Interconnections between diabetic corneal neuropathy and diabetic retinopathy: diagnostic and therapeutic implications

Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes mellitus. Diabetic corneal neuropathy refers to the progressive damage of corneal nerves. Diabetic retinopathy has traditionally been considered as damage to the retinal microvasculature. However, growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit, which includes both the retinal vascular structures and neural tissues. Diabetic retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular screening. However, diabetic corneal neuropathy is commonly overlooked and underdiagnosed, leading to severe ocular surface impairment. Several studies have found that these two conditions tend to occur together, and they share similarities in their pathogenesis pathways, being triggered by a status of chronic hyperglycemia. This review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy, whether diabetic corneal neuropathy precedes diabetic retinopathy, as well as the relation between the stage of diabetic retinopathy and the severity of corneal neuropathy. We also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.

METTL3‑mediated m6A methylation and its impact on OTUD1 expression in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and chronic inflammation, often exacerbated by cigarette smoke exposure. Ovarian tumor protease domain‑containing protein 1 (OTUD1), a deubiquitinase, has previously been identified as a negative regulator of inflammation through its suppression of NF‑κB signaling. The present study explored the role of OTUD1 in COPD and the regulatory effects of N6‑methyladenosine (m6A) methylation on OTUD1 expression. The expression of OTUD1 in COPD was analyzed using public datasets (GSE38974 and GSE69818). In addition, BEAS‑2B cells were exposed to cigarette smoke extract (CSE) to investigate OTUD1 expression changes. OTUD1 overexpression and knockdown models were also constructed, and the levels of inflammation‑related genes and proteins, inflammatory cytokines and cell pyroptosis were measured using reverse transcription‑quantitative PCR, western blotting, ELISA and flow cytometry. The role of methyltransferase‑like 3 (METTL3)‑mediated m6A methylation in regulating OTUD1 was also examined. Notably, OTUD1 expression was significantly reduced in advanced COPD compared with that in the earlier stage. Furthermore, CSE exposure suppressed OTUD1 expression, which was associated with increased cell pyroptosis and elevated levels of the inflammatory cytokines IL‑1β and IL‑18. OTUD1 overexpression mitigated these effects, indicating its protective role against CSE‑induced cellular damage. Furthermore, METTL3‑mediated m6A methylation inhibited OTUD1 expression, with YTH m6A RNA binding protein 2 (YTHDF2) acting as the reader of this modification. Knockdown of METTL3 or YTHDF2 reduced m6A methylation and restored OTUD1 expression, highlighting a potential mechanism by which cigarette smoke suppresses OTUD1 through enhanced m6A methylation. In conclusion, OTUD1 may serve a protective role in COPD by inhibiting inflammation and reducing cell damage caused by cigarette smoke exposure. The suppression of OTUD1 through METTL3‑mediated m6A methylation and YTHDF2 interaction represents a novel mechanism contributing to COPD pathogenesis, suggesting potential therapeutic targets for mitigating disease progression.

Exploring associations between dual sensory impairment and neuropsychiatric disorders: Insights from a prospective cohort study in the UK Biobank

BACKGROUND

Evidence of dual sensory impairment (DSI) characterized by comorbid hearing impairment (HI) and visual impairment (VI) is limited in neuropsychiatric disorders. Moreover, the underlying mechanisms remain elusive.

METHODS

Using data from 169,165 UK Biobank participants, we compared cognition and mental health across the no sensory impairment, HI, VI, and DSI groups and investigated the association between the number of sensory impairments and neuropsychiatric disorders in longitudinal COX analyses. We also analyzed the associations of sensory function and its interaction with brain structure, functional connectivity, inflammatory markers, and metabolites and explored their mediating roles.

RESULTS

DSI participants exhibited poor cognition and mental health, and had a higher risk of neuropsychiatric disorders compared to those with HI/VI alone. Both HI and VI were linked to atrophic changes in the hippocampus, thalamus, precuneus, parietal cortex, middle temporal gyrus, etc., and reduced white matter integrity. Brain regions associated with HI and VI exhibited decreased functional connectivity with other cortexes. Hearing and visual performance exhibit a significant interaction in relation to cognitive function, mental health, and metabolites. Brain structures, inflammation, and metabolic biomarkers significantly associated with HI and VI mediated the relationship between sensory impairments and cognition/mental health.

CONCLUSION

Compared to HI/VI alone, DSI is associated with poorer cognitive function, mental health, and a higher risk of neuropsychiatric disorders, potentially driven by the interaction between HI and VI. Additionally, HI and VI are linked to brain atrophy, reduced white matter integrity, and altered functional connectivity. Furthermore, brain structure, inflammation, and metabolic biomarkers mediate the relationship between sensory impairments and cognition/mental health.

Brain-derived neurotrophic factor (BDNF) as biomarker in stem cell-based therapies of preclinical spinal cord injury models: A systematic review

Stem cell-based therapies offer promising treatment for spinal cord injury (SCI) by reducing inflammation, restoring plasticity, and supporting neuroprotection and nerve regeneration. Brain-derived neurotrophic factor (BDNF) is crucial in SCI pathophysiology. This study reviews the impact of stem cells on BDNF expression in preclinical SCI models. A thorough search was performed in PubMed, Scopus, and Web of Science until June 2023, identifying studies on the effects of stem cells on BDNF in SCI. Two researchers reviewed and extracted data from relevant studies. This review is registered in the Prospective Register of Systematic Reviews (PROSPERO) with the registration number [CRD42023441466]. Out of 923 records, 51 studies met the inclusion criteria, involving rats (46 studies) and mice (5 studies). The contusion or compression model was used in 40 studies, and the transection model in 11. The most common stem cell types were bone marrow mesenchymal stem cells (BM-MSCs), neural stem cells (NSCs), and adipose-derived stem cells (ADSCs). BM-MSCs increased BDNF expression in 16 studies, NSCs in 9 studies, and ADSCs in only one study. This review highlights that BM-MSCs and NSCs are effective in enhancing BDNF expression in preclinical SCI models, while other stem cell types may not significantly affect BDNF levels. These findings suggest variability in the effectiveness of different stem cell therapies in modulating BDNF production for SCI treatment.

Bioinspired smart dentin ECM-chitosan hydrogels for dentin-pulp complex regeneration

OBJECTIVES

Approximately two-thirds of the world's population suffers from dental caries, and clinical treatment of the resulting lesions varies from dental fillings to devitalization. Despite recent advances in regenerative endodontic therapy, scaffolds intended for the regeneration of the dentin-pulp complex with innate odontogenic potential and microarchitecture similar to these dental tissues are still scarce. Taking advantage of the physio-biological properties of demineralized dentin extracellular matrix (ECM), we developed a functional hydrogel that combines insoluble molecules of dentin with chitosan.

METHODS

Dentin powder obtained from extracted teeth was partially demineralized with acetic acid. Demineralized dentin and chitosan powder were separately dissolved in acetic acid to form suspensions that were then mixed in volume ratios of 25/75 or 50/50 (v/v %). The extrudability and gelation time of hydrogel precursors were assessed. Three-dimensional constructs were fabricated following pre-hydrogels pH-adjustment, injection into custom-made molds and incubation at 37 °C. Constructs were characterized for infrared spectral analysis, relative sol-gel fraction, degree of porosity, flexural elastic modulus, in-vitro biodegradability, in-vitro bioactivity, antimicrobial properties against Enterococcus faecalis and biocompatibility for OD-21 cells.

RESULTS

For most of the tested properties, the two proposed hydrogels showed differences, but regardless of these differences, both materials presented morphology, biomechanical attributes, cytocompatibility, and antibacterial properties to serve as dental pulp cell-inducing scaffolds.

CONCLUSIONS

Dentin ECM-chitosan hydrogels exhibited in-vitro bioactivity, biocompatibility, and antimicrobial properties to be considered as promising candidates for application as injectable scaffolds for dentin-pulp complex regeneration.

CLINICAL SIGNIFICANCE

Extracellular matrices (ECMs) from native tissues have long been considered ideal scaffolds for tissue regeneration. Here, we describe the physicochemical, mechanical, and biological attributes of newly developed hydrogels derived from the functionalization of demineralized dentin ECM with chitosan. The proposed dentin-ECM-chitosan hydrogels have demonstrable microarchitecture, biophysical characteristics, biocompatibility, and antibacterial capacity to produce cell-inducing scaffolds for use in regenerative dentistry.

Indole alkaloids from Uncaria rhynchophylla and their inhibitory activities against α-glucosidase

Sixteen indole alkaloids were isolated from the hook-bearing stems of Uncaria rhynchophylla (Rubiaceae family), including seven undescribed ones, uncarialines F-L (1-5, 7, and 8), and a naturally occurring alkaloid, 3-epicorynanthine (6). Among them, alkaloids 1 and 2 were identified as rare quaternary ammonium alkaloids, and alkaloid 7 exhibited an unprecedented indole alkaloid framework. Their structures were characterized by a comprehensive analysis of NMR, MS, ECD and single-crystal X-ray diffraction. Notably, alkaloid 5 demonstrate potent inhibitory activity against α-glucosidase, with an IC50 value of 18.45 ± 0.77 μM. Furthermore, the inhibitory kinetics of α-glucosidase revealed that alkaloid 5 belong to the mix inhibition type. Molecular docking analysis showed that alkaloid 5 possessed superior binding affinity with α-glucosidase (-10.7 kcal/mol).

Targeting CDK1 inhibits Golgi apparatus stress-mediated neuroinflammation and neuronal apoptosis after intracerebral hemorrhage by modulating GRASP55 phosphorylation

Cyclin-dependent kinase 1 (CDK1) has been found to be associated with neuronal apoptosis. However, the role of CDK1 in intracerebral hemorrhage (ICH) remains unclear. The aim of this study was to investigate the role of CDK1 in mediating neuroinflammation and neuronal apoptosis through the modulation of Golgi apparatus stress (GAS) in ICH. In this study, rats received collagenase IV injections to induce ICH, while primary neurons and PC-12 cells were stimulated with Hemin to establish ICH models. We observed that CDK1 expression was upregulated and GAS levels increased after ICH. Downregulation of CDK1 significantly attenuated neuronal damage and GAS levels after ICH. In addition, CDK1 downregulation reduced inflammatory cytokine levels in both in vitro and in vivo models of ICH. Interestingly, the phosphorylation of Golgi reassembly-stacking protein 55 (GRASP55) was significantly increased after ICH. However, CDK1 downregulation was able to reverse this change. Our data show that CDK1 phosphorylates GRASP55 through the T225 site. Lastly, mutating the GRASP55 T225 phosphorylation site abolished the CDK1-mediated exacerbation of GAS, neuronal apoptosis, and inflammatory responses in vitro. In summary, targeted inhibition of CDK1 suppresses GAS-mediated neuroinflammation and neuronal apoptosis after ICH by regulating GRASP55 phosphorylation. Research on CDK1 may offer clinicians new insights into the treatment of patients with ICH.

Comparison of mortality trends in patients with rheumatic mitral valve disease and nonrheumatic mitral valve disease: A retrospective study in US from 1999 to 2020

BACKGROUND

Mitral valve disease (MVD) can have both rheumatic and nonrheumatic etiologies. However, differences in mortality remain unknown.

METHODS

We extracted age-adjusted mortality rates (AAMRs) per 100,000 persons from the CDC WONDER database and stratified them by sex, region, and race. Annual percent change (APC) and average annual percent change (AAPC) were calculated using Joinpoint regression. Pairwise comparison was used to identify significant differences for MVD mortality trends between rheumatic and nonrheumatic patients.

RESULTS

From 1999 to 2020, a total of 72,085 deaths were recorded in patients with rheumatic MVD, while 132,300 occurred in those with nonrheumatic MVD. The AAMR for nonrheumatic patients was twice as high as that for rheumatic patients throughout the study period, and AAPC differed significantly between the groups (p < 0.05). Females with rheumatic MVD were observed to have a higher AAMR (1.1) than their male counterparts (0.8), but those with nonrheumatic MVD exhibited a similar AAMR for both females and males. Among rheumatic patients, NH (non-hispanic) Whites were reported to have the highest AAMR (1.0), followed by NH Black or African Americans (0.8), Hispanic or Latinos (0.7), and NH Asian or Pacific Islanders (0.7). Among nonrheumatic patients, NH Whites exhibited the highest AAMR (1.9), followed by NH Black or African Americans (1.4), NH Asian or Pacific Islanders (1.1), and Hispanic or Latinos (1.0). The AAMR in Rural areas was higher than that in Urban areas for patients with both rheumatic and nonrheumatic MVD.

CONCLUSION

Comprehensive public health strategies are essential to improving survival outcomes.

Self-determination theory interventions in self-care of cardiovascular disease: A systematic review

BACKGROUND

Cardiovascular disease (CVD) is a leading cause of death and disability worldwide. Effective self-care behaviours are critical for the secondary prevention of CVD, however many individuals fail to engage in these self-care activities in the long-term. Self-determination theory (SDT) offers a robust theoretical framework for understanding motivations for engaging in self-care. SDT-based interventions may improve self-care in people with CVD but has yet to be systematically reviewed.

OBJECTIVES

A systematic review was conducted to determine the effectiveness of SDT-based interventions on global measures of self-care of CVD, as well as specific self-care activities.

METHODS

A literature search was conducted in August 2024 using MEDLINE, CINAHL, Embase, Global Health, APA PsycINFO, and SocINDEX. The inclusion criteria involved randomised controlled trials and cluster randomised trials that tested the effect of SDT-based interventions on self-care activities among adults with CVD.

RESULTS

A total of 251 publications were screened and 7 studies included in the review. Results revealed inconsistent application of SDT principles across the included studies. While some incorporated all psychological needs according to SDT, others focused on only selected needs. Nevertheless, supporting people's autonomy emerged as a consistent core component across all interventions. Three studies reported improvements in global self-care, two found improvements in physical activity, while one found no significant effect on physical activity, and another found no significant effect on dietary habits and smoking behaviours. There was considerable variation in the measurement of self-care with some studies focussed on global measures, while others targeted specific aspects of self-care such as diet or exercise, which prohibited meta-analysis.

CONCLUSIONS

Findings from this systematic review showed that SDT-based intervention demonstrated potential for enhancing self-care in individuals with CVD. However, the limited number of eligible studies and methodological heterogeneity preclude definitive conclusions about their effectiveness for improving self-care.

PRACTICE IMPLICATIONS

Healthcare professionals should foster competence, relatedness, and autonomy support while adopting a holistic approach to self-care. Combining group and one-to-one interventions and integrating health education and goal-setting can promote maintained self-care adherence.

MRI-based predictive model with obesity metabolic phenotype for postoperative survival in HBV-related hepatocellular carcinoma

PURPOSE

Obesity metabolic phenotypes may influence survival outcomes in hepatocellular carcinoma (HCC) patients. This study aimed to develop an MRI-based model for postoperative survival prediction in HBV-related HCC patients, focusing on obesity metabolic phenotypes.

METHODS

A retrospective cohort of 381 HBV-related HCC patients (312 males; mean age 55.9 ± 10.7 years) who underwent preoperative MRI and curative surgery was studied. Patients were categorized into three phenotypes: normal weight (NW), metabolically healthy overweight/obesity (MHOO) and metabolically unhealthy overweight/obesity (MUOO). Univariate and multivariate Cox regression analyses identified independent predictors of overall survival (OS). A predictive model was established and validated with cross-validation.

RESULTS

MHOO patients showed significantly better overall survival (OS) than NW patients (adjusted HR = 0.42, P = 0.030), while MUOO had no significant effect on OS (adjusted HR = 0.92, P = 0.779). Independent predictors included MHOO (HR = 0.44, P = 0.036), AST/ALT ratio > 1 (HR = 2.61, P = 0.001), tumor burden score > 5.0 (HR = 3.02, P < 0.001) and arterial rim enhancement (HR = 3.61, P < 0.001). The combined model achieved good performance in both training (C-index = 0.737) and validation (C-index = 0.715) sets. The predicted high-risk patients had worse OS than low-risk patients in the whole cohort (P < 0.001) and in patients at BCLC stage A (P < 0.001). The model outperformed the BCLC and CNLC staging systems in predictive efficacy (all P < 0.001) and clinical net benefit.

CONCLUSIONS

MHOO is protective for OS in HBV-related HCC. The MRI-based model integrating obesity metabolic phenotype, AST/ALT ratio, tumor burden score and arterial rim enhancement is valuable in survival prediction, offering superior prognostic stratification compared to current staging systems.

Efficacy of cranial electrotherapy stimulation for treating primary and secondary depression in adults: A meta-analysis of randomized controlled trials

BACKGROUND

Antidepressants use is linked to poor response, treatment discontinuation, and treatment-resistant depression. However, evidence regarding efficacy of cranial electrotherapy stimulation (CES) in treating depression is limited. Therefore, we conducted the first meta-analysis to explore efficacy of CES in treating primary and secondary depression in adults.

METHODS

PubMed, Embase, CINAHL, Web of Science, EBSCOHost, and Cochrane Library were comprehensively searched. Dersimonian-Lard random-effects model in Comprehensive Meta-Analysis 4.0 was used, presenting Hedges' g with corresponding 95 % confidence interval (CI) for depressive symptoms and Quality of life (QoL) while odds ratio (OR) for safety and acceptability of CES. Heterogeneity was examined using Cochrane's Q and I2 statistics with moderator analysis determining sources of variation.

RESULTS

Sixteen randomized controlled trials involving 1148 adults were included. CES significantly reduced depressive symptoms with small effect (g = -0.33 [95%CI -0.46, -0.20]) compared to non-CES treatment; it was safe (OR = 0.84 [95%CI 0.32, 2.18]) and acceptable (OR = 0.72 [95%CI 0.41, 1.27]). CES revealed non-significant effect on improving QoL (g = 0.13 [95%CI -0.05, 0.31]). Substantial improvement of CES were observed for females (β = -0.010 [95%CI -0.019, -0.0003]), secondary depression (g = -0.42 [95%CI -0.58, -0.27]), current >100 μA (g = -0.38 [95%CI -0.58, -0.18]), frequency > 100 Hz (g = -0.50 [95%CI -0.81, -0.20]), length ≤ 30 min (g = -0.39 [95%CI -0.64, -0.14]), sessions/week ≤5times (g = -0.34 [95%CI -0.49, -0.19]), and duration ≤5 weeks (g = -0.45 [95%CI -0.63, -0.27]).

CONCLUSIONS

CES, a safe adjunctive therapy, demonstrates small effect in the treatment of depression. Future research should explore long-term effects of CES for treating adults with depression.

Leptin attenuates diabetic cardiomyopathy-induced cardiac remodeling via regulating cGAS/STING signaling and Opa1-mediated mitochondrial fusion

PURPOSE

This investigation seeks to elucidate the contribution of leptin to the pathogenesis of diabetic cardiomyopathy (DCM).

METHODS

Mice were rendered diabetic through the administration of streptozotocin (STZ). Leptin was delivered via subcutaneously implanted osmotic pumps. Assessments of cardiac performance, hypertrophy, and fibrosis were conducted using echocardiography, Hematoxylin and Eosin (H&E), Wheat Germ Agglutinin (WGA), and Masson trichrome staining. Myocardial apoptosis and oxidative stress were quantified through TUNEL assay and biochemical markers of oxidative stress, including Malondialdehyde (MDA), 4-Hydroxynonenal (4-HNE), and 3-Nitrotyrosine (3NT). Mitochondrial structure was examined using Transmission Electron Microscopy (TEM). Primary neonatal cardiomyocytes were subjected to high glucose (HG) conditions. The fluorescent indicators MitoTracker Green and MitoSOX Red were employed to evaluate mitochondrial morphology and function within the cardiomyocytes.

RESULTS

Mice with diabetes displayed marked cardiac hypertrophy and fibrosis, as indicated by H&E, WGA, and Masson staining. The administration of leptin significantly mitigated the cardiac pathological manifestations in diabetic mice. Leptin increased the expression of Opa1 and enhanced mitochondrial fusion and function in cardiomyocytes exposed to HG. The cGAS/STING signaling pathway may serve as a pivotal intermediary for leptin to facilitate Opa1-driven mitochondrial fusion.

CONCLUSIONS

Leptin appears to safeguard against hyperglycemia-induced mitochondrial oxidative damage and DCM by modulating the cGAS/STING signaling cascade and Opa1-mediated mitochondrial fusion. These results propose that leptin could be a promising agent for promoting mitochondrial fusion and preventing diabetes-associated cardiac pathologies.

An update on the role and mechanisms of periodontitis in cardiovascular diseases

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Despite extensive studies into the causes and therapies for CVDs, their incidence and prevalence continue to increase. Periodontitis is a multifactorial, chronic inflammatory disease related to systemic health. Current research suggests that periodontitis may be an unconventional risk factor for CVDs and it may increase the risk of CVDs such as atherosclerosis, coronary heart disease, myocardial infarction, hypertension, heart failure as well as cardiomyopathy. For all these reasons, it is quite plausible that prevention of periodontitis has an impact on the onset or progression of CVDs. Therefore, in this review, we investigated the association between periodontitis caused by oral microorganisms and different CVDs. In addition, we discuss the various mechanisms by which periodontitis contributes to the onset and progression of CVDs. Our review aims to raise global awareness of periodontitis, particularly its role in CVDs, provide a basis for the prevention and treatment of CVDs and offer potential therapeutic targets.

Biliverdin alleviates cerebral ischemia-reperfusion injury by regulating the P4hb/MAPK/mTOR pathway to inhibit autophagy

BACKGROUND

Biliverdin (BV) exhibits anti-inflammatory and antioxidative effects. Autophagy activation is crucial in the pathogenesis of cerebral ischemia-reperfusion injury (CIRI). This study aimed to investigate whether BV could ameliorate CIRI by regulating autophagy.

METHODS

A middle cerebral artery occlusion-reperfusion (MCAO/R) model in Sprague-Dawley (SD) rats and an oxygen-glucose deprivation/reoxygenation (OGD/R) model in PC12 cells were employed to explore the neuroprotective effects of BV and its underlying mechanisms. In these rats, once BV was administered post-MCAO/R, its treatment efficacy and underlying mechanisms were evaluated through behavioral, morphological, and molecular analyses. Alternatively, for PC12 cells, following successful OGD/R modeling, BV, autophagy activator rapamycin, prolyl 4-hydroxylase beta (P4hb) knockdown or overexpression, and the specific inhibitors of three classic autophagy pathways were applied. Cell viability (using CCK8 assay), Calcein/PI staining, autophagosome staining (using MDC assay), reverse transcription quantitative polymerase chain reaction, and western blot were subsequently carried out to investigate the mechanisms by which BV ameliorates CIRI.

RESULTS

BV alleviated CIRI by inhibiting autophagy. Further investigation suggested that BV downregulated P4hb expression. In vitro experiments showed that P4hb knockdown reduced autophagy in post-CIRI cells, while its overexpression reversed the effects of BV. Rescue experiments indicated that MAPK pathway inhibitors counteracted the effects of P4hb overexpression on autophagy post-CIRI.

CONCLUSION

BV improves CIRI by regulating the P4hb/MAPK/mTOR signaling pathway to inhibit autophagy, offering a novel therapeutic strategy for ischemic stroke.

C-reactive protein-to-albumin ratio is associated with increased depression: An exploratory cross-sectional analysis

BACKGROUND

Depression, prevalent globally, significantly impacts psychological and physical health. As a burgeoning biomarker, C-reactive protein-to-albumin ratio (CAR) offers insights into metabolism-immune status and disease diagnosis. This exploratory investigation seeks to elucidate the relationship between CAR and depression.

METHODS

This cross-sectional investigation utilized data from the National Health and Nutrition Examination Survey (NHANES). Depression was assessed using the PHQ-9 questionnaire. To examine the relationship between CAR and depression risk, we employed a multivariable logistic regression analysis and a restricted cubic spline (RCS) approach. Furthermore, subgroup analyses were performed to validate the consistency of the findings across specific populations.

RESULTS

This investigation enrolled 13,159 adult participants, comprising 8.15 % with depression. Compared with participants without depression, those diagnosed with depression showed a significantly higher CAR level. Each one - unit increase in log10-transformed CAR (log-CAR) was associated with an 58 % increase in the incidence of depression (Odds Ratio = 1.58, 95 % Confidence Interval: 1.33-1.88). A non-linear dose-response relationship was detected between CAR and depression risk (non-linear p < 0.001). Furthermore, the strength of this association persisted undiminished throughout multiple subgroup analyses. Notably, among individuals with a prior history of metabolic diseases, the observed association remained consistent.

CONCLUSIONS

A distinct positive correlation was observed between CAR and depression in U.S. adults. Further large-scale, well-controlled studies are needed to validate the reliability and establish the generalizability of these findings.

Development of low glycemic index food products with wheat resistant starch: a review

With the growing recognition of the health benefits associated with GI foods in managing type 2 diabetes and alleviating oxidative stress, wheat-based low-GI foods enriched with resistant starch (RS) emerging as a promising alternative to refined grains in daily diets. This review provides a comprehensive overview of the health benefits of RS, delving into its types, characteristics, and the mechanisms underpinning its resistance to hydrolysis. To enhance the functionality of RS, various modification techniques-encompassing chemical, enzymatic, physical, and combinatory approaches-have been explored to increase RS content in wheat-based foods while improving their sensory attributes. Additionally, the incorporation of phytochemicals and other natural extracts into low-GI food formulations has demonstrated potential to enhance both nutritional and sensory properties. This review also examines market trends for low-GI foods, identifying key challenges in industrial manufacturing processes. By addressing these issues, this work aims to support future research and guide the development of improved standards for low-GI wheat-based food products.

The impact of folic acid deficiency on ischemic stroke: Role of inflammation and long noncoding RNA H19

It has been validated that folic acid deficiency (FD) is associated with an increased risk of stroke and a worse prognosis. However, the specific mechanisms by which FD exerts its detrimental effects on ischemic stroke (IS) have not been fully understood. The results of this case-control study indicated that patients with IS had a decreased serum folate level, along with up-regulated long non-coding RNA H19 (lncRNA H19) and enhanced inflammatory responses. Meanwhile, it was corroborated that the serum folate level was negatively correlated with H19 expression and the systemic immune-inflammation index (SII). Similarly, FD was demonstrated to exacerbate neurological injury in the middle cerebral artery occlusion/reperfusion (MCAO/R) rats by up-regulating the expression of inflammatory cytokines and H19 in both peripheral blood and brain tissue. Notably, the alterations in the expression of these factors in peripheral blood were consistent with those observed in brain tissue. Additionally, in a co-culture of N2a neurons and BV2 microglia, FD promoted the transition of BV2 cells towards a pro-inflammatory state by up-regulating the expression of H19, which aggravated neuronal injury. Moreover, blocking H19 in BV2 cells mitigated inflammation and partially reversed the injury in N2a cells exacerbated by FD after the treatment with oxygen-glucose deprivation and reperfusion (OGD/R). These findings provide a more in-depth insight into the regulatory role of H19-mediated systemic inflammatory responses in the context of FD, suggesting the potential clinical utility of folic acid in managing ischemic brain injury.

Global, regional and national ischemic heart disease burden attributable to a high-sodium diet in 204 countries, 1990-2019: A systematic analysis for the global burden of disease study

BACKGROUND AND AIM

Globally, the prevalence of poor diets poses a serious threat to public health and development. This research set out to evaluate the worldwide impact of high-sodium diet-related ischemic heart disease(IHD) from 1990 to 2019.

METHODS AND RESULTS

The present study employed data on the mortality of IHD that were sourced from the Global Burden of Disease (GBD) 2019 survey, which encompassed 204 countries. Age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life-year rates (ASDR) were evaluated at several levels, including age, sex, region, and sociodemographic index (SDI). In 2019, 777,200 mortalities worldwide from IHD were linked to high-sodium diets [95 % uncertainty interval (UI): 185.3-1773.1]. There were 29.8 (95 % UI: 2.3-22.6) and 210.4 (95 % UI: 56.5-449.3) ASMR and ASDR per 100,000 people, respectively. Men were more affected by IHD than women, and older people were more affected than younger people. Regions with higher SDI had lower ASDR and ASMR compared to areas with lower SDI. The estimated annual percentage change(EAPC) for ASMR and ASDR between 1990 and 2019 was -1.09 % (95 % CI: 1.15 % to -1.03 %) and -1.02 % (95 % CI: 1.07 % to -0.96 %), respectively.

CONCLUSIONS

As a result of excessive sodium diets, there is an increasing global burden of IHD, which is impeding social and economic development globally, even though ASMR and ASDR have declined over time. Furthermore, these results will be useful in helping to create policies and carry out focused initiatives to reduce high-sodium diets around the world.

Association between animal protein intake and overweight/obesity: A systematic review and meta-analysis of observational studies

AIMS

To conduct a systematic review and meta-analysis of observational studies to investigate the association between Animal Protein Intake (API) and overweight/obesity across different age groups.

DATA SYNTHESIS

This review is registered in the International Prospective Register Of Systematic Reviews - PROSPERO database (CRD42023467451). Observational studies on the association between API and the outcome of overweight/obesity were included, up to September 2024, from ten databases. The risk of bias and study quality appraisal was assessed using the Agency for Health Care Research and Quality (AHRQ) tools for cross-sectional studies and the Newcastle-Ottawa Scale (NOS) for cohort studies. A systematic review and meta-analysis were performed with 14 and 11 studies, respectively, assessing individuals aged eight to 89 years, 55 % female. The meta-analysis indicated an increased likelihood of obesity with API in two cross-sectional studies (OR 1.18; 95 %CI 1.12-1.24; p < 0.001; I2: 0 %). Daily intake of animal protein ranging from 44.7 to 67.8 g/day (or 8.8 %-11.4 % of Kcal/day, on average) was associated with obesity. The risk of bias was considered low/moderate for most studies according to AHRQ, and four of the six cohort studies were rated as moderate quality by NOS.

CONCLUSIONS

API appears to be associated with a higher likelihood of developing overweight/obesity, and increased Body Mass Index (BMI). Despite the multicausal nature of obesity, these findings suggest that reducing API may decrease the likelihood of overweight/obesity in the studied age groups.

Angoroside C: A potent AMPK activator in the aqueous extract of Scrophularia ningpoensis, alleviates metabolic syndrome in db/db mice

BACKGROUND

Scrophularia ningpoensis Hemsl. (SN) is a traditional herbal medicine used for treating diabetes mellitus (DM). Previous studies indicated that the aqueous extract of SN (AESN) improves type 2 DM (T2DM) by activating AMP-activated protein kinase (AMPK), but the active components were unclear.

PURPOSE

This study aimed to identify the compound in AESN responsible for AMPK activation and to verify its therapeutic effects on T2DM.

METHODS

Rats were administered AESN intragastrically. The absorbed compounds in serum samples were analyzed using LC-MS/MS and subjected to molecular docking with AMPK. The compound with the highest docking score was further verified using SPR, CETSA, and TR-FRET to confirm its effects on AMPK activation. Primary mouse hepatocytes were used to examine the effects of angoroside C (ANC) on AMPK activity, Akt/GSK3β signaling, NLRP3 inflammasome activation, and lipid accumulation. An AMPK inhibitor was used to determine whether the effects were AMPK-dependent. In type 2 diabetic db/db mice, various dosages of ANC were administered intragastrically to observe its therapeutic effects.

RESULTS

Among the 17 absorbed prototype compounds, ANC exhibited the strongest binding ability to AMPK. SPR, CETSA, and TR-FRET assays confirmed that ANC binds to and activates AMPK. In hepatocytes, ANC activated the Akt/GSK3β signaling, suppressed NLRP3 inflammasome activation, and inhibited lipid accumulation in an AMPK-dependent manner. In db/db mice, ANC intervention improved glucose and lipid metabolic disorders, insulin resistance, and histopathological abnormalities in a dose-dependent manner, while activating AMPK and alleviating lipid metabolic disorders and metabolic inflammatory responses.

CONCLUSION

ANC can treat T2DM by directly binding to and activating AMPK.

Long-term exposure to major constituents of fine particulate matter and sleep disorders among children and adolescents: A population-based survey in Guangdong province, China

Long-term exposure to PM2.5 is associated with sleep health in adults, but its impact on children and adolescents remains unclear. This cross-sectional study analyzed 64,203 children and adolescents (6-18 years) from four cities in Guangdong, China, to assess the impact of PM2.5 and its major constituents on sleep disorders. Sleep disorders were assessed using the Sleep Disturbance Scale for Children. Generalized linear mixed models and weighted quantile sum regression were applied to assess the joint effects of PM2.5 constituents. The results indicated a positive association between PM2.5 and sleep disorders. For example, the odds of sleep disorder increased with per interquartile range (IQR) increase in PM2.5 concentrations [odds ratio (OR): 1.15, 95 % confidence interval (CI):1.06, 1.26). Black carbon (BC) and organic matter (OM) increase the odds by 16 % (95 % CI: 9, 24 %) and 23 % (95 % CI: 9, 39 %), respectively. Notably, combustion-related BC (44.3 %) and OM (24.3 %) contributed the key contributors to the mixture risk. Children and adolescents with limited outdoor activity (< 2 hours/day) were more vulnerable to PM2.5 exposure (P for interaction = 0.028). These findings highlight that stricter air pollution regulations and targeted measures to reduce children's exposure to combustion-derived pollutants are essential for protecting sleep health and overall well-being.

The impact of different types of extreme temperature events on mental disorders: A case-crossover study in Anhui Province, China

BACKGROUND

Extreme temperatures are expected to be more frequent, intense, and complex in the context of climate change. However, epidemiologic evidence about associations between extreme temperature and mental disorders is limited.

METHODS

We conducted a case-crossover study in Anhui Province, China, focusing on outpatients diagnosed with mental and behavioral disorders (ICD-10 codes: F00-F99), further classified into schizophrenia (F20-F21), depression (F32-F33), and anxiety (F40-F41). Defining the day of each outpatient visit to the Anhui Mental Health Center as the case day, a total of 762,895 case days and 3,362,574 control days were included in the study, covering the period from 2019 to 2021. Each subject was geocoded based on their home address and matched with environmental exposures, including meteorological data and air pollutant data sourced from the CN05.1 and the TAP dataset, respectively. Extreme temperature events were categorized into heat and cold extremes, further divided into daytime, nighttime, and compound extremes.

RESULTS

Among the outpatient visits for mental disorders included in this study, the proportions were schizophrenia (28.9 %), depression (23.9 %), and anxiety (18.5 %). Exposure to extreme heat and cold was associated with increased risks of outpatient visits for mental disorders, with odds ratios (ORs) of 2.23 (95 %CI: 2.16-2.30) and 1.95 (95 %CI: 1.89-2.01), respectively. Compound heat extremes posed the highest risk of mental disorders (OR = 1.17, 95 %CI: 1.13-1.22), followed by nighttime (OR = 1.11, 95 %CI: 1.08-1.14) and daytime heat (OR = 1.05, 95 %CI: 1.04-1.07). Notably, the risk of mental disorders significantly elevated with the increased intensity and duration of extreme heat events. Besides, extreme heat was strongly associated with higher risks of depression, schizophrenia and anxiety, while extreme cold was notably linked to schizophrenia.

CONCLUSION

These findings indicate a significant correlation between extreme temperature exposure and elevated mental disorder risks, emphasizing the urgent need to address increased mental health risks posed by extreme temperatures in the changing climate.

Distinct neurotoxic mechanisms of thallium and lead: Calcium-mediated apoptosis and iron-induced ferroptosis in zebrafish at environmental concentrations

Environmental neurotoxicants, such as thallium (Tl) and lead (Pb), pose significant risks to human health, yet their toxicological mechanisms remain poorly understood. This study investigates the distinct mechanisms of Tl+- and Pb2+-induced neurotoxicity at environmentally relevant concentrations using zebrafish embryos as a model. Transcriptomic analyses revealed minimal overlap in gene expression changes between the two metals, underscoring their unique toxicological pathways. Further study demonstrated that Tl+ disrupted calcium homeostasis, activating the calcium signaling pathway and triggering apoptosis via MAPK signaling. In contrast, Pb2+ exposure triggered ferroptosis, characterized by iron overload and lipid peroxidation, with significant involvement of oxidative stress and disruption of iron metabolism. Cellular assays validated these findings, confirming the critical roles of calcium and iron dysregulation in neuronal damage. These results emphasize the complexity of metal-induced neurotoxicity and the importance of studying pollutants at realistic exposure levels. Understanding the divergent pathways of Tl+- and Pb2+-induced neurotoxicity provides critical insights for mitigating their environmental and public health impacts, highlighting the need for targeted regulatory strategies to address heavy metal pollution effectively.

Subchronic ozone exposure leads to multi-organ injuries with differential reversibility in male C57BL/6 J mice

Ozone, a prevalent environmental pollutant, poses significant risks to human health. This study systematically evaluates the impact of subchronic ozone exposure on multiple organs using three-month-old male C57BL/6 J mice exposed to 0.5 or 2.0 ppm ozone for 12 weeks, followed by 4-week recovery period. Subchronic ozone exposure caused systemic damage, including weight loss, inflammation, oxidative stress, and dyslipidemia, with varying degrees of reversibility. Comprehensive histopathological and functional analyses revealed dose-dependent injuries, organ-specific response patterns, and varying recovery capacities within a 4-week cessation of exposure. The lung demonstrated the highest susceptibility with dose-dependent damage and high reversibility. In contrast, the liver, kidneys, and brain, exhibited milder yet largely irreversible damage, particularly at 2.0 ppm. Transcriptomic analyses identified high reversibility in lung inflammation pathways, persistent metabolic dysregulation in the liver and kidneys, neurodegeneration-related perturbations in the brain with minimal recovery capacity. Furthermore, common molecular drivers, such as oxidative stress and inflammation, were identified across all organs, revealing both unique and shared mechanisms of injury and recovery. These findings underscore the systemic nature of ozone toxicity and the need for targeted interventions. Persistent dyslipidemia and metabolic dysregulation in the liver and kidneys emphasize the necessity for ongoing monitoring and potential interventions for individuals exposed to elevated ozone levels.

Exploring the association between air pollution and urogenital congenital anomalies: a global ecological analysis

The relationship between air pollution and urogenital congenital anomalies (UCAs) remains poorly understood. This study performed an ecological analysis of air pollution emissions and the burden of UCAs, aiming to offer new global insights for air pollution control. Data were obtained from the Global Burden of Disease Study (2021) and Emission Database for Global Atmospheric Research. Joinpoint regression assessed temporal trends in burden of UCAs, mixed-effects, nonlinear lag and time-varying effect models were used to investigate potential associations between air pollution emissions and burden. The burden indicators were incidence, deaths and disability-adjusted life years. From 1990 to 2021, the global incidence of UCAs generally declined, with a significant increase observed since 2016. Our analysis identified a positive correlation between burden of UCAs and several air pollutants. Sulfur dioxide(SO2), ammonia and nitrogen oxides(NOX) are significantly associated with the incidence of UCAs, while SO2, NOX, and non-methane volatile organic compounds are significantly associated with the mortality and disability-adjusted life years rate of UCAs. Sex-specific subgroup analysis indicated differing responses to these pollutants. However, the effect of sulfur dioxide on burden was consistent across sex. Notably, we also found that some pollutants have hysteresis effects that contradict the immediate effects. Additionally, the relationship between air pollution and burden displayed distinct variations over years. This study enhances our understanding of the health impacts on UCAs associated with air pollution, suggested that pregnant women should stay away from ammonia and SO2. It also emphasizes that strengthening air pollution control should be a key monitoring policy.

Metabolomic machine learning predictor for arsenic-associated hypertension risk in male workers

Arsenic (As)-induced hypertension is a significant public health concern, highlighting the need for early risk prediction. This study aimed to develop a predictive model for occupational As exposure and hypertension using metabolomics and machine learning. A total of 365 male smelting workers from southern regions were selected. Forty workers from high and low urinary arsenic (U-As) exposure groups were chosen for non-targeted metabolomics analysis. Univariate analysis revealed that U-As is a risk factor for blood pressure and hypertension (P < 0.05). Restricted cubic spline (RCS) analysis showed that both systolic and diastolic blood pressure, as well as hypertension risks, increased with U-As, with a threshold at 32 µg/L. Of 1145 metabolites, 383 differentially expressed metabolites (382 upregulated, 1 downregulated) were identified. Least absolute shrinkage and selection operator (LASSO) regression was used to construct a predictive model for occupational hypertension, with N-hexosyl leucine, myristic acid, gamma-glutamylvaline, and pregnanediol disulfate as predictors. The area under the curve (AUC) of the receiver operating characteristic (ROC) for the predictive model was 0.917, indicating strong predictability and accuracy. This model, based on metabolomics and machine learning, provides an effective tool for early identification and intervention for occupational populations at high risk of hypertension due to As exposure.

Hospital-Diagnosed Traumatic Head Injury and Associated Risk of Developing ALS: A Nationwide Population-Based Case-Control Study

BACKGROUND AND OBJECTIVES

Previous studies have suggested that traumatic head injury (THI) may be a risk factor of amyotrophic lateral sclerosis (ALS) development, yet the association remains unclear. We aimed to determine whether hospital-diagnosed THI is an important ALS risk factor, and we investigated the magnitude and duration of associated ALS risk.

METHODS

In this population-based case-control study, we used individual-level data linkage across nationwide health registers from 1980 to 2021 to identify patients with hospital-diagnosed ALS. Each patient was matched 1:10 with individuals from the general population by age, sex, and diagnostic index date. We used conditional logistic regression to examine the relative risk of ALS associated with having previous hospital-diagnosed THI. To avoid the effect of reverse causation, we investigated ALS risk within several time windows and repeated all analyses after restricting THI exposures to more than 3 years before the date of ALS diagnosis.

RESULTS

THI was observed in 4.7% of 5,943 ALS cases vs 3.7% of 59,426 controls, with a matched odds ratio (OR) of 1.3 (95% CI 1.1-1.4). However, the risk of ALS declined considerably with increasing time since head injury, with a high OR of 4.5 (95% CI 2.8-7.3) observed within the 6 months before ALS diagnosis. If head injury was suffered 6-12 months before ALS diagnosis, the OR was 2.4 (95% CI 1.4-4.0). Restricting the analysis to THI suffered more than 3 years before ALS diagnosis, we found no association with an OR of 1.1 (95% CI 1.0-1.3).

DISCUSSION

Although a strong association of ALS with THI experienced ≤1 year before ALS diagnosis was evident, our results suggest that this is due to reverse causation. When restricting the analysis to a period deemed relevant for causative events leading to ALS development, no association was observed. Consequently, we do not consider THI an important ALS risk factor. This study was limited by the inability to consider minor THIs not receiving hospital attendance. Future research should explore alternative models to unfold this possible ALS risk factor.

Combined exposure of sleep deprivation and environmental particulate matter drives aging in multiple systems

Sleep disturbance accelerates aging, with accompanying exposure to air pollution. However, most studies ignore the combined exposure. This study aimed to investigate the combined effects of sleep deprivation and PM2.5 exposure on multi-system aging and to explore the damage mechanisms. The sleep deprivation instrument and the Shanghai Meteorological and Environmental Animal Exposure System (Shanghai-METAS) were used to construct a combined exposure model for one month. Our study used multiple behavioral, imaging, and molecular biological examinations to describe the aging characteristics in the cardiovascular system, metabolism, and central nervous system. Besides, the mechanisms in Sirt1, Wnt10β pathways were explored and correlation of damage among tissues was clarified. Based on sleep disruption, PM2.5 exposure was able to induce elevated serum T-CHO levels, impaired conditioned learning ability, abnormal brain tissue metabolic levels, and aberrant expression of multiple molecular markers related to cellular senescence, whereas PM2.5 exposure alone did not induce changes in the above indices. In addition, the Sirt1, Wnt10β pathway mediated cardiac and hepatic aging induced by combined exposure. Moreover, there was a significant correlation between heart and liver aging damage, which suggesting heart-liver axis may be involved in the aging process. Sleep deprivation and PM2.5 exposure trigger senescence in multiple tissues. In particular, on the basis of sleep deprivation, PM2.5 accelerates of the aging process in several tissues and organs. The problem of air pollution on top of sleep disturbance should be taken seriously, as it has a greater potential to accelerate aging than air pollution.

Novel sodium-hydrogen exchanger 1 inhibitors with diphenyl ketone scaffold: Design, Synthesis, mechanism and evaluation in mice model of heart failure

Sodium-hydrogen exchanger 1 (NHE1) is a potential target for drug discovery of heart failure (HF). Cardioprotection effect of empagliflozin (EMPA) was reported to be related to binding with NHE1 protein. Herein, a series of NHE1 inhibitors bearing benzhydryl and diphenyl ketone skeleton were rationally designed and efficiently synthesized. Cell viability assay and pH recovery experiment based on H9c2 cells were conducted and compound 7g was found to have equal NHE1 inhibitory activity to cariporide (0.64 μM) with the IC50 values of 0.78 μM. In vitro, 7g at 1 μM effectively rescued glucose deprivation (GD)-induced cellular damage by decreased overload of Ca2+ concentration and reactive oxygen species (ROS), improved mitochondrial dysfunction and autophagy. In vivo, compared with the clinically approved drug empagliflozin (30 mg/kg), 7g alleviated left ventricular systolic dysfunction in a heart failure model induced by isoproterenol (ISO) at lower concentration (10 mg/kg). In summary, this study supplies a promising lead compound with novel scaffold for NHE1 inhibitor and also provide a feasible strategy for HF drug discovery.

Targeting the contact-kinin system: A cyclopeptide with anti-thromboinflammatory properties against stroke

The contact-kinin system plays a central role in the thromboinflammatory pathology of ischemic stroke. Modulating this pathway represents a promising strategy for the prevention and treatment of ischemic stroke. Based on our recent findings demonstrating that the short peptide SD6 (SLGASD), derived from a specific influenza-related immunoglobulin heavy chain junction region sequence, exhibits anti-coagulant properties, we designed a cyclized version, cycloSD6, and evaluated its anti-ischemic stroke potential. Notably, cycloSD6 showed enhanced inhibition of activated coagulation factor XII (FXIIa; with an inhibition constant (Ki) of 41.27 μM) and plasma kallikrein (PKa; Ki: 28.54 μM), two key enzymes in the contact-kinin system, surpassing the inhibitory effects of its linear form. In vitro, 4-100 μM of CycloSD6 inhibited LPS-induced inflammation. And CycloSD6 at doses of 1 and 4 mg/kg displayed significant anti-thrombotic functions in several mouse models, including carrageenan-induced tail thrombosis, FeCl3-induced arterial thrombosis, and cortical photothrombosis models, and did not affect mouse tail bleeding time. The peptide also exerted comparable anti-ischemic stroke effects to those of ecallantide (DX-88), a kallikrein inhibitor approved for the treatment of hereditary angioedema, in a mouse model of transient middle cerebral artery occlusion. Thus, this short peptide CycloSD6, which dual targets FXII and PKa, harbors anti-thromboinflammation and anti-stroke properties with low bleeding risk. And these findings suggest that cycloSD6 may serve as a potential therapeutic candidate or template for the development of agents targeting ischemic stroke.

The roles and functions of ergothioneine in metabolic diseases

The global prevalence of metabolic diseases is on the increase, and it has become a significant threat to the health and lives of individuals. Ergothioneine (EGT) is a natural betaine amino acid found in various foods, particularly mushrooms. EGT cannot be synthesized by mammals; it is absorbed into small intestinal epithelial cells by a cationic protein, the novel organic cation transporter 1 (OCTN1), and transported to certain organs including liver, spleen, kidney, lung, heart, eyes and brain. EGT has been reported to exhibit antioxidant, anti-inflammatory, anti-apoptotic, anti-aging, and metal-chelating effects. The unique chemical properties and biological functions of EGT position it as a promising candidate for the research and treatment of metabolic diseases. This review summarizes EGT's capacities, potential therapeutic effects on multiple metabolic diseases, and their specific mechanisms. Finally, we outline challenges for future research on EGT and aspire to establish it as a prospective therapeutic agent for metabolic diseases.

Interictal suppression in patients with mesial temporal lobe epilepsy: A simultaneous PET/fMRI study

Previous stereotactic-electroencephalography (SEEG) results have suggested that seizure-onset zones (SOZs) could be suppressed by strengthened inward connectivity from the rest of the brain during interictal periods, which might explain why people with epilepsy did not have seizures continuously. However, the limited coverage of SEEG contacts and allocation bias hindered a more comprehensive survey of interictal suppression at the whole-brain level. Previous studies also lacked a direct comparison between patients and healthy controls due to the invasive nature of SEEG. In the present study, we introduced metabolic connectivity mapping (MCM), a simultaneous FDG-PET/fMRI-based measure of effective connectivity, to evaluate the inward and outward connectivity of the SOZs in patients with mesial temporal lobe epilepsy (MTLE). Specifically, simultaneous FDG-PET/fMRI data was acquired from 23 patients with left MTLE, 24 patients with right MTLE, and 25 healthy controls. At the whole-brain level, there was significant increase of inward MCM connectivity to the SOZs, which mostly came from mesial-temporo-limbic, anterior and posterior midline regions of the default mode network (DMN) and subcortical nuclei. There was also significant decrease of outward MCM connectivity from the SOZs, which mainly projected to the regions within DMN. The increased net inward MCM to the SOZs, calculated by subtracting outward MCM from the inward MCM, was positively correlated with seizure frequency. Within DMN, MTLE patients showed decreased MCM from the SOZs to posterior cingulate cortex and right ventromedial prefrontal cortex and increased effective connectivity from posterior cingulate cortex to the SOZs. Based on the MCM patterns within DMN, we were able to classify the epileptic side of MTLE with an accuracy of 91.67 % (79.17 % for MRI-negative patients). Overall, our results provide whole-brain evidences for the interictal suppression hypothesis. We also found that the regions within DMN play a critical role in the suppression of SOZs. The pattern of such suppressive network might also serve as potential features for the localization of SOZs. Our neuroimaging results does not only provide a comprehensive understanding of interictal suppression at the whole-brain level, but also shed lights on a non-invasive and time-efficient way for SOZs localization.

Associations of Tai Chi With Depression and Anxiety Among Older Adults: Nationwide Study Findings From a Network Perspective

Within the global population, depression and anxiety are common among older adults. Tai Chi is believed to have a positive impact on these disturbances. This study examined the network structures of depression and anxiety among older Tai Chi practitioners vs non-practitioners. Propensity score matching (PSM) was used to construct a non-practitioner group based on Chinese Longitudinal Healthy Longevity Survey (CLHLS) data. 346 Tai Chi practitioners and 1019 non-practitioners were included. The prevalence and severity rates of depression were significantly lower among Tai Chi practitioners compared to non-practitioners though there was no group difference for anxiety. Network analysis showed that, among Tai Chi practitioners, "Felt sadness", "Uncontrollable worrying" and "Trouble relaxing" were the most central symptoms. In contrast, among non-practitioners, the most central symptoms were "Felt sadness", "Uncontrollable worrying", and "Nervousness". Key bridge symptoms linking depressive and anxiety symptoms were "Worry too much", "Bothered by things" and "Uncontrollable worrying" in Tai Chi practitioners and "Nervousness", "Felt nervous/fearful" and "Sleep quality" in non-practitioners. This study underscored how practising Tai Chi is associated with reduced overall prevalence and severity of depression and different interactions of depressive and anxiety symptoms among older adults. Central and bridge symptoms differed between Tai Chi practitioners and non-practitioners.

Low and high air temperature and cardiovascular risk

Temperature extremes are one facet of global warming caused by climate change. They have a broad impact on population health globally. Due to specific individual- and area-level factors, some subgroups of the population are at particular risk. Observational data has demonstrated that the association between temperature and mortality and cardiovascular mortality is U- or J-shaped. This means that beyond an optimal temperature, both low and high temperatures increase cardiovascular risk. In addition, there is emerging epidemiological data showing that climate change-related temperature fluctuations may be particularly challenging for cardiovascular health. Biological plausibility for these observations comes from the effect of cold, heat, and temperature fluctuations on risk factors for cardiovascular disease. Shared mechanisms of heat and cold adaptation include sympathetic activation, changes in vascular tone, increased cardiac strain, and inflammatory and prothrombotic stimuli. The confluence of these mechanisms can result in demand ischemia and/or atherosclerotic plaque rupture. In conclusion, public health and individual-level measures should be taken to protect susceptible populations, such as patients with risk factors and/or pre-existing cardiovascular disease, from the adverse effects of non-optimal temperatures. This review aims to provide an overview of the association between temperature extremes and cardiovascular disease through the lens of pathophysiology and observational data. It also highlights some specific meteorological aspects, gives insight to the interplay of air temperature and air pollution, touches upon social dimensions of climate change, and tries to give a brief outlook into what to expect from the future.

Inhalers or nebulisation of salbutamol in childhood asthma exacerbations in emergency departments

PURPOSE

Asthma exacerbations often lead to paediatric emergency department (PED) visits, but evidence for paediatric management remains limited, and recommendations under discussion. This study compared salbutamol delivered via nebulisation and pressurised metered dose inhalers (pMDI) with a holding chamber in children with mild to severe asthma exacerbations.

METHODS

A two-centre study was conducted during eight months, comparing hospitalisation rates, clinical improvement, side effects, and PED visit length in the overall population and in children under and over 6 years old.

RESULTS

A total of 384 patients were included, primarily with mild and moderate exacerbations of similar severity between groups. The discharge rate was comparable between groups in the overall population (82.7 % without any nebulisation in the pMDI group versus 81.6 %, p = 0.93), but higher for children under 6 years old treated with pMDI (98.1 % versus 76.9 %, p < 0.001). The pMDI group exhibited significantly lower hospitalisation rates (p < 0.001) and shorter PED visits (1.7 [1.2-2.6] hours versus 4.0 [2.6-5.3] hours, p < 0.001) while receiving lower salbutamol doses (0.10 [0.05-0.16] mg/kg versus 0.81 [0.55-1.18] mg/kg, p < 0.001) with less ipratropium and oral corticosteroids (p < 0.001 and p < 0.001). The pMDI group demonstrated fewer side effects, particularly oxygen dependence, especially in children under 6 (p < 0.001).

CONCLUSION

The study suggests that salbutamol via pMDI with a holding chamber is as effective as nebulisation for treating mild to moderate childhood asthma exacerbations. This approach results in fewer hospitalisations, reduced side effects, and shorter PED visits. Educating patients on pMDI use and efficacy could further decrease emergency visits for asthma exacerbation.

Status and Opportunities for Improvement in Pain Education in Europe: A European Pain Federation EFIC Multiple-Methods Study

BACKGROUND

Pain is one of the most prevalent health issues in Europe, yet the quality of pain education for healthcare professionals remains unclear. This study assessed the status of undergraduate and postgraduate pain education for nurses, physicians, psychologists, and physiotherapists across Europe, identifying key strategies to enhance training and improve healthcare outcomes.

METHODS

A study using multiple methods was conducted, comprising a scoping review, an online survey of educators, and qualitative interviews with EFIC chapters and professional educational bodies.

RESULTS

The scoping review of 11 studies revealed a paucity of evidence, with significant heterogeneity in the hours dedicated to pain training and inconsistencies in both content, teaching, and assessment methods across European curricula. The survey of educators (n = 511) showed wide variability in pain education coverage, with psychology curricula particularly underrepresented compared to the more structured programmes in medicine and physiotherapy. The interviews highlighted curriculum constraints, lack of resources, and limited specialised staff as key barriers. They also underscored the importance of integrating pain education across all disciplines through international and interdisciplinary collaboration to enhance training efforts.

CONCLUSIONS

Significant gaps persist in the depth, consistency, and delivery of pain education for undergraduate and postgraduate health professionals across Europe. The absence of standardised, evidence-based curricula underscores the need for consistent pain education across all disciplines. Implementing targeted educational standards, increasing interdisciplinary training, and supporting qualified educators are essential to address this fragmented landscape. Standardising pain education has the potential to greatly improve patient outcomes by equipping healthcare professionals with more effective pain management skills.

SIGNIFICANCE STATEMENT

This multiple method study provides an updated and comprehensive overview of the current state of pain education for healthcare professionals in Europe at undergraduate and postgraduate levels. Substantial gaps remain in the depth, consistency, and delivery of pain education for both undergraduate and postgraduate healthcare professionals across Europe. This underscores the need to enhance pain education at the undergraduate level, with EFIC's existing medicine and physiotherapy resources offering potential models, alongside wider efforts to implement comprehensive postgraduate training. Standardising the delivery of targeted pain education has the potential to greatly improve patient outcomes by equipping healthcare professionals with more effective pain management skills.

Depressive symptoms trajectories and cardiovascular disease in Chinese middle-aged and older adults: A longitudinal cohort study

OBJECTIVES

Depression is increasingly recognized as a potential factor associated with cardiovascular disease. Unlike single time-point assessments, evaluating the long-term trajectories of depressive symptoms may offer deeper insights into their relationship with CVD. This study examines the association between long-term depressive symptoms trajectories and CVD among middle-aged and older Chinese adults.

METHODS

This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2018, including 8792 participants aged 45 years and older. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D 10). Self-reported cardiovascular events (such as heart attack and stroke) were recorded in 2018. Group-Based Trajectory Modeling (GBTM) was employed to identify long-term patterns of depressive symptoms trajectories.

RESULTS

Three distinct depressive symptoms trajectories were identified: stable low depressive symptoms (53.0 %), moderate increasing depressive symptoms (36.8 %), and high depressive symptoms (10.2 %). Multivariable logistic regression revealed a significant association between depressive symptoms trajectories and CVD after adjusting for covariates. Compared to the stable low depressive symptoms trajectory group, the moderate increasing depressive symptoms trajectory group showed a significantly stronger association with heart disease, while the persistently high depressive symptoms trajectory group exhibited significantly higher likelihoods of both heart disease and stroke.

CONCLUSIONS

Long-term depressive symptoms trajectories are strongly related to elevated likelihoods of CVD in middle-aged and older adults in China. These findings highlight the need for sustained depression management to mitigate cardiovascular outcomes.

Purine xanthine oxidase inhibitors are not conducive to the prognosis of chronic heart failure: a meta-analysis

BACKGROUND

According to previous studies, the efficacy of xanthine oxidase inhibitors (XOIs) in patients with chronic heart failure (CHF) is still controversial. Therefore, the purpose of this study was to investigate the efficacy of XOIs in patients with CHF.

METHODS

Up to July 2024, we searched PubMed, EMBASE, Medline, Web of Science, and Cochrane Library for studies on the efficacy of XOI in patients with CHF. The main results included all-cause mortality, cardiovascular (CV) mortality, and heart failure (HF) hospitalization rates. The results were evaluated by hazard ratio (HR) and 95% confidence interval (95% CI).

RESULTS

A total of eight studies were included in this meta-analysis, of which five were cohort studies and three were randomized controlled trials (RCTs). The total sample size was 301,345. The experimental group was exposed to allopurinol or hydroxypurinol. The all-cause mortality (HR = 1.26, 95% CI 1.05-1.51, p = 0.013) and CV mortality (HR = 1.58, 95% CI 1.17-2.14, p = 0.03) in the experimental group were higher than those in the control group. In terms of HF hospitalization, there was no difference between both groups (HR = 1.21, p = 0.292). Subgroup analysis showed that the CV hospitalization rate of the experimental group was higher than that of the control group, regardless of frequency and dose levels. The all-cause mortality in the low-dose group was higher than that in the control group (HR = 1.39, p = 0.033). The CV mortality of the low-dose group (HR = 1.55, p = 0.006) and the prevalent group (HR = 1.50, p = 0.042) was higher than that of the control group.

CONCLUSION

Purine XOI exposure may be unfavorable for the prognosis of CHF patients and is affected by the frequency and dose of use.

Do Personalized Nutrition Interventions Improve Dietary Intake and Risk Factors in Adults With Elevated Cardiovascular Disease Risk Factors? A Systematic Review and Meta-analysis of Randomized Controlled Trials

CONTEXT

Dietary modifications can improve cardiovascular disease (CVD) risk factors. Personalized nutrition (PN) refers to individualized nutrition care based on genetic, phenotypic, medical, behavioral, and/or lifestyle characteristics. PN may be beneficial in improving CVD risk factors, including diet. However, this has not been reviewed previously.

OBJECTIVE

The aim was to evaluate the effectiveness of PN interventions on CVD risk factors and diet in adults at elevated CVD risk.

DATA SOURCES

Six databases were searched for randomized controlled trials published between 2000 and 2023 that tested the impact of PN interventions on CVD risk factors in people at elevated risk.

DATA EXTRACTION

Risk of bias was assessed using the Academy of Nutrition and Dietetics Quality Criteria checklist. Data synthesis of eligible articles included participant characteristics, intervention details, and change in primary CVD risk factor outcomes, including blood pressure (BP), plasma lipids, and CVD risk score, and secondary risk factors, including anthropometric outcomes and diet quality. Random-effects meta-analyses were conducted to explore weighted mean differences (WMDs) in change or final mean values for studies with comparable data (studies with dietary counseling interventions) for outcomes including BP, blood lipids, and anthropometric measurements.

DATA ANALYSIS

Of 7676 identified articles, 16 articles representing 15 studies met the inclusion criteria. Studies included between 40 and 563 participants and reported outcomes for CVD risk factors, including hyperlipidemia (n = 5), elevated BP (n = 3), overweight/obesity (n = 1), and multiple risk factors (n = 6). Risk of bias was low. Results suggested potential benefit of PN on systolic BP (WMD: -1.91; 95% CI: -3.51, -0.31 mmHg) and diastolic BP (WMD: -1.49; 95% CI: -2.39, -0.58 mmHg) and dietary intake in individuals at high CVD risk. Results were inconsistent for plasma lipid and anthropometric outcomes.

CONCLUSION

Results were promising for PN interventions that used dietary counseling on CVD risk factors in at-risk individuals. However, further evidence for other personalization methods is required, including improving methodological quality and longer study duration in future PN interventions.

SYSTEMATIC REVIEW REGISTRATION

OpenScience Framework (https://doi.org/10.17605/OSF.IO/SHVWP).

Magnesium Deficiency: The Insidious Executor of the Liver Disease

Magnesium (Mg), which is predominantly present in cells as a micronutrient, is involved in numerous vital physiological processes, such as DNA repair and energy metabolism. Mg deficiency has been reported to contribute toward the advent and progression of a variety of liver diseases; in particular, these two pathological entities may synergistically act. Given the significant impact and increasing burden of liver diseases on global healthcare resources and economic expenditure, it is tempting to manage Mg insufficiency as novel promising therapeutic strategies. In this review, we comprehensively elaborate on the complicated relationship between Mg deficiency and several contextual liver diseases, with concentrating on the underlying molecular mechanisms.

High local type-2 inflammation is linked to response in severe asthma treated with anti-Interleukin-5 receptor

BACKGROUND

Benralizumab is an anti-IL-5 receptor (IL-5R) therapy linked to a huge improvement of the condition of patients with severe eosinophilic asthma. The goal of this study was to identify baseline airway markers of remission and response after anti-IL5R therapy.

METHODS

This observational study included 45 patients initiated with an anti-IL-5R. Remission was defined as: no oral corticosteroids intake, no exacerbation, a good asthma control (ACQ <1.5 and/or ACT >19) and a good lung function (FEV1 ≥ 80 % predicted and/or an improvement ≥10 %). Components of remission were also assessed individually to evaluate the response of patients. Sputum levels of mediators implicated in inflammation and remodeling were measured before treatment.

RESULTS

Among the 45 patients, 12 were classified in remission. These patients were younger at baseline, had a lower smoking exposure, better asthma control and quality of life and a higher FeNO compared to the others. Moreover, baseline blood eosinophil counts were similar but sputum IL-6 and IL-8 levels were significantly higher in the non-remission group. Finally, patients who only improved their ACT or ACQ score had higher baseline FeNO values or sputum eosinophil percentage respectively. Those who increased their FEV1 ≥ 10 % presented a higher baseline sputum eosinophil percentage, sputum eotaxin-3 level and a trend for a higher sputum IL-5 level.

CONCLUSION

High baseline airway T2 markers appeared to be associated with response to anti-IL-5R therapy. Lower sputum IL-6 and IL-8 levels were linked to remission. These results need to be validated in a bigger cohort.

Socioeconomic position and type 2 diabetes: Examining the mediating role of social cohesion-The Maastricht Study

The relationship between socioeconomic position and type 2 diabetes is well-established; individuals of lower socioeconomic position experience substantially higher rates of the disease. This study investigated the mediating role of perceived and ecometric area-level social cohesion in the association between socioeconomic position and incident type 2 diabetes. In a prospective population-based cohort, The Maastricht Study, we analyzed data from 6,604 participants (age¯ = 58.6 years, 55% female) with a median follow-up of 8.1 (IQR 5.1-10.1) years. We examined whether perceived or area-level social cohesion (in 500 m squares, five-character postal code areas, and neighborhood areas) mediated the association between socioeconomic position (represented by educational attainment, occupational status, or income) and incident type 2 diabetes. We employed a causal mediation approach based on linear regression and Cox proportional hazards models. Individuals with lower socioeconomic position were more likely to perceive lower social cohesion and to live in areas with diminished social cohesion. Lower area-level social cohesion was associated with an increased risk of developing type 2 diabetes. The mediating effect of social cohesion was more pronounced in urban areas. In urban areas, the total effect of education (contrasting the 83rd and 17th percentiles) on type 2 diabetes incidence was a hazard ratio (HR) of 2.03 (95% CI: 1.62-2.58), with area-level social cohesion mediating 24.4% (11.1%-40.3%) of this effect. In less urban areas, social cohesion mediated 12.6% (5.2%-23.0%) of a HR of 1.89 (1.50-2.40). Similar findings were observed with occupational status and income, and across other aggregation levels. Socioeconomic position is linked to lower social cohesion, which is associated with an increased risk of type 2 diabetes. Enhancing social cohesion in disadvantaged areas may help reduce diabetes-related health disparities, particularly in urban settings. Further research is needed to better understand the mechanisms underlying these relationships.

Intestinal IL-17 family orchestrates microbiota-driven histone deacetylation and promotes Treg differentiation to mediate the alleviation of asthma by Ma-Xing-Shi-Gan decoction

BACKGROUND

Gut microbiota imbalance is well-known as one important trigger of allergic asthma. Ma-Xing-Shi-Gan decoction (MXSG) is a traditional Chinese medicine prescription with ideal clinical efficacy on asthma. However, whether and how MXSG exerts its efficacy on asthma through gut microbiota remains unclear.

PURPOSE

To investigate the underlying mechanism of MXSG against asthma using multi-omics technologies.

METHODS

An asthma model was established using 8-week-old C57BL/6 J mice, after which they were daily administrated with high-, medium- and low-dose MXSG for 7 days. Histopathological examinations and flow cytometry were performed to evaluate the effects of MXSG on lung immune injury. Key regulatory pathways were predicted via network pharmacology and verified using 16S rRNA sequencing, metagenomics, metabolomics, and in vivo experiments including the knockout of the targeting gene.

RESULTS

MXSG alleviated asthma symptoms, elevated intestinal microbial diversities, and enriched potential beneficial microbes such as Lactococcus, Lactobacillus, and Limosilactobacillus. Network pharmacology and experimental validation highlighted the IL-17/Treg signaling as crucial for asthma treatment. IL-17 knockout experiments revealed its necessity for Treg differentiation during asthma. Moreover, IL-17-deficient asthmatic mice exhibited lower levels of Lactobacillus and significant changes in microbial genes involving histone deacetylases (HDAC) and short-chain fatty acids (SCFAs). Finally, MXSG significantly boosted SCFA production and reduced HDAC9 expression, which were correlated with Treg cell ratios.

CONCLUSION

Our study delineates a novel mechanism where MXSG synergizes with the IL-17 family to enrich intestinal beneficial microbes (e.g. Lactobacillus) and SCFAs. This inhibits the expression of SCFA-downstream HDAC9 to promote Treg differentiation, and thus potentially alleviates asthma.

Development and validation of a convenient dementia risk prediction tool for diabetic population: A large and longitudinal machine learning cohort study

BACKGROUND

Diabetes mellitus has been shown to increase the risk of dementia, with diabetic patients demonstrating twice the dementia incidence rate of non-diabetic populations. We aimed to develop and validate a novel machine learning-based dementia risk prediction tool specifically tailored for diabetic population.

METHODS

Using a prospective from 42,881 diabetic individuals in the UK Biobank, a rigorous multi-stage selection framework was implemented to optimize feature-outcome associations from 190 variables, and 32 predictors were final retained. Subsequently, eight data analysis strategies were used to develop and validate the dementia risk prediction model. Model performance was assessed using area under the curve (AUC) metrics.

RESULTS

During a median follow-up of 9.60 years, 1337 incident dementia cases were identified among diabetic population. The Adaboost classifier demonstrated robust performance across different predictor sets: full model with 32 predictors versus streamlined simplified model with 13 predictors selected through forward feature subset selection algorithm (AUC: 0.805 ± 0.005 vs. 0.801 ± 0.005; p = 0.200) in model development employing an 8:2 data split (5-fold cross-validation for training). To facilitate community generalization and clinical applicability, the simplified model, named DRP-Diabetes, was deployed to a visual interactive web application for individualized dementia risk assessment.

LIMITATIONS

Some variables were based on self-reported.

CONCLUSIONS

A convenient and reliable dementia risk prediction tool was developed and validated for diabetic population, which could help individuals identify their potential risk profile and provide guidance on precise and timely actions to promote dementia delay or prevention.

p38γ modulates ferroptosis in brain injury caused by ethanol and cerebral ischemia/reperfusion by regulating the p53/SLC7A11 signaling pathway

Ischemic stroke, a neurological condition with a complicated etiology that is accompanied by severe inflammation and oxidative stress, and ethanol (EtOH) may aggravate ischemia/reperfusion (I/R)-induced brain damage. However, the effect of prolonged alcohol intake on acute brain injury remains ambiguous. As part of the mitogen-activated protein kinase (MAPK) family, p38γ is involved in ferroptosis and inflammation in various diseases. This study explored how p38γ is involved in the effects of chronic EtOH consumption and brain injury caused by cerebral I/R. Brain damage was induced in the mice via the administration of a liquid alcohol-containing diet for 8 weeks, middle cerebral artery occlusion reperfusion (MCAO/R), or a combination of both. We verified that EtOH significantly exacerbated MCAO/R-induced brain damage, ferroptosis and inflammation. Notably, p38γ levels were increased in experimental mouse and cell models. p38γ knockdown markedly attenuated brain tissue damage, oxidative stress, and inflammatory cell infiltration in EtOH + MCAO/R-treated mice. Mechanistic experiments revealed that p38γ may regulate inflammation and ferroptosis through the p53/SLC7A11 pathway. Overall, our experimental results indicate that p38γ is crucial for regulating EtOH- and I/R-induced brain damage by modulating the p53/SLC7A11 pathway.

Vitamin D: What role in obesity-related cancer?

Obesity is an important risk factor for incidence and death for many types of cancer. Vitamin D reduces risk of incidence and death for many types of cancer. This review outlines the mechanisms by which obesity increases risk of cancer, how vitamin D reduces risk of cancer, and the extent to which vitamin D counters the effects of obesity in cancer. Vitamin D is a partial ally against some of obesity's pro-carcinogenic effects, notably by reducing inflammation and regulating sex hormone receptors, leptin resistance, cellular energy metabolism, the microbiome, and hypoxia. However, it can act stronger in against the renin-angiotensin system, insulin resistance, and oxidative stress in cancer. Additionally, excess fat tissue sequesters vitamin D and, along with its dilution in increased body volume, further reduces its bioavailability and serum concentration, limiting its protective effects against cancer. In conclusion, while vitamin D cannot reverse obesity, it plays a significant role in mitigating its pro-carcinogenic effects by targeting several mechanisms.

Children and adolescents' demand for psychiatric services: Insight from the a nine-year-period visits population change in Nanjing, China

BACKGROUND

The prevalence of mental health issues among children and adolescents has been increasing. The objective of this study is to delineate the evolving characteristics of psychiatric visits among this demographic, including sex differences in service utilization, and to evaluate the capacity of existing medical resources to meet their needs for such visits.

METHODS

The data were sourced from Nanjing Brain Hospital and retrieved from outpatient and inpatient records of individuals aged 18 and below who visited the psychiatric department between the dates of July 2015 and June 2024. A descriptive analysis of the temporal changes in clinical features and general data was conducted, and an ETS time series model was employed to forecast whether visit demands are being met.

RESULTS

A total of 594,510 visits were recorded across both outpatient and inpatient systems. The overall number of visits increased year by year, with the fastest growth rate among patients with mood disorders. Furthermore, the growth rate of boys was significantly slower than that of girls (outpatient: OR = 0.93, P < 0.001; inpatient: OR = 0.91, P < 0.001). The ETS time series analysis indicated that future visit trends are expected to stabilize, with a significant proportion of children and adolescents still requiring N-CAP visits (outpatient: 31 %; inpatient: 44 %). In the inpatient system, the majority of this population is concentrated in the 17-18 age group (73 %).

CONCLUSION

The number of psychiatric visits for children and adolescents has been increasing on an annual basis. The current medical resources are insufficient to meet the growing demand.

Inhibition of the cGAS-STING pathway: contributing to the treatment of cerebral ischemia-reperfusion injury

The cGAS-STING pathway plays an important role in ischemia-reperfusion injury in the heart, liver, brain, and kidney, but its role and mechanisms in cerebral ischemia-reperfusion injury have not been systematically reviewed. Here, we outline the components of the cGAS-STING pathway and then analyze its role in autophagy, ferroptosis, cellular pyroptosis, disequilibrium of calcium homeostasis, inflammatory responses, disruption of the blood-brain barrier, microglia transformation, and complement system activation following cerebral ischemia-reperfusion injury. We further analyze the value of cGAS-STING pathway inhibitors in the treatment of cerebral ischemia-reperfusion injury and conclude that the pathway can regulate cerebral ischemia-reperfusion injury through multiple mechanisms. Inhibition of the cGAS-STING pathway may be helpful in the treatment of cerebral ischemia-reperfusion injury.

Unlocking the Cardiovascular Benefits of Walnuts: Insights on Molecular Mechanism From Animal Studies

The health-promoting benefits of walnut consumption are substantially ascribed to its fatty acid (FA) profile, which is rich in polyunsaturated FA with an exceptionally high n-3 to n-6 ratio. There are also phytonutrients in walnuts that are linked to health welfare. This review article integrates all studies on the effects of walnuts on the cardiovascular system performed on experimental animals, and thus is a source of data on the mechanisms underlying the observed effects. These studies, which are very diverse in experimental design, indicate that a diet enriched with walnuts or treating animals with walnut extract or chemical constituents of walnuts, has many favorable effects on heart and vascular system function. The cardiovascular effect of walnuts depends on the metabolic status of the organism. Among the cardiovascular effects of walnuts is that they improve the FA profile in the circulation and heart in favor of n-3 polyunsaturated FAs. In addition, a favorable effect on triglyceride and cholesterol status, which reduces cardiovascular disease risk, is observed. Intake of walnuts promotes FA catabolism and has anti-inflammatory, antioxidant, and antiarrhythmic effects. Walnuts also have a beneficial effect on vascular tone, accompanied by a decrease in blood pressure and reduced risk for atherosclerosis. In conclusion, studies on experimental animals encourage the consumption of walnuts as a simple, convenient approach to improve cardiovascular health.