tbuckley/cabot-search huggingface dataset:
Radiographic structural damage in axial spondyloarthritis: is there a preferred way to quantify progression over time? Comparison of blinded versus unblinded mSASSS scoring
Authors: Xenofon Baraliakos, Mikhail Protopopov, Valeria Rios Rodriguez, Murat Torgutalp, Ani Dilbaryan, Hildrun Haibel, Joachim Sieper, Juergen Braun, Martin Rudwaleit, Denis Poddubnyy
Journal: Annals of the Rheumatic Diseases (2025)

Structural progression in spine in axial spondyloarthritis (axSpA) is assessed by conventional radiographs and quantified by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Blinded mSASSS scoring might be associated with 'background noise,' and for assessing a slow-progressing disease such as axSpA, high sensitivity to change without loss of specificity is crucial. The aim of this study was to compare the sensitivity to change of blinded vs unblinded application of mSASSS for identification of a preferred way of assessing radiographic damage in axSpA over time. Cervical and lumbar radiographcs of axSpA patients participating in a national inception cohort (GErman SPondyloarthritis Inception Cohort) obtained at baseline and after 2 years were scored using the mSASSS by 5 experienced readers, 2 blinded and 3 unblinded to chronology. Mean scores were used for calculations. Overall, 210 patients (37.3 years, 51% male, 79% human leukocyte antigen B27 positive) were included. The mean baseline mSASSS was 4.2 ± 8.3 vs 3.4±7.9 and mean mSASSS progression was 0.7 ± 2.3 vs 1.0 ± 1.9 for the blinded vs unblinded scoring method, respectively (P = .005). Progression of ≥2 mSASSS units was found in 30 (14.3%) vs 37 (17.6%) patients in blinded and unblinded scoring. In the shift analysis, mSASSS worsening was found in 35 (0.8%) vs 109 (2.2%) and improvement in 4 (0.1%) vs 2 (0.04%) of a total of 4.373 and 4914 vertebral edges in the blinded vs unblinded group, respectively. The majority of progression was found for the development of syndesmophytes in both groups. More mSASSS progression was detected using unblinded vs blinded scoring. Scoring spinal radiographs with known chronological order seems to be more sensitive to changes.
Pulmonary arterial hypertension in adults with Still’s disease: another pulmonary manifestation associated with HLA-DRB1*15
Authors: Athénaïs Boucly, Stéphane Mitrovic, Maryvonnick Carmagnat, Laurent Savale, Xavier Jaïs, Jean-Luc Taupin, Estibaliz Lazaro, Emilie Berthoux, Nicolas Schleinitz, Maria-Rosa Ghigna, Joanna Kedra, Xavier Mariette, Céline Roussin, Pierre-Antoine Juge, Marc Humbert, Olivier Sitbon, David Montani, Bruno Fautrel
Journal: Annals of the Rheumatic Diseases (2025)

Inflammatory lung disease in Still's disease (SD) has recently been described. Among its manifestations, pulmonary arterial hypertension (PAH) is a rare and life-threatening event, with only a few case reports published. The objective was to report the largest adult cohort of PAH occurring in the context of SD. We identified 16 adult SD patients with PAH (PAH+) by a call for observations from the CRI-IMIDIATE (Club Rhumatismes & Inflammation - Immune-Mediated Inflammatory Disease Alliance for Translational and Clinical Research) network (https://cri-net.com/recherche/reseau-CRI-Imidiate/) and a search of the French pulmonary hypertension network registry. Patient characteristics and disease evolution were retrospectively compared with those of 111 SD controls without PAH (PAH-) followed in a reference centre. The profile of patients in the PAH+ and PAH- groups differed: 100% versus 69.4% female (P = .006), 75% versus 17.1% Black (P < .0001), more active SD both at diagnosis and throughout the disease course, and more likely to present macrophage activation syndrome (62.5% vs 14.4%, P < .0001) and exhibit eosinophilia during the disease course (68.7% vs 7.2%, P < .0001). For the 84 out of 127 patients with genetic typing, the HLA-DRB1*15 allele was more prevalent in PAH+ than PAH- patients (8/11 [72.7%] vs 22/73 [30.1%], P = .014). PAH+ patients more frequently received canakinumab and immunosuppressants than did PAH- patients and had higher frequency of drug reactions to interleukin 1 (IL-1) and/or IL-6 inhibitors (37.5% vs 7.2%, P = .002). Mortality was higher in PAH+ than PAH- patients (37.5% vs 0.9%, P < .0001), and all deaths were related to SD flare. These results reinforce the association between the HLA-DRB1*15 allele and severe forms of SD and raise the question of therapeutic optimisation in such patients.
The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality
Authors: John Torous, Jake Linardon, Simon B. Goldberg, Shufang Sun, Imogen Bell, Jennifer Nicholas, Lamiece Hassan, Yining Hua, Alyssa Milton, Joseph Firth
Journal: World Psychiatry (2025)

The expanding domain of digital mental health is transitioning beyond traditional telehealth to incorporate smartphone apps, virtual reality, and generative artificial intelligence, including large language models. While industry setbacks and methodological critiques have highlighted gaps in evidence and challenges in scaling these technologies, emerging solutions rooted in co‐design, rigorous evaluation, and implementation science offer promising pathways forward. This paper underscores the dual necessity of advancing the scientific foundations of digital mental health and increasing its real‐world applicability through five themes. First, we discuss recent technological advances in digital phenotyping, virtual reality, and generative artificial intelligence. Progress in this latter area, specifically designed to create new outputs such as conversations and images, holds unique potential for the mental health field. Given the spread of smartphone apps, we then evaluate the evidence supporting their utility across various mental health contexts, including well‐being, depression, anxiety, schizophrenia, eating disorders, and substance use disorders. This broad view of the field highlights the need for a new generation of more rigorous, placebo‐controlled, and real‐world studies. We subsequently explore engagement challenges that hamper all digital mental health tools, and propose solutions, including human support, digital navigators, just‐in‐time adaptive interventions, and personalized approaches. We then analyze implementation issues, emphasizing clinician engagement, service integration, and scalable delivery models. We finally consider the need to ensure that innovations work for all people and thus can bridge digital health disparities, reviewing the evidence on tailoring digital tools for historically marginalized populations and low‐ and middle‐income countries. Regarding digital mental health innovations as tools to augment and extend care, we conclude that smartphone apps, virtual reality, and large language models can positively impact mental health care if deployed correctly.
Breaking the glass ceiling: women's scientific participation in the 24th World Congress of Psychiatry
Authors: Mariana Pinto da Costa, Bernardo Ng, Thelma Sanchez, Alejandro Molina, Jacqueline Cortés Morelos, David Saucedo‐Martinez, Yolanda Pica Ruiz, Artin Mahdanian, Sara Medved, Danuta Wasserman
Journal: World Psychiatry (2025)
How can measurement‐based care improve psychotherapy processes and mental health service delivery? A synthesis of expert perspectives
Authors: Christian Moltu, Maartje van Sonsbeek, Bram Bovendeerd, Kim de Jong, Michael Barkham, Célia Sales, Andrew McAleavey, John Mellor‐Clark, Brian Schwartz, Samuel Schieffelin Nordberg, Jenna Jacob, Wolfgang Lutz, Victor Kaldo, Pauline Janse, Heidi Brattland, Angelo Compare, Susan Douglas
Journal: World Psychiatry (2025)
Bipolar II disorder: a state‐of‐the‐art review
Authors: Michael Berk, Asier Corrales, Roth Trisno, Seetal Dodd, Lakshmi N. Yatham, Eduard Vieta, Roger S. McIntyre, Trisha Suppes, Bruno Agustini
Journal: World Psychiatry (2025)

Bipolar II disorder (BD‐II) is currently identified by both the DSM‐5 and ICD‐11 as a distinct subtype of bipolar disorder, defined by at least one depressive episode and at least one hypomanic episode, with no history of mania. Despite its prevalence and impact, the literature on BD‐II remains relatively sparse. This paper provides a comprehensive overview of the available research and current debate on the disorder, including its diagnostic criteria, clinical presentations, comorbidities, epidemiology, risk factors, and treatment strategies. Patients with BD‐II often present with recurrent depressive episodes, which outnumber hypomanic episodes by a ratio of 39:1. The condition is therefore often misdiagnosed as major depressive disorder and treated with antidepressant monotherapy, which may worsen its prognosis. The recognition of BD‐II is further complicated by the overlap of its symptoms with other disorders, in particular borderline personality disorder. Although BD‐II is often perceived as a less severe form of bipolar disorder, evidence suggests significant functional and cognitive impairment, accompanied by an elevated risk of suicidal behavior, including a rate of completed suicide at least equivalent to that observed in bipolar I disorder (BD‐I). Psychiatric comorbidities, in particular anxiety and substance use disorders, are common. The disorder is associated with a high prevalence of numerous physical comorbidities, with a particularly high risk of comorbid cardiovascular diseases. Various genetic and environmental risk factors have been identified. Inflammation, circadian rhythm dysregulation and mitochondrial dysfunction are being studied as potential pathophysiological mechanisms. Current treatment guidelines, often extrapolated from BD‐I and depression research, may not fully address the unique aspects of BD‐II. Nevertheless, substantial evidence supports the value of some pharmacological treatments – primarily mood stabilizers and atypical antipsychotics – augmented by psychoeducation, cognitive behavioral or interpersonal and social rhythm therapy, and lifestyle interventions. Further research on BD‐II should be a priority, in order to refine diagnostic criteria, identify potentially modifiable risk factors, and develop targeted interventions.
Views of international experts on challenges to early intervention for bipolar disorder
Authors: Sue M. Cotton, Vani Jain, Aswin Ratheesh, Clare Shelton, Craig Macneil, Kate M. Filia, Jacob Crouse, Annabel Burnside, Emily Clarke, Alesha Prasad, Rosie Arnold, Paul Badcock, Melissa Hasty
Journal: World Psychiatry (2025)
Women's reproductive mental health: currently available evidence and future directions for research, clinical practice and health policy
Authors: Louise M. Howard, Claire A. Wilson, Thomas J. Reilly, Katrina M. Moss, Gita D. Mishra, Ella Coupland‐Smith, Anita Riecher‐Rössler, Soraya Seedat, Shubulade Smith, Julia R. Steinberg, Jenneke van Ditzhuijzen, Sian Oram
Journal: World Psychiatry (2025)

Sex and gender differences in the epidemiology of mental disorders are well documented. Less well understood are the drivers of these differences. Reproductive health represents one of the gendered determinants of mental health that may affect women throughout their life course. In this paper, we review common reproductive events that may be associated with mental ill health, including menstruation (with premenstrual dysphoric disorder appearing for the first time in recent classifications of mental disorders), contraception, abortion, sexual dysfunction, hypersexuality, sexual violence, reproductive coercion, infertility and associated gynaecological conditions, and menopause. Such reproductive events may differentially affect women globally via a range of potential biological and psychosocial mechanisms. These include, for example, vulnerability to the physiological changes in hormone levels across the menstrual cycle; side effects of treatment of mental disorders; inflammation underpinning endometriosis and polycystic ovarian syndrome as well as mental disorders such as depression; intersections with gender disadvantage manifesting, for example, as structural barriers in accessing menstrual products and sanitation, contraception and abortion, underscoring the broader social determinants impacting women's mental health. Greater understanding of these mechanisms is guiding the development of effective interventions, which are also reviewed here. However, key evidence gaps remain, partly as a result of the historic gender bias in mental health research, and the neglect of reproductive health in clinical practice. Furthermore, while several women's health strategies have recently been proposed internationally, they do not usually include a focus on mental health across the life course, particularly for women with severe mental illness. Integrating co‐designed reproductive health interventions into primary and secondary mental health care settings, providing tailored care, increasing the evidence base on effective interventions, and empowering women to make informed choices about their reproductive health, could improve not only reproductive health but also women's mental health across the life course.
Distinct cognitive trajectories in the early course of psychosis are associated with clinical and functional outcomes longitudinally
Authors: Kathryn E. Lewandowski, Julia Blotner, Beier Yao, Rachel Hechinger, Michael J. Coleman, Martha E. Shenton
Journal: World Psychiatry (2025)

Cognitive dysfunction is a core dimension in psychotic disorders and among the strongest predictors of disability and poor quality of life. Cognitive impairments are highly heterogeneous, and cross‐sectional studies have consistently found evidence of distinct cognitive profiles both within diagnoses and transdiagnostically. Findings regarding the course of cognitive impairments over time have been mixed. We hypothesized that subgroups of patients in the early course of psychosis show distinct cognitive trajectories that can be identified using data‐driven methods, and that these subgroups differ on clinical and functional outcomes over time. Persons with schizophrenia‐spectrum disorders or mood disorders with psychosis in the early course of illness (N=127) were assessed using clinical, functional and cognitive measures at three timepoints: baseline, 8 and 16 months. Group‐based trajectory modeling was used to identify cognitive subgroups, which were then compared on clinical and functional measures using multilevel models. We identified three distinct cognitive subgroups: an Impaired group, an Average group, and a High‐Functioning group. Cognition was stable over the follow‐up period in the Impaired and High‐Functioning groups, whereas the Average group showed cognitive improvement. Groups did not differ in terms of diagnostic distribution, baseline clinical symptoms, and most baseline functional and demographic measures. However, over the follow‐up, group membership predicted changes in negative symptoms, social functioning, and patient‐reported outcomes, with the Impaired group showing the most severe illness course. We conclude that patients in the early course of psychosis show distinct cognitive trajectories that predict future symptoms and social functioning, despite presenting no clinical differences at baseline. These findings have implications for understanding biology‐cognition associations, which may be related to heterogeneity; developing predictive models for clinical and functional outcomes; and personalizing treatment to support patients’ cognitive, clinical and functional needs towards improving illness course.
Effectiveness of clozapine augmentation with specific doses of other antipsychotics in schizophrenia: a meta‐analysis from two nationwide cohorts
Authors: Jari Tiihonen, Antti Tanskanen, Ellenor Mittendorfer‐Rutz, Oliver D. Howes, Christoph U. Correll, Dan Siskind, Heidi Taipale
Journal: World Psychiatry (2025)

Although clozapine is the most effective medication for treatment‐resistant schizophrenia, response is inadequate in over half of people with that condition. There is limited guidance available on effective clozapine augmentation strategies. We studied the comparative effectiveness of specific doses of oral olanzapine, quetiapine, risperidone and aripiprazole augmentation of clozapine treatment on the risk of hospitalization due to a psychotic episode, as a marker for severe relapse, among patients with schizophrenia or schizoaffective disorder. In this population‐based study, patients with one of those diagnoses receiving clozapine were identified from Finnish (years 1995‐2017, N=14,053) and Swedish (years 2006‐2021, N=8,743) nationwide registers. The risk of hospitalization due to a psychotic episode associated with periods of antipsychotic augmentation of clozapine treatment vs. same‐dose clozapine monotherapy was assessed by a within‐individual design, using each individual as his/her own control to eliminate selection bias, and analyzed with stratified Cox models. The two national cohorts were first analyzed separately; then results were combined using a random‐effect meta‐analysis. Secondary outcomes were somatic hospitalization, and hospitalization for psychosis or a somatic cause. The only augmentation associated with a significantly decreased risk of hospitalization due to psychosis in both countries was medium‐dose (9 to &lt;16.5 mg/day) aripiprazole combined with high‐dose (≥330 mg/day) clozapine, and this combination was associated with the best outcome in the meta‐analysis (adjusted hazard ratio, aHR=0.68, 95% CI: 0.62‐0.75, p&lt;0.0001). Among patients using medium‐dose (180 to &lt;330 mg/day) clozapine, medium‐dose aripiprazole augmentation was the only treatment more effective than clozapine monotherapy after Bonferroni correction (aHR=0.79, 95% CI: 0.70‐0.91, p=0.0006). The use of all high‐dose augmentations was associated with an increased risk of hospitalization due to psychosis. Only aripiprazole augmentations were associated with a decreased risk of hospitalization for psychosis or a somatic cause, and the lowest risk was observed for medium‐dose aripiprazole plus high‐dose clozapine (aHR=0.70, 95% CI: 0.58‐0.84, p=0.0001). This meta‐analysis of two nationwide cohorts, totaling almost 23,000 patients using clozapine, indicates that medium‐dose aripiprazole augmentation of clozapine treatment is associated with a 20‐30% decreased risk of severe relapse compared with clozapine monotherapy within the same individuals, while augmentation with higher doses of aripiprazole (as well as with high doses of all other antipsychotics) is associated with an increased relapse risk.
<i>Anaerobutyricum soehngenii</i> improves glycemic control and other markers of cardio-metabolic health in adults at risk of type 2 diabetes
Authors: Ilias Attaye, Julia K. Bird, Max Nieuwdorp, Sahin Gül, Jos F. M. L. Seegers, Steven Morrison, Stijn Hofkens, Hilde Herrema, Nam Bui, Marie-Luise Puhlmann, Willem M. de Vos
Journal: Gut Microbes (2025)

Anaerobutyricum soehngenii (previously Eubacterium hallii) is a butyrate-producing next-generation beneficial microbe generally recognized as safe. Several short-term intervention trials by A. soehngenii L2-7 have shown improvement of insulin sensitivity in prediabetic subjects and type 2 diabetes patients. To determine the long-term cardiometabolic benefits and safety, we performed a 3-month double-blind, randomized placebo-controlled intervention in 98 prediabetic insulin-resistant adults in Europe and U.S. with daily administration of encapsulated cells of A. soehngenii CH-106, a tetracycline-sensitive isogenic derivative of strain L2-7. Compared to placebo, A. soehngenii-treated subjects showed significantly reduced glycemic variability (1% reduction in the coefficient of variation; p = 0.01) and improved glycemic control (6% reduction in the overall net glycemic action-1; p < 0.05), including reduced serum glycated hemoglobin (HbA1c) levels when including the 4-week washout period (1 mmol/mol reduction; p < 0.05). Moreover, diastolic blood pressure was significantly reduced in all A. soehngenii-treated subjects (3 mm Hg; p < 0.05). The study product was well-tolerated and had no effect on the global intestinal microbiota composition, including alpha and beta-diversity, besides an increased abundance of A. soehngenii in the treatment group, indicative of compliance. The U.S. participants, compared to those in Europe, responded best, notably in the oral glucose tolerance tests (15% improvement in the area-under-the curve of plasma glucose levels; p = 0.039) or coefficient of variation (reduction of 3.1%; p < 0.05). This potentially relates to a more severe prediabetic state in U.S. subjects, associated with significantly reduced (1.5-3.5-fold) relative abundance of Bifidobacterium, Coprococcus, Ruminococcus spp. and two-fold increased relative abundance of Lachnoclostridium spp. In conclusion, daily oral supplementation with A. soehngenii was safe and improved various markers of glycemic control, reduced HbA1c levels and diastolic blood pressure, indicating a novel microbiome-based approach to improve cardio-metabolic health in adults at risk for developing type 2 diabetes.Clinical trial reg. no. NCT04529473, clinicaltrials.govSocial media summary 120 characters: Anaerobutyricum soehngenii supplementation improves #cardio-metabolic health in subjects at risk for type 2 #diabetes.
GFI1-driven transcriptional and epigenetic programs maintain CD8+ T cell stemness and persistence
Authors: M Zeeshan Chaudhry, Evelyn Chen, Hiu On Man, Aneesha Jones, Renae Denman, Huiyang Yu, Qiutong Huang, Adrian Ilich, Jaring Schreuder, Severine Navarro, Zewen K Tuong, Gabrielle T Belz
Journal: Nature Immunology (2025)
Identification of a resistance-exercise-specific signalling pathway that drives skeletal muscle growth
Authors: Wenyuan G Zhu, Aaron C Q Thomas, Gary M Wilson, Chris McGlory, Jamie E Hibbert, Corey Gk Flynn, Ramy K A Sayed, Hector G Paez, Marius Meinhold, Kent W Jorgenson, Jae-Sung You, Nathaniel D Steinert, Kuan-Hung Lin, Martin J MacInnis, Joshua J Coon, Stuart M Phillips, Troy A Hornberger
Journal: Nature Metabolism (2025)