Whether metabolically unhealthy normal weight (MUNW) is associated with subclinical carotid atherosclerosis (SCAS) and how its risk compares with that of metabolically unhealthy overweight/obesity (MUO) remain uncertain, particularly in longitudinal analyses and across age groups.

A cross-sectional sample (n = 26,202) and a longitudinal subcohort (n = 4,938) were derived from a health examination database; all participants in the longitudinal subcohort were free of SCAS at baseline. Participants were classified into four metabolic-obesity phenotypes based on body mass index and metabolic health status: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obesity (MUO). SCAS was defined as carotid intima-media thickness ≥1.0 mm and/or carotid plaque.

Compared with metabolically healthy normal weight (MHNW), MUNW was associated with increased odds of prevalent SCAS (OR 1.55, 95% CI 1.30-1.84) and increased risk of incident SCAS (HR 1.69, 95% CI 1.12-2.56). Compared with MUO, MUNW showed a numerically higher risk estimate for prevalent SCAS, although the difference was not statistically significant (OR 1.11, 95% CI 0.93-1.32, P = 0.247); a similar pattern was observed for incident SCAS (HR 1.25, 95% CI 0.83-1.91, P = 0.290). Metabolically healthy overweight/obesity (MHO) was associated with prevalent but not incident SCAS (OR 1.10, 95% CI 1.02-1.20; HR 1.14, 95% CI 0.94-1.38). A significant phenotype-by-age interaction was observed (P = 0.029); among adults aged <50 years, MUNW was associated with more than twofold higher odds of prevalent SCAS (OR 2.33, 95% CI 1.39-3.76). Findings were consistent in sensitivity analyses excluding covariates overlapping with phenotype definitions and in plaque-restricted analyses.

MUNW was associated with increased odds of prevalent SCAS and a higher hazard of incident SCAS after multivariable adjustment, with numerically higher risk estimates than MUO, although direct comparisons did not reach statistical significance.

Managing STEMI and high-risk NSTEMI-equivalent patients on chronic oral anticoagulation (OAC) undergoing primary PCI poses competing ischaemic and bleeding risks.

This single-centre retrospective study enrolled 604 consecutive STEMI/high-risk NSTEMI patients undergoing primary PCI (2012-2023). OAC users (n = 100) were compared with propensity score-matched controls (n = 203). Primary endpoints included all-cause mortality, bleeding, stroke, recurrent MI and rehospitalisation over a mean 3-year follow-up.

OAC users had a higher prevalence of prior ischaemic stroke/TIA (19% vs. 3%, p < 0.001) and known coronary artery disease (33% vs. 20%, p = 0.015). In-hospital mortality was comparable (7% vs. 5.9%, p = 0.80). Postdischarge long-term mortality was significantly higher in OAC users (31% vs. 14.8%, p = 0.001), as were access-site haematoma (8% vs. 2%, p = 0.02) and minor bleeding (7% vs. 1.5%, p = 0.03). On multivariable Cox regression, OAC use was not an independent mortality predictor (HR 0.81, 95% CI 0.47-1.37, p = 0.43); age, reduced ejection fraction and chronic kidney disease were the principal determinants.

Despite higher postdischarge mortality and bleeding, OAC use was not independently associated with mortality after adjustment. Comorbidity burden drives prognosis, emphasising comprehensive risk stratification in this population.

Cardiovascular diseases are the leading cause of mortality worldwide, with myocardial infarction (MI) contributing significantly to this burden. While age-related differences in cardiac remodeling and healing post MI are well-documented clinically, appropriate pre-clinical studies are needed to evaluate the underlying pathological mechanisms and to further improve therapeutic interventions. Here, we compared LV remodeling between young and aged C57BL/6 mice, following permanent LAD ligation, using CMR imaging after 2, 7, and 28 days of MI induction. At baseline conditions, aged mice exhibited higher end-diastolic and end-systolic volumes and tended to have a reduced deformation capacity. Post-MI, both groups showed significant LV dilation, loss of contractility, and impaired ejection fraction. Interestingly, young mice undergo larger proportional geometric changes relative to their pre-infarction state. At the same time, histological data of labeled heart sections pointed to a more rapid healing process in young animals. These findings highlight the critical role of age in modulating cardiac remodeling and, thus, challenge the commonly held hypothesis of an age-dependent increase of LV remodeling.

Phlegmon is a severe skin and soft tissue infection (SSTI) that can escalate rapidly if not promptly recognized and treated. Its early presentation may appear deceptively mild, potentially delaying recognition of its severity. Without timely intervention, phlegmon can extend into deeper tissues and result in life-threatening systemic complications. Although SSTIs are common, progression from a seemingly minor scratch injury to a fulminant upper extremity infection complicated by compartment syndrome and multiorgan failure is uncommon. This case is reported to highlight the potential severity of such presentations and the importance of early recognition and intervention.

We present the case of a 58-year-old German female teacher who developed a severe left upper extremity SSTI following a minor scratch injury sustained from a student. Despite initial conservative management with antibiotic therapy, the condition progressed to severe phlegmon with compartment syndrome, culminating in sepsis and multiorgan failure characterized by acute renal failure, disseminated intravascular coagulation (DIC), and early liver failure. Urgent surgical intervention was required, including fasciotomy, surgical debridement, and multiple revision procedures. Microbiological cultures initially identified Streptococcus pyogenes (Group A). During the later course of treatment, Pseudomonas aeruginosa was detected in revision samples. Empirical intravenous antibiotic therapy with Meropenem was initiated and subsequently adjusted to Ampicillin/Sulbactam according to microbiological findings. The patient required hemodialysis because of acute renal failure but gradually recovered, allowing discontinuation of dialysis. At follow-up, the infection had resolved and the skin grafts demonstrated satisfactory healing; however, significant functional deficits persisted despite intensive rehabilitation.

This case underscores the critical importance of early diagnosis and aggressive multidisciplinary management in preventing severe complications associated with SSTIs. Furthermore, it highlights that seemingly minor skin injuries may progress to compartment syndrome and life-threatening systemic complications. Early recognition, prompt surgical intervention, and coordinated multidisciplinary care were essential for successful infection control and limb preservation.

Adoptive T cell transfer remains a fundamental technique for dissecting the molecular mechanisms governing T cell differentiation. A successful adoptive-transfer experiment typically relies on labor-intensive construction of specific congenic mouse strains to distinguish donor from host cells. This limitation may be addressed by a readily detectable surface reporter. Thy1 is a candidate, but it remains unclear whether it is a reliable reporter for monitoring adoptively transferred CD8⁺ T cell differentiation because Thy1 is a functional protein involved in thymic development and cell activation. To address this question, we systematically evaluated the reliability, stability, and functional neutrality of Thy1.1 and Thy1.2, two Thy1 isoforms, as adoptive-transfer reporters during CD8⁺ T cell differentiation in vivo. Our results show that endogenous Thy1 expression remains stable across the differentiation stages examined. In the experimental settings tested, exogenous Thy1 reporter expression did not measurably alter the assessed differentiation phenotypes or donor-cell recovery. We further constructed and validated a Thy1 reporter-based platform that captured phenotypes associated with both loss-of-function (shRNA) and gain-of-function (cDNA) modulation of the transcription factor T-bet. This system provides a practical option for congenic background-independent adoptive transfer and genetic studies of CD8⁺ T cell differentiation.

This study investigated the macroscopic neural mechanisms of cognitive impairment after Deep Nuclei Intracerebral Hemorrhage (DNICH) from the dimensions of brain activity and brain networks, and further identified characteristic fingerprints of cognitive representation.

Patients with cognitive impairment after DNICH and healthy controls (HC) were prospectively and consecutively enrolled. Resting-state fMRI (rs-fMRI) data and the cognitive scale Mini-Mental State Examination (MMSE) were collected. Spontaneous brain activity measured by fractional Amplitude of Low-Frequency Fluctuations (fALFF) was used to identify hub brain regions of cognitive representation, which were then used as Regions of Interest (ROI) for Functional Connectivity (FC) analysis, in order to investigate the potential mechanisms after DNICH cognitive impairment and identify characteristic fingerprints for distinguishing patients with dementia (dementia was defined as MMSE ≤ 17).

This study enrolled 139 patients with DNICH and 100 HC. There were no significant differences in baseline characteristics including age, gender, years of education, height, and weight between the two groups. Hematomas were predominantly located in the bilateral basal ganglia, more commonly on the left side, with varying degrees of thalamic and white matter involvement. Whole-brain zfALFF analysis showed that MMSE scores were significantly correlated with zfALFF values in brain regions including right dorsolateral prefrontal cortex (R-DLPFC) and posterior cingulate cortex (PCC), with R-DLPFC positively correlated and PCC negatively correlated with cognition (AlphaSim correction, p < 0.01; cluster size >19). In addition, FC within the executive control network (ECN) and default mode network (DMN) was abnormally altered in patients with cognitive impairment and was closely associated with cognitive function (r = -0.29-0.51). FC fingerprints demonstrated stable predictive ability for dementia status (AUC = 0.70-0.73).

Abnormal coordination of intra-network and inter-network FC of ECN and DMN may represent a shared neural mechanism of cognitive impairment after DNICH. Modulating FC between these hub brain regions (R-DLPFC and PCC) may provide new therapeutic strategies for cognitive recovery after DNICH.

Stroke is a primary contributor to global adult morbidity, frequently resulting in debilitating gait disturbances that impede independence. While standard neurorehabilitation remains essential, the advent of robot-assisted gait training (RAGT) provides a platform for high-intensity, reproducible interventions designed to stimulate neuroplasticity. This systematic review evaluated the literature from 2015 to 2025 to determine the influence of RAGT on neural reorganization and functional outcomes in stroke survivors.

A systematic search of MEDLINE, PubMed, Scopus, and Cochrane Library was performed for studies published between 2015 and 2025. The inclusion criteria were randomized controlled trials, systematic reviews, and meta-analyses investigating RAGT in acute, subacute, and chronic stroke patients. The evaluation metrics included clinical functional scales (e.g., the Berg Balance Scale and the 10-Meter Walk Test) and neurophysiological markers (e.g., fMRI, fNIRS, QEEG, and BDNF).

Analysis of 23 randomized trials and multiple meta-analyses indicated that RAGT combined with conventional therapy yielded significant improvements in gait speed (standardized mean difference [SMD] = 0.47) and balance (mean difference [MD] = 4.58). Neuroimaging revealed increased activation of the primary motor cortex and supplementary motor areas. Electrophysiological data confirmed reductions in the Power Ratio Index, suggesting normalized cortical activity. End-effector systems have demonstrated superior efficacy in the subacute phase compared to exoskeletons.

RAGT serves as a potent driver of cortical and spinal neuroplasticity by facilitating high-repetition task-specific stimuli. Early intervention during the subacute phase maximizes functional recovery. Future research should prioritize standardizing the dosing and longitudinal monitoring of neural connectivity. Trial Registration Status: Not Applicable.

Cerebral small vessel disease (CSVD) is the key pathological basis of vascular depression. The precise identification of its neuroimaging markers is of core value for early diagnosis, elucidation of its pathological mechanism, and individualized treatment. Recent advances in magnetic resonance imaging (MRI) and artificial intelligence (AI) have enabled automated, high-throughput characterization of CSVD-related brain lesions. However, the translation of these technical advances into clinical tools for depression-specific prediction and classification remains at an early stage.

This manuscript aims to summarize the application of traditional visual scoring systems in assessing the burden of CSVD and its association with depressive symptoms. Review the current status of imaging and AI research on CSVD-related depression. To provide a direction for the development of more precise and efficient imaging diagnostic tools for the future, and ultimately promote the practical application and utilization of precision medicine in the field of CSVD-related depression.

Cirrhotic cardiomyopathy (CCM) is a condition observed in patients with chronic liver disease, characterized by dysfunction in both cardiac diastolic and/or systolic function. This condition is often underdiagnosed due to a lack of awareness and the possibility of misdiagnosis. Consequently, there is limited data regarding subclinical CCM in individuals with end-stage liver disease. Furthermore, there is currently no established cardiac biomarker to assess cardiovascular risk and outcomes in patients with liver cirrhosis. To address this issue, we conducted a scoping review to map the existing evidence and identify research gaps in echocardiographic assessment of left atrial (LA) function for detecting CCM in patients with liver cirrhosis.

We systematically searched the Scopus, PubMed, and Web of Science databases using Population, Concept, and Context framework. The population is adult patients with liver cirrhosis. The concept is to assess LA function via echocardiography. Context is to detect CCM.

We identified 364 articles, of which 24 were eligible for full-text review. Ultimately, 20 articles were included in the final analysis. Our dataset revealed various cardiovascular manifestations involving LA. Key findings related to CCM included LA enlargement and increased LA diameter and volume, which correlated with the Child-Turcotte-Pugh and Model for End-Stage Liver Disease scores. Additionally, we observed a reduction in LA strain. LA diameter, volume, and LA strain were associated with outcome prediction.

Evaluating LA function with advanced echocardiographic techniques offers a promising approach for early detection and prognostic assessment of CCM. To translate these findings into standardized clinical practice, bridging existing evidence gaps with well-designed studies is crucial.

Urinary incontinence (UI) is a prevalent yet underreported condition significantly impacting women's quality of life. In Saudi Arabia, cultural stigma often prevents help-seeking, and comprehensive data on its impact are limited. This study aimed to estimate the prevalence and severity of UI among women in Saudi Arabia, identify associated medical and obstetric risk factors, and evaluate its impact on quality of life in order to inform a policy and service framework for integrated, stigma-sensitive care.

A cross-sectional study was conducted among 629 adult women across Saudi Arabia using an online, self-administered questionnaire. The instrument included sociodemographic sections, the validated International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), and assessments of risk factors and quality-of-life impact. Data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression.

Regarding the amount leaked among the 291 women who reported incontinence, most reported small-volume leakage: 238 (81.8%), while moderate 51 (17.5%) and large amounts 2 (0.7%) were relatively rare. Key risk factors identified included higher age, overweight/obesity (with 60.7% of frequent UI cases being overweight), and multiparity (46.3% of all women had ≥ 3 deliveries). The impact on quality of life was substantial: 25.4% reported an impact on their social life, and 21.0% reported feelings of anxiety or nervousness. Multivariable analysis revealed that severe social impact was independently associated with high leakage frequency (AOR = 4.25, p < 0.001), higher perceived interference (AOR = 1.28, p < 0.001), and experiencing anxiety (AOR = 3.02, p = 0.005).

UI is highly prevalent among women in Saudi Arabia, with significant physical and psychosocial consequences. Symptom severity and psychological distress are the primary drivers of social impairment. There is an urgent need for targeted public health initiatives to destigmatize UI, raise awareness, and improve access to treatment. These findings support a national framework that embeds routine UI screening in primary care, strengthens access to pelvic-floor and weight-management services, and integrates mental-health support and culturally sensitive awareness campaigns to reduce stigma and improve quality of life.