Edible seeds have gained substantial scientific attention for their exceptional nutrient density and potential health-promoting properties. They are rich in dietary fiber, high-quality proteins, mono- and polyunsaturated fatty acids, omega-3 fatty acids, vitamins (E, C, and K), and minerals such as magnesium, zinc, potassium, and iron. Bioactive compounds like polyphenols, carotenoids, and peptides contribute to their strong antioxidant and anti-inflammatory effects, helping to mitigate oxidative stress and inflammation linked to chronic diseases. This review focuses on pumpkin, flax, sesame, chia, and melon seeds, valuable sources of essential micronutrients and bioactives with demonstrated nutraceutical potential. Pumpkin seeds enhance immune strength because of their mineral profile, whereas chia seeds provide omega-3 fatty acids associated with neuroprotection and anti-Alzheimer's effects. The omega-3 content of flax and chia seeds offers cardioprotective benefits, whereas sesame lignans (sesamin) exhibit lipid-lowering and anti-aging properties. Flaxseed's secoisolariciresinol diglycoside (SDG) contributes to cardiovascular and anti-cancer effects, and melon seed squalene supports immune health and exerts anti-cancer activity. Mechanistic studies highlight these seeds' ability to regulate molecular pathways related to oxidative stress, inflammation, hypertension, diabetes, cancer, and metabolic disorders. Their bioactive constituents act through antioxidant, anti-inflammatory, and metabolic-regulating mechanisms, validating their classification as functional foods. Evidence from clinical and biochemical studies largely supports these benefits, although some claims stem from preliminary or in vitro findings. Overall, pumpkin, flax, sesame, chia, and melon seeds demonstrate significant potential as natural sources of nutrients and bioactive compounds that promote cardiovascular, metabolic, and immune health. Their integration into daily diets and functional food formulations could play a vital role in preventing lifestyle-related chronic diseases and enhancing overall well-being.

Macrophages are the predominant immune cell type found in active multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE) lesions, where they contribute to demyelination and axonal damage. Depending on the lesion stage, these cells can exhibit either a pro-inflammatory or neurotoxic phenotype that drives central nervous system (CNS) injury or an anti-inflammatory phenotype that promotes remyelination. Therefore, strategies that modulate macrophage function may offer therapeutic benefits for MS. Polyethylene glycol (PEG) has shown anti-inflammatory and neuroprotective effects in various models of inflammation and neurodegeneration, but the mechanisms involved remain poorly understood. In this study, we investigated the potential of PEG and PEG-based delivery systems to modulate EAE. Although PEG alone did not alter EAE progression, it suppressed the pro-inflammatory phenotype of macrophages in vitro. Given the clinical potential and macrophage-targeting properties of larger PEGylated liposomes, we assessed the impact of large (~700 nm) PEGylated liposomes in EAE. These liposomes selectively targeted activated, CNS-infiltrating macrophages and, when administered to mice either before or after neurological manifestations of EAE had developed, they significantly reduced both clinical signs as well as demyelination in the spinal cord. Mechanistically, this treatment reduced macrophage secretion of pro-inflammatory cytokine IL-1β and decreased macrophage and T cell infiltration into the CNS compared to untreated controls. Together, these findings highlight the therapeutic potential of macrophage-targeted PEGylated liposomes in controlling IL-1β-mediated neuroinflammation in MS and potentially other neurodegenerative diseases.

Maternal anti-Ro/SSA (Sjögren's syndrome-related antigen A) [± anti-La/SSB (Sjögren's syndrome type B antigen)] antibodies can lead to neonatal lupus, which may present most severely as autoimmune congenital atrioventricular block (CAVB). Although CAVB is uncommon (~ 2% of anti-Ro/SSA-positive pregnancies), once a complete block develops, spontaneous reversal is rare, and many affected infants require permanent pacemaker implantation. Consequently, prevention and early detection are critical components of management, particularly in pregnancies following previous antibody-mediated losses.

A 34-year-old woman with primary Sjögren's syndrome, high-titer anti-Ro/SSA and anti-La/SSB, and a history of five prior pregnancy losses-two early (biochemical, 7 weeks) and three midtrimester (16-21 weeks) complicated with severe fetal complete heart block (one demise, two terminations for hydrops)-presented for her sixth pregnancy. A multidisciplinary protocol was implemented, including hydroxychloroquine 400 mg/day, methylprednisolone (initially 6 mg/day, briefly increased to 32 mg/day at 14-16 weeks, then tapered to 8 mg/day), low-dose aspirin 50 mg/day, and fondaparinux 2.5 mg/day from ovulation throughout pregnancy, along with scheduled intravenous immunoglobulin (IVIG; 20 g at 4, 6 + 6, and 8 + 2 weeks; followed by 20 g/day × 3 at 14, 18, and 22weeks). From 14weeks, weekly fetal echocardiography with Doppler atrioventricular (AV)-interval monitoring (16-26weeks) remained normal. At 38 + 2weeks, a cesarean section delivered a female infant weighing 2,710 g and measuring 49 cm, with Apgar scores of 9/10. Neonatal telemetry/ECG showed sinus rhythm at 144 bpm without AV block. Echocardiography revealed a patent ductus arteriosus and a small atrial septal defect, with moderate pulmonary hypertension (SPAP 51 mmHg). Brain MRI and EEG were normal, and there were no cutaneous, hepatic, hematologic, or other features of neonatal lupus. Postpartum, the mother continued methylprednisolone 6 mg/day, hydroxychloroquine 400 mg daily, and enoxaparin 4,000 IU once daily for 4 weeks maintain disease suppression and thromboprophylaxis.

In an anti-Ro/SSA-positive pregnancy at extreme risk, a prevention-first, protocol-driven approach-centered on hydroxychloroquine, judicious immunomodulation, and structured AV-interval surveillance-successfully averted CAVB and resulted in a pacemaker-free live birth. Minor cardiac lesions warrant ongoing follow-up; however, the absence of conduction disease underscores the clinical utility of this strategy in carefully selected, extreme-risk pregnancies.

Electrocardiograms (ECGs) and troponin (Tn) testing are essential tools for the diagnosis and management of cardiac conditions. Prompt diagnosis using these tools can significantly improve patient outcomes.

The objective of this study was to design and create a deep-learning model capable of predicting high-sensitivity troponin (hs-Tn) elevation in patients undergoing chest-pain triage. We developed a novel, multi-modal, externally validated deep-learning model that incorporates ECG data, age, and sex to predict high-sensitivity troponin-T elevation. The dataset used for this study was multi-centre and externally validated, drawing from data collected in two emergency rooms. The study population included all patients presenting to the ER with either chest pain or dyspnoea during the study period, where an ECG was recorded and a Tn test was performed. The model was trained on a dataset comprising 35 821 ECGs, with a positive fraction of 35.7%. It achieved an internal area under the receiver operating characteristic (AUROC) of 0.8958 ± 0.0040 (95% CI) and an AUROC of 0.8765 ± 0.0110 in external validation. The model's Score-CAM saliency maps demonstrated high activation from the ST-segment, indicating that the model draws information from relevant ECG segments.

This study presents new opportunities for enhancing triage processes, enabling more rapid and accurate alerts to physicians regarding acute myocardial infarctions. The primary benefit of predicting Tn elevation lies in the objectivity of the label compared with compounded clinical outcomes and diagnoses.

Exposure to adverse childhood experiences (ACEs) has consistent associations with increased long-term risk of cardiovascular disease (CVD). However, links of distinct ACE subtypes and particular ACEs with later-life CVD are insufficiently understood. This longitudinal cohort study initially recruited 20,452 participants from the China Health and Retirement Longitudinal Study and Life History Survey. Follow-up data were obtained from five waves conducted between 2011 and 2020. ACEs were measured with ten items adapted from the Life Stressor Checklist-Revised, a measure that includes five threat-related ACEs and five deprivation-related ACEs. The outcome measure was CVD (including heart disease and stroke) during the follow-up period. Multivariate Cox proportional hazards regression models assessed links of cumulative ACEs, ACE subtypes, and individual ACEs with CVD incidence. Of 13,920 included participants, 8434 (60.6 %) reported exposure to at least one ACE. During the study period of 9 years, 2689 participants (19.3 %) received a clinical diagnosis of CVD, including 2098 (15.1 %) with heart disease and 683 (4.9 %) with stroke. Both threat-related ACEs (hazard ratio [HR], 1.08; 95 % CI, 1.03-1.12) and deprivation-related ACEs (HR, 1.08; 95 % CI, 1.01-1.15) were independently associated with increased risk of CVD, with the strongest association observed for stroke. Findings underscore the importance of considering threat- and deprivation-related ACEs in assessments and targeted intervention studies as potential means of yielding long-term cardioprotective benefits.

Coronary artery calcium (CAC) scoring is an established marker of atherosclerotic burden and cardiovascular risk. While the Agatston score is the clinical gold standard, alternative visual scoring methods-including the Visual Ordinal Score, Weston Score, and Vessel-specific extent-based score-are increasingly used, particularly in non-gated or opportunistic CT imaging. This study aimed to compare the diagnostic performance, inter-observer reliability, and correlation of different visual scoring methods against the Agatston score.

A total of 299 cases were evaluated using ECG-gated CT scans. Each case was independently scored in a blinded fashion by two observers using three visual methods: (1) Visual Ordinal Score (VS), (2) Weston Score (WS) and (3) Vessel-specific extent-based score (VSES). A novel visual CAC score was derived by combining Weston and Vessel-specific extent-based scoring (= Weston Extent Score, WES). Cohen's Kappa and Intraclass Correlation Coefficients (ICC) were used for inter-observer agreement. Classification performance was assessed against Agatston-based categories (No CAC, Mild, Moderate, Severe), including accuracy, precision, sensitivity, and specificity. Correlation analyses were conducted using Pearson and Spearman coefficients.

All scoring methods showed high correlation with the Agatston score (Spearman ρ > 0.87; p < 0.001). Visual scoring demonstrated the highest inter-observer agreement (Kappa = 0.94, ICC = 0.97), followed by Weston (Kappa = 0.90) and Vessel-Specific scores (Kappa = 0.77). Visual scoring also yielded the highest accuracy (Observer 1: 91.3 %, Observer 2: 90.0 %) The newly derived WES score achieved 80.9 % accuracy, with macro-averaged specificity of 93.8 % and improving diagnostic accuracy compared to WS and VSES.

Different visual scoring offers excellent reproducibility and diagnostic accuracy for CAC classification, with strong correlation to the Agatston score. The newly-derived WES score could be useful in providing a practical balance regarding volumetric information (CAC densitiy) and anatomical distribution of CAC. These findings support the implementation of structured visual CAC scoring in clinical and opportunistic CT settings.

Hydrogels, with excellent hydrophilicity and high-water content, have emerged as highly versatile biomaterials for tissue engineering and regenerative medicine. On account of the natural mimicry of extracellular matrix (ECM), moisture retention, porosity, biocompatibility, biodegradability, and tunable functionality, they provide crucial structural and biochemical support for tissue repair. As chronic wounds, aging, and degenerative diseases continue to increase, hydrogels offer great potential to overcome the limitations of traditional therapies. Despite these developments, there remains a crucial need for hydrogels that can effectively address the complex, multiphase nature of tissue repair while being cost-effective and easily applicable in various clinical settings. This review begins by taking wound healing as a representative example, particularly elaborating on the process of wound healing and therapeutic strategies to illustrate the importance of hydrogel design by tissue engineering technology. We then comprehensively evaluate the emerging hydrogel systems that integrate multiple therapeutic functions, including drug delivery, infection prevention, stimulus responsiveness, and clinical translation for wound dressings. Additionally, this review further extends to the application scope and incorporates the latest research advancements of multifunctional hydrogels in other biomedical applications. Finally, we summarize the shortcomings of existing studies and propose future research directions, with a view to providing a valuable reference basis for the development of multifunctional hydrogels within the realm of tissue engineering and regenerative medicine.

Risk of venous thromboembolism (VTE) recurrence remains high in patients with cancer-associated thrombosis (CAT), despite therapeutic anticoagulation. Identifying patients at risk of treatment failure is still a challenge.

We aimed to assess the performance of the Ottawa score in predicting VTE recurrence in a large homogeneous population of patients with CAT treated with the same anticoagulant, tinzaparin, for at least 3 months.

Individual patient data from 3 prospective cohort studies and 1 randomized controlled trial were pooled (PROSPERO: CRD42019119907). Clinical events of interest were adjudicated by independent central adjudication committees in all 4 studies.

Among the 1413 patients included, the Ottawa score could be calculated for 1088 of whom 646 (59.4%) were classified at high risk of recurrence (Ottawa score ≥ 1). The 6-month cumulative incidence of recurrent VTE was 5.0% (95% CI, 3.2-7.8) in the Ottawa low-risk group and 8.5% (95% CI, 6.6-10.8) in the high-risk group. The area under the receiver operating characteristic curve was 0.56 (95% CI, 0.51-0.62). The sensitivity of the dichotomized Ottawa score (score ≥ 1) was 72.8% (95% CI, 62.6%-83.0%), the specificity was 41.9% (95% CI, 37.8%-45.9%), the positive predictive value was 8.6% (95% CI, 6.4%-10.8%), and the negative predictive value was 95.3% (95% CI, 93.3%-97.4%). Introducing additional predictive factors failed to significantly improve the score's performance.

Despite the large number of patients and anticoagulant treatment standardization, the Ottawa score failed to accurately predict recurrent VTE in patients with CAT treated with tinzaparin.

Platelets play a central role in hemostatic and inflammatory responses during septic shock, with lipids being essential for their function. However, the specific lipidomic alterations occurring in platelets during septic shock remain poorly understood.

This study aimed to characterize platelet lipidomic changes in septic shock and investigate their associations with disease severity.

In this matched case-control study, platelets were isolated from 49 septic shock patients and 47 nonseptic controls (matched for age, gender, and comorbidities). Lipidomic profiling was performed using untargeted lipidomics to identify significant alterations in the platelet lipidome. Associations among lipid changes, clinical data, and plasma biomarkers of coagulopathy and inflammation were explored.

More than 60% of the annotated platelet lipids were significantly altered in septic shock. Cholesteryl esters, sphingomyelins, lysophosphatidylcholines, and ether-lipids were significantly reduced, while ceramide levels increased. Fatty acyl chain remodeling displayed distinct patterns, with polyunsaturated fatty acids increasing in triacylglycerols and decreasing in phospholipids. Lipid alterations were strongly associated with thrombocytopenia, and lysophosphatidylcholine levels inversely correlated with disease severity, as indicated by the Sequential Organ Failure Assessment score.

Septic shock induces significant disruptions in the platelet lipidome, with the extent of these alterations correlating with sepsis-associated thrombocytopenia severity. The observed changes affect multiple lipid classes, surpassing those reported under physiological conditions or in other diseases. These findings highlight the impact of sepsis-driven dysregulated inflammation and coagulopathy on platelet lipid composition, providing new insights into sepsis pathophysiology.

Rheumatic heart disease (RHD) is a key contributor to maternal cardiovascular morbidity and mortality in sub-Saharan Africa (SSA). Though low- and middle-income countries (LMICs), particularly those in SSA, face a greater burden of RHD, existing systematic reviews have not specifically focused on cardiac and obstetric complications among affected women. We aimed to study cardiac and obstetric complications in pregnant and postpartum women with RHD in SSA and to evaluate the rate of valvular interventions in pregnant or postpartum women with severe disease.

We performed a systematic search in MEDLINE and online sources for studies of women of childbearing age (15-49 years) with RHD published after 2000 in SSA. Included study types were randomized controlled trials, retrospective and prospective cohort studies, case-control studies, case reports, and case series. Two authors independently extracted data and critically appraised articles. PROSPERO registration number: CRD42024628121.

We identified 1,478 unique citations, and nine full-text studies met inclusion criteria. Included studies were case series (7), one cohort study, and one case-control study, including a total of 787 pregnant women with cardiac disease, of whom the majority had RHD. Mitral stenosis and regurgitation were the most common valve lesions. Heart failure and arrhythmia occurred in at least 12.9% and up to 36% of study participants, respectively. Eight studies reported deaths due to cardiac causes (median: six deaths due to cardiac disease; total number of deaths: 56). Preterm labor/delivery was the most reported obstetric event, with incidence ranging from 5.2-35.2%. Few pregnant patients received any valve intervention.

Pregnant women with RHD in SSA are at risk for both adverse cardiac and obstetric outcomes in pregnancy, particularly heart failure and preterm labor. Future efforts may include registries focused on pregnant women with RHD and scaling cardiac interventional capacity to benefit pregnant women with RHD in SSA.

We performed a systematic search in MEDLINE and online sources to study cardiac and obstetric complications and rates of valvular interventions in pregnant and postpartum women with rheumatic heart disease (RHD) in sub-Saharan Africa (SSA). Two authors independently extracted data and critically appraised articles. Nine full-text studies met inclusion criteria, capturing 787 pregnant women with cardiac disease, mostly RHD. Heart failure and arrhythmia occurred in at least 12.9% and up to 36% of study participants, respectively. Fifty-six deaths were reported from cardiac causes. Preterm labor/delivery was the most reported obstetric event, and few pregnant patients received any valve intervention. We found that women with RHD in SSA are at risk for adverse cardiac and obstetric outcomes in pregnancy, particularly heart failure and preterm labor. Future efforts may include registries focused on pregnant women with RHD and scaling cardiac interventional capacity to benefit pregnant women with RHD in SSA.