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Neovascularization and vascular remodeling are functionally important for brain repair after stroke. We show that neutrophils accumulate in the peri-infarct cortex during all stages of ischemic stroke. Neutrophils producing intravascular and intraparenchymal neutrophil extracellular traps (NETs) peak at 3–5 days. Neutrophil depletion reduces blood-brain barrier (BBB) breakdown and enhances neovascularization at 14 days. Peptidylarginine deiminase 4 (PAD4), an enzyme essential for NET formation, is upregulated in peri-ischemic brains. Overexpression of PAD4 induces an increase in NET formation that is accompanied by reduced neovascularization and increased BBB damage. Disruption of NETs by DNase 1 and inhibition of NET formation by genetic ablation or pharmacologic inhibition of PAD increases neovascularization and vascular repair and improves functional recovery. Furthermore, PAD inhibition reduces stroke-induced STING-mediated production of IFN-β, and STING knockdown and IFN receptor-neutralizing antibody treatment reduces BBB breakdown and increases vascular plasticity. Collectively, our results indicate that NET release impairs vascular remodeling during stroke recovery. Following ischemic insult, neovascularization and vascular remodelling play an essential part in the repair of brain damage. Here the authors show that neutrophil extracellular traps serve a detrimental role in the regeneration process, limiting the functional recovery of the brain post injury.

Considerable specific cross-sectional and review studies have linked exposure to green spaces to improving public health, but there is no bibliometric review attempting to systemically and retrospectively analyze these existing articles. Here we aim to uncover global research status, trends, and future prospects in green spaces and health (G-H) research then propose a framework for the underlying mechanisms and pathways that link green space to public health. We obtained 18 961 G-H research publications from the core Web of Science collection from 1901 to 2019, analyzing the characteristics of publication outputs, key scientific disciplines, and differences in performance between countries and institutions. Besides, content analysis was conducted to analyze the keywords, including keyword co-occurrence analysis and keyword clustering analysis. We found: (1) a steady quantitative increase in publications, active journals, and involved countries and institutions since the 1990s; (2) a signi cant increase and changes in G-H related interdisciplinary categories, with environment-related disciplines becoming the mainstream; (3) research focus and trends that were identified based on the analysis of high-frequency co-occurring keywords; (4) three main knowledge domains, namely, green spaces and physical health, mental health, and ecosystem health, that were identified and visualized based on keyword clustering analysis; (5) a framework of underlying mechanisms and pathways linking green space to public health that is proposed based on visualization of the three main knowledge domains. We suggest that the main challenge of G-H research is to further clarify in-depth the underlying mechanisms and pathways from multiple perspectives, including multiple nations, disciplines, and study designs. The lack of co-occurring keywords and clustering information related to social well-being suggests that research related to 'social health' is lacking. Based on a clear understanding of the quantity, quality, and characteristics of green space for public health, a health-based environmental plan should be proposed in the future.

Automated vocal performance assessment requires the integration of objective acoustic analysis and subjective expert opinions under uncertainty. Nevertheless, all current AI-based scoring methods ignore the issue of expert hesitation, whereas traditional Multi-Criteria Decision-Making (MCDM) models cannot simultaneously solve the problem of objective weighting and interpretable ranking. This paper will present a Fermatean Fuzzy (FF) Criteria Importance Through Intercriteria Correlation (CRITIC) Multi-Attributive Ideal-Real Comparative Analysis (MAIRCA) fusion system in automated vocal analysis decision support systems. It is a unique framework that incorporates: (i) Fermatean Fuzzy Sets (FFS) to specify expert reluctance and expression of uncertainty, (ii) the CRITIC method to obtain objective criterion weights depending on contrast intensity and inter-criteria conflict, and (iii) the MAIRCA method to produce deviation-based and interpretable rankings. The effectiveness of the proposed model is shown by a hypothetical case study that embraced six vocal performers and six multidimensional criteria. Findings indicate constant and convergent rankings, objective selection of influential criteria, and sensitivity analysis resistance. The proposed framework offers a robust, uncertainty-conscious, and bias-reduced assessment mechanism, which is more methodologically advanced than AI-only and traditional fuzzy decision- making methods in the evaluation of performance in the arts.

Background As the internet develops and 5G technology becomes increasingly prominent, the internet has become a major source of health-related information. Increasingly, people use the internet to find health-related information, and digital health literacy is now a set of essential capabilities to improve their health in the digital era. However, little is known about the factors that influencing digital health literacy. This study aimed to assess digital health literacy scores and identify its influencing factors among internet users in China. Additionally, this study explored the participant’s actual skills using an additional set of performance-based items from the Digital Health Literacy Instrument (DHLI). Methods An online cross-sectional study was conducted in August 2022. Participants aged ≥18 years were recruited to complete the survey. Data were collected using the Chinese revised version of the DHLI, the self-reported internet use questionnaire, and the sociodemographic questionnaire. We conducted multivariate linear regression analyses to explore the relationships among the sociodemographic variables, behavior of internet use, and the digital health literacy scores. Results In total, 702 participants completed the survey. The mean DHLI score was 2.69 ± 0.61. Multivariate linear regression analyses showed that the age groups 35–49 (β = − 0.08, P  = 0.033), 50–64 (β = − 0.161, P  < 0.001), and ≥ 65 (β = − 0.138, P  < 0.001) were negatively associated with DHL scores. However, education level, including bachelor’s or associate degree (β = 0.255, P  = 0.002) and master’s degree and above (β = 0.256, P  < 0.001), frequency of health-related Internet usage (β = 0.192, P  < 0.001), the number of digital devices used (β = 0.129, P  = 0.001), and OHISB (β = 0.103, P  = 0.006) showed a positive relationship with DHL scores. Conclusions The study findings demonstrate that age, educational levels, number of technological devices used, and greater use of the web for health information were independently associated with DHL scores. Healthcare providers should consider providing training programs tailored to specific sociodemographic factors to improve the ability that find and use accurate information online to meet digital health services, which contributes to enhance their self-management and reduce health disparities.

Mantle cell lymphoma (MCL) is a subtype of Non-Hodgkin lymphoma (NHL) of mature B-cells characterized by translocation, which is typically due to excess expression of Cyclin D1. Although with the progress in our knowledge of the causes for MCL and available treatments for MCL, this cancer is still incurable. Age, male gender, rapid advancement, significant nodal involvement, elevated serum lactate dehydrogenase level, and prognostic indications including increased expression of Ki-67 and presence of TP53 mutation, are symbols of poor outcome. Advanced immunotherapy using chimeric antigen receptor (CAR)-T cells is advantageous for patients suffering from B-cell malignancies and MCL. Targeting B-cell antigens on the cell surface is a feasible approach in re-occurring (R/R) MCL because of significant responses obtained in other B-cell cancers. USFDA has approved brexucabtagene autoleucel (Tecartus, KTE-X19), a novel CAR T-cell therapy to be used in patients with MCL who have not responded to previous treatments or have relapsed. The FDA approved this new treatment depending on the outcomes of the ZUMA-2 clinical trial. Serious adverse reactions, moderate anti-tumor activity, allergen withdrawal, antigen escape, limited tumor infiltration, and trafficking are major barriers to successful CAR T-cell therapy. This review is a brief synopsis of the development of CAR T-cell therapy for MCL.

The glymphatic system (GS) is a novel defined brain-wide perivascular transit network between cerebrospinal fluid (CSF) and interstitial solutes that facilitates the clearance of brain metabolic wastes. The complicated network of the GS consists of the periarterial CSF influx pathway, astrocytes-mediated convective transport of fluid and solutes supported by AQP4 water channels, and perivenous efflux pathway. Recent researches indicate that the GS dysfunction is associated with various neurological disorders, including traumatic brain injury, hydrocephalus, epilepsy, migraine, and Alzheimer’s disease (AD). Meanwhile, the GS also plays a pivotal role in the pathophysiological process of stroke, including brain edema, blood–brain barrier (BBB) disruption, immune cell infiltration, neuroinflammation, and neuronal apoptosis. In this review, we illustrated the key anatomical structures of the GS, the relationship between the GS and the meningeal lymphatic system, the interaction between the GS and the BBB, and the crosstalk between astrocytes and other GS cellular components. In addition, we contributed to the current knowledge about the role of the GS in the pathology of stroke and the role of AQP4 in stroke. We further discussed the potential use of the GS in early risk assessment, diagnostics, prognostics, and therapeutics of stroke.

Diabetic neuropathy (DN) is a prevalent and debilitating complication of diabetes mellitus, significantly impacting patient quality of life and contributing to morbidity and mortality. Affecting approximately 50% of patients with diabetes, DN is predominantly characterized by distal symmetric polyneuropathy, leading to sensory loss, pain, and motor dysfunction, often resulting in diabetic foot ulcers and lower-limb amputations. The pathogenesis of DN is multifaceted, involving hyperglycemia, dyslipidemia, oxidative stress, mitochondrial dysfunction, and inflammation, which collectively damage peripheral nerves. Despite extensive research, disease-modifying treatments remain elusive, with current management primarily focusing on symptom control. This review explores the complex mechanisms underlying DN and highlights recent advances in diagnostic and therapeutic strategies. Emerging insights into the molecular and cellular pathways have unveiled potential targets for intervention, including neuroprotective agents, gene and stem cell therapies, and innovative pharmacological approaches. Additionally, novel diagnostic tools, such as corneal confocal microscopy and biomarker-based tests, have improved early detection and intervention. Lifestyle modifications and multidisciplinary care strategies can enhance patient outcomes. While significant progress has been made, further research is required to develop therapies that can effectively halt or reverse disease progression, ultimately improving the lives of individuals with DN. This review provides a comprehensive overview of current understanding and future directions in DN research and management.

(1) Background: To review the associated factors of sarcopenia in community-dwelling older adults. (2) Methods: PubMed, Embase, Web of Science, and four Chinese electronic databases were searched for observational studies that reported the associated factors of sarcopenia from inception to August 2021. Two researchers independently selected the literature, evaluated their quality, and extracted relevant data. The pooled odds ratio (OR) and its 95% confidence interval (CI) were calculated for each associated factors of sarcopenia using random-effects/fixed-effects models. Publication bias was assessed using funnel plot and the Eggers test. We performed statistical analysis using Stata 15.0 software. (3) Results: A total of 68 studies comprising 98,502 cases were included. Sociodemographic associated factors of sarcopenia among community-dwelling older adults included age (OR = 1.12, 95% CI: 1.10–1.13), marital status (singled, divorced, or widowed) (OR = 1.57, 95% CI: 1.08–2.28), disability for activities of daily living (ADL) (OR = 1.49, 95% CI: 1.15–1.92), and underweight (OR = 3.78, 95% CI: 2.55–5.60). Behavioral associated factors included smoking (OR = 1.20, 95% CI: 1.10–1.21), physical inactivity (OR = 1.73, 95% CI: 1.48–2.01), malnutrition/malnutrition risk (OR = 2.99, 95% CI: 2.40–3.72), long (OR = 2.30, 95% CI: 1.37–3.86) and short (OR = 3.32, 95% CI: 1.86–5.93) sleeping time, and living alone (OR = 1.55, 95% CI: 1.00–2.40). Disease-related associated factors included diabetes (OR = 1.40, 95% CI: 1.18–1.66), cognitive impairment (OR = 1.62, 95% CI: 1.05–2.51), heart diseases (OR = 1.14, 95% CI: 1.00–1.30), respiratory diseases (OR = 1.22, 95% CI: 1.09–1.36), osteopenia/osteoporosis (OR = 2.73, 95% CI: 1.63–4.57), osteoarthritis (OR = 1.33, 95% CI: 1.23–1.44), depression (OR = 1.46, 95% CI: 1.17–1.83), falls (OR = 1.28, 95% CI: 1.14–1.44), anorexia (OR = 1.50, 95% CI: 1.14–1.96), and anemia (OR = 1.39, 95% CI: 1.06–1.82). However, it remained unknown whether gender (female: OR = 1.10, 95% CI: 0.80–1.51; male: OR = 1.50, 95% CI: 0.96–2.34), overweight/obesity (OR = 0.27, 95% CI: 0.17–0.44), drinking (OR = 0.92, 95% CI: 0.84–1.01), hypertension (OR = 0.98, 95% CI: 0.84–1.14), hyperlipidemia (OR = 1.14, 95% CI: 0.89–1.47), stroke (OR = 1.70, 95% CI: 0.69–4.17), cancer (OR = 0.88, 95% CI: 0.85–0.92), pain (OR = 1.08, 95% CI: 0.98–1.20), liver disease (OR = 0.88, 95% CI: 0.85–0.91), and kidney disease (OR = 2.52, 95% CI: 0.19–33.30) were associated with sarcopenia. (4) Conclusions: There are many sociodemographic, behavioral, and disease-related associated factors of sarcopenia in community-dwelling older adults. Our view provides evidence for the early identification of high-risk individuals and the development of relevant interventions to prevent sarcopenia in community-dwelling older adults.

Climate warming has increased the risk of recurrent drought hazards. Previous research has indicated potential associations between climate warming and extreme climate events. Due to short distance spatial variability in meteorological variables, the prevalence of extreme values may result in biased inferences or reduce the scope of regional drought analysis. Therefore, precise inferences of spatiotemporal characteristics of regional drought are challenging. In this study, we provide a new weighting scheme to diminish the effect of extreme values for the regional aggregation of precipitation data. We used K – Components Gaussian Mixture Models (K–CGMM) based on the standardization procedure to achieve maximum computational accuracy. Consequently, the article proposes a new regional drought index – the Bias Diminished Weighted Regional Drought Index (BDWRDI). We assessed the performance of BDWRDI by calculating the Standardized Precipitation Index (SPI) using data from six meteorological stations in the Northern area of Pakistan. We found that the proposed weighting scheme can greatly diminish the effect of extreme values during the spatiotemporal aggregation of precipitation data. In addition, the strong positive correlation of BDWRDI with individual SPIs endorses the proposed weighting scheme and the proposed drought indicator for regional drought analysis.