Omics technologies enable deep profiling of human atherosclerosis but have mostly been applied in small studies lacking integration with other data modalities. AtherOMICS is a biobanking project linking multiomic atherosclerotic plaque phenotyping with blood biobanking, in vivo imaging, and clinical data. Here, we present the study protocol and show pilot results that demonstrate technical feasibility. Since August 2022, 246 patients scheduled to undergo carotid or femoral endarterectomy at Ludwig-Maximilians-Universität Klinikum (Munich, Germany), have been enrolled (median age, 73 years; 32% female), with recruitment ongoing. Plaques undergo systematic histological characterization of lipid core, calcification, intraplaque hemorrhage, fibrous cap, macrophages, and smooth muscle cells. Single-nucleus RNA sequencing (n = 17) has confirmed macrophages as the dominant intraplaque cell type, whereas paired plaque and plasma affinity-based proteomics (n = 88) quantified 2841 shared proteins showing low plaque-plasma correlation (median ρ = 0.10). Cross-modality image integration [histology, ex vivo magnetic resonance imaging (MRI), in vivo MRI, and computed tomography angiography] proved feasible. Together, AtherOMICS enables multimodal characterization of human atherosclerosis aiming for the discovery of athero-specific drug targets, molecular signatures of atheroprogression, and noninvasive biomarkers of plaque vulnerability.

Aortic stenosis is the most common valvular heart disease in the United States, and it affects up to 3.7% of the general population. Atherosclerosis results in progressive calcification of the aortic valve, leading to valve narrowing. Aortic stenosis is more common in older adults and men and in those with bicuspid aortic valves or cardiovascular risk factors. Classic symptoms of aortic stenosis include exertional angina, dyspnea, syncope, presyncope, and symptoms of heart failure. Patients may present with atypical symptoms (eg, fatigue, exercise intolerance), which may be mistaken for other cardiopulmonary conditions or attributed to aging. Transthoracic echocardiography is the preferred test for diagnosis because it can classify the severity of aortic stenosis. Asymptomatic patients with aortic stenosis may be monitored with echocardiography every 3 to 5 years for mild stenosis, 1 to 2 years for moderate stenosis, and 6 to 12 months for severe stenosis. No specific treatment prevents the need for aortic valve replacement or reverses aortic stenosis. Aortic valve replacement is indicated in patients with symptomatic severe aortic stenosis and in a subset of those with asymptomatic severe stenosis. There is no difference in mortality between transcatheter aortic valve replacement and surgical valve replacement.

Evidence on age at diagnosis of dementia and differentiation of dementia subtypes in Bangladesh is limited. This study aimed to determine age at diagnosis, examine factors associated with dementia subtypes, and evaluate the discriminatory utility of neuroimaging scales in a Bangladeshi clinical population.

The Community Awareness and Research on Early Dementia (CARED) study was a cross-sectional observational study conducted 2019-2024 at a tertiary care centre in Bangladesh. A total of 658 adults presenting with cognitive impairment, undergoing evaluation for suspected dementia were included. Diagnoses were established using DSM-5 criteria by a multidisciplinary team. Patients were categorized into dementia subtypes. Pseudodementia was retained as separate comparator group. Multivariable regression analyses were performed to identify factors associated with dementia subtypes. Receiver operating characteristic (ROC) curve analyses were used to assess the discriminatory performance of neuroimaging scales.

Among 658 patients, Alzheimer's-related dementia (ARD) accounted for 51.7% of cases. The mean age at diagnosis was significantly higher in ARD compared with non-Alzheimer's-related dementia (nARD) (67.7 ± 10.8 vs 64.3 ± 11.4 years, P < 0.001). In multivariable analysis, nARD was associated with an earlier age at diagnosis by 4.3 years compared with ARD. Vascular dementia was associated with hypertension, OR 4.2 (95% CI 1.1-16.6), P = 0.04, and smoking, OR 13.1 (95% CI 1.6-103.3), P = 0.01. Neuroimaging scales demonstrated variable discriminatory performance. Medial temporal atrophy showed good discrimination for ARD (AUROC 0.752), while Fazekas scores demonstrated good performance for vascular dementia (AUROC 0.838) and mixed dementia (AUROC 0.836). Global cortical atrophy showed moderate discriminatory ability for frontotemporal dementia (AUROC 0.659).

Age at diagnosis varied across dementia subtypes in this Bangladeshi clinical cohort, with non-Alzheimer's diagnosed earlier than Alzheimer's. Structured MRI visual rating scales showed variable subtype-specific discriminatory performance, suggesting that they may provide adjunctive information for dementia subtype differentiation when interpreted alongside multidisciplinary clinical assessment.

Drug-coated balloon (DCB) therapy for in-stent restenosis (ISR) relies on efficient drug transfer during balloon-artery contact. Surface micro-patterning has been proposed to enhance transfer efficiency without altering the antiproliferative drug. This study evaluated a linear micro-patterned DCB (LMDCB) compared with a comparator paclitaxel-coated DCB in a porcine coronary ISR model.

ISR was induced by bare-metal stent implantation followed by a 4-week maturation period. In two prespecified cohorts (1 month: 10 animals, 20 segments; 3 months: 4 animals, 8 segments), paired ISR segments within each animal were treated with LMDCB or a comparator paclitaxel-coated DCB (3.0 µg/mm2). Endpoints included quantitative coronary angiography (QCA), optical coherence tomography (OCT), and histology.

At 1 month, LMDCB demonstrated a larger minimum lumen diameter (2.3 ± 0.2 mm vs 1.9 ± 0.4 mm; p = 0.019) and lower percent diameter stenosis (13.3 ± 4.8% vs 23.7 ± 9.3%; p = 0.003). OCT showed lower mean neointimal thickness (0.2 ± 0.1 mm vs 0.3 ± 0.1 mm; p = 0.008). Histology showed lower neointimal area (2.4 ± 0.7 mm2 vs 2.9 ± 1.1 mm2; p = 0.011) and percent area stenosis (36.6 ± 10.4% vs 44.4 ± 17.8%; p = 0.013), with comparable vascular healing indices. In the independent 3-month cohort, QCA and OCT findings were similar between groups. Exploratory histology in a limited subset suggested a larger lumen and lower percent area stenosis with LMDCB.

In this porcine coronary ISR model, LMDCB was associated with reduced neointimal proliferation and improved luminal dimensions at 1 month compared with a comparator paclitaxel-coated DCB, without impaired vascular healing. In a separate 3-month cohort, imaging findings were comparable between devices, while histology remained exploratory.

Digital health technologies increasingly support long-term stroke management and rehabilitation, but technophobia may hinder their acceptance and sustained use among older patients with stroke. Evidence in this population remains limited.

This study aimed to examine the level, associated factors, and subjective experiences of technophobia toward digital health technologies among older patients with stroke, and inform targeted interventions.

We used an explanatory sequential mixed methods design. In the quantitative phase, older patients with stroke were recruited by convenience sampling from a tertiary grade A hospital in Shanghai, China, between January 15, 2024, and January 2, 2025. Participants completed a general information questionnaire and the Chinese versions of the Technophobia Scale, the eHealth Literacy Scale, the Perceived Social Support Scale, and the Stroke Self-Efficacy Questionnaire. Univariable, correlation, and multivariable linear regression analyses were performed. Qualitative participants were purposively selected from the quantitative sample using maximum variation sampling informed by quantitative findings. Semistructured interviews conducted between February 6 and April 30, 2025, were analyzed using reflexive thematic analysis. Quantitative and qualitative findings were integrated to elucidate associated factors and their contextual manifestations.

Among 343 quantitative participants, the median technophobia score was 25.0 (IQR 22.0-33.0). Multivariable linear regression showed lower technophobia scores among patients with monthly per capita household income of Renminbi (Chinese yuan; RMB) 5000-6999 (RMB 1=US $0.14 as of January 29, 2026) versus less than RMB 1000 (B=-3.60, 95% CI -6.44 to -0.76; P=.01) and among occasional versus never users of digital health technologies (B=-3.98, 95% CI -6.94 to -1.03; P=.008). Higher eHealth literacy (B=-0.45, 95% CI -0.58 to -0.32; P<.001), perceived social support (B=-0.35, 95% CI -0.42 to -0.29; P<.001), and stroke self-efficacy (B=-0.08, 95% CI -0.13 to -0.02; P=.01) were also associated with lower technophobia scores. Fifteen qualitative participants were interviewed, yielding 4 themes: affordability of digital health technologies, adoption and proficiency in using digital health technologies, influence of social relationship networks, and resources for digital health technology competence. Integrated analysis indicated broad convergence and complementarity between the quantitative and qualitative findings.

Technophobia varied among older patients with stroke and was associated with monthly per capita household income, frequency of digital health technology use, eHealth literacy, perceived social support, and stroke self-efficacy. These findings suggest that technophobia is not limited to operational difficulties but may reflect the interplay of personal resources, social support, and technology use contexts. Stroke-specific digital health interventions may need to address eHealth literacy, stroke self-efficacy, social support, and user experience to promote acceptance and use among older patients with stroke.

Stroke is a leading cause of long-term disability worldwide. Persistent lower-extremity motor and somatosensory impairments after stroke commonly limit walking and balance despite rehabilitation. Virtual reality (VR)-integrated robotic rehabilitation may support structured, goal-directed ankle-foot practice; however, evidence for ankle-foot-focused sensorimotor protocols remains limited. In particular, approaches that combine robot-assisted motor training with plantar tactile localization and VR-supported joint position sense training to target plantar sensory and proprioceptive function are scarce.

This study aims to evaluate the effectiveness of a structured, VR-integrated, robot-assisted ankle-foot sensorimotor rehabilitation protocol compared with a content-matched manual training protocol in individuals with chronic stroke and to examine its effects on clinical and sensorimotor outcomes.

This is an assessor-blinded, 2-arm, parallel-group randomized controlled trial. Thirty individuals with chronic stroke will be randomized 1:1 to the robot-assisted training group or the manual training group. All participants will receive conventional rehabilitation. In addition, the robot-assisted training group will receive a structured robot-assisted ankle-foot training program integrated with VR and assist-as-needed control, whereas the manual training group will receive the same structured ankle-foot training protocol delivered manually by a physiotherapist. Interventions will be delivered 3 times per week for 6 weeks, for a total of 18 sessions. Total session duration will be time matched between groups at 50 to 60 minutes per session. The primary outcome will be the change in 10-meter walk test-derived walking speed from baseline to 6 weeks. The secondary outcomes will include 2-minute walk test distance, ankle range of motion, joint position sense, plantar tactile sensation, muscle tone, motor performance, static and dynamic balance, and stroke-specific quality of life.

This study is funded by the Scientific and Technological Research Council of Turkey (TÜBİTAK) under the 1002-A Rapid Support Program (grant 225S390). Recruitment began in March 2026 and is planned to continue until May 2027. As of March 25, 2026, four participants have been enrolled and are currently receiving the assigned intervention. Data analysis will begin once all enrolled participants have completed post-intervention assessments.

This trial will provide evidence on whether a structured robot-assisted ankle-foot sensorimotor training program offers additional benefit compared with a content-matched manual training protocol in individuals with chronic stroke. The findings may contribute to the development of standardized, individualized, and sensorimotor-oriented rehabilitation protocols for improving walking and balance after stroke.

Cardiovascular diseases remain the leading cause of mortality worldwide, with ischaemic heart disease the leading contributor and acute myocardial infarction accounting for the majority of ischaemic heart disease deaths. This study presents the development and technical validation of a low-cost, integrated wearable system for multi-parameter cardiorespiratory monitoring designed to support heart-attack detection algorithms. The system comprises two devices: a wristband incorporating a MAX30105 photoplethysmography sensor for cardiac pulse-wave and SpO[Formula: see text] acquisition, and a chest band featuring novel optical respiratory detection and an MPU6050 inertial measurement unit for respiratory rate and movement monitoring. Both devices use ESP32-C3 microcontrollers with Bluetooth Low Energy connectivity to a custom mobile application enabling real-time visualization and cloud-based storage. Validation was conducted against clinical-grade reference equipment (ADInstruments physiograph and EDAN iM8 monitor) in 43 healthy volunteers, yielding 50 acquisitions: 30 at rest and 20 post-physical activity. This is a technical feasibility study in healthy young volunteers; validation in clinical populations remains future work. Heart rate showed the closest agreement with the reference (percentage error ±1.94%, [Formula: see text] post-activity; limits of agreement [Formula: see text] to 4.21 BPM), followed by respiratory rate (±3.47%, [Formula: see text]). SpO[Formula: see text] error remained within tolerance (1.64% at rest, 2.98% post-activity) but showed weak correlation with the reference owing to range restriction in a healthy cohort, and is not yet suitable for applications requiring absolute saturation values. This study demonstrates that a low-cost, multi-sensor wearable system can achieve accuracy meeting the prespecified feasibility criterion ([Formula: see text]5% error) in a healthy young cohort, establishing technical feasibility as a prerequisite to validation in the cardiovascular patient populations for which the system is ultimately intended.

To compare and rank the efficacy of brain-computer interface-coupled robotic rehabilitation (BCI-robot), robot-assisted therapy, motor imagery (MI), and conventional rehabilitation for upper-limb recovery after stroke, and to explore whether treatment effects differed according to key clinical and intervention-related characteristics.

A systematic search was conducted in 11 databases from inception to March 31, 2026. Randomized controlled trials enrolling adults with post-stroke upper-limb motor impairment were included. The primary outcome was the Fugl-Meyer Assessment of Upper Extremity (FMA-UE). Secondary outcomes included the Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), and Modified Barthel Index (MBI). Direct pairwise meta-analyses were performed using mean differences (MDs) with 95% confidence intervals (CIs), and a frequentist network meta-analysis was conducted to synthesize direct and indirect evidence and rank interventions using P-scores.

Twenty-three reports representing 22 independent study cohorts were included, comprising 727 participants. Network meta-analysis showed no significant inconsistency, and the consistency model was adopted. BCI-robot ranked highest for improving FMA-UE according to the P-score analysis (P-score = 0.992), followed by robot-assisted therapy (0.641), MI (0.240), and conventional rehabilitation (0.127). In direct comparisons, BCI-robot produced a statistically significant improvement in FMA-UE versus conventional rehabilitation (MD = 6.80, 95% CI 4.29 to 9.30). The point estimate exceeded the 5.25-point (minimal clinically important difference) MCID, although the lower confidence limit did not. Compared with robot-assisted therapy, BCI-robot showed a statistically significant but small improvement (MD = 2.04, 95% CI 0.29 to 3.78), with both the point estimate and the entire 95% CI remaining below the MCID. Follow-up-duration subgroup analyses suggested that BCI-robot remained favorable over conventional rehabilitation in both < 3-month and ≥ 3-month subgroups, whereas no significant follow-up advantage over robot-assisted therapy was observed. For secondary outcomes, BCI-robot significantly improved WMFT versus conventional rehabilitation (MD = 8.94, 95% CI 5.22 to 12.65) and MBI versus conventional rehabilitation (MD = 3.37, 95% CI 0.10 to 6.63). A significant benefit for MBI versus robot was also observed (MD = 8.61, 95% CI 1.76 to 15.46), although this result was not robust in sensitivity analysis. No significant advantage was found for ARAT. Exploratory subgroup analyses suggested that, compared with robot-assisted therapy, the additional benefit of BCI-robot was more apparent in studies delivering more than four sessions per week.

BCI-robot ranked highest for improving FMA-UE and may provide a clinically important benefit over conventional rehabilitation, although the magnitude remains uncertain. Its additional benefit over robot-assisted therapy was small and unlikely to be clinically important. Evidence for longer-term effects and for activity-level and daily-function outcomes remains limited, and the findings should be interpreted cautiously.

Hereditary angioedema (HAE) is a rare disease characterized by recurrent swelling episodes that may affect sleep and quality of life. Because data on sleep disorders in Latin American patients with HAE are limited, we assessed their prevalence and clinical correlates using structured sleep and HAE patient-reported outcome measures.

To assess the prevalence/impact of sleep disorders in HAE patients using validated tools.

This cross-sectional, multicenter online survey included adult patients (> = 18 years) with clinician-confirmed HAE from 13 reference centers in five Latin American countries. Data were collected between August and December 2023. Sleep was assessed using the Global Sleep Assessment Questionnaire (GSAQ), SATED scale, and STOP-Bang; HAE was assessed using the Hereditary Angioedema Activity Score (HAE-AS), Angioedema Control Test (AECT), and Angioedema Quality of Life questionnaire (AE-QoL). Logistic regression models were adjusted for age, sex, and BMI.

The final analytic sample included 139 participants. Most patients had HAE-C1INH type 1 (64.0%) and were female (68.4%). Only 6.5% had good sleep health, and the mean SATED score was 5.46 (1.87). Insomnia was reported by 54.0% of participants, and 34.5% had STOP-Bang moderate-to-high OSA risk. In age-, sex-, and BMI-adjusted models, severe HAE activity was associated with higher odds of insomnia (OR = 2.62, 95% CI: 1.28-5.35, P = 0.008), RLS/PLMD (OR = 5.85, 95% CI: 1.59-21.62, P = 0.008), and STOP-Bang moderate-to-high OSA risk (OR = 2.37, 95% CI: 1.01-5.55, P = 0.047). Higher AE-QoL fatigue/mood and fears/shame scores were associated with several sleep outcomes. AECT control status did not show a consistent independent association after simultaneous adjustment.

In this exploratory cross-sectional study, HAE activity and quality-of-life impairment were associated with several sleep outcomes. Targeted sleep screening may be useful in HAE care pathways if these associations are confirmed in prospective studies.

Post-haemorrhagic ventricular dilatation (PHVD) is a severe complication of germinal matrix-intraventricular haemorrhage in preterm infants and is associated with significant morbidity and adverse neurodevelopmental outcomes. In 2023, national recommendations for PHVD management were revised, but implementation has not been evaluated. We aimed to assess diagnostic and therapeutic practices across Dutch neonatal intensive care units (NICUs), quantify inter-centre variation, and provide a basis for a national PHVD registry.

A nationwide, cross-sectional survey was disseminated among representatives from nine Dutch NICUs and seven affiliated paediatric neurosurgical departments. Per centre, one paediatrician and paediatric neurosurgeon reported institutional practices regarding monitoring, cerebrospinal fluid (CSF) drainage thresholds, temporising interventions, permanent CSF diversion criteria, follow-up, and research priorities. Practices were compared to the Dutch guideline.

All NICUs and neurosurgical centres responded. PHVD case volume varied (< 5 patients/year in 3/9 centres; > 20 in 1/9). Diagnostic thresholds were ventricular index > 97th percentile and anterior horn width > 6 mm in 7/9 centres, with higher or additional criteria in 2/9. Initial temporising management consisted of serial lumbar punctures and ventricular access device (VAD) placement. VAD tap duration before permanent diversion was typically 4-6 weeks (6/7). Ventriculoperitoneal shunting was the preferred permanent intervention in all centres, with weight thresholds of 2.0-2.5 kg.

Following implementation of a national guideline, PHVD management in Dutch NICUs demonstrates high consistency in core diagnostics and treatment principles, showing that national standardisation of PHVD care is feasible. Residual variation is concentrated in areas where evidence remains limited, identifying priorities for future collaborative research.