Cardiovascular diseases (CVDs) and Alzheimer's disease (AD) are among the most prevalent chronic conditions, contributing significantly to global morbidity and healthcare burdens. These diseases are increasingly recognized as interconnected through shared mechanisms such as vascular dysfunction, oxidative stress, hypertension, and systemic inflammation, collectively referred to as the CVD-AD axis. Although therapeutic strategies exist for each condition, integrated approaches targeting these common pathways remain limited. This review highlights marine-derived bioactive peptides (BAPs) as multifunctional, sustainable agents for the simultaneous prevention of CVD and AD. It summarizes recent advances in their production, purification, and characterization, with emphasis on enzymatic hydrolysis and separation techniques. Marine BAPs exhibit diverse bioactivities, antioxidant, anti-inflammatory, lipid-lowering, antihypertensive, and neuroprotective, addressing key pathological mechanisms of the CVD-AD axis. Their small size, stability, and favorable safety profile support absorption and initial bioavailability, while sustainable sourcing from underutilized marine biomass enables eco-friendly production. Despite their potential, barriers to scalable production, product standardization, and regulatory approval remain; however, incremental advances are being made toward overcoming these issues. Together with these advances, marine BAPs remain promising candidates for functional foods and nutraceuticals, providing integrated preventive strategies for age-related diseases and supporting long-term cardiovascular and cognitive health.

Background: Despite advances in the management of acute coronary syndrome (ACS), women continue to experience higher long-term mortality and lower access to secondary prevention compared with men. Objective: This study aimed to assess whether a universally inclusive, nurse-led secondary prevention program implemented at a University Hospital improved post-ACS outcomes and reduced gender disparities in risk factor control and mortality. Methods: This retrospective, observational study compared two cohorts of ACS survivors discharged from Bellvitge University Hospital: a pre-intervention cohort (2018) and a post-intervention cohort (2022). The nurse-led program included universal enrollment of all ACS patients, early follow-up, pharmacological optimization, therapeutic exercise, lifestyle counseling, and coordination with primary care. Outcomes included lipid and glycemic control and 18-month mortality, stratified by sex. Results: A total of 409 patients were included (2018: n = 200; 2022: n = 209), of whom 130 were women. Women were older and had more comorbidities. Post-program implementation, the proportion of patients without post-discharge blood testing dropped from >50% to <17% in both sexes. Lipid and glycemic control improved significantly at both early (1-4 months) and late (9-18 months) follow-up. Early differences favoring men disappeared by 18 months. Mortality decreased by 27.5% in men and 47.6% in women, representing a significantly greater relative reduction among women (p = 0.0001). Conclusions: A structured, nurse-led secondary prevention program with systematic inclusion improved clinical outcomes and significantly narrowed the gender gap in cardiovascular mortality. These findings demonstrate that equitable, protocolized care led by advanced practice nurses can reduce systemic inequities in cardiovascular health.

Invasive fungal infections are frequent complications in patients with hematologic malignancies due to immunosuppression and intensive treatments. In Colombia, limited diagnostic availability, heterogeneous prescribing practices, and emerging antifungal resistance highlight the need for optimized use. We evaluated an interdisciplinary antifungal stewardship intervention in the hematology unit of a tertiary-care hospital. A quasi-experimental before-and-after study included 353 hospitalized patients receiving systemic antifungals between 1 January 2023 and 31 December 2024 (1154 prescriptions). Following the intervention, antifungal prescribing shifted toward increased prophylaxis and reduced therapeutic use, with substantial reduction in prophylactic Amphotericin B dosing, stable treatment dosing, and selective changes in agent choice, including decreased voriconazole and discontinuation of some broad-spectrum drugs. Microbiological sampling decreased, reflecting a more targeted diagnostic approach rather than improved documentation. Antifungal consumption patterns showed redistribution among agents rather than uniform reduction. Prophylaxis-related costs increased, while treatment-related costs decreased without statistical significance. ICU admissions and in-hospital mortality remained unchanged. These results demonstrate that structured antifungal stewardship programs are feasible and safe in hematology units in middle-income settings, supporting more rational antifungal use without compromising patient outcomes.

Background: Atherosclerotic cardiovascular disease (ASCVD) frequently coexists with type 2 diabetes (T2D), amplifying morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1RA) confer significant cardiovascular benefits and are recommended for patients with T2D and established ASCVD. However, real-world use may not reflect a complication-driven therapeutic approach. Methods: This retrospective study included adults with T2D and established ASCVD (prior myocardial infarction, ischemic stroke, transient ischemic attack, or symptomatic peripheral arterial disease) consecutively admitted to the internal medicine and cardiology departments of a tertiary hospital over a 60-day period. Pre-admission medication use, comorbidities, and laboratory parameters were recorded. Factors associated with GLP-1 RA use were assessed using logistic regression before and after 1:1 propensity score (PS) matching. Results: Among 202 eligible patients, 49 (24.3%) were treated with a GLP-1RA. GLP-1RA users were younger (71.9 vs. 77.8 years, p < 0.001), had lower hypertension prevalence (61.2% vs. 78.4%, p = 0.02), and were more frequently on insulin (69.4% vs. 25.5%, p < 0.001) and sodium-glucose cotransporter 2 inhibitors (55.1% vs. 28.1%, p = 0.001). After PS matching (48 pairs), demographic and comorbidity differences were attenuated, although insulin remained strongly associated with GLP-1RA therapy (Odds Ratio 11.85, p < 0.001). Neither cardiovascular disease burden-captured through the presence of multiple cardiovascular comorbidities-nor renal function were independently associated with GLP-1RA use after adjustment. Conclusions: In patients with T2D and established ASCVD, GLP-1RA use was more strongly associated with the intensity of glucose-lowering therapy-particularly insulin use-than with cardiovascular or renal risk profiles. These findings should be interpreted with caution given the retrospective observational design and the limited availability of glycated hemoglobin, anthropometry and diabetes duration data. However, they suggest that, in real-world clinical practice, GLP-1RA prescribing may remain predominantly glucose-centric rather than complication-driven, underscoring the need for improved implementation of contemporary diabetes guidelines.

The increasing impact of infectious, cardiovascular and neurodegenerative diseases has intensified the demand for early and decentralized diagnostics. Label-free electrochemical biosensors are promising candidates, offering high sensitivity, low reagent consumption and miniaturizable, low-cost architectures for point-of-care (PoC) testing. This review summarizes advances in immobilization strategies, recognition elements such as DNA, antibodies, aptamers, and molecularly imprinted polymers, as well as electrode platforms including glassy carbon, screen-printed, and 3D-printed systems, with an emphasis on DNA biosensors, multiplexed configurations, and applications to disease biomarkers. Beyond analytical performance, we critically examine the barriers that keep most devices at the proof-of-concept stage, including bioreceptor stability and immobilization, limited validation in real samples, reliance on conventional materials, challenges in scalable manufacturing, transport, and storage, and the absence of fully integrated PoC systems. Finally, we discuss significant advances in sensitivity, reproducibility, and application to real samples, but note that translation to real-world use and commercialization remains limited.

Brain diseases, including neurodegenerative disorders, brain tumors, and ischemic strokes, have shown significant threats to human neurological health and quality of life. With the aging population, the incidence of brain diseases continues to rise, further exacerbating public health issues. Traditional diagnostic methods, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), are hindered by limited image resolution and a high reliance on costly equipment. Single-molecule detection technologies, such as digital ELISA, have shown great promise for improving sensitivity, but their complex procedures and high costs remain barriers. Nanozymes, nanomaterials with enzyme-like activity, have emerged as a potential alternative. These materials offer high stability and lower costs in comparison with natural enzymes, making them ideal for portable, high-throughput diagnostics. In this review, we mainly summarize the types and applications of nanozymes with peroxidase-like activity and oxidase-like activity in brain disease biomarker detection and discuss the challenges and future directions for their clinical use.

Health data are essential to guide effective public policies, especially in contexts of increasing complexity and the need for rapid responses. The Global Burden of Disease (GBD) study is central to burden of disease estimates, including in the European Union (EU). This study identified gaps in the data underlying morbidity estimates in the 2023 GBD study for 27 EU countries.

The GBD2023 Sources Tool was used to identify morbidity data sources, which were analysed by country, year, age, and disease. Data coverage was defined as the inclusion of at least one source for all combinations of age, country, year, and disease.

Highest data coverage was observed in Sweden, Austria, and Germany, and lowest in Hungary, Romania, and Bulgaria. There was high coverage for infectious diseases, but considerable gaps for leading morbidity causes, including musculoskeletal (15.9%) and mental disorders (32.9%) and unintentional injuries (28.1%). Data coverage was highest for the 2000s.

The study highlighted variations in EU morbidity data coverage in the GBD2023, suggesting potential differences in estimate reliability. Differences may stem from national health information systems and data-sharing barriers. To enhance estimate accuracy and benchmarking among European health systems, improving data collection and utilization is crucial.

Introduction The lifetime risk of developing acute coronary syndrome (ACS) is heavily influenced by modifiable factors like smoking, hypertension, diabetes, and lifestyle, as well as non-modifiable factors such as age, sex, and genetic predisposition. As the primary symptom of ACS, chest pain accounts for the most common reasons for emergency department visits and outpatient cardiac evaluations in the United States, posing a significant diagnostic challenge to clinicians. ACS carries a massive economic burden, with high direct costs from hospitalizations and high indirect costs like lost productivity, impacting healthcare systems, especially in rural areas like West Virginia, with a high prevalence of risk factors associated with cardiovascular disease progression. Circulating biomarkers present a promising approach in the research and clinical practice of various diseases as they are minimally invasive, highly cost-effective, and provide high specificity. So, the objective of the present study was to evaluate the potential of a biomarker panel in differentiating cardiac causes of chest pain in non-ACS patients in West Virginia. Methods The exploratory cross-sectional study was conducted in patients from a hospital in West Virginia, United States. Patients who were referred to the Rapid Access Chest Pain Clinic were enrolled. Patients were selected based on the established inclusion and exclusion criteria. The plasma samples from chest pain patients, in comparison with age-matched controls, were used for the assessment of circulating biomarkers of cardiac dysfunction such as N-terminal pro-B-type natriuretic peptide (NT-proBNP), Myosin-binding protein C (MyBP-C), creatine kinase-myocardial Band (CK-MB), and neopterin. Results Our results showed that there was a significant elevation in these biomarkers in patients with chest pain in comparison with healthy controls. The correlation analysis revealed a significant link between these parameters and NT-proBNP, the well-established and highly specific predictive markers of cardiac injury and cardiac function decline. This multimarker approach that assessed the additive value of the proposed biomarker analysis may provide an earlier assessment of overall patient risk and may aid in identifying patients with a higher risk of an adverse event. Conclusion The findings in the present study demonstrate the potential of the four-biomarker panel in identifying the cardiac causes of chest pain and the future translational applicability of the proposed biomarker panel to determine and compare the prognostic abilities for early ACS detection through detailed longitudinal studies. This may also help in diagnosis, risk stratification, and guidance of treatment, further allowing management of cardiac function decline and improved health outcomes in the high-risk population of West Virginia.

Human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CM) are a valuable tool for modeling cardiac diseases, drug testing, and regenerative applications. However, their application is limited by the immature phenotype of iPSC-CM. During maturation from fetal to adult phenotype cardiomyocytes undergo a transition from glycolysis to oxidative phosphorylation for energy production, which is supported by efficient tricarboxylic acid (TCA) cycle activity. Our metabolomics data suggest that the level of intermediates of TCA cycle including succinate, malate, fumarate, and α-ketoglutarate was very low in iPSC-CM. Therefore, we investigated the effect of supplementation with these metabolites on the maturation of iPSC-CM. We cultured iPSC-CM in glucose (Glu), galactose (Gal), or galactose plus TCA cycle intermediates (Gal+TCA) and evaluated the incremental effect of TCA cycle intermediates supplementation relative to Glu and Gal. The treatment with these TCA cycle intermediates led to improved calcium handling and cellular morphology of iPSC-CM relative to Glu and Gal. Furthermore, the treatment with TCA cycle metabolites enhanced electrical activity, improved mitochondrial health, and the cells were shifting toward oxidative phosphorylation relative to Glu only. This shift in the energy metabolism was associated with an upregulation in the expression of cardiomyocyte maturation genes and downregulation in the expression of fetal genes in Gal + TCA group relative to Glu. Overall, the benefits of Gal+TCA supplementation were quite evident compared to Glu alone but generally modest relative to Gal supplementation, supporting that TCA cycle intermediates supplementation can be used as an adjunct strategy to promote iPSC-CM maturation.

To examine sex differences and identify associated risk factors for cardiovascular disease (CVD) among adults in Somaliland, in order to inform targeted public health interventions.

A cross-sectional analysis of nationally representative survey data.

Community-based, covering all regions of Somaliland.

A sample of 20,669 adults from the 2020 Somaliland Demographic and Health Survey (SLDHS).

Not applicable (observational study).

The primary outcome was the prevalence of self-reported, doctor-diagnosed CVD (including coronary heart disease, hypertensive heart disease, and stroke). Key determinants were assessed via adjusted odds ratios (AOR) from multivariable logistic regression.

The overall CVD prevalence was 0.94%, with significant sex and geographic disparities. Hypertension was the strongest predictor overall (AOR = 4.68, 95% CI: 3.26-6.71), with a greater effect in females (AOR = 5.10, 95% CI: 3.23-8.04). Diabetes was a significant risk factor for males only (AOR = 2.59, 95% CI: 1.11-6.07). Widowhood and rural residence increased CVD risk for females, while nomadic residence was protective for males.

This study reveals significant, sex-specific disparities in CVD determinants in Somaliland. Public health strategies must prioritize hypertension and diabetes control, improve healthcare access for women-particularly widowed and rural residents-and develop regionally tailored interventions to mitigate the growing CVD burden.