METHODS: BMP10 levels were quantified in 2085 chronic HF patients from the European BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) cohort and in 1487 patients from the Scottish validation cohort. Multivariable linear regression identified independent associates of BMP10. Proteomic analysis of 6369 proteins with subsequent gene set enrichment analysis was used to explore biological pathways associated with elevated BMP10. Cox proportional hazards models adjusting for established risk factors were used to associate BMP10 levels with clinical outcomes, including all-cause mortality and HF hospitalisation.
RESULTS: In a multivariable model including clinical and echocardiographic parameters, log-transformed and standardised BMP10 levels were significantly associated with a history of atrial fibrillation (Sβ=0.419; p<0.001), and with echocardiographic features reflecting atrial stress, such as increased left atrial diameter (Sβ=0.075; p=0.048). By contrast, these were not among the strongest associates of NT-proBNP levels. Gene set enrichment analysis showed significant overrepresentation in pathways of muscle contraction and extracellular matrix organisation. Higher log-transformed and standardised BMP10 levels predicted a combined outcome of 2-year all-cause mortality and HF rehospitalisation (HR=1.10, 95% CI=1.02-1.19), with the validation cohort yielding comparable results.
CONCLUSION: BMP10 emerges as a novel biomarker reflecting atrial stress and remodelling in chronic HF patients. Its additional predictive value for adverse outcomes underscores its potential utility in enhancing risk stratification and guiding therapeutic interventions in HF management.
RECENT FINDINGS: Asia is the epicenter of diabetes. There have been marked advances with genotyping and phenotyping of the Asian patient with T2D, particularly with young onset diabetes where early beta cell failure and rapid progression of complications are more frequent. As Asians have lower muscle mass and higher adiposity, sarcopenia is increasingly associated with diabetes. Response to lifestyle and pharmacotherapy are generally similar, but unique features exist with different populations. Across Asia, use of guideline directed medical therapy for cardio-renal protection are recommended, but uptake of these newer agents are suboptimal and barriers exist with regards to standardized care.
SUMMARY: Although many similarities have been observed across Asia, due to the heterogeneity of populations within Asia, further research is required to streamline and pave the way towards precision medicine. There is an urgent need for region wide consensus to minimize barriers to diabetes care and stigma in diabetes terminology across Asia.
METHODS: This study used data from a nationwide cross-sectional survey in Malaysia. Participants involved were older people aged 60 years and above. Data collected were on dementia risk factors as well as dementia screening. Dementia screening was done using the Identification and Intervention for Dementia in Elderly Africans cognitive screening tool. Univariate analysis and multiple logistic regression were carried out to determine the factors associated with dementia.
RESULTS: There were 3774 participants involved in this study. Multiple logistic regression showed factors associated with dementia among older people were those aged 70 years and above, Indian ethnic group, being single, primary or no formal education, as well as those with hypertension. Interestingly, our findings also showed that older people with hypercholesterolemia have lower odds of having dementia.
CONCLUSIONS: Multiple factors were associated with dementia in Malaysia, highlighting the need to implement multiple interventions strategies, by taking a lifetime approach emphasizing education, physical as well as social aspects.
METHODS: This qualitative study employed purposive and snowball sampling to recruit community pharmacists in Malaysia. Semi-structured interviews were conducted, exploring pharmacists' perspectives on barriers, counselling approaches, follow-up strategies, and opinions on smoking cessation services. Thematic analysis was employed to identify key themes and sub-themes.
KEY FINDINGS: Three main themes emerged from the data analysis: barriers, counselling and enhancing follow-up, and pharmacists' opinions on professional fees. Under the theme of barriers, sub-themes included underutilization by the public, poor follow-up by customers, time constraints, lack of educational materials and support, and customer perception. The counselling and enhancing follow-up theme encompassed shared decision-making, motivational intervention, follow-up via phone calls or messaging apps, and providing rebate vouchers. Pharmacists' opinions on professional fees revealed mixed perspectives, with some advocating for fees to recognize the professional service provided, while others expressed concerns about access barriers.
CONCLUSIONS: Community pharmacists face challenges in delivering smoking cessation services, such as underutilization, poor follow-up, time constraints, and affordability. However, strategies like shared decision-making and proactive communication can enhance effectiveness. Addressing professional fees and collaborative efforts are essential to optimising these services.
MATERIALS AND METHODS: We retrospectively analyzed the clinical and imaging data of cervical cancer patients diagnosed pathologically at our hospital from January 2021 to June 2024. All patients underwent routine magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and APT imaging before treatment. Apparent diffusion coefficient (ADC) and APT values were measured. Based on the pathological results, patients were categorized into LVSI (+) and LVSI (-) groups, and PMI (+) and PMI (-) groups. Independent sample t-tests were used to compare the ADC and APT values between these groups. Receiver operating characteristic (ROC) curves were used to assess the sensitivity, specificity, and area under the curve (AUC) of ADC, APT, and ADC + APT in predicting PMI and LVSI. The Delong test was employed to compare the diagnostic performance among these measures.
RESULTS: A total of 83 patients were included, with 56 in the LVSI (-) group, 27 in the LVSI (+) group, 35 in the PMI (-) group, and 16 in the PMI (+) group. The ADC values for the LVSI (+) and PMI (+) groups were significantly lower than those for the LVSI (-) and PMI (-) groups (P
METHODS: A group of doctors with various specialties, who have used VYC-25L extensively since it first became available in their countries (3-5 years), share clinical experience and guidance on optimal use.
RESULTS: VYC-25L has a unique rheological and physicochemical profile that provides elevated lift capacity and enhanced projection, significant moldability immediately after injection, high levels of tissue integration, reversibility with hyaluronidase, and a long duration of clinical effects-typically lasting at least 24 months. The properties of VYC-25L have created new possibilities for nonsurgical facial medical aesthetics. However, as with any novel product, it is important that injectors recognize how best to use it for the benefit of patients. When first utilizing VYC-25L, it is advisable to start with the chin and jawline to gain familiarity with the gel characteristics before moving into other facial areas, and to consider splitting treatment over two or more sessions. Attention must also be given to injection volume, with less product typically required with VYC-25L compared to other fillers with similar indications. Key principles of good practice should be followed, including appropriate patient selection and pretreatment education, suitable choice of injection device and plane, aseptic technique, slow and careful administration method, and sufficient posttreatment follow-up.
CONCLUSIONS: By adhering to these principles, VYC-25L can produce natural-looking and highly durable outcomes without substantial safety concerns.