BMC Medicine最新文献

{"title":"Effect of sodium-reduced potassium-enriched salt substitutes on stomach cancer: the Salt Substitute and Stroke Study (SSaSS).","authors":"Xinyi Zhang, Xuejun Yin, Mei Ling Yap, Qiang Li, Liping Huang, Yishu Liu, Bo Zhou, Zhifang Li, Yi Zhao, Jixin Sun, Yan Yu, Lijing L Yan, Yangfeng Wu, Bruce Neal, Maoyi Tian","doi":"10.1186/s12916-025-04068-0","DOIUrl":"https://doi.org/10.1186/s12916-025-04068-0","url":null,"abstract":"<p><strong>Background: </strong>There is an association between increased dietary sodium intake and the risk of stomach cancer. Lowering dietary sodium intake with sodium-reduced potassium-enriched salt substitutes may reduce this risk. To evaluate the effects of sodium-reduced potassium-enriched salt substitutes on the risk of stomach cancer and other types of cancer.</p><p><strong>Methods: </strong>The primary analyses of the Salt Substitute and Stroke Study (SSaSS) defined the effects of sodium-reduced potassium-enriched salt substitutes compared to regular salt on the risk of stroke. This post-hoc investigation explored effects on stomach and other cancers. SSaSS was an open-label, cluster randomised controlled trial done in 600 Chinese villages among 20,996 participants. Villages were assigned at random in a 1:1 ratio to receive sodium-reduced potassium-enriched salt substitutes or continue regular salt use. Fatal and hospitalised cancer events were identified through direct face-to-face follow-up and record linkage, with adjudication of fatal, but not non-fatal events.</p><p><strong>Results: </strong>During a mean follow-up of 4.7 years, there were 1040 cancer events (507 fatal, 533 non-fatal) recorded. There were 212 stomach cancers, 725 other cancers, and 103 cancers with an unknown primary site. There was a trend toward but not a significant effect of randomised treatment on total stomach cancer (rate ratio (RR) 0.77, 95% confidence interval (CI) 0.54 to 1.08). The RR for adjudicated fatal stomach cancer was 0.66 (95% CI 0.44 to 1.00) compared to 0.88 (95% CI 0.56 to 1.37) for unadjudicated non-fatal stomach cancer. There was no detectable effect on total cancer at any site (RR 0.94, 95% CI 0.81 to 1.08), adjudicated fatal cancer at any site (RR 0.85, 95% CI 0.69 to 1.05), or unadjudicated non-fatal cancer at any site (RR 1.04, 95% CI 0.88 to 1.23).</p><p><strong>Conclusions: </strong>There was no effect of sodium-reduced potassium-enriched salt substitutes on stomach cancer or other cancer types detected. Trends toward protection against fatal and non-fatal stomach cancer align with the observational epidemiology and warrant further investigation.</p><p><strong>Trial registration: </strong>This trial was registered in ClinicalTrials.gov as NCT02092090.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"236"},"PeriodicalIF":7.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978402","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":"Clonal hematopoiesis of indeterminate potential and risk of autoimmune thyroid disease.","authors":"Xue Zhang, Yuqing Wang, Huiwen Xue, Yingsuo Zhao, Mingcheng Liu, Hui Wei, Qianwei Liu","doi":"10.1186/s12916-025-04077-z","DOIUrl":"https://doi.org/10.1186/s12916-025-04077-z","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disease, often remaining asymptomatic until the thyroid is significantly affected. Clonal hematopoiesis of indeterminate potential (CHIP) has been reported to drive many inflammatory diseases and autoimmune diseases. The association between CHIP and AITD is scarcely reported. This study aims to investigate whether CHIP is associated with the risk of AITD.</p><p><strong>Methods: </strong>We conducted a prospective community-based cohort study at the UK Biobank. CHIP, defined as the exposure, was identified using whole-exome sequencing (WES) data. AITD was sourced from the inpatient hospitalization register, the death register, and the primary healthcare register. Cox regression models were utilized to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the association between CHIP and AITD. Next, we conducted a subgroup analysis to investigate the role of specific gene mutations (DNMT3A, TET2, ASXL1, PPM1D, SRSF2, and JAK2) in the investigated association. Finally, we assessed the association across small CHIP clones (variant allele frequency, VAF: 2-10%) and large CHIP clones (VAF ≥ 10%). All models were adjusted for sex, age, ethnicity, education, Townsend deprivation index, body mass index, smoking status, and drinking status.</p><p><strong>Results: </strong>A total of 454,618 individuals were included in the final analysis. We identified 14,059 (3.1%) participants with CHIP. Compared with individuals without CHIP, those with CHIP were generally older and more likely to be smokers. Over a median follow-up of 12.7 years (interquartile range, IQR: 11.9-13.5), 21,708 cases with AITD were diagnosed. CHIP was associated with an increased risk of AITD (HR 1.11, 95% CI 1.03-1.19). Specifically, individuals with TET2-mutant CHIP (HR 1.23, 95% CI 1.07-1.41) had an elevated risk of AITD. A large CHIP clone (HR 1.17, 95% CI 1.08-1.27) was associated with an increased risk of AITD. Focusing on large CHIP clone, we also observed an association between TET2-mutant (HR 1.27, 95% CI 1.10-1.47) and ASXL1-mutant (HR 1.33, 95% CI 1.02-1.73) CHIP and risk of AITD.</p><p><strong>Conclusions: </strong>Individuals with CHIP were associated with a modestly increased risk of AITD, especially TET2-mutant CHIP. Future studies are needed to verify current findings and elaborate potential mechanisms.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"237"},"PeriodicalIF":7.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963244","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":"Maternal B12 deficiency during pregnancy dysregulates fatty acid metabolism and induces inflammation in human adipose tissue.","authors":"Jinous Samavat, Joseph Boachie, Philip G McTernan, Mark Christian, Ponnusamy Saravanan, Antonysunil Adaikalakoteswari","doi":"10.1186/s12916-025-04056-4","DOIUrl":"https://doi.org/10.1186/s12916-025-04056-4","url":null,"abstract":"<p><strong>Background: </strong>Adipose tissue (AT) responds to excess calorie intake; however, the deficit in micronutrients accompanied by the modern lifestyle is often overlooked. Micronutrient deficiency in pregnancy, particularly vitamin B12 (B12), is commonly associated with higher adiposity, dyslipidemia, and type 2 diabetes (T2D). Studies have demonstrated that dyslipidemia can trigger pro-inflammatory status. However, the release of the pro-inflammatory factors in a tissue-specific micronutrient deficient environment is unexplored. Therefore, we investigated the role of B12 deficiency on lipid metabolism and inflammatory mediators in both in vitro and ex vivo models including human pre-adipocytes, primary adipocytes, mature human white AT (WAT), and its association with metabolic risk.</p><p><strong>Methods: </strong>Paired abdominal subcutaneous and omental WAT (ScWAT and OmWAT) were chosen based on serum B12 (< 150 pM) from 115 Caucasian pregnant women. Human primary Sc adipocytes from women with different BMI (lean, overweight, obese, morbidly obese) and pre-adipocyte cell line (Chub-S7) were differentiated in various concentrations of B12. Serum B12, folate, lipids, cytokines, biochemical parameters, gene expression, intracellular triglyceride (TG), and mitochondrial function were assessed.</p><p><strong>Results: </strong>In pregnant women with low B12 levels, BMI and serum TG were significantly higher, and high-density lipoprotein (HDL) was lower (p < 0.05). B12 deficiency in both depots of AT correlated with higher expression of genes in fatty acid (FA) synthesis, elongation, desaturation, TG synthesis, and reduced fatty acid oxidation (FAO) (p < 0.05). In vitro adipocytes with low B12 demonstrated that TG synthesis utilizing radiolabeled FA was higher and mitochondrial function was impaired. We also found that the expression of pro-inflammatory cytokines in AT was increased, and circulatory cytokines inversely associated with serum B12 (p < 0.05).</p><p><strong>Conclusions: </strong>Our novel data highlights that B12 deficiency dysregulates lipids and induces inflammation in AT and circulation, which could contribute to adipocyte dysfunction exacerbating cardiometabolic risk during pregnancy.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"232"},"PeriodicalIF":7.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978657","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":"Probiotic mitigates gut hypoperfusion-associated acute gastrointestinal injury in patients undergoing cardiopulmonary bypass: a randomized controlled trial.","authors":"Xiaofang Yang, Ruisheng Liu, Zhijing An, Boxia Li, Yanyan Lin, Yuanmin Li, Bing Song, Jinqiu Yuan, Wenbo Meng, Christian Waydhas","doi":"10.1186/s12916-025-04082-2","DOIUrl":"https://doi.org/10.1186/s12916-025-04082-2","url":null,"abstract":"<p><strong>Background: </strong>Acute gastrointestinal injury (AGI) after cardiopulmonary bypass (CPB) is associated with poor prognosis. This study aimed to evaluate the effect of preoperative probiotic supplementation on the incidence of AGI in patients undergoing CPB procedure.</p><p><strong>Methods: </strong>This was a double-blind, randomized controlled trial conducted in a single center. The patients undergoing HVR with CPB between September 2022 and February 2023 were randomly assigned to receive either probiotic (Lac group) or placebo (Placebo group). The probiotic was administered daily for seven days prior to surgery.Univariate and multivariate logistic regression analysis was performed to identify independent risk factors for AGI. A P-value < 0.05 was considered statistically significant. Gut microbiota composition was assessed using 16 s rRNA analysis.</p><p><strong>Results: </strong>A total of 52 patients were randomly assigned to two groups (26 in the Lac group, 26 in the Placebo group). Patients were followed for at least 30 days after surgery. During the follow-up period, 15 of the 52 patients (28.85%) developed AGI. The incidence of AGI was significantly lower in the Lac group (15.38%) compared to the Placebo group (42.31%), with a difference of 26.93% (P = 0.032). Moreover, patients in the Lac group had a significantly shorter ICU stay (6 [5, 36] vs. 5 [4, 5.5] days, P = 0.041) and a lower incidence of nosocomial infections (11.54% vs. 34.62%, P = 0.048). Multivariate analysis identified a higher Cardiac Surgery Score (CASUS) and CPB duration ≥ 132 min as independent risk factors for AGI, whereas probiotic supplementation was the only protective factor. Furthermore, 16S rRNA sequencing revealed significant differences in gut microbiota composition between the Lac and Placebo groups.</p><p><strong>Conclusions: </strong>Preoperative probiotic supplementation may be an effective strategy to reduce the incidence of AGI and AGI-related complications in CPB patients. These findings suggest that probiotics could be considered a preventive intervention for AGI in this patient population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT05498948.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"238"},"PeriodicalIF":7.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978658","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":"Longitudinal association of cumulative risk factors in early life, genetic risk, and healthy lifestyles during adulthood with the risk of type 2 diabetes.","authors":"Jiajin Hu, Honghao Yang, Yilin Liu, Lu Zheng, Xiaoyan Zhang, Jing Yang, Zhe Yang, Xiaochuan Wang, Borui Liu, Hong Cui, Izzuddin M Aris, Yang Xia","doi":"10.1186/s12916-025-04025-x","DOIUrl":"https://doi.org/10.1186/s12916-025-04025-x","url":null,"abstract":"<p><strong>Background: </strong>The combined influence of early life risk factors on the type 2 diabetes (T2D) development is not well-studied, and it is unclear whether these associations can by modified by genetic risk and healthy lifestyles in later life.</p><p><strong>Methods: </strong>We studied 148,621 participants in the UK Biobank. We calculated early-life risk scores (ERS) by summing the cumulative number of three early-life risk factors: low birth weight, maternal smoking during pregnancy, and non-breastfed as a baby. We estimated polygenic risk scores (PRS) for T2D and calculated participants' modifiable healthy lifestyle score (MHS) during adulthood.</p><p><strong>Results: </strong>A total of 7,408 incident T2D were identified. ERS showed a positive dose-response association with T2D risk. Compared with participants with 0 ERS, those with 3 ERS had the highest risk of developing T2D (hazard ratio [HR]: 1.93; 95% confidence interval [CI]: 1.65, 2.26). This association was not modified by T2D-PRS or MHS. In the joint exposure analyses, compared with participants with the lowest risk exposure (i.e., lowest ERS combined with lowest T2D-PRS/healthy lifestyle in later life), we observed highest risk of T2D among individuals with the highest ERS combined with the highest tertile of T2D-PRS (HR = 6.67, 95% CI: 5.43, 8.20) or an unhealthy lifestyle in later life (HR = 4.99, 95% CI: 3.54, 7.02), respectively.</p><p><strong>Conclusions: </strong>Early-life risk factors are associated with a higher risk of T2D in a dose-response manner, regardless of genetic risk or later-life healthy lifestyle. Therefore, identifying early-life modifiable risk factors is helpful to develop strategies of T2D prevention.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"239"},"PeriodicalIF":7.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964497","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":"Machine learning technique-based four-autoantibody test for early detection of esophageal squamous cell carcinoma: a multicenter, retrospective study with a nested case-control study.","authors":"Yi-Wei Xu, Yu-Hui Peng, Can-Tong Liu, Hao Chen, Ling-Yu Chu, Hai-Lu Chen, Zhi-Yong Wu, Wen-Qiang Wei, Li-Yan Xu, Fang-Cai Wu, En-Min Li","doi":"10.1186/s12916-025-04066-2","DOIUrl":"https://doi.org/10.1186/s12916-025-04066-2","url":null,"abstract":"<p><strong>Background: </strong>Autoantibodies represent promising diagnostic blood-based biomarkers that may be generated prior to the first clinically detectable signs of cancers. In present study, we aimed to identify a novel optimized autoantibody panel with high diagnostic accuracy for clinical and preclinical esophageal squamous cell carcinoma (ESCC) using machine learning (ML) algorithms.</p><p><strong>Methods: </strong>We identified potential autoantibodies against tumor-associated antigens with serological proteome analysis. Serum autoantibody levels were measured by ELISA. Using a training set (n = 531), 102 models based on ML algorithms were constructed, and Partial Least Squares Generalized Linear Models (plsRglm) was selected out using receiver operating characteristics (ROC), Kolmogorov-Smirnov (K-S) test, and Population Stability Index (PSI), and further validated through an internal validation set (n = 413), external validation set 1 (n = 371), and external validation set 2 (n = 202). Then, we validated the ability of plsRglm model in predicting preclinical ESCC by a nested case-control study (24 preclinical ESCCs and 112 matched controls) within a population-based prospective cohort study.</p><p><strong>Results: </strong>ROC analysis, K-S test, and PSI showed that plsRglm model based on four autoantibodies (ALDOA, ENO1, p53, and NY-ESO-1) exhibited the better diagnostic performance and robustness, which provided a high diagnostic accuracy in diagnosing ESCC with the respective AUCs (sensitivities and specificities) of 0.860 (68.8% and 90.4%) in the training set, 0.826 (65.3% and 89.1%) in the internal validation set, and 0.851 (69.2% and 87.3%) in the external validation set 1. For early-stage ESCC, this signature also maintained diagnostic performance [0.817 (62.3% and 90.4%) in the training set; 0.842 (62.5% and 89.1%) in the internal validation set; 0.854 (63.2% and 87.3%) in the external validation set 1; and 0.850 (67.3% and 90.1%) in the external validation set 2]. In the nested case-control study, this plsRglm model could detect the presence of preclinical ESCC with the AUC of 0.723, sensitivity of 54.2%, and specificity of 86.6%.</p><p><strong>Conclusions: </strong>Our findings indicated that the plsRglm model based on four autoantibodies might help identify preclinical and early-stage ESCC.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"235"},"PeriodicalIF":7.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965470","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 role of environmental access to exercise opportunities in cardiovascular mortality: evidence from a nationwide study.","authors":"Xiaowen Wang, Yongshi Gu, Ying Wang, Yuqing Qiu, Tianling Chen, Philip K Hopke, Kai Zhang, Shao Lin, Yanji Qu, Ziqiang Lin, Xinlei Deng, Jie Sun, Shuming Zhu, Xueqing Deng, Sizhe Li, Xian Lin, Zhicheng Du, Yuantao Hao, Wangjian Zhang","doi":"10.1186/s12916-025-04060-8","DOIUrl":"https://doi.org/10.1186/s12916-025-04060-8","url":null,"abstract":"<p><strong>Background: </strong>Environmental access to exercise opportunities plays a crucial role in determining the level of physical activity within a population. However, it is unclear how environmental factors contribute to disparities in physical activity and health outcomes. We explored the associations between county-level access to exercise opportunities and cardiovascular disease (CVD) mortality across US counties.</p><p><strong>Methods: </strong>We conducted an ecological analysis using aggregated data from two primary sources: the County Health Rankings and Roadmaps data and CDC WONDER mortality data. We compared county-level age-adjusted CVD mortality across county-level quartiles of access to exercise opportunities and physical inactivity. Stratification was performed based on age, sex, race, and urbanization variables. The rate ratio (RR) for CVD mortality was also calculated using generalized linear models.</p><p><strong>Results: </strong>We observed significant variations in CVD mortality across different levels of exercise opportunities access and physical inactivity, which was consistent across all demographic subgroups (P < 0.001). Access to exercise opportunities was significantly associated with a reduced risk of CVD mortality (RR = 0.93 [0.91-0.95]), and the association was most pronounced for acute myocardial infarction (AMI) mortality (RR, 0.80 [0.76-0.85]). The county-level physical inactivity was significantly associated with an increased risk of CVD mortality (RR, 1.16 [1.14-1.17]), especially for ischemic heart disease (IHD) (RR, 1.35 [1.31-1.38]) and AMI (RR, 1.32 [1.25-1.38]). All demographic subgroups demonstrated similar benefits in reducing the risk of CVD by improving the county-level indicators of physical activity.</p><p><strong>Conclusions: </strong>Counties have the potential to make significant environmental strides in improving the cardiovascular health of their populations by enhancing access to exercise opportunities in the context of urbanization.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"228"},"PeriodicalIF":7.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974729","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 story of pain in people with dementia: a rationale for digital measures.","authors":"Monica Patrascu, Line I Berge, Ipsit V Vahia, Brice Marty, Wilco P Achterberg, Heather Allore, Richard R Fletcher, Bettina S Husebo","doi":"10.1186/s12916-025-04057-3","DOIUrl":"https://doi.org/10.1186/s12916-025-04057-3","url":null,"abstract":"<p><strong>Background: </strong>The increasingly older world population presents new aging-related challenges, especially for persons with dementia unable to express their suffering. Pain intensity and the effect of pain treatment are difficult to assess via proxy rating and both under- and overtreatment lead to neuropsychiatric symptoms, inactivity, care-dependency and reduced quality of life. In this debate piece, we provide a rationale on why valid digitalization, sensing technology, and artificial intelligence should be explored to improve the assessment of pain in people with dementia.</p><p><strong>Main text: </strong>In dementia care, traditional pain assessment relies on observing the manifestations of typical pain behavior. At the same time, pain treatment is complicated by polypharmacy, potential side effects, and a lack of around-the-clock, timely measures. But proper pain treatment requires objective and accurate measures that capture both the levels of pain and the treatment effects. Sensing systems research for personalized pain assessment is underway, with some promising results regarding associations between physiological signals and pain. Digital phenotyping, making use of everyday sensor data for monitoring health behaviors such as patterns of sleep or movement, has shown potential in clinical trials and for future continuous observation. This emerging approach requires transdisciplinary collaboration between medical and engineering sciences, with user involvement and adherence to ethical practices.</p><p><strong>Conclusion: </strong>Digital phenotyping based on physiological parameters and sensing technology may increase pain assessment objectivity in older adults with dementia. This technology must be designed with user involvement and validated; however, it opens possibilities to improve pain relief and care.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"227"},"PeriodicalIF":7.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965570","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: Robust circulating microRNA signature for the diagnosis and early detection of pancreatobiliary cancer.","authors":"Shuichi Mitsunaga, Masafumi Ikeda, Makoto Ueno, Satoshi Kobayashi, Masahiro Tsuda, Ikuya Miki, Takamichi Kuwahara, Kazuo Hara, Yukiko Takayama, Yutaro Matsunaga, Keiji Hanada, Akinori Shimizu, Hitoshi Yoshida, Tomohiro Nomoto, Kenji Takahashi, Hidetaka Iwamoto, Hideaki Iwama, Etsuro Hatano, Kohei Nakata, Masafumi Nakamura, Hiroko Sudo, Satoko Takizawa, Atsushi Ochiai","doi":"10.1186/s12916-025-04079-x","DOIUrl":"https://doi.org/10.1186/s12916-025-04079-x","url":null,"abstract":"","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"225"},"PeriodicalIF":7.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964517","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 high-normal blood pressure defined by the 2023 European Society of Hypertension guideline with mortality in the Chinese population: a nationwide, population-based, prospective study of 3.6 million adults.","authors":"Zhiwei Li, Mengmeng Liu, Bowang Chen, Yuelin Wu, Hui Jia, Ruirui Geng, Yixiao Wang, Xiaoyan Zhang, Yang Yang, Jianlan Cui, Jiapeng Lu, Zhiping Guo, Xi Li, Weili Zhang","doi":"10.1186/s12916-025-04055-5","DOIUrl":"https://doi.org/10.1186/s12916-025-04055-5","url":null,"abstract":"<p><strong>Background: </strong>The relationship between high-normal blood pressure (BP) and mortality lacks high-quality evidence based on large population cohorts. This study aims to comprehensively investigate the association of high-normal BP and its trajectory with all-cause and cause-specific mortality.</p><p><strong>Methods: </strong>In this community-based population cohort from the China Health Evaluation And risk Reduction Through nationwide teamwork (ChinaHEART) project, 3,598,940 participants aged 35-75 years with data for baseline BP were included. High-normal BP was defined as a systolic BP (SBP) of 130-139 mmHg and/or a diastolic BP (DBP) of 85-89 mmHg at baseline. Overall, 78,130 participants with three or more BP measurements were included in the trajectory pattern analysis during the follow-up. Four BP change trajectory patterns were identified.</p><p><strong>Results: </strong>For the baseline BP analysis, compared with the optimal BP group (SBP < 120 mmHg and DBP < 80 mmHg [18.1%]), participants with high-normal BP (18.7%) had an increase of 4% in all-cause mortality risk (hazard ratio [HR] 1.04, 95% confidence interval [CI] 1.01-1.07) and an increase of 28% in cardiovascular disease (CVD) mortality risk (HR 1.28, 95% CI 1.21-1.34), with the greatest increase in mortality risk observed for hemorrhagic stroke (HR 1.75, 95% CI 1.55-1.98). Among the BP trajectory patterns, compared with participants with optimal-stable BP, those with high-normal-increasing BP had an increase of 35% in all-cause mortality risk (HR 1.35, 95% CI 1.07-1.70) and an increase in CVD mortality risk of 57% (HR 1.57, 95% CI 1.11-2.24), with the greatest increase in mortality risk also observed for hemorrhagic stroke (HR 3.75, 95% CI 1.50-9.34). Approximately 0.7% and 1.6% of all-cause mortality was attributable to high-normal BP at baseline and the high-normal-increasing BP trajectory pattern, respectively.</p><p><strong>Conclusions: </strong>Individuals with high-normal BP at baseline exhibited a significantly elevated mortality risk and especially for risk of hemorrhagic stroke mortality during the follow-up. This positive association may be mainly attributed to the \"high-normal-increasing\" BP change over time.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"226"},"PeriodicalIF":7.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978343","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}