The engagement of youth in the design of services that promote and increase the uptake of essential services to reduce HIV and other sexually transmitted infections is vital to sustaining these preventive services. The study objective is to identify strategies for sustaining HIV prevention services among Nigerian youth, in partnership with community-based organizations, through a crowdsourced open call and designathon in Nigeria.

From February to March 2024, Nigerian youth (ages 14-24) submitted ideas to an open crowdsourcing call on how community-based organizations in Nigeria might sustain HIV self-testing and youth-friendly preventive services for at-risk youth. The submissions were scored in each domain: relevance, novelty, scalability, replicability, potential for sustainability, and promotion of equity and fairness, with an integer score of 1 (low) to 3 (high)(S1). Ten teams were selected to participate in the 72-hour designathon. Both quantitative and qualitative analysis was conducted. The study used thematic analysis and the PEN 3-Cultural Model to categorize qualitative data into six themes. Descriptive statistics were used to calculate participants' demographic characteristics.

One hundred and seventy-eight participants submitted entries; 161 were online entries, and 17 were received via WhatsApp. The majority of participants were female (57.1%) and aged 19-23 years (55.0%), with a mean age of 21.7 (±4.1). Most participants were from the southwest of Nigeria (53.8%), had secondary education (68.9%), and were students (67.9%). About one-third of teams (31.1%) indicated collaborating with non-governmental organizations as a promising way to sustain preventive services. Six themes emerged: Adapted Intervention Design and Delivery, Youth Engagement and Education, Organization Setting, Socio-cultural and Community Context, Community Leadership Through Training and Financial Resources, and Sustainment Through Community Collaboration.

The crowdsourcing contest open call and designathon engaged youth from diverse backgrounds, and it is a practical way to generate solutions from key stakeholders affected by the community's prevailing health issues. Developing service delivery strategies that engage, educate, and collaborate with youth on HIV prevention could be sustainable. However, this will not be conclusive without implementing them over time to test their feasibility and sustainability.

BACKGROUND Coronary artery embolism (CAE) is an infrequent but clinically significant non-atherosclerotic cause of ST-elevation myocardial infarction (STEMI). It presents unique diagnostic and therapeutic challenges due to its varied etiologies and the frequent absence of significant coronary artery disease. While atrial fibrillation is the most recognized cardiac arrhythmia associated with coronary embolism, atrial flutter as an embolic source remains underreported. This report highlights the complexities of diagnosing and managing CAE manifesting as an atypical STEMI and sudden cardiac arrest in a patient with previously undiagnosed atrial flutter, emphasizing the critical importance of identifying underlying embolic sources, particularly atrial flutter, to guide appropriate therapy. CASE REPORT An 82-year-old woman with non-ischemic cardiomyopathy presented after an out-of-hospital ventricular fibrillation cardiac arrest. Her post-resuscitation electrocardiogram revealed an inferior STEMI. Emergency coronary angiography demonstrated abrupt embolic occlusions in the distal right coronary artery, without evidence of significant underlying atherosclerosis. Percutaneous coronary intervention was performed to restore blood flow. After the procedure, telemetry revealed new-onset atrial flutter, the presumed embolic source. Her hospital course was complicated by severe global hypokinesis out of proportion to the infarct territory and progressive respiratory failure, ultimately leading to a family decision to transition to comfort care. CONCLUSIONS This case underscores the critical need to consider coronary artery embolism in the differential diagnosis for STEMI, particularly in patients lacking significant atherosclerotic disease burden. The presence of arrhythmias, such as atrial flutter, should raise strong clinical suspicion for an embolic etiology. While a good outcome was not achieved in this specific case, early recognition of CAE remains crucial for guiding appropriate revascularization strategies and initiating prompt anticoagulation to prevent recurrent thromboembolic events in surviving patients.

Cell migration plays a critical role in various physiological and pathological processes, particularly in the development and repair of cardiac diseases. It is a complex, multi-step process involving different mechanisms and cell types. This review summarizes the roles of cardiac cell migration in cardiac immune responses, myocardial regeneration, and chronic inflammation. Specifically, we explore how cardiac cells promote repair and regeneration following myocardial injury through migration. In addition, the article reviews the impact of cell migration on processes such as angiogenesis and fibrosis, which are crucial for myocardial repair and pathological states. Due to the complexity of intercellular interactions, signaling pathways, and microenvironmental factors, understanding cardiac cell migration remains a significant challenge. Further research into these migratory mechanisms will help uncover their pathological roles in cardiac diseases and provide new therapeutic approaches for cardiac repair and regeneration. This review also highlights the migratory mechanisms of major cardiac cell types and examines the regulatory roles of chemokines in these processes. Furthermore, we discuss how cardiac cells engage in localized migration under different disease conditions, thereby contributing to the heart's self-repair.

The cardioprotective potential of Hymenaea rubriflora Ducke's stem bark hydroalcoholic extract (HR-HAc) has not yet been investigated. This study aimed to quantify HR-HAc's antioxidant capacity and evaluate its effects on blood pressure (BP) and vascular reactivity in spontaneously hypertensive rats (SHR).

SHR and normotensive Wistar Kyoto (WKY) rats received intravenous HR-HAc (2.5-60 mg/kg). Mean arterial pressure (MAP) and heart rate (HR) were measured with or without atropine and propranolol. Isolated aortas from SHR and WKY rats were exposed to HR-HAc (0.1-729 μg/ml), with or without endothelium and K+ channel blockers. Phenolic content and antioxidant activity were quantified using standard colorimetric and chromatographic methods.

In SHR rats, HR-HAc produced dose-dependent hypotension and bradycardia. MAP reduction in WKY rats was similar, while HR was unaffected. Atropine significantly attenuated HR-HAc-induced reductions in MAP and HR in SHR rats. HR-HAc induced potent endothelium-independent relaxation in SHR rat aortas, which was significantly reduced by tetraethylammonium or 4-aminopyridine. In WKY rats, vasorelaxant effects were endothelium-dependent.

HR-HAc lowers MAP and induces bradycardia in SHR via muscarinic receptors, while also promoting vasodilation through activation of voltage- and calcium-activated K+ channels. These distinct mechanisms highlight HR-HAc as a promising preclinical antihypertensive candidate.

Aortic aneurysms, including thoracic aortic aneurysms (TAA) and abdominal aortic aneurysms (AAA), represent a group of severe vascular lesions with insidious onset and high mortality. Currently, effective diagnostic markers and pharmacological interventions remain lacking in clinical practice. Extracellular vesicles (EVs), as key mediators of intercellular communication, have attracted increasing attention in the research on aortic aneurysms due to their high content of bioactive molecules, favorable biocompatibility, low immunogenicity, and inherent targeting capacity. This review systematically elaborated on the research progress on EVs in TAA and AAA, highlighting their significant role in the development and progression of aortic aneurysms. EVs play a crucial role by mediating core pathological processes, including endothelial dysfunction, phenotypic transformation of vascular smooth muscle cells, inflammatory immune responses, and extracellular matrix remodeling. Additionally, this review discussed the potential of disease-specific molecules carried by EVs as novel liquid biopsy markers for the early diagnosis of aortic aneurysms. Furthermore, this review evaluated the application prospects of EVs as natural drug delivery platforms and EV-based therapeutic strategies for aortic aneurysm through engineering modifications (such as targeting peptide modification and biomaterial integration). In particular, "cell-free" immunomodulatory therapies, which enhance targeting capacity to lesion sites through engineering modifications and focus strategically on regulating the phenotype and function of key immune cells (such as macrophages), are increasingly emerging as a cutting-edge direction with the greatest translational potential in this field. Despite challenges such as targeted delivery, the integration of engineering technologies with nanomedicine holds promise for opening new avenues for the precise prevention and treatment of aortic aneurysms through EV-based integrated diagnostic and therapeutic strategies.

Artificial intelligence (AI) is entering the study of hypertension, serving both primarily clinical purposes - to assist practicing physicians - and research objectives. Hypertension presents certain specific characteristics that should be carefully considered when using AI. The measured value of blood pressure is an extremely variable parameter that is difficult to standardize and measure with precision. At present, AI is able to provide very simple, clear, and well-documented answers to clinical questions regarding the management of patients with hypertension. Its role in research is perhaps somewhat less well developed. Several studies have been published on the use of AI in identifying patients with secondary hypertension, on the risk of future hypertension in normotensive individuals, and on the risk of heart failure and other complications of hypertension. A common issue with all these studies is the relative paucity of controlled clinical trials comparing AI with traditional procedures drawing on medical literature and clinical experience ("natural intelligence"), precisely designed to quantify the potential superiority of AI over natural intelligence on key end-points of real clinical value. This is similar to the approach currently taken when testing a new diagnostic or therapeutic procedure. Obviously, these considerations should be viewed as encouragement, not as a barrier, to continuing clinical research in the field of AI in hypertension. It is also important that scientific articles on AI published in medical journals be written using terms that doctors can understand, to ensure transparency and interpretability.

Accidental hypothermia is an underdiagnosed condition with a significant impact on public health. With the aim of providing the basis for a comprehensive care framework, 12 panelists from 3 Spanish scientific societies (SEDAR, SEMES and SEMICYUC) developed this multidisciplinary consensus document. Through a systematic search and the final synthesis of 281 articles including 1,704,632 patients, 37 recommendations were developed through a 2-round Delphi process, distributed across 8 application domains based on the organization of a rescue chain: prehospital prevention, initial evaluation, management and transport, hospital detection, care of the polytraumatized patient, hospital rewarming, cardiac arrest, and resuscitation. Robust consensus among panelists (>75% agreement) and excellent internal consistency (ω = 0.913) were achieved, providing a solid document that may serve as a basis for the implementation of standardized protocols.

Danon disease (DD) is a rare X-linked dominant lysosomal storage disorder caused by mutations in the LAMP2 gene. It is typically characterized by a triad of intellectual disability, skeletal myopathy, and cardiomyopathy. Due to the X-linked inheritance pattern, males often present with more severe manifestations. We report an atypical presentation of DD in a young male with isolated cardiomyopathy, incidentally diagnosed during evaluation of an abnormal electrocardiogram showing a pseudo-left bundle branch block in the setting of a Wolff-Parkinson-White pattern. Further workup revealed heart failure with reduced ejection fraction on echocardiography, and cardiac MRI demonstrated late gadolinium enhancement of the left ventricular walls with sparing of the basal septum. Genetic testing confirmed the diagnosis of DD. The patient was managed with guideline-directed medical therapy and received an implantable cardioverter-defibrillator for primary prevention of arrhythmia. He ultimately underwent heart transplantation with a satisfactory clinical outcome. This case underscores the importance of maintaining a high index of suspicion and pursuing comprehensive cardiac and genetic evaluation in young patients with unexplained cardiomyopathy, as early diagnosis of underlying conditions like DD can enable timely and potentially life-saving interventions.

Lactococcus garvieae bloodstream infection in a woman in Germany resulted in spondylodiscitis and bioprosthetic mitral valve endocarditis. Six weeks of ceftriaxone followed by 10 days of doxycycline led to sustained clinical and microbiological resolution. This case highlights the need for thorough diagnostic testing and individualized, shared decision-making in infective endocarditis cases.

Hypertension serves as a pivotal risk factor for myocardial ischemia reperfusion injury (MIRI). Reciprocally, MIRI exacerbates hypertension by inducing oxidative stress, inflammatory responses, cardiomyocyte death, fibrosis-associated myocardial remodeling, and RAAS system disruption, forming a vicious feedback cycle. This study aimed to investigate the regulatory role and underlying molecular mechanism of the lactate-related signaling axis in cardiomyocyte ferroptosis during MIRI, and to identify novel potential therapeutic targets for interrupting this detrimental feedback loop.

In vivo mouse MIRI models, in vitro cardiomyocyte oxygen‒glucose deprivation/reoxygenation (OGD/R) models, and spontaneously hypertensive rat (SHR) models were successfully established. Oxaloacetate and β-alanine were administered to inhibit lactate production and protein lactylation, respectively. Hematoxylin‒eosin (HE) and Masson staining were performed to evaluate myocardial histopathological damage and fibrosis. Immunohistochemistry (IHC) and Western blotting were used to detect the protein expression levels of lysine lactylation (Kla), H3K18la, alanyl-tRNA synthetase 1 (AARS1), and acyl-CoA synthetase long-chain family member 4 (ACSL4). An enzyme-linked immunosorbent assay (ELISA) was adopted to quantify the lactate content and ferroptosis-related marker levels. Transmission electron microscopy (TEM), immunofluorescence staining, and chromatin immunoprecipitation (ChIP) assays were separately utilized to observe the mitochondrial ultrastructure, assess cellular lipid peroxidation, and verify gene promoter enrichment.

Lactate, Kla, and H3K18la levels were markedly elevated in the MIRI and OGD/R models, accompanied by severe myocardial injury, fibrosis, and excessive cardiomyocyte ferroptosis. Inhibition of lactate production effectively reduced lactylation levels and mitigated ferroptosis as well as myocardial structural damage. Mechanistically, H3K18la was enriched in the promoter region of ACSL4 to facilitate its transcriptional activation, and knockdown of ACSL4 markedly reversed OGD/R-triggered cardiomyocyte ferroptosis. AARS1 overexpression strengthened lactylation and ACSL4 expression to promote ferroptosis, while its mutant did not. Notably, hypertension aggravated MIRI, promotes further increases in the level of histone lactylation mediated by AARS1, and exacerbates ferroptosis. Pharmacological intervention with β-alanine blocked the lactate/AARS1/H3K18la/ACSL4 axis and attenuated MIRI-induced myocardial damage.

Abnormal lactate accumulation facilitates H3K18la modification via AARS1-dependent regulation, which transcriptionally activates ACSL4 and modulates cardiomyocyte ferroptosis, ultimately contributing to the pathological progression of MIRI. Targeting the lactate/AARS1/H3K18la/ACSL4 regulatory axis is a promising and viable therapeutic strategy for MIRI intervention.