Thermal stress has been associated with gestational diabetes mellitus (GDM), but ambient temperature alone inadequately captures integrated thermal stress. The Universal Thermal Climate Index (UTCI) is comprehensive, while residential greenness's role remains unclear. This study aimed to investigate the nonlinear and lagged associations between maternal thermal stress, assessed using the UTCI, and GDM risk, and to examine whether residential greenness modified these associations.

This hospital-based prospective birth cohort included 2,984 pregnant women recruited in Fuzhou, China, between January 2020 and October 2024. GDM was defined by a 75-g oral glucose tolerance test (OGTT) or a documented clinical diagnosis during pregnancy. Maternal thermal exposure during the 12-week preconception period and the first 24 weeks of pregnancy was assessed using UTCI based on spatiotemporally matched reanalysis data. Residential greenness was characterized using the annual mean Enhanced Vegetation Index (EVI). Distributed lag nonlinear models were applied to examine the nonlinear and lagged associations between UTCI and GDM and to evaluate whether residential greenness modified these associations.

Compared with the median UTCI, lower UTCI during the 12-week preconception period was associated with a lower GDM risk (RR = 0.67, 95% CI: 0.53-0.84), whereas it was associated with an increased risk during the first trimester (RR = 1.15, 95% CI: 1.02-1.28). Higher UTCI showed delayed associations with GDM, with the strongest risk observed during the second trimester (RR = 1.17, 95% CI: 1.01-1.36). Women with junior college or undergraduate education were more susceptible to thermal stress. Residential greenness modified the UTCI-GDM association during the preconception period, with lower risks observed under combinations of lower UTCI with moderate-to-low EVI and higher UTCI with extremely high EVI.

The association between thermal stress and GDM varied across exposure windows. Preconception cold exposure was associated with a lower GDM risk, whereas early-pregnancy cold exposure was associated with a higher risk. The second trimester appeared to be a critical susceptibility window for heat-related GDM risk. Residential greenness modified the UTCI-GDM association during the preconception period. These findings support time-specific thermal exposure interventions and urban greening strategies to reduce maternal thermal vulnerability and improve GDM prevention.

We investigated the contribution of antecedent gestational diabetes mellitus (GDM) or gestational hypertensive disorder (GHTD) to the risk of cardiovascular disease (CVD) among women with Type 2 diabetes mellitus (T2DM).

In a population-based cohort using the Ministry of Health of Ontario (Canada) healthcare administrative data, women without prior CVD with T2DM and a history of GDM or GHTD as of 1 January 2018 (n = 11 525, mean age: 43 years) were age-matched to three comparator cohorts (women with T2DM and no history of GDM or GHTD [n = 11 525], women without T2DM and without GDM or GHTD [n = 11 525] and men with T2DM [n = 11 525]). Incident CVD (coronary artery disease [CAD] and cerebrovascular disease) and heart failure (HF) were assessed until 31 December 2023.

There were 1231 CVD events over a median follow-up of 6 years. Compared to women with T2DM but no history of GDM or GHTD, women with T2DM and a history of GDM or GHTD exhibited higher incident CVD (adjusted hazard ratio [aHR]: 1.19, 95% CI: 1.01, 1.41) and CAD (aHR: 1.35, 95% CI: 1.10, 1.66) risks. They also had higher CVD (aHR: 3.70, 95% CI: 2.79, 4.91), CAD (aHR: 4.96, 95% CI: 3.43, 7.19), cerebrovascular disease (aHR: 2.41, 95% CI: 1.54, 3.76) and HF (aHR: 4.95, 95% CI: 2.05, 11.94) risks versus women without T2DM and no history of GDM or GHTD. However, they had lower CVD, CAD, cerebrovascular disease and HF risks, compared to men with T2DM.

Among women with T2DM, prior GDM or GHTD conferred a higher CVD risk.

Diabetes mellitus is a prevalent non-communicable disease that adversely affects multiple dimensions of quality of life in children and adolescents. This study aimed to assess disease-specific quality of life (Ds-QoL) among children with diabetes and to identify associated demographic and clinical factors. A cross-sectional study was conducted in 2020-2021 in major paediatric diabetes clinics in Khartoum, Sudan. A total of 138 children with diabetes and their parents were recruited using systematic random sampling. Disease-specific quality of life was assessed using the Paediatric Quality of Life Inventory (PedsQL) 3.0 Diabetes Module. Demographic, clinical, and care-related variables were analysed using bivariate tests and multivariable models, including generalized linear modelling. Participants had a mean age of 11.1 ± 3.6 years; 64% were female, and 74.6% resided in urban areas. Type 1 diabetes was predominant (92.8%), and glycaemic control was poor in 92.3% of participants (mean HbA1c = 9.38 ± 2.59%). Children reported higher overall Ds-QoL scores than 2 pa^rents (75.35 ± 12.02 vs. 70.82 ± 15.94). Significant child-parent differences were observed in diabetes symptoms (p = 0.003) and worry (p < 0.001), while communication scores were comparable. Increasing age was associated with greater treatment burden (r = - 0.332, p < 0.001) and diabetes-related worry (r = - 0.254, p = 0.004). Sociodemographic variables were not significantly associated with overall Ds-QoL. Hospitalization, hypoglycaemia, and diabetic ketoacidosis were associated with lower child-reported Ds-QoL, whereas regular follow-up was associated with higher Ds-QoL. In multivariable analysis, hypoglycaemia (B = - 4.97, p = 0.027) and diabetic ketoacidosis (B = - 6.48, p = 0.012) independently predicted poorer child-reported Ds-QoL. At the same time, glycaemic control was the only independent predictor of parent-reported Ds-QoL (p = 0.001). Diabetes-specific quality of life in children is primarily influenced by clinical stability and acute complications rather than sociodemographic factors. Integrating child and parent perspectives and strengthening follow-up and metabolic control may improve quality-of-life outcomes.

This descriptive retrospective study evaluated the content, completeness and usability of information available in the Human Pluripotent Stem Cell Registry (hPSCreg®), including registered cell lines, research projects, clinical studies, donor characteristics and regulatory information.

We analysed data registered in hPSCreg® from January 2008 to December 2021. We analysed the data regarding cell lines, research projects, clinical studies, diseases, countries and legal issues.

There were 7538 total cell lines registered in the hPSCreg®. The most common derivation and generation countries were the United Kingdom, the United States, Germany and China. There were 3139 (46.5%) cell lines labelled as readily obtainable for a third party; few (7.2%) were labelled as available for commercial use. The most common diseases of the donor were Parkinson's disease, Alzheimer's disease and diabetes mellitus. Complete characterization data were available for the minority of the cell lines. The most common sponsor of research projects registered in the hPSCreg® was the European Union's Seventh Framework Programme (FP7). There were 97 registered clinical trials in the hPSCreg®. Challenges identified were incomplete user-entered information, entry of non-standardized information about diseases and continuing verification of the evolving legal status of embryonic stem cell (ESC) research per country.

The hPSCreg® represents an important international resource for stem cell research; however, this evaluation identified substantial variation in data completeness and standardization across registry fields. Future development should focus on improving the completeness of key metadata, standardization of terminology and systematic monitoring of registry data quality.

Previous studies have suggested an association between phthalate exposure and metabolic syndrome (MetS); however, prospective evidence remains limited. This cohort study investigated the association between phthalate exposure and MetS, its components, and incident type 2 diabetes mellitus (T2DM). Data were drawn from the Taiwan Biobank. Eligible participants had baseline urinary phthalate metabolite measurements and no pre-existing MetS. Urinary concentrations of 10 phthalate metabolites were quantified using liquid chromatography-tandem mass spectrometry. Changes in waist circumference, blood pressure, blood glucose, and lipid profiles between baseline and follow-up were calculated. Incident T2DM was identified by linking participants' medical records. Multivariable linear regression, logistic regression and Cox proportional hazard regression models were performed. Over a mean follow-up of 4.25 years, 102 of 790 participants (12.9%) developed MetS. Each ln-unit increase in baseline MiBP was associated with greater increases in HbA1c (0.04%). The association between MiBP and increase in triglycerides and total cholesterol , and between DEHP metabolites and increased HbA1c and decreased HDL-c did not remain statistically significant after false-discovery-rate (FDR) correction. No association was observed with the MetS prevalence. Among 556 participants without pre-existing T2DM, 22 (3.96%) developed T2DM. Each ln-unit increase in baseline MnBP was associated with 1.82-fold higher risks of incident T2DM after adjustment although this association did not remain significant after FDR correction. Neither sex nor agesignificantly modify these associations. This prospective study suggested that DBP was associated with deterioration of HbA1c and lipid profiles, whereas a potential association between DBP and increased risk of T2DM requires further confirmation.

Cardiac amyloidosis (CA) is an increasingly recognized cause of heart failure (HF), and sex differences in the clinical outcomes of SGLT2i in HF patients with CA remain insufficiently studied.

To study the sex related differences of SGLT2i among HF patients with CA.

We used TriNetX to identify adults (≥18 years) with HF and CA on SGLT2i therapy from Jan 2021 to May 2025. Patients with end-stage renal disease (ESRD), chronic kidney disease (CKD) stage 5, atrial fibrillation/ atrial flutter (AF/AFL), type 1 diabetes mellitus (T1DM), or diabetic ketoacidosis (DKA) were excluded. The primary and secondary outcomes were compared between males and females in the overall sample and in subgroups stratified by HF phenotype. These groups were balanced by sex using a 1:1 propensity score matching. Cox regression and Kaplan-Meier curves assessed outcomes at 6 months and 3 years.

Among 1485 patients with CA+HF on SGLT2i, 34.7% were female. After matching, 478 patients (mean age 70±13 years) were identified in each group. No significant sex-based differences were found in mortality (HR 0.93; 95% CI 0.65-1.33), stroke, acute MI, incident AF, ESRD, or MACE. The risk of acute HF diagnosis at 6 months was also similar. However, among 271 matched HFpEF patients, females had a lower 3-year all-cause mortality rate compared to males (HR 0.54; 95% CI 0.32-0.90), while among 245 HFrEF patients, females had a higher 3-year all-cause mortality rate compared to males (HR 1.79; 95% CI 1.08-2.96).

Comparable outcomes were observed across sexes in HF+CA patients treated with SGLT2i. However, variable outcomes between sexes across the HF spectrum warrant further investigation.

Emotion regulation and glycaemic responses are closely interconnected, with difficulties in one domain often exacerbating the other. This relationship is particularly evident in adolescents with Type 1 Diabetes Mellitus (T1DM), where glucose dysregulation is associated with heightened stress.Here, we investigated whether Affective Touch, a form of gentle tactile stimulation known to reduce stress and physiological arousal, modulates emotional and physiological responses in adolescents with and without T1DM. Affective Touch (slow touch) and non-Affective Touch (faster touch) were administered in two sessions while participants watched negative videos. Heart rate was continuously monitored, and glucose levels were tracked at four time points in the T1DM group only. Participants rated video valence and arousal and touch pleasantness.Across both groups, Affective Touch was perceived as more pleasant than non-Affective Touch and was associated with reduced heart rate, indicating a comparable calming effect in adolescents with and without T1DM. Blood glucose levels in the T1DM group showed a time-dependent decrease.Overall, the preserved hedonic and autonomic effects of Affective Touch across groups suggest that this form of touch may represent a feasible, non-invasive supportive strategy in contexts where stress regulation is relevant, including this clinical population.

To investigate the additional prognostic value of anatomic and hemodynamic parameters derived from coronary computed tomography angiography (CCTA) over clinical characteristics in type 2 diabetes mellitus (T2DM) patients with stable coronary artery disease (CAD).

A multicenter cohort of 798 T2DM patients with stable CAD (training/test cohort: 478/320) was retrospectively included. The endpoints were major adverse cardiovascular events (MACE). Univariate and multivariate Cox regression analyses were used to identify independent clinical and CCTA-derived predictors. These independent predictors were subsequently used to construct the clinical model and the imaging model, respectively. The Coronary Artery Disease-Reporting and Data System (CAD-RADS) was used in combination with significant clinical and CCTA features to establish the combined model. The performance of the 3 models was evaluated with concordance index (C-index) and time-dependent area under the curve (time-AUC). Net reclassification improvement (NRI) was used to assess the additional prognostic value of CCTA parameters.

In the test cohort, the clinical model, which incorporated previous myocardial infarction (prior MI) and hyperlipidemia, achieved a C-index of 0.631 (95% CI, 0.503-0.760). The imaging model constructed by the change in CT-derived fractional flow reserve (ΔCT-FFR) achieved a C-index of 0.744 (95% CI, 0.623-0.866). The combined model obtained the highest C-index of 0.755 (95% CI, 0.562-0.849). Compared with the clinical model, the combined model demonstrated superior diagnostic performance (P = 0.014; P = 0.042) in the test cohort, achieving time-AUC values of 0.683 and 0.637 for 1-year and 5-year MACE, respectively.

The combined model based on prior MI, hyperlipidemia, ∆CT-FFR and CAD-RADS can effectively predict the risk of MACE in T2DM patients with stable CAD. CCTA-based anatomic and hemodynamic parameters have additional value in predicting MACE compared with clinical characteristics.

Hemorrhagic conversion (HC) remains one of the most feared complications after mechanical thrombectomy (MT) for acute ischemic stroke and is associated with poor clinical outcomes. Evidence regarding predictors of HC after MT remains inconsistent. We sought to determine the incidence, predictors, and clinical impact of HC in a large contemporary cohort.

We conducted a retrospective analysis of a prospectively maintained database including consecutive patients who underwent MT for acute ischemic stroke between January 2016 and December 2024. Baseline clinical, radiographical, and procedural variables were collected. Outcomes were compared between patients with and without HC using 1:1 propensity score matching. Multivariable logistic regression was performed to identify independent predictors of HC.

Among 896 patients undergoing MT, 267 (29.8%) experienced HC. After propensity score matching, HC remained associated with worse discharge neurological status (National Institutes of Health Stroke Scale 12.7 vs 9.6; P = .013), longer hospital length of stay (12.3 vs 9.9 days; P = .004), higher rates of decompressive craniectomy (9.4% vs 2.2%; P < .001), and increased likelihood of nonhome discharge (83% vs 71%; P < .001). In-hospital mortality was not significantly different after matching. On multivariable analysis, independent predictors of HC included higher admission National Institutes of Health Stroke Scale score (odds ratio [OR]: 1.04), diabetes mellitus (OR: 2.08), chronic kidney disease (OR: 1.76), and ≥3 thrombectomy passes (OR: 1.75). Increasing age (OR: 0.98), Black race (OR: 0.61), stent-retriever alone thrombectomy (OR: 0.53), and posterior circulation strokes (OR: 0.27) were all significantly associated with lower odds of HC.

HC occurs in approximately one-third of patients undergoing MT and is independently associated with substantial neurological morbidity and healthcare utilization. Stroke severity, metabolic comorbidities, stroke location, and procedural complexity are key determinants of hemorrhagic risk. These findings support the need for enhanced risk stratification, and heightened postprocedural vigilance in high-risk patients.

Gastroesophageal cancers (GEC) have high mortality rates with poor prognosis, especially at late stages. This is partly due to unspecific symptoms at early stages, early treatment resistance, and recurrence after curative-intent treatment. Circulating tumor DNA (ctDNA) has gained attention for early cancer diagnosis and longitudinal monitoring. This narrative review summarizes the recent developments of genomic ctDNA analysis for early GEC diagnosis and longitudinal monitoring across 57 relevant studies. For early diagnosis, several studies combined genomic ctDNA analysis with other ctDNA approaches or serum biomarkers. These approaches achieved high sensitivities and specificities in cancer detection within GEC while accurately predicting the tissue of origin, The use of genomic ctDNA analysis has also been studied for longitudinal monitoring of GEC patients during and after various treatment regimens. Studies have shown that ctDNA dynamics is highly consistent with treatment response and disease progression. CtDNA could frequently detect disease progression before conventional methods, thereby displaying its potential application in longitudinal monitoring. Genomic ctDNA analysis could also detect recurrence after curative-intent treatment and, in many cases, before clinical detection. However, ctDNA has low abundance in total cell-free DNA during low-burden disease. Additionally, methodological variation in ctDNA processing and quantification complicates interpretation across studies.