To investigate the predictive value of computed tomography angiography (CTA)-derived fractional flow reserve (FFR), fat attenuation index (FAI), and plaque characteristics for the occurrence of major adverse cardiac events (MACE) in patients with coronary artery heart disease (CAD).

A total of 205 CAD patients were retrospectively enrolled at our hospital, and their demographic and clinical data were analyzed accordingly. All patients underwent CTA, and their FFR, FAI and plaque characteristics were measured. According to the occurrence of MACE within a 36-month follow-up period, the patients were divided into a MACE group (n = 42) and a non-MACE group (n = 163). The clinical data, FFR, FAI, and plaque characteristics were compared between the 2 groups, and logistic regression analysis was performed to identify factors associated with MACE in CAD patients. FFR, FAI, and plaque burden (PB) were further compared among patients with different degrees of coronary artery stenosis, and Spearman correlation analysis was performed to evaluate the associations of FFR, FAI, and PB with the severity of coronary artery stenosis. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of FFR, FAI, and PB for MACE in CAD patients.

Compared with those in the non-MACE group, the body mass index (BMI), the proportion of patients with vascular lesions involving 2 or more coronary arteries, the proportion of patients with severe coronary stenosis, FAI, lipid plaque volume, non-calcified plaque volume, and PB were significantly higher (all P < 0.05) in the MACE group, whereas FFR was significantly lower (P < 0.05) in the MACE group. Variables with variance inflation factor (VIF) < 3 on collinearity diagnostics were included in multivariate logistic regression analysis. The results showed that multivessel lesion (odds ratio [OR], 2.188; 95% CI, 1.304-3.671), severe coronary artery stenosis (OR, 2.918; 95% CI, 1.608-5.295), increased FAI (OR, 2.635; 95% CI, 1.510-4.598), and increased PB (OR, 2.396; 95% CI, 1.382-4.157) were risk factors for MACE in CAD patients (P < 0.05), while increased FFR (OR, 0.373; 95% CI, 0.221-0.630) was a protective factor (P < 0.05). Stratified analysis by the severity of coronary artery stenosis showed that patients with mild stenosis had significantly higher FFR and significantly lower FAI and PB than those with moderate or severe stenosis (all P < 0.05), and that patients with moderate stenosis had significantly higher FFR and significantly lower FAI and PB than those with severe stenosis (all P < 0.05). Spearman correlation coefficient analysis revealed that the severity of coronary artery stenosis was positively correlated with FAI (r = 0.687; 95% CI, 0.598-0.760) and PB (r = 0.664; 95% CI, 0.571-0.741) (P < 0.05), but negatively correlated with FFR (r = －0.712; 95% CI, －0.782 to －0.628; P < 0.05). ROC curve analysis showed that the areas under the curve (AUCs) for predicting MACE in CAD patients using FFR, FAI, and PB individually were 0.831 (95% CI, 0.750-0.876), 0.790 (95% CI, 0.719-0.861), and 0.724 (95% CI, 0.646-0.802), respectively, whereas the combined model using the 3 parameters achieved an AUC of 0.927 (95% CI, 0.890-0.964), demonstrating superior predictive performance.

CTA-derived FFR, FAI, and PB are significantly correlated with the severity of coronary artery stenosis in patients with CAD. Combined assessment of these parameters demonstrates higher predictive value for the occurrence of MACE in patients with CAD.

Cardiovascular disease (CVD) remains a major global health challenge, and early action among young populations is critical. The aim of this study was to assess cardiovascular health among young adults aged 18-44 years in the Turkestan region using the American Heart Association Life's Essential 8 (LE8) framework and to explore health care workers' perspectives on determinants of cardiovascular health and primary health care (PHC) strategies for prevention.

A mixed-methods study design was used. In the quantitative component, cardiovascular health was assessed among adults aged 18-44 years attending urban and rural PHC facilities using an adapted LE8 approach. The overall LE8 score was calculated as the arithmetic mean of eight standardized component scores (0-100). Continuous and categorical variables were analyzed using independent-samples t-tests and chi-square (χ²) tests, respectively. In the qualitative component, semi-structured interviews were conducted with PHC nurses involved in preventive and screening programs. Interviews continued until thematic saturation was achieved and were analyzed using conventional thematic content analysis.

A total of 843 young adults participated in the study (urban: 432; rural: 411), including 289 males (34.3%) and 554 females (65.7%). Most participants had intermediate cardiovascular health (67.6%), while 28.9% had high and 3.4% had poor cardiovascular health according to the LE8 framework. Rural participants reported a healthier diet, higher physical activity, and longer sleep duration but also had substantially higher smoking prevalence and obesity. Urban participants achieved higher overall LE8 scores, largely due to lower tobacco exposure. Females, particularly in urban areas, had more favorable cardiovascular health profiles, with better smoking and sleep scores and higher overall LE8 scores than males. Interviews with seven PHC nurses indicated that cardiovascular risk factors increased after the age of 40, were more common among men, and were influenced by cultural, behavioral, and economic factors. Nurses emphasized the need to strengthen workplace- and community-based cardiovascular prevention programs.

Most young adults in the Turkestan region demonstrated moderate cardiovascular health; however, modifiable cardiovascular risk factors remain common. These findings support the implementation of gender-specific and region-specific cardiovascular prevention strategies, culturally tailored lifestyle interventions, tobacco-control measures, and earlier cardiovascular screening within PHC settings.

Platelet count fluctuations are common in patients with intracerebral hemorrhage (ICH), but the prognostic relevance of these fluctuations remains uncertain.

We conducted a retrospective multicenter cohort study using MIMIC-IV as the primary cohort and an independent Chinese cohort for external validation. Platelet count CV was calculated as the sample standard deviation divided by the mean of at least three observed, nonmissing platelet measurements obtained during the index hospitalization within 15 days before ICU admission. Missing measurement fields were excluded and were not treated as zero. Logistic regression, Cox models, restricted cubic splines, Kaplan-Meier analyses, subgroup analyses, reclassification metrics, and sensitivity analyses were performed. Primary multivariable models additionally adjusted for platelet measurement count, and effect estimates were reported per 0.1-unit increase in CV.

The primary cohort included 2,202 patients, of whom 294 died during the index hospitalization. After adjustment for clinical covariates and platelet measurement count, each 0.1-unit increase in platelet count CV was associated with in-hospital mortality (OR, 1.21; 95% CI, 1.07-1.38; p = 0.003), 28-day mortality (HR, 1.14; 95% CI, 1.04-1.26; p = 0.006), 90-day mortality (HR, 1.11; 95% CI, 1.02-1.21; p = 0.014), and 360-day mortality (HR, 1.11; 95% CI, 1.02-1.20; p = 0.016). Results were consistent in fixed-three-measurement and landmark sensitivity analyses. Adding platelet count CV produced modest reclassification improvement (continuous NRI, 0.209; 95% CI, 0.079-0.372; IDI, 0.007; 95% CI, 0.001-0.019). In the external cohort, platelet count CV was associated with 28-day mortality after multivariable adjustment (HR per 0.1-unit increase, 1.141; 95% CI, 1.007-1.292; p = 0.042).

Higher pre-ICU platelet count CV was associated with mortality after adjustment for clinical covariates and platelet-monitoring frequency. The association was directionally reproduced in the external cohort, although the effect estimate was modest. Prospective studies with standardized platelet-sampling schedules are needed before clinical implementation.

To develop and validate CT-based radiomics models incorporating intrathrombus and perithrombus features for predicting complete recanalization [modified Thrombolysis in Cerebral Infarction (mTICI)2c/3] after endovascular thrombectomy (EVT) in acute ischemic stroke (AIS), and to identify the optimal machine learning classifier.

This retrospective study included 406 AIS patients with anterior circulation large-vessel occlusion from three centers (December 2018-April 2024). Patients were allocated to training (n = 178), internal testing (n = 77), and external validation (n = 151) cohorts. Complete recanalization was defined as mTICI 2c/3. A total of 428 radiomics features were extracted from non-contrast CT and CT angiography (CTA). Least absolute shrinkage and selection operator (LASSO) regression and eleven classifiers were employed.

The combined intrathrombus-perithrombus model with logistic regression achieved area under the curve (AUC) values of 0.93 (training), 0.88 (testing), and 0.86 (validation), outperforming single-region models. Decision curve analysis confirmed superior clinical utility. The perithrombus region contributed dominantly (10 of 15 features) to the combined model.

The combined CT-based radiomics model effectively predicts complete recanalization, providing an objective tool for patient selection and treatment optimization.

Dysnatremia is a common complication following non-traumatic subarachnoid hemorrhage (SAH). Potential causes include induced hypernatremia and hyponatremia related to cerebral vasospasm or cerebral salt wasting syndrome. Based on bedside observations, this study is aimed to investigate the correlation between changes in serum sodium during an external ventricular drain (EVD) wean trial and wean trial outcomes.

A retrospective analysis was performed on a cohort of patients admitted with SAH from a large volume tertiary center. The cohort comprises patients admitted to the neuroscience ICU between 2012 and 2022 with subarachnoid hemorrhage complicated by obstructive hydrocephalus. The primary outcome was defined as successful wean if the EVD was removed at the end of a wean attempt or failed if the EVD was reopened or if a ventriculoperitoneal shunt was placed.

The cohort included 985 patients and consisted of 1,318 unique wean attempts, of which 790 were successful and 528 were unsuccessful. Patients with failed attempts had overall higher clinical and radiographic hemorrhage grades. Serum sodium concentration (mEq/L, mean ± standard deviation) on the day of wean initiation was 139.3 ± 8.5 in the successful wean group versus 140.7 ± 6.6 in the failed group (p < 0.001). During the first 3 days of the wean attempt, serum sodium decreased by 0.8 ± 7.8 mEq/L in the successful group compared with 1.5 ± 5.8 mEq/L in the failed group (p = 0.048). There was no statistically significant difference in the cumulative sodium intake before (up to 2 days) or during the wean attempt between the groups. In a multivariable mixed effect logistic regression analysis, the slope of the change in serum was associated with the wean attempt outcome (odds ratio [95% confidence interval] of 1.324 [1.174-1.506]). When cases with positive or negative sodium changes were analyzed separately, both were independently associated with outcome, with a higher rate of change associated with increased risk of failure.

Temporal changes in serum sodium during EVD wean attempts after subarachnoid hemorrhage may represent a new trigger for post-SAH dysnatremia. These changes are not directly explained by iatrogenic exposures. These hypothesis-generating findings warrant validation in prospective trials.

Health-related quality of life (HRQoL) after stroke is multidimensional, yet conventional analyses often overlook the complex interactions among its domains and how these might differ by functional status.

This study aimed to model and compare the network architecture of HRQoL between stroke survivors with mild-to-moderate versus severe functional dependence.

In this multi-center cross-sectional study, 451 inpatients were assessed using the Stroke-Specific Quality of Life (SS-QOL) scale across 12 domains. Participants were stratified into a Mild-Moderate group (Barthel Index, BI > 40; n = 259) and a Severe group (BI ≤ 40; n = 192). Polychoric correlations were used to account for the ordinal nature of the SS-QOL items. Strength centrality and bridge expected influence (based on a priori communities: Physical, Psychological, Social, General) were calculated to identify hubs and bridges. Network stability was assessed via bootstrap analysis, and a Network Comparison Test (NCT) was performed to compare global strength and network structure between groups.

Although network structure did not differ significantly between groups (p = 0.928), the severe dependence group showed significantly higher global strength (p = 0.021), suggesting a more densely connected HRQoL network. In the Mild-Moderate group, strength centrality was highest for Self-Care (S7; 1.209) and Social Roles (S8; 1.014). In the Severe group, strength centrality was highest for Upper Extremity Function (S10; 1.124) and Thinking (S9; 1.031). Bridge expected influence was highest for Thinking (S9; 0.694) in the mild-moderate group and for Language (S3; 0.722) and Thinking (S9; 0.701) in the severe group. Network stability was acceptable in both groups (CS-coefficients: 0.595 and 0.438 for strength centrality).

The fundamental architecture of post-stroke HRQoL differs across levels of functional dependence. These findings support a precision rehabilitation framework: one targeting the synergy between physical functions in milder cases, and another focused on supporting cognitive integrity and social adaptation in severe disability.

Uric acid is considered a potential risk factor for stroke; However, whether the association between hyperuricemia and stroke outcomes follows a linear or nonlinear pattern remains unclear. Therefore, this study conducted a dose-response meta-analysis based on cohort studies to investigate the association between hyperuricemia and stroke outcomes.

We systematically searched PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database from inception to April 2026. Cohort studies reporting the associations of uric acid with stroke incidence and mortality outcomes were included. Dose-response meta-analyses were performed by generalized least-squares estimation and restricted cubic splines with three knots located at the 10th, 50th, and 90th percentiles.

A total of 25 cohort studies involving 1,300,263 participants were included. Conventional meta-analysis showed that hyperuricemia was significantly associated with stroke incidence (RR = 1.20, 95%CI: 1.11-1.29) and mortality (RR = 1.36, 95%CI: 1.17-1.58). Subgroup analysis indicated that hyperuricemia significantly increased the risks of stroke incidence (RR = 1.22, 95%CI: 1.08-1.38) and mortality (RR = 1.42, 95%CI: 1.15-1.77) among women. Regarding stroke subtype, hyperuricemia was significantly associated with the incidence (RR = 1.21, 95%CI: 1.03-1.42) and mortality (RR = 1.23, 95%CI: 1.01-1.49) of ischemic stroke. A J shaped dose-response relationship was found between uric acid and stroke incidence (p = 0.0023), with risk rising across uric acid levels from104 to 764.5 μmol/L and a nadir at 225 μmol/L, whereas no significant nonlinear relationship was observed for stroke mortality.

Hyperuricemia is associated with increased risks of stroke incidence and mortality, especially in women and ischemic stroke. A J-shaped dose-response relationship was observed for stroke incidence, but not for stroke mortality. Monitoring uric acid levels and their longitudinal changes may be valuable in stroke prevention strategies.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420261394403, identifier PROSPERO (CRD420261394403).

Adherence to compression stocking wear is essential for reducing venous leg ulcer recurrence, yet adherence rates remain low. This study examined the relationship between a novel digital clinical decision-aid (the Personalized and Multidimensional Compression Assessment and Intervention [PAMCAI]), clinician practice, and patient adherence with compression stocking use, by embedding a prospective comparative cohort study within a pilot randomized controlled trial. The clinical notes of occupational therapists using PAMCAI were compared with those not using PAMCAI on their documentation of adherence and frequency of wear, identification of patient-specific barriers and attempts to address barriers. The relationship between higher documentation scores and patient adherence was also explored. Thirty-six medical records from 18 patients demonstrated significantly higher documentation scores when PAMCAI was used for all three categories (p < 0.001). Improvements in adherence were positively associated with documentation quality in the targeted categories (p < 0.001). These findings indicate that PAMCAI supports practice changes that translate to improved patient adherence, highlighting the potential value of clinician-focused decision-aids in venous leg ulcer care.

Socioeconomic factors are associated with cardiovascular morbidity. We investigated the association between education level and incident heart failure (HF), acute coronary events (AMI), and cerebrovascular events (stroke) following hospitalization with first-detected atrial fibrillation (AF).

In this nationwide retrospective observational cohort study using linked Swedish national registers, we included patients who received a first diagnosis of AF during hospitalization from 1995 to 2008. Education levels were categorized as primary, secondary, or academic, and patients were followed for up to five years. Outcomes were first hospitalization for HF, AMI, or stroke. Associations were assessed using cause-specific Cox proportional hazard models, for men and women separately. Models were adjusted for age, calendar year of AF diagnosis, whether AF was the primary or secondary admission diagnosis, comorbidity diagnoses and thromboembolic risk.

The cohort comprised 263,172 patients (mean age 72.5 ± 10.4 years; 56.2% male). Compared with primary education, secondary and academic education levels were associated with lower adjusted risks of HF and AMI in both females and males. For HF, adjusted hazard ratios (HR) were 0.96 (95% CI 0.93-1.00) for secondary and 0.82 (95% CI 0.77-0.87) for academic education in females, and 0.93 (95% CI 0.90-0.96) and 0.76 (95% CI 0.72-0.80), respectively, in males. For AMI, adjusted HRs were 0.89 (95% CI 0.85-0.93) and 0.71 (95% CI 0.65-0.77) in females, and 0.91 (95% CI 0.87-0.94) and 0.75 (95% CI 0.71-0.80) in males. For stroke, lower adjusted risks were observed only in the academic education group. Baseline comorbidity burden and thromboembolic risk were higher in lower education groups.

In this large nationwide cohort of patients hospitalized with AF, higher education level was associated with lower adjusted hazards of incident HF and AMI over five years, while the association with stroke was weaker. Education level may be considered a risk marker when planning follow-up and preventive care after hospitalization with AF.

BackgroundShort-video platforms have become important sources of health information, but the quality and reliability of venous thromboembolism (VTE)-related short videos remain unclear. This study evaluated VTE-related short videos on TikTok and Bilibili and conducted an exploratory examination of factors associated with video likes.MethodsOn February 27, 2025, the top 150 videos from each platform were retrieved according to the platforms' default ranking algorithms. Video quality and reliability were assessed using the Global Quality Score (GQS), modified DISCERN (mDISCERN), and Medical Quality Video Evaluation Tool (MQ-VET). In an exploratory analysis, an eXtreme Gradient Boosting (XGBoost) model was developed to examine factors associated with video likes.ResultsA total of 184 videos were included, comprising 81 from Bilibili and 103 from TikTok. Bilibili videos were longer, covered more VTE-related topics, and had higher median numbers of saves and shares, as well as higher GQS, mDISCERN, and MQ-VET scores than TikTok videos. TikTok videos received more likes and comments, while videos from professional uploaders on TikTok demonstrated higher quality and reliability. In the exploratory XGBoost analysis, follower count contributed the most to predicting video likes, followed by days since upload and the use of subtitles.ConclusionThe overall quality and reliability of VTE-related short videos were suboptimal. Greater professional involvement and clearer reporting of evidence sources, references, and update information may enhance the educational value of online VTE-related short videos.