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Microbial ecosystem comprises a complex community in which bacteria interact with each other. The potential roles of the intestinal microbiome play in human health have gained considerable attention. The imbalance of gut microbial community has been looked to multiple chronic diseases. Cardiovascular diseases (CVDs) are leading causes of morbidity worldwide and are influenced by genetic and environmental factors. Recent advances have provided scientific evidence that CVD may also be attributed to gut microbiome. In this review, we highlight the complex interplay between microbes, their metabolites, and the potential influence on the generation and development of CVDs. The therapeutic potential of using intestinal microbiomes to treat CVD is also discussed. It is quite possible that gut microbes may be used for clinical treatments of CVD in the near future.

Island building change detection is a critical technology for environmental monitoring, disaster early warning, and urban planning, playing a key role in dynamic resource management and sustainable development of islands. However, the imbalanced distribution of class pixels (changed vs. unchanged) undermines the detection capability of existing methods and severe boundary misdetection. To address issue, we propose the MSDT-Net model, which makes breakthroughs in architecture, modules, and loss functions; a dual-branch twin ConvNeXt architecture is adopted as the feature extraction backbone, and the designed Edge-Aware Smoothing Module (MSA) effectively enhances the continuity of the change region boundaries through a multi-scale feature fusion mechanism. The proposed Difference Feature Enhancement Module (DTEM) enables deep interaction and fusion between original semantic and change features, significantly improving the discriminative power of the features. Additionally, a Focal–Dice–IoU Boundary Joint Loss Function (FDUB-Loss) is constructed to suppress massive background interference using Focal Loss, enhance pixel-level segmentation accuracy with Dice Loss, and optimize object localization with IoU Loss. Experiments show that on a self-constructed island dataset, the model achieves an F1-score of 0.9248 and an IoU value of 0.8614. Compared to mainstream methods, MSDT-Net demonstrates significant improvements in key metrics across various aspects. Especially in scenarios with few changed pixels, the recall rate is 0.9178 and the precision is 0.9328, showing excellent detection performance and boundary integrity. The introduction of MSDT-Net provides a highly reliable technical pathway for island development monitoring.

Gestational diabetes mellitus (GDM) represents a prevalent pregnancy complication with long-term health implications for offspring. While metabolic outcomes have been extensively studied, sex-specific effects on neurodevelopment remain poorly understood. Here we investigated the sex-dependent impact of maternal GDM on offspring brain development and behavior using a high-fat diet and low-dose streptozotocin induced mouse model. We found that adult female offspring exposed to maternal GDM exhibited depressive-like behaviors and sustained impairments in hippocampal neurogenesis across multiple developmental stages (embryonic, weaning and adult), characterized by reduced neural stem cell proliferation and altered differentiation. By contrast, male offspring displayed substantial metabolic dysfunction but no sustained neurogenic deficits beyond the embryonic period. Metabolomic analysis revealed persistent downregulation of myo-inositol in female offspring hippocampus, associated with disruptions in neurogenic signaling pathways. In vitro experiments with female-derived neural stem cells confirmed that hyperglycemic conditions directly impaired proliferation and differentiation, partly through oxidative stress mechanisms. These findings establish a sex-specific vulnerability to GDM-induced neurodevelopmental alterations and identify myo-inositol metabolism as a potential therapeutic target for preventing long-term neuropsychiatric consequences in female offspring. Maternal GDM induces sex-specific effects on offspring neurodevelopment, with females exhibiting persistent hippocampal neurogenesis deficits and depressive-like behaviors, while males show neurogenic resilience. The identification of myo-inositol depletion and oxidative stress as potential contributors to female-specific neurogenic impairments provides new insights into sex-specific vulnerability to maternal metabolic disturbances and suggests potential targets for intervention. HFD, High fat diet; STZ, Streptozotocin; GCL, Granule cell layer; SGZ, Subgranular zone; NSCs, Neural stem cells. Figure created with BioRender.com. Sex-specific effects of GDM on offspring neurogenesis Gestational diabetes mellitus (GDM), a condition of glucose intolerance first identified during pregnancy, affects about 15% of pregnant women globally, posing risks to both maternal and offspring health. This study explores how GDM impacts neurodevelopment, particularly focusing on depressive- and anxiety-like behaviors in offspring. Using a GDM mouse model, researchers tracked hippocampal neurogenesis and examined neurometabolic changes and oxidative stress. The results showed that GDM selectively induces depressive-like behaviors in female offspring, linked to impaired neurogenesis and reduced synaptic plasticity in the hippocampus. Notably, female offspring exhibited decreased dendritic complexity and reduced levels of neurotransmitters such as serotonin and dopamine. These findings highlight the sex-specific impact of GDM on neurodevelopment, with potential implications for understanding the developmental origins of neuropsychiatric disorders. Future research could explore therapeutic interventions targeting metabolic-neural pathways to mitigate these effects. This summary was initially drafted using artificial intelligence, then revised and fact-checked by the author.

Among 118 pregnant women with Covid-19 in Wuhan, China, the vast majority had a mild course of disease.

We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasis score greater than or equal to 5. The maternal outcomes included the changes in organ function 24 h after ICU admission. The durations of hospital stay and ICU stay were recorded as secondary outcomes. Among 297 ICU admissions (median Sequential Organ Failure Assessment score, 4) for obstetric diseases, there were 87 DIC cases, with an estimated DIC incidence of 87 per 87,580 deliveries. Postpartum hemorrhage was the leading disease associated with DIC (71, 81.6%), followed by hypertensive disorders (27, 31.0%), sepsis (15, 17.2%), acute fatty liver of pregnancy (11, 12.6%) and amniotic fluid embolism (10, 11.5%). Compared with patients without DIC, those with DIC had higher rates of multiple organ dysfunction syndrome/death (27.6% vs 4.8%, p = 0.000), organ failure (36.8% vs 24.3%, p = 0.029), among which organ failure included acute renal failure (32.2% vs 10.0%, p = 0.000), respiratory failure (16.1% vs 8.6%, p = 0.057), disturbance of consciousness (12.6% vs 2.4%, p = 0.000) and DIC group also had higher rates of massive transfusion (52.9% vs 21.9%, p = 0.000), hysterectomy (32.2% vs 15.7%, p = 0.001), longer ICU (4 days vs 2 days, p = 0.000) and hospital stays (14 days vs 11 days, p = 0.005). DIC and amniotic fluid embolism were independent risk factors for organ failure in patients admitted to the ICU. Postpartum hemorrhage was the leading cause of DIC associated organ failure in obstetrics admitted to the ICU. The control of obstetric bleeding in a timely manner may improve obstetric prognoses.

Objective Implantation of the conceptus in a twin cesarean scar pregnancy (CSP) is considered the rarest type of ectopic pregnancy. Preserving the fetus in utero and effectively dealing with CSP can be challenging. This study aimed to determine the clinical value of ultrasonography by monitoring imaging changes in twin CSP following selective feticide. Methods Ultrasonographic and clinical data were collected from four patients with twin CSP who were treated between December 2017 and December 2018 at our hospital. Results All patients had a history of cesarean section, followed by a heterotopic CSP, with one embryo implanted into the uterine cavity and the other located in the anterior isthmus. All of the patients were pregnant with twins with double chorionic and amniotic sacs, and all gave birth in our hospital. The patients underwent feticide at 8 to 9 weeks of gestation, after which we focused on monitoring the implantation. Delivery was performed by cesarean section according to scores of an ultrasonic scoring system and clinical manifestations. The patients’ uterus was preserved and they recovered. Conclusions This study shows that ultrasound is useful for determining the timing of clinical termination of CSP by selective feticide.

Background With lifestyle changes, the incidence of diabetes has been steadily increasing, and hypertension remains a significant risk factor impacting cardiovascular health. Understanding the potential effects of blood pressure on diabetes risk is, therefore, crucial. This study aims to comprehensively explore the relationship between blood pressure and diabetes risk. Methods A total of 211,809 individuals undergoing health check‐ups were included in this analysis. Participants were divided into four groups based on the quartiles of systolic and diastolic blood pressure, with the primary outcome being the incidence of new‐onset diabetes. Results Over an average follow‐up period of 3.1 years (±0.94 years), 3,000 men (1.42%) and 1,173 women (0.55%) were newly diagnosed with diabetes. Multivariable Cox regression analysis demonstrated that blood pressure is an independent predictor of new‐onset diabetes (systolic blood pressure HR 1.07 per SD increase, 95% CI: 1.01–1.12, P for trend <0.001; diastolic blood pressure HR 1.11 per SD increase, 95% CI: 1.06–1.17, P for trend 0.001). The optimal cutoff for systolic blood pressure in predicting new‐onset diabetes was found to be 123 mmHg (area under the curve 0.7014, sensitivity 0.65, specificity 0.64), which was superior to the predictive efficacy of diastolic blood pressure (area under the curve 0.6645, sensitivity 0.63, specificity 0.62). Subgroup analyses indicated that the risk of blood pressure‐related diabetes was significantly higher in middle‐aged individuals compared to older adults (P for interaction <0.05). Additionally, women showed a higher risk of systolic blood pressure‐related diabetes than men, and normal‐weight individuals exhibited a higher risk than those with obesity (P for interaction <0.05). Conclusions This cohort study within a Chinese population highlights that, after adjusting for other confounding factors, blood pressure is an independent risk factor for diabetes. This association is particularly pronounced among middle‐aged individuals, women, and those of normal weight. Moreover, systolic blood pressure demonstrates superior predictive efficacy for diabetes compared to diastolic blood pressure. This cohort study within a Chinese population highlights that, after adjusting for other confounding factors, blood pressure is an independent risk factor for diabetes. This association is particularly pronounced among middle‐aged individuals, women, and those of normal weight. Moreover, systolic blood pressure demonstrates superior predictive efficacy for diabetes compared to diastolic blood pressure.

To determine the factors predicting the probability of severe postpartum hemorrhage (SPPH) in women undergoing repeat cesarean delivery (RCD). This multicenter, retrospective cohort study involved women who underwent RCD from January 2017 to December 2017, in 11 public tertiary hospitals within 7 provinces of China. The all-variables model and the multivariable logistic regression model (pre-operative, operative and simple model) were developed to estimate the probability of SPPH in development data and external validated in validation data. Discrimination and calibration were evaluated and clinical impact was determined by decision curve analysis. The study consisted of 11,074 women undergoing RCD. 278 (2.5%) women experienced SPPH. The pre-operative simple model including 9 pre-operative features, the operative simple model including 4 pre-operative and 2 intraoperative features and simple model including only 4 closely related pre-operative features showed AUC 0.888, 0.864 and 0.858 in development data and 0.921, 0.928 and 0.925 in validation data, respectively. Nomograms were developed based on predictive models for SPPH. Predictive tools based on clinical characteristics can be used to estimate the probability of SPPH in patients undergoing RCD and help to allow better preparation and management of these patients by using a multidisciplinary approach of cesarean delivery for obstetrician.

To characterize the gut microbiota in patients with preeclampsia (PE) compared with healthy controls. We analyzed and compared the microbiota communities in the feces of 48 PE patients with 48 age-, gestational weeks-, and pre-pregnancy body mass index-matched healthy controls using 16S rRNA gene sequencing, and also we tested fecal and plasma lipopolysaccharide (LPS) and plasma trimethylamine-N-oxide (TMAO) concentration levels in the two groups. Compared with the control group, microbial alpha diversity was lower in the PE group, but there was no statistically significant difference between the two groups. At the phylum level, Firmicutes (51.64% PE vs. 59.62% Control, < 0.05), Bacteroidetes (40.51% PE vs. 34.81% Control, < 0.05), Proteobacteria (4.51% PE vs. 2.56% Control, < 0.05), and Actinobacteria (2.90% PE vs. 1.77% Control, < 0.05), exhibited significant differences between the PE group and the control group. LEfSe analysis found 17 differentially abundant taxa between the two groups. PICRUSt analysis found that in the KEGG pathways, the microbial gene functions related to LPS biosynthesis were higher in the fecal microbiome of the PE group. The fecal and plasma LPS concentrations and plasma TMAO concentrations of PE patients were higher than those of the healthy controls. PE patients had gut microbiota dysbiosis and increased plasma LPS and TMAO levels, which will lead to a better understanding of the relationship between the gut microbiota and PE.

To investigate changes in coagulation during twin pregnancies. Methods: A total of 108 women with twin pregnancies and 442 women with singleton pregnancies were recruited. Coagulation tests, including fibrinogen (Fib), activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT), were performed during the course of the pregnancy. The level of fibrinogen gradually increased during singleton pregnancies, while the APTT and PT levels showed a decreasing trend with increasing gestational weeks. In twin pregnancies, the changes in PT and TT were similar, but other parameters displayed a different trend. Fibrinogen showed no significant difference between the second and third trimesters, while APTT showed an increasing trend from the second trimester to the third trimester. Compared with singleton pregnancies, the level of fibrinogen was higher in women pregnant with twins. APTT was longer in women pregnant with twins than in women with singleton pregnancies in the third trimester. PT was shorter in women pregnant with twins than in women with singleton pregnancies in the first and third trimesters. TT was shorter in women pregnant with twins than in women with singleton pregnancies in the first and second trimesters. Through this retrospective longitudinal analysis, this study presents the main coagulation parameter changes in singleton and twin pregnancies and confirms that coagulation is more enhanced in twin pregnancies than in singleton pregnancies.