To evaluate the contribution of health anxiety, mental defeat and fear of recurrence and progression (FRP) as variables in the adjustment process following cardiac events and subsequent wellbeing, adjustment and rehabilitation.

A two-part study was conducted: cross-sectionally examining psychological factors shortly following a cardiac event and longitudinally examining how these variables were associated with adherence and physical/psychological outcomes of cardiac rehabilitation.

A UK-based sample of post-cardiac event patients (N = 176, M_age = 66.1, SD = 10.0) was categorized as high health anxiety with depression and/or anxiety, depression or anxiety only, or neither health anxiety nor depression/anxiety. Mental defeat and FRP were compared across groups pre-rehabilitation and examined in relation to adherence to, and outcomes of, an 8-session cardiac rehabilitation programme.

Analyses indicated significantly higher mental defeat and FRP in those with health anxiety than in the other groups. However, regression analyses showed that neither health anxiety, mental defeat, nor FRP was significantly associated with rehabilitation adherence or outcomes.

This study identified mental defeat and FRP as important factors in health-anxious cardiac patients, with implications for the coping and adjustment process and rehabilitative efforts. No linear association between these variables and rehabilitation adherence and outcomes was found, suggesting that more nuanced approaches to identifying their impact on rehabilitation may require development.

Atherosclerotic cardiovascular diseases (ASCVDs) are a leading cause of mortality globally and in the United Arab Emirates. Despite regional studies on the ASCVD risk, no prior study has assessed the ASCVD risk within the academic community of the University of Sharjah. This study aimed to estimate the 10-year predicted ASCVD risk among university employees aged ≥40 years and to identify associated lifestyle risk factors.

 In this cross-sectional study, a stratified random sample of 124 employees aged 40 or older without a prior history of ASCVD was enrolled. The primary outcome was the 10-year ASCVD risk score calculated using the Mayo Clinic ASCVD risk calculator (Mayo Clinic, Rochester, MN). Data were analyzed using IBM Statistical Package for the Social Sciences Statistics version 22.0 (IBM Corp., Armonk, NY). Associations between ASCVD risk scores and lifestyle factors were assessed using Mann-Whitney U and Kruskal-Wallis tests, with statistical significance set at p < 0.05.

Among the 124 participants included in the study (59.7% male and 40.3% female participants), the mean 10-year predicted ASCVD risk was classified as high at 37.16% (standard deviation ± 17.47). ASCVD risk scores were significantly higher among smokers compared with nonsmokers (48.6% vs. 32.7%, p < 0.001) and similarly elevated among participants with diabetes compared with nondiabetics (55.1% vs. 33.9%, p < 0.001). Physical activity level was also significantly associated with ASCVD risk (p = 0.009), while fruit and vegetable intake, saturated fat intake, daily sitting duration, and working hours showed no significant association (p > 0.05).

Employees aged ≥40 years at the University of Sharjah demonstrate a markedly high predicted 10-year ASCVD risk. Smoking, diabetes, and physical inactivity were identified as key modifiable risk factors associated with higher predicted ASCVD risk. These findings underscore an urgent need for targeted workplace health promotion interventions to reduce cardiovascular risk in this population.

Stroke remains a major cause of disability and death. While central adiposity may contribute to vascular risk, the role of the body roundness index (BRI) (a waist-height-derived anthropometric indicator) in community screening populations is not well defined. We therefore investigated the association between BRI and prevalent stroke in a community-based screening sample.

Using data from a ChinaHEART cohort branch (6,858 adults), BRI was calculated from anthropometric measurements. Prevalent stroke was ascertained by self-reported physician diagnosis. Receiver operating characteristic (ROC) analysis was used to determine the optimal BRI cutoff. Logistic regression, adjusted for age, sex, marital status, smoking, alcohol use, hypertension, diabetes, blood pressure, fasting glucose, and lipid parameters, was performed to examine the association between BRI and prevalent stroke. Restricted cubic spline (RCS) analysis and subgroup/interaction analyses were further conducted.

Among 6,858 participants, 192 (2.8%) reported prior stroke. The bootstrap-derived BRI cutoff was 4.597 (95% CI 4.149-4.798). High BRI (≥4.6) was associated with higher odds of prevalent stroke in the fully adjusted model (OR 1.766, 95% CI 1.279-2.438). BRI alone showed limited discrimination (AUC 0.584), while multivariable models achieved higher AUC (0.740 in the fully adjusted model). Adding BRI produced ΔAUC increases. RCS showed no evidence of nonlinearity.

Our findings support BRI as a simple, non-invasive anthropometric measure that may offer complementary discriminatory information for community screening/triage; prospective studies with validated outcomes are warranted to confirm clinical utility.

Residual kidney risk persists in hypertensive patients despite guideline-directed blood pressure (BP) management. Whether systemic inflammation is preferentially associated with the development of distinct early chronic kidney disease (CKD) phenotypes remains uncertain.

This retrospective cohort study included 5,904 hypertensive patients with preserved baseline kidney function. The primary exposure was the C-reactive protein-to-lymphocyte ratio (CLR). Outcomes assessed were incident proteinuric CKD, isolated estimated glomerular filtration rate (eGFR) decline, and any incident CKD. Phenotype-specific associations were evaluated using multivariable cause-specific Cox models. We additionally assessed the additive interaction between CLR and BP control, and evaluated the incremental predictive value of CLR beyond traditional risk factors.

During a median follow-up of 34.1 months, 598 participants developed proteinuric CKD, 89 developed isolated eGFR decline, and 728 developed any incident CKD. Higher CLR was independently associated with proteinuric CKD (per 1-SD: HR 1.14, 95% CI 1.05-1.24; highest vs lowest quartile: HR 1.46, 95% CI 1.15-1.85) and any incident CKD (per 1-SD: HR 1.13, 95% CI 1.05-1.22), but not with isolated eGFR decline (per 1-SD: HR 1.05, 95% CI 0.85-1.29). A significant additive interaction emerged between high CLR and uncontrolled BP (RERI 0.30), synergistically amplifying renal risk. Adding CLR to traditional risk models significantly improved risk reclassification (NRI 0.083, P = 0.008).

In hypertensive patients, elevated CLR preferentially predicts new-onset proteinuria over isolated eGFR decline. As an accessible biomarker for renal risk stratification, CLR can identify patients requiring vigilant proteinuria surveillance and comprehensive management, particularly those with uncontrolled BP.

Community screening programs increasingly use World Health Organization (WHO) cardiovascular disease (CVD) risk charts to identify individuals at high predicted 10-year risk. The atherogenic index of plasma (AIP), derived from triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C), may capture atherogenic dyslipidemia and support pragmatic risk stratification.

We conducted a cross-sectional analysis of baseline data from the China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) community screening program in Luohe, China. Among 6,860 screened participants, 6,702 with complete data for AIP computation, WHO risk classification, and prespecified covariates were included. The outcome was the WHO CVD risk chart-defined predicted 10-year CVD high-risk category (high risk: ≥20%), rather than adjudicated or incident CVD events. AIP was calculated as log10(TG [mmol/L]/HDL-C [mmol/L]) and modeled as both a continuous and categorical exposure; spline models tested nonlinearity, and ROC analyses evaluated discrimination and derived a Youden-index cutoff. In addition, we performed an explainable machine-learning pipeline for CVD high-risk prediction using LASSO logistic regression for feature selection (AIP forced-in), followed by a random forest classifier and SHAP-based interpretation.

Of 6,860 screened participants, 6,702 were included in the analytic sample (median age 58 years; 38% men). The WHO CVD risk chart-defined predicted 10-year CVD high-risk category was present in 1,440 (21%) participants and was more frequent in the high-AIP group than in the low-AIP group. Higher AIP was associated with higher odds of CVD high-risk status. Restricted cubic splines supported a non-linear association. Discrimination was modest for AIP alone (AUC 0.557) and improved in adjusted models (AUC 0.650). In the machine-learning pipeline (LASSO + random forest), the random forest model achieved an AUC of 0.792, and SHAP analyses ranked LDL-C and history of hypertension as the strongest contributors, with AIP remaining among the top predictive features.

In this community-based ChinaHEART population, higher AIP was non-linearly associated with the WHO CVD risk chart-defined predicted 10-year CVD high-risk category. Although AIP alone had limited discrimination, it may serve as a simple adjunct marker to triage individuals for intensified risk assessment in primary-care screening settings.

The aging of hematopoietic stem cells (HSCs) impairs their regenerative and self-renewal capacities, contributing to immune dysfunction and hematologic diseases, yet safe and effective rejuvenation strategies remain elusive.

This study employed a human data-driven, metabolism-centered approach to identify endogenous compounds with rejuvenating potential for aged HSCs. Genome-scale metabolic models and single-cell transcriptomic analyses were used to characterize metabolic changes in human and mouse HSCs. Aged mice were treated with cholesterol sulfate (CS), and HSC functionality was assessed via proliferation assays, DNA damage analysis, and bone marrow transplantation. Molecular docking and in vivo experiments further explored the role of the nuclear receptor RORA.

Supplementation with CS in aged mice enhanced HSC proliferation, reduced DNA damage, and restored hematopoietic output. Metabolic modeling revealed increased CS hydrolysis as a key alteration in aged HSCs, while single-cell transcriptomics showed that CS treatment suppressed inflammatory signaling and eliminated stress-responsive HSC subpopulations. Mechanistically, CS was identified as a potent ligand that activates RORA. Functional studies suggested that RORA functions as a key mediator in this process.

CS supplementation reverses aging-associated HSC decline by enhancing proliferation, reducing DNA damage, and modulating inflammatory pathways, with RORA serving as an essential mediator. These findings highlight the CS-RORA axis as a promising therapeutic target for rejuvenating aged HSCs and preserving hematopoietic function.

There is high comorbidity and complex pathological mechanisms between metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiovascular disease (CVD), and the accuracy of traditional risk assessment tools is insufficient. The paper highlights that artificial intelligence (AI) including machine learning and deep learning capable of integrating clinical, imaging, and multi-omics data to enhance the precision of diagnosing MASLD and staging liver fibrosis, the related model has AUC greater than 0.85, and moreover, AI can also accurately predict CVD risk of patients with MASLD, which related model has AUC greater than 0.8 and whose performance is better than traditional scoring systems. In the medical field, deep learning facilitates the quantification of liver fat, along with the evaluation of coronary plaque and screening for lesions across different organs. Multimodal AI has the potential to reveal novel mechanisms and biomarkers of diseases. In addition to these challenges which include data quality and model generalization, the paper also points to future directions such as federated learning. AI offers a fresh perspective on assessing risks, understanding mechanisms, and implementing clinical interventions for MASLD-CVD.

Apixaban is widely recommended as first line therapy for atrial fibrillation (AF) and venous thromboembolism (VTE). Despite the widespread availability of dosing guidelines, anecdotal evidence suggests clinicians do not routinely follow these recommendations. Inappropriate dose reduction is associated with suboptimal patient outcomes. This project aimed to review current prescribing practices of apixaban 2.5 mg against guidelines to identify potentially inappropriate prescribing.

A single-centre, retrospective review of all adult patients admitted to a large tertiary hospital in Perth, Australia, who were dispensed apixaban 2.5 mg between 1 January 2023 and 31 December 2024, was undertaken. Patients were identified via dispensing records. Demographics, indication, comorbidities, concurrent medications and laboratory data were collated. Each case was assessed against current guidelines to determine whether dosing was appropriate or potentially inappropriate. Data were analysed using quantitative statistics.

A total of 303 patients were dispensed apixaban 2.5 mg in the audit period. Of these 178 (59%) were newly initiated. The mean age of the cohort was 79 years (standard deviation [SD] 12.6), with 49% female. Of the 128 patients (72%) newly initiated on apixaban 2.5 mg for non-valvular AF, 53 (41%) patients received a potentially inappropriate dose. A further 19 patients (11% of the entire cohort) received a potentially inappropriately low dose for acute VTE treatment.

A significant proportion of patients initiated on apixaban 2.5 mg received potentially inappropriate doses. These findings highlight the need for targeted anticoagulation stewardship and clinician education to optimise patient outcomes.

This study aimed to assess the detection rate and spectrum of pathogenic variants (PVs) and candidate variants (variants of uncertain significance, VUS) in AVM patients.

In this retrospective multicenter cohort study, tissue and blood samples were collected from 114 patients with extracranial AVMs during treatment or when clinically indicated, for dedicated molecular genetic analyses. PVs (solved) and VUS were detected by targeted sequencing on DNA using gene panels analyzing genes suspected to be associated with AVMs. Unsolved cases were further categorized into unrestricted and restricted, with the latter reflecting methodological limitations. Subgroup analyses were carried out based on affected genes to explore associated genotype-phenotype correlations.

PVs were identified in 80.7% (92/114) and VUS in 5.3% (6/114), resulting in a total detection rate of 86.0% (98/114). Unsolved cases accounted for 11.4% (13/114) including 6/13 (46.2%) with methodological restrictions. Somatic PVs were most frequent in KRAS (21.1%, 24/114), MAP2K1 (17.5%, 20/114), HRAS (8.8%, 10/114), and BRAF (7.9%, 9/114). Germline variants were found in RASA1 (7.0%, 8/114), PTEN (5.3%, 6/114), and EPHB4 (3.5%, 4/114). In a few cases, somatic variants in RASA1 (1.8%, 2/114) and PTEN (2.6%, 3/114) were identified. Additional PVs occurred in PIK3CA (3.5%, 4/114), SOS1 (2.6%, 3/114), GNAQ (1.8%, 2/114), and RIT1, RAF1, and GNA14 (each 0.9%, 1/114). Within the RAS/MAPK pathway, RAS variants (KRAS, HRAS) were linked to more severe clinical stages (65.6% vs. 40.0% MAP2K1 and 37.5% BRAF, p = 0.027) and higher relapse rates (55.6% vs. 43.8% MAP2K1 and 0% BRAF, p = 0.049). Germline variants showed a distinct distribution pattern with more syndromic presentations (61.1% vs. 15.6%, p < 0.001) compared to mosaic variants.

Broad and sensitive testing enables a high detection rate of causative variants in AVMs. PVs and VUS detected reveal a broader genetic spectrum than previously recognized. Somatic RAS PVs were associated with more advanced disease stages and higher relapse rates than MAP2K1 and BRAF variants, while germline variants were more frequently linked to syndromic patterns.