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Remote ischemic preconditioning (RIpreC) is a strategy for remotely protecting target organs such as the brain by applying brief ischemia and reperfusion to the limb. However, the mechanisms underlying RIpreC-induced neuroprotection remain unclear. We aimed to investigate the neuroprotective effects of RIpreC on the peroxisome proliferator-activated receptor-gamma coactivator 1 alpha (PGC-1α)/ fibronectin type III domain-containing protein 5 (FNDC5)/ brain-derived neurotrophic factor (BDNF) pathway in rat models of ischemic stroke. Rats were assigned to three groups: ischemia-reperfusion injury (IR, The online version contains supplementary material available at 10.1007/s12975-026-01422-z. Show less

Flourishing is a key positive psychological construct that has been linked to favorable health-related outcomes in patients with inflammatory bowel disease in prior research. However, current research often overlooks the variations in flourishing levels within this population, as well as the mechanisms through which flourishing interacts with disease progression. This study aimed to identify latent categories of flourishing among patients with inflammatory bowel disease and to analyze the potential influencing factors. This study employed a cross-sectional, descriptive exploratory design involving 316 patients diagnosed with inflammatory bowel disease. Data collection was carried out using a general information questionnaire, the Flourishing Scale (FS), the IBD Self-Efficacy Scale (IBD-SES), the Resilience Scale for Inflammatory Bowel Disease (RS-IBD), and the Social Support Rating Scale (SSRS). Latent profile analysis (LPA) was utilized to identify potential subgroups exhibiting flourishing, while multiple logistic regression analysis was conducted to evaluate the influencing factors. The flourishing of individuals with inflammatory bowel disease was classified into three latent groups: the low flourishing-low support beneficiary group ( Patients with inflammatory bowel disease demonstrate three distinct latent categories of flourishing. Healthcare professionals should implement more accurate and targeted intervention measures based on the characteristics and influencing factors of different potential categories, in order to improve the flourishing levels of patients with inflammatory bowel disease. Show less

West Nile virus (WNV), an arbovirus of emerging global interest, can cause neuroinvasive disease in humans. Currently, no protective vaccine or specific treatment is available for human WNV encephalitis. The virus induces neuronal cell death, while astrocytes and microglia cells are suspected to contribute to WNV pathology. Hence, understanding their role is crucial for future treatment approaches. In this study, we establish a WNV encephalitis model using human cerebral organoids, generated with male iPSCs. Infection results in heterogeneous kinetics with an early strong replication potentially leading to viral clearance, while a late peak was associated with more long-term infection. Viral foci are seen in cortical-like areas, rich in neurons and astrocytes, however void of microglia. Pro-inflammatory cytokines (IL-6, TNF-α, IL-18), chemokines (CXCL10, CCL17, CX3CL1, CCL2) and biomarkers (IL-1RA, sTREM-1, sRAGE, BDNF) are increasingly released. Conclusively, human cerebral organoids make suitable WNV encephalitis models with valuable properties to study acute and long-term infection. Show less

Gout is an acute inflammatory arthritis triggered by monosodium urate (MSU) crystal deposition and activation of innate immune responses. In addition to inflammasome signaling, emerging evidence suggests that metabolic reprogramming of arachidonic acid (AA) pathways amplifies inflammatory responses during gout flares. However, the contribution of upstream fatty acid desaturation processes that regulate endogenous AA availability remains poorly defined. 1,2,3,4,6-Penta-O-galloyl-β-D-glucose (PGG) is a naturally occurring polyphenol with reported anti-inflammatory activity, but its effects on MSU-induced fatty acid metabolism and gouty inflammation have not been well established. Publicly available bulk and single-cell transcriptomic datasets from human and mouse gout studies were analyzed to assess dysregulation of AA-associated pathways. MSU-induced inflammatory responses were examined in mouse bone marrow-derived macrophages and in a murine MSU-induced gout model. Macrophages were treated with PGG prior to MSU stimulation, and inflammatory cytokine production, phagocytosis, and expression of fatty acid desaturases were assessed. Lipidomic analysis of macrophages and plasma was performed using gas chromatography-mass spectrometry (GC-MS) to quantify arachidonic acid and related fatty acids. In vivo disease severity, cytokine expression, and anti-inflammatory markers were evaluated following PGG treatment. Analysis of public datasets revealed consistent dysregulation of arachidonic acid-associated inflammatory pathways during gout flares. In macrophages, MSU stimulation increased expression of fatty acid desaturases FADS1 and FADS2 and promoted accumulation of arachidonic acid, concomitant with robust production of pro-inflammatory cytokines. PGG treatment significantly suppressed MSU-induced FADS1, FADS2 and arachidonic acid levels, and attenuated pro-inflammatory cytokine production. PGG also markedly impaired macrophage phagocytosis of MSU crystals. In vivo, PGG treatment significantly reduced clinical disease severity in an MSU-induced gout model, suppressed fatty acid desaturation and arachidonic acid accumulation in plasma, decreased pro-inflammatory cytokine expression, and enhanced anti-inflammatory markers. These findings identify fatty acid desaturation as an important metabolic contributor to gouty inflammation and demonstrate that PGG suppresses MSU-induced inflammation by limiting endogenous arachidonic acid availability, reducing inflammatory amplification, and impairing MSU crystal phagocytosis. Targeting upstream fatty acid metabolism represents a potential therapeutic strategy for modulating acute gout flares beyond conventional anti-inflammatory approaches. Show less

Lipoprotein(a) (Lp(a)) is a causal risk-factor for atherosclerotic cardiovascular disease including acute ischemic stroke (AIS). The underlying pathomechanisms mediating this risk are less well understood, especially in AIS caused by large artery atherosclerosis (LAA). In this observational cohort study, we evaluated the association of Lp(a) with markers of LAA, namely carotid intima media thickness (cIMT) and the presence of extra- or intracranial vessel narrowing plaques. Among participants of the BIOSIGNAL cohort study we determined Lp(a) levels within 24 h after symptom onset in 1161 AIS patients from the single center of Zurich. cIMT was determined using a semi-automated computerized edge tracking software, internal carotid artery (ICA) stenosis was graded according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, intracranial ultrasound was performed by transcranial color-coded duplex (TCCD). Higher Lp(a) levels were not associated with an increased cIMT in univariable or multivariable regression models containing known cardiovascular risk factors. Higher Lp(a) levels were not associated with the presence of neither extracranial high-grade ICA-stenosis nor significant intracranial stenosis assessed by neurovascular ultrasound. In AIS patients higher Lp(a) levels were not associated with clinical markers of atherosclerotic burden despite its association with LAA-stroke etiology and an increased risk for stroke recurrence. Date of registration: 17–10-2014. Registration-URL: http://www.clinicaltrials.gov; Unique identifier: NCT-02274727. The online version contains supplementary material available at 10.1186/s12944-026-02913-6. Show less

B-cell maturation antigen (BCMA) is the main target for chimeric antigen receptor (CAR)-T cells in multiple myeloma (MM), demonstrating promising outcomes. However, unlike what happens with CART19 in lymphoblastic leukemia and non-Hodgkin's lymphoma, a high proportion of patients will relapse after CAR-T BCMA therapy due to insufficient antigen expression, low CAR-T cell persistence and/or T-cell exhaustion. In other B cell malignancies, second-generation anti-CD19 4-1BB CARs with CD28-transmembrane domain (TMD) have shown high efficacy and a favorable toxicity profile. We have developed a second-generation CD8α-TM BCMA-4-1BBζ CAR-T product, ARI0002h (Cesnicabtagene-autoleucel) for patients with relapsed/refractory MM. We hypothesized that replacing the TMD of ARI0002h with a CD28-TMD could increase efficacy and reduce tumor escape while maintaining a tolerable toxicity profile. We generated CAR-T cells using T-cells isolated from buffy coats and evaluated the efficacy and fitness of CAR-Ts at day 8-10 of expansion against several MM cell lines. In vitro analyses included cytotoxicity, proliferation, cytokine secretion, T-cell subset markers, activation and exhaustion profiling, metabolomic assays, and RNA-seq after multiple tumor challenges. In in vivo xenograft studies using NSG mice, with tumor cells expressing GFP-ffLuc, disease progression was monitored weekly via bioluminescence imaging. Despite showing similar in vitro performance regarding cytotoxicity, proliferation and cytokine production, ARI2h-TM28 outperforms ARI0002h in a low BCMA expression setting and achieves superior in vivo tumor control and survival in relapse models with antigen downregulation. Furthermore, ARI2h-TM28 showed an optimized metabolic profile, more oxidative and energetic compared with ARI0002h, with downregulation of proinflammatory genes in CD8 T cells, contributing altogether both to reduced exhaustion and increased persistence of the CARs, improving their efficacy in preclinical models. Incorporating a CD28-TMD into the ARI0002h CAR enhances tumor control even in relapse models with downregulation of the target antigen, offering improved long-term disease management. This modification increases potency against MM tumor cell lines with both normal and reduced BCMA expression, demonstrating superior metabolic endurance and in vivo activity. Show less

Depression is one of the most prevalent and disabling non-motor symptoms in Parkinson's disease (PD), forming a bidirectional relationship with motor dysfunction that worsens quality of life. Pharmacological treatments exhibit limited and inconsistent efficacy, and may lead to adverse interactions. Acupuncture may improve both depressive and motor symptoms by regulating the neuro-immune-endocrine network, but high-quality evidence remains insufficient. This study aims to evaluate the efficacy and safety of acupuncture as an adjunctive therapy for depression in PD and to explore potential biological correlates of clinical changes using predefined serum biomarkers. In this single-center, evaluator-blinded, randomized controlled trial, 88 patients with PD and comorbid depression will be randomly assigned to an acupuncture group or a waitlist control group. The primary outcome is the change in the Montgomery-Asberg Depression Rating Scale (MADRS) score. Secondary outcomes include motor function, anxiety, sleep quality, and overall quality of life. Exploratory analyses will assess serum inflammatory cytokines, brain-derived neurotrophic factor (BDNF), and kynurenine/tryptophan (KYN/TRP) ratio. We hypothesize that adjunctive acupuncture may improve depressive and motor symptoms compared with the control. Exploratory analyses will examine whether clinical changes are associated with changes in relevant biomarkers. This study will provide rigorous evidence for acupuncture as an adjunctive therapy, offering a non-pharmacological strategy to optimize the comprehensive management of PD and disrupt the bidirectional emotion-motor interplay. https://www.chictr.org.cn/, identifier ChiCTR2500113443. Show less

Upwards of 50% of people do not respond to the primary treatment modalities for major depressive disorder (MDD), which has led to increased attention and use of alternative methods, including exercise and psychedelics. While interventions using either exercise or psychedelics have demonstrated largely positive results in isolation, their synergistic potential has yet to be explored. As such, this commentary provides an overview of exercise/psychedelics as a treatment for depression and their potential synergy and/or complementarity. From a biological perspective, psychedelics acutely enhance brain-derived neurotrophic factor (BDNF) signalling, while exercise provides sustained BDNF elevation; psychedelics enhance neuroplasticity largely in the cortex (with only modest effects in the hippocampus), while exercise boosts hippocampal neurogenesis; psychedelics increase glutamate release via stimulation of 5-HT Show less

Following spinal cord injury (SCI), neuroinflammation driven by lipid-laden macrophage foam cells is a key pathology, yet how these cells manage their lipid homeostasis is unclear. We delineate a neuroprotective axis in which macrophages deploy apolipoprotein E (APOE) to transfer intracellular lipids to neighboring cells, especially fibroblasts. Genetic ablation of The online version contains supplementary material available at 10.1186/s12974-026-03756-9. Show less

Snacktivity—brief, high-frequency bouts of moderate-to-vigorous physical activity (MVPA) integrated into daily routines—may interrupt prolonged sitting and help accumulate total activity. Step count is a practical proxy for this pattern, yet the cadence thresholds that map short-bout stepping to MVPA and the relevance of bout–cadence patterns to adiposity remain unclear. This study aimed to examine the associations between accelerometer-derived step metrics and adiposity and to identify pragmatic step-based thresholds in older women. We conducted a cross-sectional study of 1,109 community-dwelling older women in Yantai, Shandong Province, China, with a mean age of 64.93 years (SD = 2.82). Step-based metrics (daily steps, MVPA and light-intensity physical activity (LPA) steps, cadence, and bout patterns) were derived from a waist-worn triaxial accelerometer. adiposity was defined using body-fat-ratio (BFR) categories assessed by multi-frequency bioelectrical impedance analysis. Multiple linear regression estimated associations with progressive adjustment for sociodemographic, lifestyle, and health-related covariates, with additional adjustment for total sedentary time. Sensitivity analyses replaced BFR with BMI and examined visceral fat mass (VFM) using linear regression. Receiver operating characteristic (ROC) analyses identified pragmatic step and cadence cut-points. MVPA step counts and cadence were consistently and inversely associated with adiposity ( Among older women, MVPA-oriented step metrics—particularly ~ 1,846 MVPA steps/day and ~ 94.3 steps/min cadence—showed inverse associations with adiposity and outperformed LPA metrics. These thresholds may serve as pragmatic, low-barrier activity targets, but causal relationships require confirmation in longitudinal and experimental studies. The online version contains supplementary material available at 10.1186/s12889-026-26912-5. Show less

Atherosclerotic cardiovascular diseases (ASCVDs) remain the primary cause of morbidity and mortality. Macrophages are involved in the progression and regression of atherosclerosis, and macrophage amino acid metabolism is important during this process. Here, we identified that the expression of cystine/glutamate antiporter Slc7a11 was upregulated by oxidized low-density lipoprotein, and specifically enhanced in the macrophages of atherosclerotic plaques. Macrophage-specific Show less

Cleft lip with or without cleft palate (CL ± P) is a common congenital anomaly with complex genetic origins. This study presents a genetic case series of three Ecuadorian families with non-syndromic cleft lip and/or palate analyzed using whole-exome sequencing (WES). We identified rare or novel variants in genes with established or emerging roles in craniofacial development. Bioinformatic analyses—while not supported by functional validation—helped prioritize several candidate variants, including a novel These findings provide exploratory genetic data from an underrepresented Latin American population and highlight the need to include diverse cohorts in genomic research to improve diagnosis and genetic counseling. The online version contains supplementary material available at 10.1186/s12903-026-07796-8. Show less

Type 2 diabetes mellitus (T2DM) represents a systemic disease that extends beyond metabolic dysfunction to include accelerated neurocognitive decline driven by oxidative stress, inflammation, and insulin resistance. Emerging evidence suggests that essential micronutrients may interact synergistically or antagonistically with biguanides, particularly metformin, to influence neurocognitive function. This systematic review synthesized preclinical and clinical evidence on the interactions between essential micronutrients and biguanides (notably metformin) in modulating neurocognitive outcomes in T2DM. Following PRISMA 2020 guidelines, we systematically searched PubMed, Web of Science, and Scopus for studies published between 2010 and 2025. After screening 226 records in Rayyan, 40 studies met the inclusion criteria. Both preclinical and clinical studies were analyzed descriptively to identify patterns of mechanistic and functional outcomes. Extracted data covered intervention types, doses, duration, biomarkers, and cognitive outcomes. Of the 40 studies, 27 (67.5%) were preclinical and 13 (32.5%) were clinical, spanning 14 countries. Most interventions involved vitamin D, zinc, magnesium, vitamin E, or polyphenols, either alone or combined with metformin. Synergistic effects were observed in 77.5% of studies, with significant improvements in fasting plasma glucose, HbA1c, insulin sensitivity, and oxidative balance. Key molecular pathways involved AMPK, PI3K/Akt, GSK3β, and Nrf2-CREB, which mediated enhanced glucose utilization, mitochondrial function, and synaptic plasticity. Antagonistic effects (10%) were mainly linked to metformin-induced vitamin B12 depletion, which impaired neurotrophic signaling and elevated homocysteine levels. Across studies, neuroprotective benefits correlated with increased BDNF, PSD-95, and SIRT1 expression, and reduced IL-6, TNF-α, and MDA levels. Most (75%) of the studies showed a synergistic interaction between biguanides (metformin) and micronutrients save a few that showed antagonistic interaction. Integrating micronutrient supplementation particularly vitamin D, zinc, and antioxidant compounds into T2DM management enhances both metabolic control and cognitive function. These findings support a paradigm shift toward combined nutraceutical-pharmacologic therapy within clinical and public health frameworks. Future research should focus on dose optimization, mechanistic validation, and long-term clinical evaluation to develop evidence-based, nutrition-sensitive diabetes care models. Show less

Peripheral nerve injury (PNI) is a significant health concern, affecting millions worldwide. Key neurotrophic factors, including nerve growth factor, brain-derived neurotrophic factor (BDNF), and glial cell line-derived neurotrophic factor, have shown promise in facilitating neural regeneration. The effects of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids have been extensively studied, emphasizing the importance of appropriate timing and duration of administration. Antioxidants such as vitamin E and melatonin have exhibited neuroprotective effects in animal models, but further research is necessary to determine their efficacy, optimal dosage, and administration in humans. Immunosuppressive agents like tacrolimus (FK506) and cyclosporin A have demonstrated substantial potential in enhancing peripheral nerve recovery. Supportive strategies, including physical therapy and neuromodulation techniques such as electrical and transcranial stimulation, have shown effectiveness in promoting nerve regeneration. Advances in bioengineering, including nerve conduits and stem cell transplantation, which mimic natural nerve repair mechanisms, hold considerable promise for improving PNI treatments. In conclusion, PNI therapy is progressing towards an integrative approach, combining surgical techniques with pharmacological interventions, bioengineering, and regenerative medicine to enhance outcomes while minimizing adverse effects. This review explores recent advancements in peripheral nerve regeneration using both natural and synthetic agents, highlighting the shift toward more comprehensive treatment strategies. Show less

Hemodialysis, as one of the main alternative treatment methods for end-stage renal disease, has received much attention in recent years. Due to the particularity of hemodialysis treatment, patients have a relatively high risk of infection during the treatment process. Hemodialysis nurses, who are the main executors of the treatment operations and have the most contact with patients, have a close relationship with the infection risk of patients. The level of their hospital infection prevention and control literacy is closely related to the infection risk of patients. To explore the current level of knowledge, attitudes, and practices (KAP) of hospital infection prevention and control among haemodialysis nurses in the Sichuan Province, China, and identified their potential categories. This provided evidence-based recommendations for improving infection control management in hemodialysis departments. A cross-sectional study was conducted From July 15 to August 15, 2025 using a convenience sampling method to survey 470 hemodialysis nurses from 78 hospitals in Sichuan Province. Participants were licensed nurses with over 3 months of hemodialysis experience. Data were collected using the A total of 460 valid questionnaires were collected, with an effective response rate of 97.87%. The average scores for knowledge, attitudes, and practices related to hospital infection prevention and control among haemodialysis nurses were 4.67 ± 0.43, 4.59 ± 0.43, and 4.74 ± 0.34, respectively. Three latent profile models were constructed, with the two-class model identified as the optimal solution, which were defined as the "Low KAP Group" (25.9%) and "High KAP Group" (74.1%). Logistic regression analysis revealed that sex, responsibility for infection control, hospital level, annual number of infection control training sessions, organizational support, and work engagement were significant influencing factors ( The KAP level of haemodialysis nurses in hospital infection prevention and control was relatively high. Hospital managers should tailor supportive work environments on the basis of the individual characteristics and work engagement of haemodialysis nurses to improve the KAP level of nosocomial infection prevention and control among haemodialysis nurses. Show less

Swiss adolescents fall short of the WHO's guideline of 60 min of moderate-to-vigorous physical activity (MVPA) per day. Developing targeted interventions or policies requires an understanding of adolescents' daily activity patterns. Since adolescents spend much time at school, it is essential to consider not only leisure but also school segments when assessing physical activity (PA). Therefore, this study investigates how Swiss adolescents' PA is distributed across different school time segments and examines to what extent they meet recommended activity levels. This cross-sectional study uses baseline data from the Active School project. The sample included 666 7th-grade students (mean age = 13.27 ± 0.55 years, 47.7% boys, 51.8% girls, 0.5% diverse) from 12 secondary schools. PA data, gathered over five schooldays using wrist-worn GENEActiv accelerometers, were segmented into physical education (PE), recess, classroom time, entire school time, and leisure time. Activity levels were categorized into inactivity (IN), light physical activity (LPA), and MVPA. Descriptive and inferential statistics (ANOVAs, Within school time, MVPA varied significantly by segment (PE: 30.59%, recess: 18.80%, classroom: 5.69%, Substantial opportunities for PA are lost across all school segments in the Swiss context, with girls consistently less active than boys. Based on these findings, segment-specific and gender-sensitive school PA policies are discussed, and a comprehensive school approach to PA promotion is recommended to support more effective and equitable PA promotion among adolescents. German Clinical Trials Register (DRKS00033362). Date of registration: January 25, 2024. Retrospectively registered. Show less

To characterize the clinical, radiological, and molecular characteristics of CNS tumors associated with Noonan syndrome (NS) and other non-Neurofibromatosis type 1 RASopathies. Twenty-four patients with concern for NS underwent clinical and central radiological review in this multi-institutional study. Whole-exome sequencing, RNA sequencing, and methylation analyses of peripheral blood and/or tumor specimens were performed. Nineteen (79%) of 24 participants had NS, 17/19 (89%) of which had a germline The online version contains supplementary material available at 10.1007/s11060-026-05478-7. Show less

Physical activity is essential for health and well-being during adolescence, and active behaviour early in life predicts higher physical activity levels in adulthood. Although adolescents with intellectual disability (ID) consistently show lower activity levels than peers without ID, national environments—such as school structures, disability support systems, and access to inclusive leisure activities—may influence these patterns. There is limited evidence from Sweden, a country with distinct educational and support frameworks for youth with ID. The present study aimed to examine physical activity patterns among Swedish adolescents with and without ID using accelerometer data. Physical activity was measured objectively using hip-worn accelerometers (ActiGraph GT3X) over seven consecutive days. This cross-sectional study included 45 adolescents with mild-to-moderate ID (median [IQR], 17.0 [14.0–19.0] years; 45.2% females) and 70 adolescents without ID (16.0 [15.0-16.3] years; 62.2% females). Physical activity was categorised as sedentary behaviour (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) and analysed across school days, weekend days, and separately for daytime and evening periods on school days. Overall, the relative amount of SB was similar between groups ( Adolescents with ID were generally less physically active than peers without ID, except during school-day daytime, where the MVPA was similar and LPA was higher. Leisure time, particularly weekends and school-day evenings, seems to be a critical period in achieving sufficient MVPA among adolescents with ID. Targeted interventions and coordinated support from key stakeholders such as school health services, paediatric health care, social care services and organised sports, with a particular focus on unstructured time, may help promote active lifestyles and reduce health disparities in this population. The online version contains supplementary material available at 10.1186/s12887-026-06679-9. Show less

To investigate the association between vaginal microbiota structure in early pregnancy and gestational diabetes mellitus (GDM) and to characterize microbial signatures for early screening for GDM. The present study was a nested case-control study recruiting pregnant women from the Nanjing Gulou Maternal-Child Health Center, China. Vaginal swabs were collected before 20 weeks of gestation for 16S rRNA sequencing. Following 1:3 propensity score matching, 45 GDM cases and 135 controls were enrolled. The final analysis included 42 GDM cases and 121 controls. A random forest model was used to explore the genera of vaginal differential microbiota associated with GDM. Based on these findings, latent profile analysis (LPA) was conducted to explore potential types of vaginal microbiota, and logistic regression was used to analyze the association between vaginal microbiota types and GDM. The GDM group exhibited elevated alpha diversity (Chao1 index, The composition and structure of vaginal microbiota in early pregnancy are different in the two groups. The vaginal microbiota in early pregnancy, which is characterized by co-dominated by The online version contains supplementary material available at 10.1186/s12866-026-04910-2. Show less

Study DesignRetrospective Single-center propensity score-matched cohort study.ObjectiveAdjacent segment disease remains a major cause of revision surgery after multilevel lumbosacral fusion, and muscle-preserving approaches may help reduce this risk. This study compared clinical and radiographic outcomes between a muscle-preserving fusion combining standalone anterior plus lateral lumbar interbody fusion (A + LLIF) vs circumferential lateral plus posterior lumbar interbody fusion (L + PLIF).MethodsPatients who underwent multilevel lumbosacral fusion (2016-2023) with either A + LLIF or L + PLIF were included. L + PLIF patients with contraindications to standalone A + LLIF were excluded. Propensity score matching, based on age, BMI, PI-LL mismatch and stenosis severity, yielded 90 1:1-matched patients. The primary outcome was revision surgery. Secondary outcomes included spinopelvic alignment, cage subsidence, and perioperative metrics.ResultsBaseline characteristics were comparable between groups (mean age 57 ± 10 years; median fusion levels: 2 [range 2-4]). The 5-year cumulative incidence of revision surgery was significantly lower with A + LLIF (1/45 events; 2.2%) than with L + PLIF (14/45 events; 31.1%; Show less

Schizophrenia primarily depends on pharmacotherapy, which has demonstrated limited efficacy in enhancing cognitive impairments. High-definition transcranial direct current stimulation (HD-tDCS) and computerized cognitive remediation therapy (CCRT) hold potential for improving cognitive impairments. This study aims to investigate the effects of combining HD-tDCS with CCRT on cognition and to explore the mechanisms of this approach in schizophrenia. This is the protocol of a randomized controlled trial. Schizophrenia patients will be randomly assigned to one of 4 groups: HD-tDCS + CCRT group (Group 1), HD-tDCS group (Group 2), CCRT group (Group 3), and a control group (Group 4). The central electrode will be personalized using magnetic resonance imaging (MRI)-guided localization in the medial prefrontal cortex (mPFC). CCRT includes 6 therapeutic modules and 10 distinct tasks. Both HD-tDCS and CCRT will be administered once daily, 5 days per week, for 4 consecutive weeks, culminating in a total of 20 sessions. Assessments will occur at baseline (T0), after 10 sessions (T1), after 20 sessions (T2), and after 6 months of follow-up (T3). The primary outcome measure is the change in cognition. We will employ multimodal MRI, serum concentrations of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) to explore the underlying mechanisms. An involvement of mPFC and synaptic plasticity in response to HD-tDCS and CCRT is hypothesized. The study will provide empirical evidence for the effectiveness of combined therapy at an individual level, explore its mechanisms, and may ultimately result in personalized medicine. ChiCTR2500102731, https://www.chictr.org.cn/hvshowprojectEN.html?id=276964&v=1.0. Show less

Evidence proved that electroacupuncture (EA) combined with antidepressants can improve the antidepressant effectiveness for depressed patients. However, the clinical mechanisms of EA remain unclear. This study aimed to observe the mechanism of EA as an adjunct therapy to escitalopram oxalate (EO) on depressed patients. This study was designed as a single-blinded, double-dummy randomized controlled trial. 61 participants were diagnosed with mild-to-moderate depression according to the International Classification of Diseases 10th Edition (ICD-10, F32) were randomly allocated to receive EA + EO placebo, EO + sham EA, or EA + EO for six weeks treatment. The clinical assessment including depression severity, quality of life (QOL) and clinical safety. Biological indicators of immune-inflammation, the brain-derived neurotrophic factor and glucocorticoid inducible genes in peripheral blood of participants were measured by using enzyme linked immunosorbent assay and real-time polymerase chain reaction respectively before and after treatment. Three interventions improved the depression severity and QOL (P < 0.05), and no inter-group difference was found in the 6th week (P > 0.05). Anxiety psychic and somatic general symptoms in the EA + EO group were improved significantly than those of the other two groups (P < 0.05). After six-week treatment of EA + EO, blood SGK1 mRNA, GILZ mRNA, and BDNF levels were increased significantly ( Show less

Clarifying relationships between amyloid, tau, and cognition is crucial to understanding dementia risk, but has been mainly performed in non-Hispanic White (NHW) participants. It is unknown whether findings are generalizable to other ethnoracial groups. We evaluated relationships between amyloid-β (Aβ) positivity, apolipoprotein E allele (APOE) ε4, tau-positron emission tomography (PET) Black (β = 0.28, p < 0.001) and Hispanic (β = 0.34, p < 0.001) participants had higher medial temporal lobe (MTL) tau than NHW participants; however, findings were attenuated when accounting for choroid plexus off-target binding. Hispanic participants showed higher tau in lateral temporal regions compared to NHW and Black participants; however, reducing meningeal off-target binding through erosion demonstrated similar lateral temporal tau across groups. Factors other than amyloid and tau may impact cognition in Black participants. PI2620 off-target ethnoracial differences should be investigated. Show less

Cognitive impairment and mood disturbances are increasingly linked to underlying mechanisms such as oxidative stress, neurotransmitter dysregulation, and reduced neurotrophic support. As conventional pharmacological treatments often provide limited efficacy or are associated with tolerability concerns, there is growing scientific interest in botanical supporting strategies that may modulate the above pathways and provide complementary support for cognitive function and emotional well-being. This study aimed to investigate the mechanistic basis of a botanical association consisting of a standardized Show less

Cerebrovascular diseases, including ischemic stroke and vascular cognitive impairment, represent a significant global health challenge due to the paucity of effective treatment options. Quercetin, a dietary flavonol, has emerged as a promising multi-target neuroprotective compound. This review elucidates the core mechanisms by which quercetin achieves vascular repair and neuroprotection in cerebrovascular diseases through synergistic regulation of multiple signaling pathways and explores strategies to bridge the gap between dietary intake and clinical application. At the vascular level, quercetin enhances antioxidant defense by activating the nuclear factor E2-related factor 2/heme oxygenase-1 axis, inhibits the Toll-like receptor 4/nuclear factor-κB pathway and NOD-like receptor protein 3 inflammasome, and maintains blood-brain barrier integrity by inhibiting matrix metalloproteinase-9 and upregulating tight junction proteins via the Wnt/ Show less

Programmed cell death (PCD) has been linked to asthma, chronic obstructive pulmonary disease (COPD) and lung function, but the underlying genetic determinants remain unclear. A comprehensive multi-omics analysis was conducted by integrating genome-wide association studies (GWAS) with methylation quantitative trait loci (mQTL), expression quantitative trait loci (eQTL), and protein quantitative trait loci (pQTL) data. To determine the causality between exposures and respiratory traits, Summary Data-Based Mendelian Randomization (SMR) and colocalization analyses were applied. External validation was performed using replication cohorts, along with transcriptome-wide association studies (TWAS), gene-based analysis, and tissue-specific analysis. Additionally, enrichment analysis was carried out to identify biological pathways linked to respiratory traits. To explore potential therapeutic targets, drug prediction and molecular docking analyses were employed to assess the pharmacological feasibility of candidate compounds. Through the integration of multi-omics analysis, we identified six PCD-related genes associated with respiratory traits. ERBB3, SFRP1, and FGFR1 demonstrated tier 1 evidence, linking them to COPD in never-smokers, forced expiratory volume in 1 second (FEV1), and FEV1/forced vital capacity (FVC), respectively. Additionally, HSPA1B and MAPK3 were classified as tier 2 genes, associated with non-allergic asthma risk and overall COPD risk, respectively. IDUA, categorized as a tier 3 gene, was related to overall asthma. These genes play critical roles in apoptotic signaling, mesenchymal development, and molecular binding processes, emphasizing their biological significance. Additionally, molecular docking demonstrated stable binding for candidate drugs and proteins encoded by identified genes. Our study offers critical insights into the genetic basis of asthma, COPD, and lung function by identifying six genes as potential biomarkers and therapeutic targets, contributing to the development of more effective interventions for these respiratory traits. Show less

Poststroke epilepsy (PSE) is a common complication following stroke and is associated with increased mortality and worse functional outcomes. There is no biomarker sufficiently to predict PSE, and antiseizure medications are initiated after the first unprovoked seizure. Early identification of patients at high risk for PSE is needed to consider preventive measures and improve management strategies. Illumina miRNA sequencing was performed on serum collected at follow-ups of patients with PSE and compared to ischemic stroke patients without epilepsy and patients with epilepsy without stroke ( miRNA profiling revealed significant differences among the groups, with miR-10b-5p expression reduced in PSE patients compared to those with stroke alone. miR-486-5p was significantly reduced in PSE patients compared to epilepsy patients. qPCR validation confirmed miR-10b-5p as a potential biomarker candidate to distinguish PSE patients from stroke patients without PSE. BDNF, a key regulator of post-stroke recovery and epileptogenesis, was identified as a primary target of miR-10b-5p. While no group-level differences in serum BDNF concentrations were observed, BDNF levels correlated with disease duration and seizure latency exclusively in the PSE group. Importantly, as samples were obtained during follow-up rather than the acute post-stroke phase, our results indicate an involvement of the miR-10b-5p/BDNF axis in long-term post-stroke remodeling or general PSE susceptibility rather than a predictive biomarker. However, the miR-10b-5p/BDNF axis may represent a biologically plausible pathway associated with post-stroke epileptogenesis and impaired post-ischemic recovery. Prospective longitudinal studies with early post-stroke sampling are required to determine its predictive value. Show less

Prior studies indicate sex-specific obesity-frailty interactions, with postmenopausal estrogen decline increasing sarcopenic obesity risk and inflammation in women. This study evaluated circulating cytokines (IL-6, TNF-α), adipokines (adiponectin, resistin), myokines (GDF-15, BDNF, myostatin), health-related biomarkers (IGF-1, IGFBP-3), and physical performance (five-times chair stand, grip strength) in pre-frail and frail older adult women classified as having low appendicular lean mass (LALM), obesity, or obesity plus LALM. In this cross-sectional study, community-dwelling women aged ≥65 years from São Paulo, Brazil were screened (July 2022-September 2023); among 280 eligible, 88 met Fried frailty criteria. Body composition was assessed by DXA and participants were categorized as LALM (<20th percentile of residuals, -1.45), obesity (body mass index, BMI ≥30 kg/m Among 88 frail women (72.7% pre-frail and 27.3% frail), obesity plus LALM showed lower IGFBP-3 and higher GDF-15 vs. LALM (P Among pre-frail and frail older adult women, obesity-with or without low lean mass-was associated with adverse metabolic/inflammatory profiles (higher resistin, GDF-15, insulin; lower IGFBP-3) in full and frail-only analyses, alongside a trend toward slower chair-stand performance. These cross-sectional findings highlight obesity-frailty interactions, warranting prospective validation. Show less

Neuroplasticity is the core process by which the brain responds to aging, learning, and injury. Reporting positive non-pharmacological intervention approaches to promote neural plasticity is a core focus of contemporary neuroscience and rehabilitation medicine. Tai Chi (TC), as a traditional Chinese physical and mental practice that deeply combines soothing body movements, breathing regulation, and spiritual focus, is increasingly attracting attention from the scientific community for its role in facilitating brain health. Our review seeks to combine recent evidence, elucidate how TC promotes neural plasticity via multi-level mechanisms, discuss its advantages in promoting cognitive, motor, and emotional functions, and investigate its clinical utilization prospects and future research challenges in neurorehabilitation. According to reviewing recent literature, we combined evidence from cross-sectional studies, randomized controlled trials, systematic reviews, and meta-analyses, with a center on citing research findings utilizing multimodal neuroimaging techniques (such as fMRI, fNIRS, EEG) and molecular biology techniques to construct a complete chain of evidence from molecules to systems. TC drives multi-level neural plasticity modifications via its unique physical and mental combination properties. At the macro level, it can enhance the gray matter volume of the hippocampus and prefrontal cortex, and promote the organizational effectiveness of large-scale functional networks in the brain. At the micro molecular level, TC establishes a favorable microenvironment for neuronal survival, synaptic plasticity, and neural repair by upregulating BDNF, increasing endogenous antioxidant defense, modulating inflammatory balance, and improving mitochondrial energy metabolism. These structural, functional, and molecular level changes collectively form the neurobiological basis for TC to promote memory and executive function, increase balance and motor management, and promote emotional regulation ability. Our review further assesses the clinical effectiveness of TC in the rehabilitation of neurological diseases, such as Parkinson's disease (PD), stroke, and mild cognitive impairment, determining that it not only decreases symptoms, but may also have the possible role to decrease disease development. Ultimately, our review delve into the challenges and future perspectives experienced by this range in the context of standardization of research paradigms, causal reasoning of mechanisms, and individualized interventions. Show less