To characterize the profile of people with advanced chronic kidney disease treated in specialized outpatient centers and to describe adherence to follow-up and assess the impact of specialized follow-up by comparing the glomerular filtration rate at baseline and after one year of follow-up.

This was a retrospective multicenter study that included people with stage 4 and 5 chronic kidney disease treated between November 2021 and October 2024, in five specialized outpatient centers in Santa Catarina state. The 12-month follow-up rate and changes in kidney function were assessed through the estimated glomerular filtration rate of people who started follow-up by October 2023.

Of the 547 people cared for during the study period, 83.0% were at stage 4 of the disease, 80.6% were elderly (>60 years), 91.8% had hypertension, 51.6% had diabetes and 65.6% were overweight or obese. Of the 237 people who started follow-up by October 2023, 211 (90.2%) completed one year of follow-up. The median estimated glomerular filtration rate remained stable during the period (22 [18-26] versus 22 [18-27] ml/min/1.73m2; p-value 0.300). Five people (2.1%) progressed to renal replacement therapy.

The population served was predominantly elderly and presented multiple risk factors for progression of chronic kidney disease. The high follow-up rate over one year and the preservation of kidney function reinforced the importance of specialized follow-up in the care of people with advanced chronic kidney disease.

Patients with higher age suffering from cardiovascular disease discharged from hospital are at greater risk of readmission within 30 days. We evaluated an innovative care program providing post-discharge support and helping patients to navigate through the healthcare system. This paper reports the findings of the process evaluation of the randomized controlled trial Cardiolotse, a nurse-led transitional care model improving care coordination for patients with cardiovascular diseases in Germany.

A process evaluation, following the guidelines of the Medical Research Council (MRC) Framework, was performed. Semi-structured interviews with all relevant target groups were conducted to gain more insight about implementation processes. Questionnaires and medical records were used to explore mechanisms of impact and understand how change was produced in the intervention. Qualitative data were analysed using content analysis with deductive and inductive categories. Descriptive statistics and subgroup analyses were utilized to explore quantitative data.

Overall, the designed training programme was perceived positively by the study nurses, so called Cardiolotsen (CLs). Patients receiving support by the CLs reported positive satisfaction ratings. Interactions between CLs and patients were reported as trustworthy and reliable. A total of approximately 12,500 contacts were made over the course of the intervention. However, changes in satisfaction scores between intervention and control groups in terms of medical treatment or the interaction between medical health providers involved in the treatment could not be determined. Furthermore, data suggested reach issues with respect to office-based physicians, as regular CL contact could not be achieved with 90% of the participating general practitioners and cardiologists.

The CLs served as an important source of support for the participating patients throughout the intervention. At regular intervals, they checked a patient's health status and their adherence to therapies after discharge. However, the process evaluation identified cross-sectoral communication and information exchange between CLs and office-based physicians as an implementation challenge.

The study was retrospectively registered at German Clinical Trial Register, http://www.drks.de/DRKS00020424 (Trial Registration Number DRKS00020424) on 18 June 2020.

Obesity is a global epidemic, which, directly and indirectly, contributes to almost all cardiovascular diseases, including atherosclerotic cardiovascular disease, heart failure and atrial fibrillation. Reduction of weight is associated with substantial improvements in cardiometabolic risk factors, including blood pressure and glycaemic control, with over 10% weight loss required to see improvement in rates of major adverse cardiovascular events. Glucagon-like peptide-1 (GLP-1) receptor agonists have changed the landscape of type 2 diabetes and obesity management, showing significant benefit in glycaemic control and weight loss. Their potential for cardiovascular benefits means that they will likely have a central role in the management of patients with obesity-related cardiovascular diseases. This review summarises currently available GLP-1-based pharmacotherapies and highlights recent trials demonstrating cardiovascular benefits, and also provides practical guidance for patient selection, available agents, their initiation and patient monitoring. This will serve as an aid for cardiovascular clinicians, who will inevitably encounter patients suitable for, or already using, these drugs in their daily practice.

In this study, we unexpectedly found that the immunoglobulin kappa light chain (Igκ) was expressed in normal cardiomyocytes of mice and humans, especially in intercalated discs (ICDs). Cardiomyocyte-specific knockout of Igκ in mice results in reduced myocardial contraction, atrioventricular block (AV block), and even sudden death. Histological analysis revealed that Igκ knockout in cardiomyocytes leads to structural disorder of ICDs, dissemination of the cytoskeleton proteins desmin and F-actin, as well as the loss of desmoplakin (DSP), N-cadherin, and connexin 43 (Cx43) on ICDs. Mechanistically, Igκ can bind to and stabilize plectin, a cytoskeleton-cross-linking protein that facilitates the assembly of desmin‒actin networks that maintain normal cytoskeletal architecture. Igκ can also anchor desmin to the DSP through plectin, thereby stabilizing the integrity of the ICDs. This molecular interplay critically reinforces cardiomyocyte cohesion and maintains structural and functional homeostasises. Our findings are the first to identify cardiomyocyte-expressed Igκ as a novel ICD-related molecule that participates in cardiomyocyte contraction and conduction by stabilizing plectins. Importantly, this work extends current arrhythmogenic cardiomyopathy (ACM) pathogenic models by revealing that ablation of the non-desmosomal gene Igκ disrupts ICD integrity, uncovering a new mechanism for non-desmosomal gene-related ACM and highlighting Igκ as a potential target for therapeutic investigations.

The development of ischemic stroke involves swiftly changing and spatially varied states, including oxidative burst, acidosis, hypoxia, endothelial dysfunction, blood-brain barrier disruption, neuroinflammation, and later tissue remodeling. This temporal structure is poorly matched by conventional single-dose neuroprotectants. Nanozyme-hydrogel systems that respond to stimuli provide a promising approach by integrating catalytic redox control with localized retention, lesion-adaptive mechanics, and release triggered by specific cues. This Mini Review critically examines the design logic of such systems for ischemic stroke. Initially, we categorize reactive oxygen and nitrogen species, low pH, hypoxia, thrombin, matrix metalloproteinases, and inflammatory signals as a pathological code for activating materials. Following this, we examine nanozyme catalytic modules, responsive hydrogel matrices, and integration approaches including encapsulation, anchoring, in situ assembly, and multi-input gating. Emphasis is on the phase-aligned management of the neurovascular unit, covering early reperfusion defense, endothelial stabilization, glial adjustment, angiogenesis, and neural reconfiguration. A key takeaway is that there is limited direct evidence of fully integrated nanozyme-hydrogel platforms specifically for stroke; the field largely relies on the intersection of advanced stroke nanozymes and responsive hydrogels. Consequently, we recommend translational benchmarks that emphasize phase-route alignment, exact catalytic activity, degradation tracking, production feasibility, and validation in various preclinical settings. Accordingly, this Mini Review is intended as a design framework for hypothesis generation and preclinical validation, rather than as evidence of clinical readiness.

Although sex is a critical biological variable determining physiology, disease risk and therapeutic responses, it remains underrepresented in biomedical research. While sex-dependent differences are well established in cardiovascular and metabolic diseases, their impact on glucagon biology is less understood. Glucagon is the key counter-regulatory hormone to insulin and plays a central role in glucose homeostasis by regulating hepatic glucose production. To date, only a limited number of studies have addressed sex-specific differences in glucagon plasma levels, secretion and α-cell function, indicating that females tend to exhibit a higher glucagon secretion. For the first time, this review summarizes the current literature on glucagon biology suggesting a sex-biased regulation of α-cell activity.

Atherosclerosis (AS) is the core pathological foundation of cardiovascular and cerebrovascular diseases, and its efficient prevention is pivotal to lowering related mortality and disability. Panax ginseng confers remarkable cardiovascular protection, whereas its anti-atherosclerotic efficacy and intrinsic mechanisms remain poorly elucidated, restricting its clinical translation. This study sought to decipher the mechanism underlying Panax ginseng mediated AS improvement via multidimensional artificial intelligence (AI) computation integrated with experimental validation.

UPLC-Q-TOF-MS/MS was employed to characterize Panax ginseng chemical constituents. Multidimensional AI computation strategies, including differential expression analysis, weighted gene co-expression network analysis, machine learning, coupled with transcriptome and database mining were utilized to screen core anti-AS targets. Meanwhile, the molecular docking, molecular dynamics simulation, cellular thermal shift assay and in vivo experiments combined with multivariate statistical analysis were performed for target verification.

55 compounds from Panax ginseng and 117 anti-AS potential targets were identified. The RXRA was recognized as the pivotal hub target via machine learning. The 14 components in Panax ginseng displayed stable binding with RXRA in molecular docking, dynamics simulations and cellular thermal shift assay. Ultimately, the experiments in vivo confirmed that Adenine, a representative compound of Panax ginseng, alleviated AS via regulating RXRA expression.

Panax ginseng exerts anti-atherosclerotic effects by targeting RXRA, with 14 active compounds (e.g., Adenine) serving as the key material basis for its pharmacological activity.

Chronic cardiovascular diseases (CVDs) remain a primary contributor to global mortality. Despite their prevalence, the comprehensive care needs of affected patients are not fully elucidated. This integrative review sought to synthesize current evidence on the multifaceted care requirements of individuals with chronic CVDs.

A comprehensive literature search was performed using PubMed, Scopus, and Web of Science, targeting studies published between 2010 and February 2025. The Whittemore and Knafl framework guided the methodology, incorporating both quantitative and qualitative research. Thematic analysis was utilized to distill key care-related themes.

The analysis of 14 studies revealed 5 predominant themes central to the care needs of patients with chronic CVDs. Health Education encompassed the dissemination of medical information, lifestyle education, guidance on using medical instruments, promotion of healthy behaviors, and counseling on diet and nutrition. Self-Care Management focused on self-care practices, medication adherence, symptom monitoring, risk factor control, and strategies to prevent complications. Holistic Support included mental health resources, emotional reassurance, support groups, assistance with daily activities, engagement of family and community, caregiver support, cost management, and socioeconomic aid. Care Coordination highlighted the importance of primary contact persons, telehealth and digital health solutions, and accessibility to healthcare services. Lastly, End-of-Life Care addressed decision-making processes, palliative care consultations, and attention to spiritual and existential needs.

This review underscores the complex and diverse care needs of patients with chronic CVDs, advocating for the adoption of comprehensive, patient-centered care models. These insights provide a foundation for designing targeted interventions and directing future research to enhance patient outcomes and quality of life.

Tuberculosis (TB) and human immunodeficiency virus (HIV) remain major global health challenges, particularly in sub-Saharan Africa where co-infection and chronic immune activation are highly prevalent. Interferon-gamma (IFN-γ) plays a central role in host defense against Mycobacterium tuberculosis, yet its determinants in real-world, high-burden populations especially in the context of metabolic and systemic inflammation are not fully understood. This study investigated clinical, inflammatory, and metabolic factors associated with circulating IFN-γ levels in adults in a high HIV/TB burden setting.

This was a cross-sectional study of 227 adults attending medical clinic at Livingstone University Teaching Hospital, Zambia. Circulating IFN-γ and a panel of inflammatory, metabolic, and renin-angiotensin-aldosterone system (RAAS) biomarkers were measured. Associations were assessed using simple and multivariable linear regression models, with log transformation applied to skewed variables. Statistical significance was defined as p < 0.05.

Among participants (median age 50 years; 64.3% living with HIV), several variables were associated with IFN-γ in unadjusted analyses, including inflammatory cytokines, hs-CRP, angiotensin II, and fasting glucose. However, in multivariable analysis, only female sex (β = -0.440, p = 0.023), fasting glucose (β = 0.153, p = 0.042), angiotensin II (log-transformed) (β = 0.688, p = 0.022), and IL-17 A (log-transformed) (β = 0.332, p = 0.019) remained independently associated with IFN-γ levels. Notably, HIV status, prior tuberculosis infection, hs-CRP, and other inflammatory markers were not independently associated after adjustment.

In this high HIV/TB burden population, circulating IFN-γ levels were independently associated with metabolic (fasting glucose), vascular-hormonal (angiotensin II), and immune (IL-17 A) factors, but not with HIV infection or prior TB after adjustment. These findings suggest that IFN-γ may reflect broader immunometabolic and inflammatory processes rather than infection-specific immune activation in treated populations. Longitudinal studies are needed to clarify the prognostic and clinical utility of IFN-γ in integrated chronic disease management.

The online version contains supplementary material available at https://doi.org/10.1186/s12982-026-02839-5.

Adolescents and young adults with rare diseases face a "medical cliff" when they age out of paediatric services, losing established care relationships and disease-specific expertise. Most rare diseases begin in childhood, since 69.9% of catalogued rare diseases are of exclusively paediatric onset. The problem is acute in China, where an estimated 20 million people live with a rare disease and systematic transitional care pathways remain largely absent.

We describe the development and implementation of an integrated paediatric-adult continuity of care model for rare diseases, the adult population it serves, and early operational indicators of its feasibility. This retrospective, descriptive analysis used clinical service data from the Children's Hospital of Fudan University, Shanghai, over a 38-month window (3 January 2023-25 February 2026); the model was implemented from September 2023. Its four components were expanded treatment authority with proactive management; a multidisciplinary paediatric-adult joint clinic; proactive follow-up with dynamic evaluation; and medical social work with psychosocial support. The programme admits patients aged 18-35 years.

In total, 2,341 patients aged ≥18 years generated 4,847 outpatient, emergency, and inpatient encounters (mean age at first encounter 22.7 ± 5.9 years; 51.7% female). Annual encounter volumes rose from 240 in 2023 to 1,412 in 2024 and 2,628 in 2025, with a further 567 in January and February 2026. Return attendances accounted for 4,373 encounters (90.2%), and 843 patients (36.0%) attended more than once. The leading specialities were neurology (29.1%), hepatology (12.2%), and endocrinology (8.1%); most encounters were by Shanghai residents (54.8%).

Repeat attendance measures utilisation rather than adherence, and rising volumes likely reflect progressive implementation and growing awareness rather than model effectiveness. With enabling policies, paediatric hospitals can deliver continuous care for adult rare disease patients, although these indicators describe service activity rather than clinical or patient-reported outcomes. The model is best characterised as continuity of care delivered within paediatric services rather than as a conventional transition programme, and offers a replicable blueprint for health systems lacking established adult subspeciality services; cross-provincial health insurance portability remains the single most critical barrier to nationwide scale-up.