Macrophage-mediated angiogenesis and lymphangiogenesis after myocardial infarction (MI) are essential for restoring cardiac perfusion and lymphatic drainage, thereby limiting cardiac tissue ischemia, edema, and fibrosis. Shuxuening injection (SXNI) is commonly used in the treatment of cardiovascular diseases in clinical practice, but its mechanism of action in mitigating cardiac remodeling after MI is still unclear.

This study aimed to investigate the effect of SXNI on ventricular remodeling after MI and to clarify its mechanism of action.

SXNI were administered at doses of 1.05 (low-dose), 2.1 (clinical equivalent-dose), and 4.2 (high-dose) mL/kg/day over a 4-week period by using a rat MI model. Pharmacodynamic assessments encompassed cardiac function, infarct size, and fibrosis areas. Angiogenesis and lymphangiogenesis were assessed via immunohistochemical staining, western blotting, qRT-PCR, and ELISA. Assessment of cardiac edema and inflammatory status used gravimetry and ELISA. CCK-8, scratch wound, and tube formation assays were conducted to detect the direct and indirect (macrophage-mediated) effects of SXNI on HUVECs and SVEC4-10 cells. Western blotting examined the underlying mechanisms. The chemical composition of SXNI was determined by ultra-high performance liquid chromatography-Q exactive-mass spectrometry (UPLC-QE-MS). Key components of SXNI capable of binding to VEGF-A/VEGF-C were screened via molecular docking. The effects of these components on VEGF-A and VEGF-C levels in macrophages were then detected using qRT-PCR and ELISA.

In MI rats, SXNI significantly enhanced cardiac function, reduced infarct size, and suppressed cardiomyocyte apoptosis. SXNI activated the VEGF-A/VEGFR2 and VEGF-C/VEGFR3 signaling pathways, thereby promoting post-MI angiogenesis and lymphangiogenesis, consequently decreasing cardiac edema, inflammation, and dysfunction. Direct intervention with SXNI does not affect the viability or tube formation ability of HUVEC or SVEC4-10 cells. However, SXNI promoted the secretion of angiogenic factors by Raw264.7 cells. SXNI-induced macrophage stimulation indirectly enhanced the proliferation, migration, and tube formation of HUVECs and SVEC4-10 cells, thereby activating VEGFR2-mediated signals (AKT/ERK1/2) and VEGFR3-mediated signals (AKT/ERK1/2) in vitro, facilitating angiogenesis and lymphangiogenesis. Seventy chemical components were identified using UPLC-QE-MS mass spectrometry. Molecular docking results suggest that ginkgolide A, ginkgolide B, rutin and quercetin 3-neohesperidoside may bind to VEGF-A and VEGF-C proteins. Subsequent cellular experiments confirmed that these compounds could regulate the expression levels of VEGF-A and VEGF-C in macrophages.

SXNI activates macrophages to secrete VEGFs, such as VEGF-A and VEGF-C, which in turn activate the VEGFR2 and VEGFR3 signaling pathways in endothelial cells and lymphatic endothelial cells, thereby promoting angiogenesis and lymphangiogenesis and ameliorating ventricular remodeling. The key active ingredients in SXNI may be ginkgolide A, ginkgolide B, rutin and quercetin 3-neohesperidoside. This work provides valuable clinical evidence supporting its use in MI patient treatment.

The high level of metabolism in the central nervous system (CNS) induces the production of large amounts of free radicals following stroke, thereby resulting in oxidative stress. The brain is particularly vulnerable to oxidative stress-induced damage due to its high oxygen consumption. Astrocytes, as key regulators of CNS homeostasis, play a critical role in modulating oxidative stress and maintaining CNS function.

Accumulating evidence has shown that astrocytes undergo polarization into two distinct states: A1 (neurotoxic and pro-inflammatory) and A2 (neuroprotective and anti-inflammatory) phenotypes following ischemic stroke, which, respectively, exhibit harmful and beneficial roles in oxidative stress-induced brain injury. In addition, metabolic crosstalk between astrocytes and neurons during the acute phase of ischemic stroke, involving lactate, amino acids, healthy mitochondria, and fatty acids, is crucial in maintaining neuronal morphology and function.

A2 astrocytes possess significant antioxidative capabilities by expressing high levels of antioxidative stress genes. Notably, the polarization of astrocytes toward the A2 subtype appears to enhance their beneficial and supportive role in metabolic crosstalk with neurons. A deeper understanding of astrocytic roles, particularly those of A2 astrocytes, in redox regulation and astrocyte-neuron metabolic crosstalk may provide novel therapeutic strategies for ischemic stroke. Therefore, in this review, we mainly discuss the roles of astrocytes, particularly A2 astrocytic polarization, in redox regulation and metabolic crosstalk with neurons following ischemic stroke.

Elucidating the molecular mechanisms underlying astrocytic polarization toward the A2 subtype during the pathological process of ischemic stroke represents a promising avenue for future research. Antioxid. Redox Signal. 44, 410-435.

Associations between chronic kidney disease (CKD) severity and incident cognitive impairment have not been evaluated in a cohort of patients with CKD.

To investigate associations between CKD severity, based on the estimated glomerular filtration rate (eGFR) and urinary protein to creatinine ratio (UPCR), and incident cognitive impairment in a cohort of patients with CKD.

This cohort study investigated 5607 participants with CKD from the ongoing Chronic Renal Insufficiency Cohort (CRIC) Study who were enrolled between 2003 to 2008 and 2013 to 2015. Statistical analysis was conducted from August 2024 to December 2025.

Estimated glomerular filtration rate and UPCR.

Global cognition and domains of verbal memory and delayed recall, attention and processing speed, and executive function were evaluated using the Modified Mini-Mental Status Examination, Buschke Selective Reminding test, and Trail Making Tests A and B, respectively. For each test, impairment was defined as a score at least 1 SD worse than the baseline cohort mean. After those with cognitive impairment at baseline were excluded, Cox proportional hazards regression models tested associations of baseline eGFR and UPCR, individually and together, with time to cognitive impairment after adjusting for demographic, lifestyle, and clinical risk factors.

The 5607 CRIC participants included 3159 men (56.3%), the mean (SD) cohort age was 59.6 (10.8) years at baseline, and the median follow-up was 6 years (range, 0.5-16 years) for the Modified Mini-Mental State Examination, 4 years (range, 0.5-13 years) for the Buschke Selective Reminding Test, and 4 years (range, 0.5-13 years) for Trail Making Tests A and B. In multivariable-adjusted analyses, each 1 SD higher log-transformed UPCR was associated with 21% increased risk of impairments in attention and processing speed (hazard ratio [HR], 1.21; 95% CI, 1.05-1.41; P = .01) and 16% increased risk of impairment in executive function (HR, 1.16; 95% CI, 1.02-1.31; P = .02). Each 1 SD lower eGFR was associated with 21% increased risk of impairment in attention and processing speed (HR, 1.21; 95% CI, 1.05-1.38; P = .006). Findings for UPCR remained nominally significant after further adjustment for eGFR, while eGFR findings were attenuated on adjustment for UPCR. Patients with a combined eGFR less than 60 mL/min/1.73 m2 and UPCR of 150 mg/g or more had a significant 38% increased risk of impairment in global cognition (HR, 1.38; 95% CI, 1.05-1.82; P = .003) compared with those with an eGFR of 60 mL/min/1.74 m2 or more and UPCR less than 150 mg/g.

This cohort study of patients with CKD suggests that a more advanced CKD stage was associated with increased incidence of cognitive impairment. These findings underscore CKD severity as a risk factor for cognitive decline across the CKD spectrum.

Social screening initiatives often prioritize identifying social risks before offering support. The extent to which the emphasis on social risks contribute to overscreening and/or underdetection of needs, overall and across demographic subgroups, remains underexplored.

To examine the agreement between self-reported social risks and needs for support and variance in risk-need concordance across racial, ethnic, and sex subgroups.

This cross-sectional study examined responses to an online or mailed survey fielded between March 2 and May 9, 2023, to Veterans Health Administration patients who visited their primary care practitioner in January or February 2023. Survey weights were used to adjust for sampling frame and nonresponse. The data were analyzed between April 6 and December 15, 2025.

Intersection of race, ethnicity, and sex.

Risk-need sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and concordance across 12 domains (paying for basics, obtaining adult caregiving, obtaining childcare, finding or keeping work, paying for food, finding or keeping housing, getting transportation, accessing the internet at home, feeling isolated, feeling lonely, getting legal assistance, and getting additional education or job training) were measured using age-adjusted relative risk ratios (ARRRs) of risk-need discordance (vs concordance), controlling for a family-wise error rate of .05.

The analytic sample included 6596 respondents, representing 937 003 veterans after weighting (unweighted number [weighted percentage]: aged <65 years, 2992 [48.5%]; aged ≥65 years, 3604 [51.5%]; 1088 identifying as Black female [4.1%], 1140 as Black male [19.4%], 939 as Hispanic female [1.6%], 1279 as Hispanic male [11.3%], 802 as White female [5.3%], and 1348 as White male [58.4%] race or ethnicity and sex). Across domains, risk-need sensitivity ranged from 42% (95% CI, 34%-49%) for housing to 99% (95% CI, 98%-99%) for loneliness, and specificity ranged from 69% (95% CI, 66%-71%) for loneliness to 98% (95% CI, 97%-99%) for childcare. The PPV ranged from 27% (95% CI, 22%-33%) for housing to 69% (95% CI, 63%-75%) for legal issues, and NPV ranged from 93% (95% CI, 91%-94%) for housing to 99% (95% CI, 99%-99%) for both childcare and loneliness. In age-adjusted models, compared with White male veterans, Black male veterans had a significantly higher likelihood of need-without-risk discordance for paying for basics (ARRR, 3.95; 95% CI, 1.80-8.64), housing (ARRR, 2.67; 95% CI, 1.59-4.48), and adult caregiving (ARRR, 2.13; 95% CI, 1.30-3.48). Additionally, compared with White male veterans, the likelihood of need-without-risk discordance for loneliness was higher among White female (ARRR, 14.02; 95% CI, 2.85-68.95), Hispanic female (ARRR, 10.87; 95% CI 2.31-51.25), and Hispanic male (ARRR, 8.08; 95% CI, 2.47-26.39) veterans. Differences for risk-without-need discordance were not significant.

This cross-sectional study of Veterans Health Administration patients found that social risk questions were better at identifying veterans without a social need than those who needed support and underdetected need for support among Black male veterans. Improved survey methods are essential to accurately detect needs in diverse populations.

Street-involved youth (SIY), particularly those who identify as 2-spirit, lesbian, gay, bisexual, transgender, queer, or other sexual and gender diverse identities (2SLGBTQ+), are among key populations disproportionately affected by HIV. We adapted and scaled-up a Peer Navigator intervention to targeted populations of SIY in six sites across Kenya (Eldoret, Huruma, Kitale) and Canada (London, Toronto, Vancouver), with the aim of increasing engagement in HIV prevention, testing, and treatment. This article presents the key quantitative findings, highlighting participant characteristics and their engagement in HIV testing and care before and after implementation of the Peer Navigator intervention. This implementation science study utilized a mixed-methods approach to investigate the adaptation, implementation, and evaluation of the Peer Navigator intervention. The PNs at each site completed study encounter forms with participants at enrollment and all follow ups between 2021 and 2024. Baseline sociodemographic characteristics were summarized separately using descriptive statistics for each study site. HIV testing and treatment outcomes are reported at baseline-reflecting participants' status prior to the intervention-and after their last encounter with Peer Navigators. A total of 686 SIY aged 16-29 years participated across all sites (Kenya, n = 631; Canada, n = 55). The Peer Navigator intervention improved access to and uptake of HIV prevention, testing, and treatment among SIY across Canada and Kenya. Participants' engagement in HIV testing increased from pre- to post-intervention across all sites, with the majority of participants reporting that they had been tested for HIV by the end of the study. This study highlights the need for access to ongoing and accessible HIV testing for all populations of SIY globally. The findings also underscore the critical need to create sustainable Peer Navigator roles to support SIY and expand the availability of widespread access to HIV testing.

Timely detection of dementia is crucial for reducing its health and societal burden. Standard tools such as the Mini-Mental State Examination (MMSE) and Cognitive Abilities Screening Instrument (CASI), although widely used, are limited by time and resource demands. This study developed and validated a machine learning-based screening tool using the Six-Question Dementia Screening Test (6Q-DS), a brief interview of six items. Data from 533 older adults at a neurology clinic in Taiwan (331 with dementia, 202 without) were analyzed with eXtreme Gradient Boosting. The 6Q-DS achieved an AUC of 0.936, sensitivity 0.879, specificity 0.951, and accuracy 0.907 for dementia vs non-dementia. For identifying very mild dementia vs non-dementia, the AUC was 0.874, with a sensitivity of 0.818, specificity of 0.805, and accuracy of 0.810. Comparable to MMSE and CASI, the 6Q-DS provides a practical, rapid, and user-friendly tool for dementia screening.

Latino populations in the United States have high levels of unmet mental health (MH) needs and MH-related stigma. Collaborative, community-based programming with predominately Latino churches is a promising approach for reducing MH stigma and unmet MH need in Latino communities. Project AMEN implemented MH workshops, homilies and text messages with Latino Catholic parishes to test this approach. We examined reach, satisfaction, effectiveness and fidelity for the overall intervention and individual activities. We collected baseline and one-year post-intervention data from n = 579 people at seven parishes in southern California. Variables included participation in and satisfaction with activities, MH stigma, sociodemographic characteristics, faith-related characteristics, MH needs, and fidelity measures for workshops. We used bivariate and multivariate modeling to describe intervention reach, satisfaction and effectiveness and to identify differences across subgroups. We describe fidelity for the MH workshop. Overall, 71% of the sample participated in at least one intervention activity. Participants were on average 48 years old, female, married, had less than high school education, and attended the parish for more than five years; 24% reported MH needs. Reach and satisfaction were greater for married individuals and those with strong connections to the parish. Individuals with MH problems had more barriers to participation. Activities most often participated in were text messages (42%), the introductory MH workshop (20%) and MH homily (20%). We observed high workshop fidelity. The number of AMEN activities predicted reduction in four types of MH stigma. AMEN showed promising results with respect to reach, satisfaction and effectiveness at reducing MH stigmaf.

During COVID-19, issues related to Asian Americans have received increased media attention, which has negatively impacted Asian Americans with disabilities living in the United States. This study aimed to explore racial and disability identity development and intersectionality between these identities among Asian Americans with disabilities using a qualitative design.

The semistructured interview was conducted with 39 participants. Many of them self-identified as having a mental health disorder. Interview questions were developed to assess factors influencing their racial and disability identity development and how the intersectionality of these two identities influenced Asian Americans with disabilities. Thematic analysis was employed to identify key themes across multiple coding steps.

Analyses yielded two themes related to disability identity development: (a) The Process of Disability Identity Development and (b) Stigma as a Barrier to Embracing Disability Identity, and two themes regarding racial identity development: (a) Cultural Connection and the Formation of Asian American Identity and (b) Social Barriers to Racial Identity Development. Subsequent subthemes were also identified. Additionally, meaningful shared experiences related to the intersectionality between disability and racial identities were identified. Participants reported significant family roles in both racial and disability identity development. Stigma toward disability and stereotypes toward Asians had a negative impact, while interactions with others with disabilities and having role models had a buffering effect on their identity development.

Findings suggest service providers need to have a better understanding of intersecting identities among Asian Americans with disabilities and to develop interventions promoting self-advocacy skills and family participation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Social anxiety is a highly prevalent and serious psychological issue, but help-seeking rates for social anxiety symptoms are relatively low. To facilitate treatment and intervention for social anxiety symptoms, it is important to understand what factors influence patients' seeking or receiving professional help. In the present study, we identified the perceived motivations and hindrances of individuals with social anxiety when deciding whether to seek professional help. We recruited 21 university students (76% female, M_age = 20.71 years) who scored above the cutoff score on the Social Phobia Inventory and interviewed them about their perceptions of social anxiety and how they cope with it, including some of their perceptions of professional help. Based on the five main constructs of the health belief model, participants reported the factors that influence their seeking professional help: (a) perceived susceptibility to health threats, (b) perceived severity of health threats, (c) perceived benefits of health-protective behaviors, (d) perceived barriers to performing these behaviors, and (e) perceived self-efficacy for these protective behaviors. The results highlight the barriers that individuals with social anxiety face when seeking professional help, which can be used to guide and improve mental health interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Military sexual trauma (MST) has been a long-standing concern within the U.S. military. Although research has examined risk factors and long-term impacts of MST, there is a gap in research about how the military impacts MST survivors' recovery and understanding mental health specialists' perspectives of MST recovery. This study aimed to identify military factors impacting an MST survivor's recovery journey from mental health specialists' perspectives. Qualitative data were collected through semistructured interviews with civilian and uniformed mental health specialists who have worked with MST survivors. Interviews followed a five-phase MST survivor's recovery model developed for this study (Phase 1: reporting the assault, Phase 2: obtaining medical care, Phase 3: accessing effective mental health care, Phase 4: institutional reintegration, and Phase 5: recovery). Responses were analyzed using reflexive thematic analysis. Seven mental health specialists (85% female and 72% active duty) participated, averaging 11.3 (6.4) years of experience and working with an average of 115.4 (172.04) MST survivors. Findings revealed that each phase of a survivor's recovery journey encounters institutional and treatment-level barriers. Reflexive thematic analysis identified 41 themes, with 19 relevant to the current aims and eight identified as facilitators or barriers to recovery within the survivor's journey to recovery model. Results suggest that military personnel's use of supportive language when an assault is disclosed-shortening wait times between appointments when completing trauma-informed protocols, providing psychoeducation on trauma, defining MST recovery outcomes, and allowing time for recovery in garrison environments-may reduce barriers to recovery. Clinical recommendations are offered to help providers reduce possible MST recovery barriers. (PsycInfo Database Record (c) 2026 APA, all rights reserved).