Chronic low-grade inflammation ("inflammaging") drives age-related decline, but whether anti-inflammatory medications preserve functional performance in older age remains unknown. This study evaluated the 5-year effect of aspirin on a modified Intrinsic Capacity (IC) index in older males and females. A post-hoc analysis of a randomised controlled trial comparing daily 100 mg aspirin to placebo in prolonging dementia- and disability-free survival (DFS) in community-dwelling individuals aged ≥ 65 years. A four-domain IC score (including cognition, locomotion, vitality and psychological well-being) was calculated annually across 18,581 participants and validated against biological and clinical measures. Linear mixed models compared IC trajectories across treatment arms. Females had lower baseline IC and a steeper decline over time than males. IC correlated with chronological age (r =  - 0.30, both sexes), a system-wide deficit-accumulation index (r =  - 0.56 and - 0.54 in females and males respectively), and epigenetic clocks (e.g., PC-PhenoAge, PC-GrimAge, and DunedinPACE), particularly in females. Clinically, lower baseline IC was associated with reduced DFS in both sexes (Q1 vs. Q5: HR = 4.62, 95% CI: 3.16-6.75; HR = 4.32, 95% CI: 3.42-5.48). Females randomized to aspirin had a small but significantly accelerated decline in IC (β: - 0.006, 95% CI: - 0.01, - 0.001, p = 0.01), whereas no effect was observed in males (p = 0.86; 3-way sex*treatment*time p = 0.06). Low-dose aspirin did not prevent functional decline and unexpectedly was associated with a small additional decline in IC in older females, highlighting the need to consider sex-specific responses to therapies.

Threatened miscarriage is one of the most common complications during pregnancy and is characterized by complex and highly heterogeneous etiologies. In recent years, with the emergence of high-quality randomized controlled trials and updates in evidence-based guidelines, the management of threatened miscarriage has gradually shifted from empirical pregnancy preservation to risk stratification and precision intervention. This review summarizes the current evidence base and recent advances in Western medical treatment for threatened miscarriage, based on the latest clinical guidelines, randomized controlled trials, systematic reviews, and meta-analyses. Particular emphasis is placed on progesterone therapy, antithrombotic treatment, hormonal regulation during pregnancy, immunomodulatory therapy, tocolysis, and nutritional support. Current evidence indicates that vaginal micronized progesterone provides clear benefits for women with early pregnancy bleeding and a history of miscarriage. In contrast, the use of low-molecular-weight heparin (LMWH) and low-dose aspirin (LDA) should be strictly restricted to selected high-risk populations. Levothyroxine (LT4) and metformin may offer potential benefits in patients with specific endocrine abnormalities; however, evidence supporting their routine use remains limited. In addition, the long-term benefits of immunomodulatory and tocolytic therapies remain uncertain. Overall, the Western medical management of threatened miscarriage should be individualized based on underlying etiological mechanisms, clinical phenotypes, and evidence-based recommendations. Future studies integrating biomarkers and multi-omics approaches are warranted to advance precision phenotyping and personalized treatment strategies for threatened miscarriage.

Duodenal ulcers are rare in infants, and their endoscopic management is challenging because of anatomical factors and limited availability of hemostatic devices compatible with narrow-caliber endoscopes. Here, we present the case of a 7-month-old female infant who developed upper gastrointestinal bleeding 9 days post-cardiac surgery while receiving aspirin therapy. Emergency esophagogastroduodenoscopy revealed a bleeding duodenal ulcer with an exposed vessel. Because of the inability to advance a standard-diameter endoscope, a narrow-caliber endoscope was used. Hemostasis was achieved using scissors-type hemostatic forceps with soft coagulation. The patient recovered without bleeding recurrence. This case highlights the importance of individualized endoscopic strategies in infants and urgent need for therapeutic devices that are compatible with narrow-caliber pediatric endoscopes.

Colored shade nets modify orchard microclimate and may influence citrus fruit metabolism and quality. We evaluated their effects on organic acid accumulation in 'Newhall' sweet orange (Citrus sinensis) over two consecutive growing seasons. In the first season, red, yellow, green, and blue nets at 40% and 60% shading were compared with open-field conditions; green 40% and blue 60%, which showed contrasting acidity responses, were evaluated further in the second season. Shade nets reduced photosynthetically active radiation, light intensity, and canopy temperature, increased relative humidity, maintained PSII efficiency, and generally lowered stress-related indicators. Blue 60% maintained the highest citric acid, malic acid, and titratable acidity, whereas green 40% produced the lowest acidity. These patterns were associated with distinct transcriptional responses: blue 60% showed sustained higher CsPH8 expression and stage-specific increases in CS2 and CS1, while green 40% showed higher expression of several organic-acid degradation-related genes, including ACO, ACL3, FUM, and NAD-ME. Correlation analysis further linked lower radiation and temperature, higher relative humidity, and improved PSII performance with greater organic acid accumulation and expression of acid synthesis- and storage-related genes. Collectively, the findings suggest that blue 60% shading is associated with improved organic acid retention through coordinated microclimatic, physiological, and transcriptional responses, supporting its potential for maintaining citrus fruit acidity under warm, high-radiation conditions.

Preeclampsia is a multisystem hypertensive disorder of pregnancy that is defined by new-onset hypertension after 20 weeks of gestation along with proteinuria or evidence of end-organ dysfunction. Affecting 2-8% of pregnancies worldwide, preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality. This disorder originates secondary to defective placentation during the first trimester, causing incomplete remodeling of the uterine spiral arteries, resulting in placental hypoperfusion, oxidative stress, and the release of anti-angiogenic factors into the maternal circulation. This pathophysiology provided researchers a rationale for the use of low-dose aspirin as a preventive strategy for preeclampsia. Early studies investigated low-dose aspirin initiated at variable gestational ages and failed to show significant reductions in the incidence of preeclampsia. However, over the years, multiple meta-analyses studying aspirin use for preeclampsia prevention revealed a consistent decrease in the incidence of preeclampsia with the use of low-dose aspirin initiated at or before 16 weeks of gestation, with the efficacy being largely dependent on the time of initiation. In 2017, a randomized controlled trial demonstrated a statistically and clinically significant reduction in the incidence of preeclampsia leading to preterm delivery with aspirin initiated before 16 weeks gestation in women identified as high risk by first-trimester algorithm-based screening. Based on the strong evidence in support of aspirin use for preeclampsia prevention, current guidelines recommend initiation of aspirin 81 mg after 12 weeks and ideally before 16 weeks for all pregnant women at increased risk for preeclampsia.

Hydrogels exhibit immense potential in wearable health monitoring owing to their exceptional biocompatibility and tissue-like flexibility. However, the rapid, energy-efficient fabrication of structurally homogeneous, multifunctional hydrogel networks remains a formidable challenge. Herein, we report an ultrafast, one-step synthetic strategy to fabricate a self-healing Fe-MXene-polyacrylic acid (PAA) hydrogel within merely 2 min. The hydrogel was incorporated into an integrated health-monitoring platform combining electrochemical sweat analysis, flexible pulse monitoring, and drug delivery. The sweat sensors exhibited sensitivities of 54.4 mV decade[-1] for K[+] and 55.2 mV decade[-1] for Na[+], approaching the theoretical Nernstian response for monovalent ions. In contrast, the pH sensor displayed a sub-Nernstian sensitivity of 30.4 mV/pH. Concurrently, benefiting from broad-range strain sensitivity (up to 1900%), a high maximum gauge factor (GF = 7.8), and robust tissue adhesion (24 kPa on porcine skin), the system enables high-fidelity dynamic capture of subtle physiological signals, such as arterial pulses. Furthermore, dynamic coordination between Fe[3+] ions and carboxylate groups (-COOH) imparts structural reversibility to the hydrogel network. In the proof-of-concept experiment, the addition of 0.1 wt% citric acid disrupted the Fe[3+]-carboxylate coordination through competitive chelation, thereby facilitating the diffusion-mediated release of paeonol from the hydrogel. Moreover, the use of a low-cost paper-based substrate enhances the environmental friendliness of the device. Upon immersion in water at room temperature, its main structure undergoes water-induced disintegration within 4 h as a result of water absorption, swelling, and progressive structural destabilization. In summary, this simple, rapid, eco-friendly, and multifunctionally integrated hydrogel platform provides a novel paradigm for developing next-generation personalized closed-loop theranostic wearables and green bioelectronics.

Suboptimal prepregnancy metabolic health predisposes women to hypertensive disorders of pregnancy (HDP). Prevention of HDP starts with prepregnancy metabolic health optimization. If hypertension is present during pregnancy, adequate blood pressure control becomes crucial. Pregnancy and lactation safety should be considered when selecting an antihypertensive medication regimen. Aspirin prophylaxis is recommended for women at risk of preeclampsia. HDPs and other APOs increase the risk of future maternal cardiovascular events. Therefore, continued surveillance, screening, and cardiometabolic health optimization after pregnancy are essential to improving long-term health.

Antinuclear antibodies (ANA) are biomarkers of immune dysregulation whose reproductive significance depends on the clinical setting and antibody profile. This narrative review synthesizes clinical and experimental evidence on ANA in infertility, assisted reproductive technology (ART), recurrent pregnancy loss (RPL), recurrent implantation failure (RIF), endometriosis and pregnancy complications. Follicular-fluid studies and experimental models implicate oocyte maturation, embryo development, trophoblast function and placental immune regulation, providing biological plausibility without establishing ANA-mediated causation in human reproductive failure. Clinical studies show enrichment of ANA in infertility and RPL populations, whereas subsequent pregnancy prognosis, ART outcomes and perinatal associations vary with population, assay, titer and endpoint. We distinguish isolated ANA positivity from specific ANA-associated autoantibodies and established autoimmune disease because these findings carry different clinical implications. Disease-directed treatment for systemic lupus erythematosus or antiphospholipid syndrome is considered separately from empirical treatment in ANA-positive infertility patients. Some intervention studies report improved early reproductive outcomes, but current evidence does not support routine corticosteroids, hydroxychloroquine, aspirin or heparin solely on the basis of ANA positivity. ANA positivity is therefore best interpreted as a context-dependent marker that may guide targeted assessment rather than an independent therapeutic target. Prospective studies linking defined antibody profiles to tissue mechanisms, reproductive outcomes and treatment response are needed to establish clinically useful applications.