong>Conclusions: </strong>Different contact behaviours based on infection and/or vaccination status suggest that public health policies targeting immunity status may influence the contact behaviour of those affected. A combined assessment of self-reported contacts, infections, and vaccinations as well as laboratory-confirmed serostatus in the population can support modelling of the spread of infections. This could help target containment policies and evaluate the impact of public health measures.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"406"},"PeriodicalIF":7.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583159","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":"Enhancing protection against vector-borne diseases in forcibly displaced communities: evaluating the efficacy of spatial repellents for cutaneous leishmaniasis control in North-East Syria.","authors":"Richard Allan, Ramona Scherrer, Ozge Erisoz Kasap, Laura Paris, Thomas Scott, Hendrik Sauskojus, Olivia Wetherill, Sara Estecha-Querol, Zaid Alkhalaf, Mehmet Karakus, Ayda Yilmaz, Bülent Alten, Louisa A Messenger","doi":"10.1186/s12916-025-04244-2","DOIUrl":"10.1186/s12916-025-04244-2","url":null,"abstract":"<p><strong>Background: </strong>In Syria, during the 14 years after the outbreak of civil war, 16.7 million people have been forced to flee their homes, of which 7.2 million remain internally displaced in 2025. Breakdown in waste management caused by aerial bombardment has created ideal conditions for cutaneous leishmaniasis (CL) transmission, vectored by phlebotomine sandflies. Displaced populations reside in flimsy shelters where conventional vector control tools are operationally unfeasible. A small, lightweight, portable transfluthrin-based spatial repellent (Mosquito Shield™) has been developed which may circumvent some of these logistical issues and provide improved protection from vector-borne diseases in harsh environments.</p><p><strong>Methods: </strong>A two-arm, non-randomised cluster trial was undertaken in Ar-Raqqa governorate, North-East Syria, to evaluate the efficacy of Mosquito Shield™ in reducing CL case incidence and sandfly densities in shelters. Weekly epidemiological monitoring was performed by MENTOR Initiative mobile clinics and supported health facilities. Entomological monitoring was performed fortnightly using indoor US Centers for Disease Control and Prevention light traps in 40 randomly selected households per study arm. Phlebotomine sandflies were morphologically identified; a subset were analysed for molecular species confirmation, blood-meal preferences and pyrethroid resistance. Household surveys and focus group discussions were used to assess intervention feasibility, acceptability and uptake.</p><p><strong>Results: </strong>Assuming a 2-month diagnosis cut-off, the CL incidence rate was 9.9 and 5.2 per 1000 in the control and intervention arms, respectively; Mosquito Shield™ demonstrated a significant impact on rate of CL infection in all ages (incidence rate ratio; IRR: 0.52 [95% CI: 0.37-0.74]; p < 0.0001). Mosquito Shield™ demonstrated a significant impact on all female sandfly density (IRR: 0.22 [95% CI: 0.14-0.33]; p < 0.0001) and blood-fed female sandfly density (IRR: 0.21 [95% CI: 0.11-0.40]; p < 0.0001). Mosquito Shield™ was received positively and perceived to be easy to use, to protect from CL, sandflies and other insect bites and required minimal behaviour change.</p><p><strong>Conclusions: </strong>Trial findings provide the first demonstrable impact of spatial repellents on CL transmission, strengthening the growing evidence basis for the effectiveness of this intervention against multiple vector species and their associated pathogens. Study results strongly support the deployment of spatial repellents to control CL in humanitarian crises.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT06917040.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"401"},"PeriodicalIF":7.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559157","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":"A scoping review of outcome selection and accuracy of conclusions in complex digital health interventions for young people (2017-2023): methodological proposals for population health intervention research.","authors":"Claire Collin, Clara Eyraud, Philippe Martin, Morgane Michel, Enora Le Roux, Corinne Alberti","doi":"10.1186/s12916-025-04245-1","DOIUrl":"10.1186/s12916-025-04245-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Determining the success of population health interventions often involves assessing multiple, multidimensional outcomes rather than a single one, which presents significant methodological challenges under the evidence-based medicine paradigm. This scoping review examines outcome selection, analysis, and interpretation, and the accuracy of conclusions in complex digital health interventions promoting health among adolescents and young adults (DHI-AYA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search of PubMed, EMBASE, ClinicalTrials.gov, PsycINFO, and CINAHL identified DHI-AYA implemented between 2017 and 2023. Studies were categorised by methodological choice regarding outcome hierarchical position: unique primary, multiple primary, or non-hierarchised outcomes. Outcomes were further classified into effectiveness, process, or economic categories. The authors' conclusions on intervention success were compared with conclusions drawn by the research team based on the reported outcome analysis strategy. Secondly, four analytical strategies were applied to a subset of selected interventions to illustrate the impact of outcome hierarchical position and number on conclusions about intervention success.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analysis of 100 studies linked to 26 DHI-AYA identified 251 distinct outcomes: 164 effectiveness, 78 process, and 9 economic outcomes. Seven interventions were evaluated using a unique primary outcome, 10 using multiple primary outcomes, and 9 using multiple non-hierarchised outcomes. Primary and secondary outcomes were predominantly effectiveness endpoints. The research team reclassified nine interventions (35%) deemed successful by authors as non-conclusive due to statistically conflicting results across outcomes. Most interventions deemed non-conclusive by the research team were evaluated using non-hierarchised outcomes (7/10, 70%). The choice of outcome analysis strategy substantially affected conclusions on intervention success.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Discrepancies in intervention success assessments highlight the need for enhanced transparency, robustness, and trustworthiness in conclusion-drawing processes. In response, five methodological proposals are formulated: (1) developing core outcome sets specific to population health intervention research (PHIR), (2) collaboratively selecting multidimensional outcomes through a steering committee that accounts for stakeholder preferences and existing theoretical models, (3) exploring multi-criteria decision analysis and consensus-driven methods to transparently combine outcomes, (4) enhancing methodological reporting through intervention development and evaluation to improve scientific integrity and reproducibility, and (5) increasing PHIR expert involvement in ethics, funding, and evaluation committees to improve recognition of evidence produced in this field.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Prospero registration number: &lt;/strong&gt;CRD420234","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"400"},"PeriodicalIF":7.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552239","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 biological aging acceleration transitions and burdens with incident cardiovascular disease: longitudinal insights from a national cohort study.","authors":"Xin Zhang, Yu Yan, Yuxin Liu, Zixin Wang, Yuchen Jiang, Shuo Zhang, Tongda Xu, Ke Wang, Chu Zheng, Ping Zeng","doi":"10.1186/s12916-025-04177-w","DOIUrl":"10.1186/s12916-025-04177-w","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have examined the association between biological aging acceleration (BioAgeAccel) and cardiovascular disease (CVD). However, the effects of BioAgeAccel transitions and burdens on CVD risk remained unclear, and little was known about the association of BioAgeAccel with age at CVD onset.</p><p><strong>Methods: </strong>We included 316,417 participants from the UK Biobank in the baseline analyses and reserved 7249 in the visit-to-visit analyses. BioAgeAccel was defined as the residual derived from a linear regression of biological age against chronological age, with higher values indicating accelerated aging. We defined BioAgeAccel transitions based on aging status at baseline and the first follow-up, and created three indicators to reflect BioAgeAccel burdens. Cox models were used to evaluate the associations of baseline BioAgeAccel, BioAgeAccel transitions, and BioAgeAccel burdens with incident CVD risk. Linear models were employed to investigate their impacts on age at CVD onset.</p><p><strong>Results: </strong>Compared to individuals maintaining stable non-accelerated aging patterns, those transitioning to accelerated aging status showed a 29.8% (4.2-61.8%) increased CVD risk, while participants with sustained accelerated aging demonstrated a more pronounced 65.5% (35.9-101.5%) risk elevation. Reversal from accelerated to non-accelerated aging status was associated with a significant 25.6% (3.9-42.3%) risk reduction compared to persistent accelerated aging. Higher BioAgeAccel burdens were related to enhanced incidence and advanced onset of CVD, all of which were greater than the effect of baseline BioAgeAccel, with cumulative BioAgeAccel showing the greatest influence on CVD risk (HR = 1.26 [1.07-1.47]) and the most pronounced contribution to earlier onset of CVD (0.989 [0.558-1.420] years). BioAgeAccel burdens were associated with a higher CVD risk compared to FRS or SCORE2 burdens and could enhance the predictive capacity of the two risk scores. Drug treatments did not substantially impact these results. We further discovered socioeconomic status likely antagonized the associations of BioAgeAccel burdens with CVD.</p><p><strong>Conclusions: </strong>This study revealed BioAgeAccel progression was associated with a higher incident CVD risk, while its reversal was linked to a lower risk. BioAgeAccel burdens were associated with increased risk and earlier onset of CVD, exceeding the effects of baseline BioAgeAccel and some well-known risk scores, and cumulative BioAgeAccel exhibited the strongest impact among them.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"347"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538774","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":"Causal link between humid heatwaves and ischemic heart disease: assessing hospitalizations and economic burden across 955 Chinese counties.","authors":"Teng Wang, Hanxu Shi, Zhisheng Liang, Haojun Fan, Taojiang Meng, Fan Dai, Wei Huang, Ming Xu, Huining Yang, Shyam Biswal, Murugappan Ramanathan, Gorden G Liu, Minghui Ren, Shengzhi Sun, Zhenyu Zhang","doi":"10.1186/s12916-025-04133-8","DOIUrl":"10.1186/s12916-025-04133-8","url":null,"abstract":"<p><strong>Background: </strong>Humid heatwaves might cause more massive destruction to human health systems, especially the cardiovascular system. However, there is no systematic approach for identifying humid heatwaves and assessing their impacts on human health and health-related economic burden. This study aims to elucidate the relationship between short-term exposure to humid heatwaves and the relative risk of hospitalization for ischemic heart disease (IHD) and the hospitalization-related economic burdens.</p><p><strong>Methods: </strong>This study utilizes hospitalization data from the Chinese Multiple-County (CMC) Hospital Network with 6,843,511 IHD cases across 1309 counties from 2016 to 2022. We employed a pre-post analysis and a causal inferential propensity score matching aided difference-in-differences (PSM-DID) approach to assess the causal effect of each type of humid heatwaves on IHD hospitalization rate changes.</p><p><strong>Results: </strong>IHD hospitalizations increased by 2.92% (95% CI, 1.17%, 4.66%), 2.76% (95% CI, 1.07%, 4.45%), and 1.60% (95% CI, 0.08%, 3.12%) following independent humid heatwaves, light precipitation involved-, and moderate precipitation involved-humid heatwaves, with annual hospitalization-related economic burden reached $154 million (95% CI, $20, $249 million), $75 million (95% CI, $14, $136 million), and $81 million (95% CI, $31, $131 million), respectively. Chronic IHD and Angina were the most sensitive subtypes. Moreover, middle-to-old and male populations were afforded the most burdens.</p><p><strong>Conclusions: </strong>As humid heatwaves become more intense, older populations with IHD should be provided with more care and medical resources. Identifying strategies and implementing actionable adaptation measures to minimize disruptions in healthcare delivery following these extremely hot and humid events is crucial to reducing IHD hospitalizations.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"359"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538778","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 vegetarian diet and risk of frailty in Chinese older adults: a prospective study.","authors":"Yilun Huang, Guliyeerke Jigeer, Yuebing Lv, Kaiyue Wang, Xinyi Ma, Jiaojiao Zou, Ruiqi Xia, Xiuhua Shen, Xiaoming Shi, Yaqi Li, Xiang Gao","doi":"10.1186/s12916-025-04232-6","DOIUrl":"10.1186/s12916-025-04232-6","url":null,"abstract":"<p><strong>Background: </strong>Although dietary patterns rich in plant-based food have been linked to lower frailty risk in older adults, the relationship between vegetarian diet and incident frailty has been understudied. Therefore, this study aimed to investigate the association between vegetarian diet and risk of frailty in a nationwide representative cohort of Chinese community-dwelling older adults (≥ 65 years old).</p><p><strong>Methods: </strong>Included were 27,917 participants (age range: 65-122 years; mean age: 86.9 ± 11.0 years) free of frailty at study entry, from the Chinese Longitudinal Healthy Longevity Survey initiated in 1998. According to the consumption of meat, fish, eggs, and milk products assessed by the food frequency questionnaire at each survey, participants were categorized as omnivores (n = 23,541) or vegetarians (n = 4376), among which were further classified as pesco-vegetarians (n = 1547), ovo-lacto-vegetarians (n = 1745), and vegans (n = 1084). Diet trajectory (from baseline to the first follow-up survey, median interval: 2.8 years) categories included Stick-To-Omnivorous, Stick-To-Vegetarian, Omnivorous-To-Vegetarian, and Vegetarian-To-Omnivorous. Frailty was defined by a frailty index > 0.25 based on 40 variables reflecting health deficits. We used multivariable time-varying Cox proportional hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of frailty risk according to different diet groups and diet trajectories.</p><p><strong>Results: </strong>During a median follow-up of 3.0 (IQR: 1.83-5.33) years, vegetarians showed a higher risk of incident frailty (HR [95% CI]: 1.13 [1.07, 1.20]) compared to omnivores. Similar patterns were observed across subgroups of vegetarian diet, including pesco-vegetarians (HR [95% CI]: 1.15 [1.05, 1.26]), ovo-lacto-vegetarians (HR [95% CI]: 1.11 [1.02, 1.20]), and vegans (HR [95% CI]: 1.12 [1.01, 1.25]). In terms of diet trajectory, maintaining vegetarian diets (HR [95% CI]: 1.19 [1.03, 1.38]), transition from the omnivorous diet to vegetarian diets (HR [95% CI]: 1.16 [1.04, 1.30]), and transition from vegetarian diets to the omnivorous diet (HR [95% CI]: 1.14 [1.02, 1.27]) were all associated with higher risks of frailty, compared with maintaining an omnivorous diet.</p><p><strong>Conclusions: </strong>In this prospective study, vegetarian diets were observed to be associated with higher frailty risk, compared to the omnivorous diet in Chinese older adults. Future research is needed to confirm our observations.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"352"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538815","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":"Associations and mediators of estimated sodium intake with cardiovascular mortality: data based on a national population cohort.","authors":"Yuan Tian, Chunying Lin, Hui Zhong, Chaoqun Wu, Yi Wu, Bowang Chen, Xiaoyan Zhang, Xueke Bai, Yang Yang, Yanping Wang, Libo Hou, Jianlan Cui, Wei Xu, Lijuan Song, Hao Yang, Wenyan He, Yan Zhang, Weili Zhang, Haibo Zhang, Xi Li, Shengshou Hu","doi":"10.1186/s12916-025-04206-8","DOIUrl":"10.1186/s12916-025-04206-8","url":null,"abstract":"<p><strong>Background: </strong>The current research on the association of sodium excretion with health outcomes is inconclusive, despite its linear relationship with blood pressure. Moreover, there is a lack of evidence regarding sodium intake. This study aims to estimate sodium intake, examine its associations with mortality, and explore potential factors that may mediate these associations.</p><p><strong>Methods: </strong>Based on a nationwide community-based population cohort in China that covered 215 counties from 31 provinces, we collected fasting morning urine from 270,991 participants aged 35-75 years during Dec 2015 and Dec 2019. We calculated 24-h urinary sodium excretion using the Kawasaki formula, and estimated daily sodium intake by adjusting for sweat excretion based on a model with ambient temperature. We fitted Cox regression models to examine its independent hazard ratios (HR) and 95% confidence intervals (CI) on mortality, and assessed the causal mediation effects of metabolic factors.</p><p><strong>Results: </strong>Among the included participants with an average age of 56 years, the mean of estimated daily sodium intake was 222.9 ± 71.0 mmol. Sodium intake was lower in elderly and women, but higher in participants living in the north or rural areas (P < 0.001 for both). In participants without antihypertensive treatment, blood pressure was positively related to sodium intake (4.14/1.58 mmHg per 100 mmol/day, P < 0.001). Compared with participants in the quintile 3 of sodium intake (i.e., 200.8-235.1 mmol/day), those in the quintile 1 (i.e., < 163.5 mmol/day) had an adjusted HR of 1.17 (95% CI: 1.05-1.30) for cardiovascular mortality, after adjusting for demographic, socioeconomic, behavioural, and clinical characteristics, as well as urinary potassium, with heart rate (29.4%) and blood glucose (18.5%) as major significant mediators. In the meantime, participants in the quintile 5 (i.e., > 278.8 mmol/day) had an adjusted HR of 1.18 (95% CI: 1.05-1.32), with systolic blood pressure (24.6%) and body mass index (2.4%) playing substantial mediating effects.</p><p><strong>Conclusions: </strong>Both high and low sodium intake are associated with increased cardiovascular mortality. The lowest risk is observed at an estimated sodium intake of 200.8-235.1 mmol/day (equivalent to 4.6-5.4 g/day). Mediation analysis suggests that blood pressure, heart rate and glycaemic disorders could be plausible explanations for this U-shaped association.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"392"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538776","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":"Brain state dynamics and working memory in patients with schizophrenia and unaffected siblings.","authors":"Feiwen Wang, Jie Yang, Jun Yang, Peng Cheng, Wenjian Tan, Danqing Huang, Maoxing Zhong, Xiawei Liu, Weiqing Huang, Zhening Liu, Lena Palaniyappan","doi":"10.1186/s12916-025-04216-6","DOIUrl":"10.1186/s12916-025-04216-6","url":null,"abstract":"<p><strong>Background: </strong>Working memory (WM) deficits are a key feature of schizophrenia and are also seen in unaffected siblings. These deficits might arise  from disrupted transitions from one brain state to another. Using a robust algorithm called the Bayesian Switching Dynamical System (BSDS), we studied hidden brain states and their transitions during a WM task in people with schizophrenia.</p><p><strong>Methods: </strong>We used BSDS to identify brain states based on regions of interest (ROIs) within the default mode network and the frontoparietal network in 161 patients with schizophrenia, 37 unaffected siblings, and 96 healthy controls during N-back (0, 2, and resting fixation) tasks. We estimated group differences in the properties of brain states and studied the influence of WM performance and clinical characteristics on them using General Linear Models.</p><p><strong>Results: </strong>We identified 4 brain states underlying the WM task: high-demand, low-demand, fixation, and non-dominant states. Compared with controls and siblings, patients showed reduced occupancy and lifetime of high-demand state during the \"2-back,\" reduced lifetime of low-demand state during the \"0-back,\" but increased occupancy and lifetime of fixation state during both task periods. Aberrant high-demand state mediated the association between WM performance and negative symptoms. Compared with controls and patients, siblings showed increased occupancy of high-demand and reduced fixation state during the resting fixation condition; this putative compensatory process correlated with better WM performance.</p><p><strong>Conclusions: </strong>Latent brain states of intrinsic connectivity that represent internal mental processes affect WM performance, influencing the expression of negative symptoms in schizophrenia and cognitive resilience in unaffected siblings.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"376"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538777","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":"Cross-national differences in the association between estimated cardiorespiratory fitness and depressive symptoms among older adults: findings from three nationwide cohort studies.","authors":"Xue He, Cong Li, GuangYao Hua, Yan Wang, Lijun Zhang, Chingyu Cheng, Jinghua Jiao, Honghua Yu, Xiaohong Yang, Lei Liu","doi":"10.1186/s12916-025-04175-y","DOIUrl":"10.1186/s12916-025-04175-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiorespiratory fitness (CRF) is a modifiable risk factor for chronic diseases, but its association with depressive symptoms remains unclear, particularly across different populations. We aimed to investigate the link between estimated CRF (eCRF) and incident depressive symptoms among individuals over 50 years old, and to explore potential cross-country variations in this association.</p><p><strong>Methods: </strong>Data were retrieved from three national cohorts: the Health and Retirement Study (HRS, United States), the English Longitudinal Study of Ageing (ELSA, England), and the China Health and Retirement Longitudinal Study (CHARLS, China). eCRF was estimated using sex-specific algorithms and categorized into low (quintiles 1), moderate (quintiles 2-3), and high (quintiles 4-5) levels. Depressive symptoms were measured using the 8-item Center for Epidemiological Studies Depression Scale (CESD-8) (cutoff ≥ 3) in HRS and ELSA, and the 10-item version (CESD-10) (cutoff ≥ 10) in CHARLS. Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.</p><p><strong>Results: </strong>This study included 13,680 participants (4195 from HRS, 5421 from ELSA, and 4064 from CHARLS) with median follow-ups of 9.78, 12.11, and 5.73 years, respectively. Depressive symptoms incidence was 22.79% in HRS, 22.15% in ELSA, and 40.58% in CHARLS. Per 1-SD increase in eCRF was associated with 9% lower risk of depressive symptoms in HRS (HR = 0.91; 95% CI, 0.87-0.96), 8% lower in ELSA (HR = 0.92; 95% CI, 0.87-0.97), but 6% higher in CHARLS (HR = 1.06; 95% CI, 1.01-1.16). Compared with the low eCRF level group, high eCRF level was associated with decreased risk of depressive symptoms in HRS (HR = 0.69; 95% CI, 0.55-0.85) and ELSA (HR = 0.62; 95% CI, 0.48-0.79), but increased risk in CHARLS (HR = 1.27; 95% CI, 1.01-1.61). Subgroup analyses revealed that the associations were modified by smoking status (HRS), by gender and presence of diabetes (ELSA), and by the presence of hypertension (CHARLS) (P for interaction < 0.05).</p><p><strong>Conclusions: </strong>A higher level of eCRF was associated with reduced depressive symptoms risk in the US (HRS) and England (ELSA) older adults but with increased risk in China (CHARLS), emphasizing the need for nation-specific public health strategies.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"363"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538841","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":"Disability in mitochondrial aerobic metabolism and Mg²⁺ transport: linking biomarkers and mechanisms of ischemic heart disease to diesel particulate matter exposure.","authors":"Ze Zhang, Gan Miao, Juan Ma, Ziyuan Li, Chuer Zheng, Jian Ding, Hao Yin, Xiangcheng Cui, Shoujie Dai, Rifat Zubair Ahmed, Yong Niu, Shanfa Yu, Xiaoting Jin, Yuxin Zheng","doi":"10.1186/s12916-025-04212-w","DOIUrl":"10.1186/s12916-025-04212-w","url":null,"abstract":"<p><strong>Background: </strong>Ischemic heart disease (IHD) is a major cardiovascular health concern. In addition to metabolic and behavioral risks, diesel particulate matter (DPM), with a widely exposed population, is an important external environmental risk factor for IHD. However, the effect biomarkers used to diagnose DPM-caused IHD and underlying mechanisms remain unknown. We investigated the biomarkers and underlying mechanisms of DPM in relation to myocardial hypoxia injury.</p><p><strong>Methods: </strong>This study applied a unique population of diesel engine testers with stable DPM exposure. Electrocardiogram examination, echocardiogram examination, serum levels of myocardial enzymes, and 6-min walking test were used for the myocardial risks assessment. A mouse model exposed to occupational environmental DPM dose and in vitro models of DPM-induced myocardial hypoxia injury were used for assessment of mitochondrial aerobic metabolism via the oxygraph-2k system, western blotting, and kits. Ion fluorescence probes, ion supplements, and mitochondrial RNA splicing protein 2 (Mrs2) overexpression transfection were used in further investigations and verifications of the mechanism of mitochondrial Mg²⁺ deficiency.</p><p><strong>Results: </strong>We identified compromised myocardial mitochondrial aerobic metabolism as a precursor biomarker for the cardiac risk of myocardial hypertrophy and hypoxia injury in DPM exposure. DPM induce mitochondrial Mg²⁺ deficiency of cardiomyocytes, which in turn disrupt the mitochondrial aerobic metabolism processes, including the tricarboxylic acid cycle, oxidative phosphorylation, and ATP synthesis. Mg²⁺ deficiency is mediated by the disruption of Mg²⁺ transport proteins, such as DPM-enhanced hyperubiquitination and degradation of Mrs2, a protein responsible for mitochondrial Mg²⁺ uptake.</p><p><strong>Conclusions: </strong>Our findings show that compromised mitochondrial aerobic metabolism, associated with Mg²⁺ deficiency, serves as a critical biomarker for DPM-induced IHD and represents a promising investigative avenue for intervention.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"379"},"PeriodicalIF":7.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12218838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538844","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}