MAFLD-previously termed NAFLD-has emerged as the most common condition on a global scale. Obesity, insulin resistance, dyslipidemia, and atherosclerosis are closely linked to its pathogenesis. Lipid dysregulation, insulin resistance, and inflammatory status are reflected by the atherogenic index of plasma (AIP), computed as the logarithmic ratio of triglycerides to HDL-C. Although multiple studies have suggested an association between AIP and MAFLD/NAFLD, the reported findings remain inconsistent. The present investigation sought to synthesize available evidence regarding the AIP-MAFLD/NAFLD relationship and to appraise the diagnostic accuracy of AIP.

This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 statement. PubMed, Embase, the Cochrane Library, and Web of Science were searched through October 2025. Fixed- or random-effects models were applied according to heterogeneity. Weighted mean difference (WMD) and pooled odds ratios (ORs) were calculated. Diagnostic performance was evaluated using a bivariate random-effects model to obtain pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curves. Subgroup analyses were performed by diagnostic criteria, age, diabetes status, BMI, and region. Meta-regression explored the influence of demographic and metabolic covariates. Sensitivity analyses and publication bias assessment using Egger regression and Deeks' asymmetry test were also conducted.

Twenty observational studies involving 245,571 adults were included. AIP levels were significantly higher in MAFLD/NAFLD patients than in controls (WMD = 0.26; 95% CI: 0.21-0.30). Elevated AIP was significantly associated with MAFLD/NAFLD risk (pooled odds ratio = 3.18; 95% CI: 2.54-3.98). Subgroup analyses demonstrated greater consistency in studies using MAFLD diagnostic criteria and among obese populations. Diagnostic meta-analysis using a bivariate random-effects model yielded a pooled sensitivity of 0.73 and specificity of 0.65, with a summary AUC of 0.75 (95% CI: 0.71-0.79), indicating moderate diagnostic accuracy. Sensitivity analyses confirmed robustness, and no significant publication bias was detected.

Elevated AIP is significantly associated with increased MAFLD/NAFLD risk and shows moderate diagnostic performance. As a simple and cost-effective index derived from routine lipid profiles, AIP may serve as a useful early screening tool for individuals at elevated risk of fatty liver disease and cardiometabolic comorbidities. Further prospective studies are warranted to clarify causality and clinical utility.

https://www.crd.york.ac.uk/PROSPERO/home, identifier CRD42025116919.

Primary aldosteronism (PA) is a common yet still underdiagnosed cause of secondary hypertension (HTN). We report two cases illustrating the variability of its clinical presentation: one revealed by left ventricular hypertrophy, the other by refractory hypertension. These observations highlight the importance of a structured diagnostic approach to determine the PA subtype and tailor management accordingly. Early diagnosis improves blood pressure control, corrects electrolyte disturbances, and prevents aldosterone-related visceral complications. These findings also support the need for more systematic screening of this common yet often overlooked condition.

Reishi (Ganoderma lucidum) is known to enhance intestinal immunity, with ganoderic acid A (GA-A) identified as one of its active constituents. However, the specific role of GA-A in regulating immune components such as immunoglobulin A (IgA) from Peyer's patches (PPs) and α-defensin 5 from Paneth cells remains unclear. Additionally, the ability of Reishi to counteract oxidative stress-induced intestinal immune suppression has not been fully elucidated. Therefore, in this study, we aimed to examine the effects of Reishi and GA-A on intestinal immunity in a rat model of ischemia-reperfusion (I/R) injury. Oral administration of GA-A increased IgA secretion from PP cells isolated from rat small intestine and upregulated the mRNA expression of rat α-defensin 5 (RD-5) and toll-like receptor 4 (TLR4) in the ileum, similar to Reishi. In contrast, GA-A did not exhibit immunostimulatory effects in TLR4-deficient mice. In the I/R rat model, both Reishi and GA-A significantly restored IgA secretion and RD-5 mRNA expression, mitigating immune suppression. They were also associated with changes in superoxide dismutase 1 (SOD1) and SOD3 mRNA expression under I/R conditions and prevented villus shedding and Paneth cell loss, indicating protection against I/R-induced intestinal immune decline. These results were comparable to those observed with caffeic acid, the positive control. Overall, these findings suggest that Reishi mitigates intestinal immune suppression caused by I/R injury, with GA-A serving as a key active component mediating these protective effects.

Cardiovascular diseases (CVDs) remain a leading cause of global morbidity and mortality. Traditional Chinese Medicine (TCM) offers a rich source of bioactive compounds with demonstrated efficacy in CVD management through multi-target mechanisms, including modulation of oxidative stress, inflammation, apoptosis, and autophagy. However, the clinical application of TCM is often hampered by inherent pharmaceutical challenges such as poor solubility, low bioavailability, and non-specific targeting. The emergence of nanoparticle (NP)-based delivery systems presents a transformative strategy to overcome these limitations.

This review comprehensively summarizes recent advances in various NP platforms, including lipid-based, polymeric, inorganic, and biomimetic nanocarriers, for the efficient and targeted delivery of TCM active ingredients in the treatment of CVDs.

A systematic discussion is conducted on how these engineered nanocarriers enhance the stability, bioavailability, and targeted accumulation of TCM compounds at pathological sites, thereby amplifying their therapeutic effects while minimizing off-target toxicity.

Nanoparticle-based delivery systems significantly improve the pharmacokinetic and biodistribution profiles of TCM-derived compounds. These platforms enable enhanced therapeutic outcomes in CVD models through improved targeting and reduced systemic side effects.

Despite these promising advances, significant challenges remain that hinder clinical translation, including the inherent complexity of multi-component TCM formulations, unresolved nanosafety concerns, lack of standardization in both herbal extracts and nano-formulations, and substantial hurdles in industrial scalability and regulatory approval. By integrating the holistic principles of TCM with the precision of nanotechnology, this evolving field holds immense promise for developing next-generation, targeted therapeutics for cardiovascular diseases, bridging the gap between traditional medicine and modern drug delivery paradigms.

Electroconvulsive therapy (ECT) is an established intervention for severe or treatment-resistant psychiatric illnesses, including depression, schizophrenia, mania and catatonia. Despite its efficacy, concerns over its risks have contributed to ongoing stigma and hesitancy regarding its use. Traditional clinical trials have demonstrated the superiority of ECT in symptom reduction compared with other treatments, yet are impractical for assessing rare or long-term outcomes. Observational studies using administrative health data can assess rare or long-term outcomes, but are limited by confounding/bias. This review synthesises evidence from studies utilising administrative health data and modern statistical methods to address clinically relevant questions about ECT's association with (a) dementia, (b) major adverse cardiovascular/cerebrovascular events, (c) suicide deaths and (d) all-cause mortality. Most studies indicate that, after adjusting for confounding, ECT does not increase the risk of dementia or major adverse cardiovascular/cerebrovascular events. Furthermore, ECT is likely associated with a substantial reduction in suicide mortality and all-cause mortality. Although observational studies cannot fully eliminate unmeasured confounding, the consistency of the findings from diverse investigators and congruence with clinical trials and neuroimaging studies lends support to their validity. These modern observational studies have yielded results that reinforce ECT's safety and efficacy supporting its position as a life-saving treatment.

Apelin is a recently identified adipokine with pleiotropic actions in cardiovascular regulation, metabolic homeostasis, bone remodeling, and reproductive physiology. Through binding to the apelin receptor (APJ), apelin has been shown to influence gonadotropin-releasing hormone (GnRH) secretion, which is essential for the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Given its potential role in the hypothalamic-pituitary-gonadal (HPG) axis, alterations in circulating apelin may contribute to hypogonadotropic hypogonadism (HH). This study aimed to investigate whether serum apelin concentrations are altered in patients with HH and to evaluate its potential relevance as a complementary biomarker in the diagnostic approach to HH.

A total of 60 participants were enrolled: 30 newly diagnosed HH patients (untreated for at least one year, with no comorbid chronic diseases) and 30 age- and body mass index (BMI)-matched healthy controls. Individuals with BMI<20 or BMI>30 were excluded to minimize confounding metabolic influences on apelin secretion. Following overnight fasting, venous blood samples were obtained for complete biochemical and hormonal profiles. Serum apelin levels were measured using a validated human ELISA kit (SunRed Biotechnology, China; intra- and inter-assay coefficients of variation<10%). Statistical analysis was performed using SPSS 17.0.

Apelin concentrations were significantly lower in HH patients compared with healthy controls (median 35.2ng/L vs. 63.3ng/L, p=0.046). ROC analysis yielded an area under the curve (AUC) of 0.65, with a sensitivity of 76% and a specificity of 64%.

These findings demonstrate reduced circulating apelin concentrations in HH, supporting the hypothesis of its involvement in GnRH regulation and the pathogenesis of hypogonadism. Although its diagnostic accuracy is modest, apelin may complement traditional hormonal markers. Further multicenter studies and mechanistic research are required to validate these observations.

Early-career researchers (ECRs) play a vital role in scientific progress; however, academic environments and personal characteristics may influence their mental health and capacity to work. This study explored factors associated with mental health among ECRs in dementia research (ECDRs).

We analyzed data from an international cross-sectional survey of 283 ECDRs using a logistic regression to examine associations between demographic, work-related, and psychosocial factors and self-reported mental health conditions. Gender interactions were tested, and significant variables were included in a multivariable model.

In this sample, imposter syndrome (odds ratio [OR] = 13.04), financial problems (OR = 3.08), being aged 25 to 34 years (OR = 3.69), and identifying as non-heterosexual (OR = 4.10) were significantly associated with higher odds of reporting a mental health condition. No significant gender interactions were identified.

Mental health among ECDRs appears particularly affected by imposter syndrome, financial strain, age, and sexual orientation. Targeted support addressing these factors may help sustain the dementia research workforce.