Coronary artery calcium (CAC) scoring is increasingly recognised as a non-invasive tool to refine cardiovascular risk assessment, particularly in asymptomatic individuals at intermediate risk. However, its clinical use remains inconsistent, shaped by varying recommendations across international and local guidelines. This systematic review compares the major guideline documents from the Cardiac Society of Australia and New Zealand (CSANZ), the American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC), focusing on three core endpoints: eligibility criteria, therapeutic thresholds and recommendations for repeat testing. While broad agreement exists on the utility of CAC scoring in intermediate-risk populations, key differences were identified. These include divergent definitions of risk, the use of formal recommendation frameworks and inconsistencies in guidance for pharmacotherapy initiation, particularly regarding statins and aspirin. The review also highlights a lack of clarity in the role of repeat scanning and variable alignment with national risk calculators. These differences may contribute to clinical uncertainty and inconsistent implementation. In the context of rising interest in precision prevention, further research evaluating CAC-guided decision-making is needed to help eventually achieve guideline harmonisation. Clearer evidence-based guidance is needed to support equitable and effective integration into routine cardiovascular risk assessment.

Preeclampsia represents an unmasking of underlying vascular and metabolic vulnerability during the physiologic stress of pregnancy. Current first-trimester screening relies heavily on body mass index which incompletely captures qualitative metabolic dysfunction, particularly in non-obese women. In this narrative perspective, we examine the atherogenic index of plasma (AIP; log10[TG/HDL-C]), which reflects triglyceride-rich lipoprotein burden and has emerged as a marker of lipid-driven vascular stress independent of adiposity. This article does not follow systematic review methodology (e.g., PRISMA) and is intended to provide a conceptual synthesis rather than an exhaustive review. Emerging obstetric evidence suggests that first-trimester AIP (≤14 weeks) is associated with an increased risk of subsequent preeclampsia, with uric acid (UA) potentially amplifying this relationship through redox-dependent mechanisms. We propose that elevated AIP and UA define an early, detectable oxidative dyslipidemia phenotype characterized by the convergence of lipotoxic and oxidative pathways, leading to endothelial dysfunction, nitric oxide (NO) depletion, platelet activation, and impaired placental perfusion. We further delineate druggable mechanistic nodes within this axis and outline a precision pharmacology framework for biomarker-enriched prevention trials. These nodes include cyclooxygenase-1 (COX-1)-mediated platelet activation (targeted by low-dose aspirin), NO pathway dysregulation (amenable to NO-supportive strategies), and xanthine oxidase-driven oxidative amplification (a potential target of redox-modulating agents). By explicitly linking early metabolic biomarkers to defined vascular pathways, this framework reframes first-trimester screening as a platform for mechanism-guided pharmacologic investigation rather than risk categorization alone. Before clinical integration, essential steps include independent validation across diverse populations, establishment of pregnancy-specific thresholds, demonstration of incremental predictive value beyond existing screening algorithms, and evidence that biomarker-guided strategies improve maternal and perinatal outcomes. Overall, these observations should be considered hypothesis-generating and require further validation before AIP-based assessment can support biologically informed, phenotype-guided prevention strategies within obstetric pharmacology.

Current regulatory neurotoxicity guidelines do not include behavioral endpoints that capture stress-related responses. Zebrafish larvae prior to independent feeding offer a promising vertebrate model for developing new approach methodologies (NAMs) because they combine neurobiological relevance with high-throughput potential. In this study, we developed and evaluated a larval thigmotaxis assay to detect behavioral alterations induced by neuroactive substances.

The planting altitude of coffee is one of the important influencing factors on coffee quality. The effects of four planting altitudes (1,000 m, AT1; 1,200 m, AT2; 1,400 m, AT3; and 1,600 m, AT4) on the microorganism community and the related metabolites in Coffea arabica cherries were investigated using Illumina-based amplicon sequencing and UPLC-MS/MS technologies, respectively. At tha same time, the contents of main flavor precursor substances (caffeine, trigonelline and chlorogenic acid) were analyzed using HPLC method. The results showed that planting altitude can significant influence the microbiomes' characteristics and endogenous metabolites of coffee. The dominant bacterial genera, Sphingomonas and Pleomorphomonas were significant differences in four planting altitudes, with the maximum relative abundance in AT3. Cladosporium and Strelitziana were the dominant fungal genera, while Vishniacozyma and Setophoma were also important in AT1, Setophoma and Didymella in AT3. 22 (AT2 vs. AT1), 68 (AT3 vs. AT1), 38 (AT3 vs. AT2), 77 (AT4 vs. AT1), 57 (AT4 vs. AT2), and 116 (AT4 vs. AT3) differentially changed metabolites were found between different planting altitudes, respectively. Moreover, caffeine, trigonelline and chlorogenic acid content was the decreas with planting altitude increased. These changes with planting altitude indicted a potential chance to find more fermentation microorganisms.

This systematic review assessed the potential effectiveness and safety of Serenoa repens (saw palmetto) for benign prostatic disorders, mainly benign prostatic hyperplasia and associated lower urinary tract symptoms. Following PRISMA guidance (PROSPERO: CRD420251032255), we searched PubMed, Cochrane and ScienceDirect for human studies from January 2020 to May 2025. Sixteen studies (>3000 participants) met criteria, including randomized trials, observational cohorts, a post hoc analysis, an open-label comparative study and a pharmacovigilance analysis. Overall, S. repens was associated with improvements in symptom severity (International Prostate Symptom Score) in several trials, with variable effects on urinary flow, post-void residual volume, and patient-reported quality of life. Signals of benefit appeared more consistently with hexanic lipidosterolic extracts and β-sitosterol-enriched preparations, and some real-world and head-to-head comparisons suggested outcomes comparable to alpha-blockers with fewer adverse events. Combination therapy, especially with the addition of alpha-blockers, showed larger symptom reductions in select populations, particularly with more pronounced baseline symptoms or prostatic inflammation. However, heterogeneity in extract formulations, dosing, study design, and outcome reporting limited cross-study comparability. Safety findings were generally favourable, with mostly mild gastrointestinal events and fewer sexual adverse effects than reported for conventional pharmacotherapies. Taken together, recent evidence supports S. repens as a potentially useful, well-tolerated option for benign prostatic hyperplasia-related symptoms - especially in certain formulations and as part of combination strategies - whilst underscoring the need for standardized, adequately powered trials to clarify which patients benefit most, optimal dosing, and durability of effects.

Preeclampsia is a severe pregnancy complication affecting pregnant people, their babies, and families. It remains a leading global cause of maternal and fetal morbidity and mortality. Our understanding of this disease continues to evolve, with opportunities for improved preeclampsia prediction, diagnosis, and management. This review outlines how placental growth factor (PlGF) could help clinicians better predict, diagnose, and ultimately manage preeclampsia and its complications. The material was originally presented at the Cannell Lecture in Toronto on 29 November 2024. The Cannell Lecture is hosted annually by the Society of Obstetricians & Gynaecologists of Canada and the University of Toronto in honour of Dr. Doug Cannell, who was Chair of the Department of Obstetrics & Gynaecology from 1950-1965.

Green coffee bean extract (GCBE) supplements are widely marketed for weight management, primarily due to their chlorogenic acids (CGAs) and caffeine content. This study evaluated the authenticity and quality of 23 commercial GCBE products by quantifying three major CGA isomers (3-CQA, 4-CQA and 5-CQA) and caffeine using HPLC-DAD. The CGA content ranged from non-detectable to 31.15%, with 5-CQA being predominant. Caffeine levels varied from non-detectable to 3.82%. Notably, two samples labelled as containing 50% CGAs had none detected, while several 'decaffeinated' products exceeded regulatory caffeine thresholds. Only three samples declared caffeine levels, none of which were fully compliant with their labels. Hierarchical cluster analysis (HCA) grouped the supplements into four distinct clusters based on total CGA and caffeine content, revealing widespread inconsistencies. These findings raise concerns over mislabelling, regulatory non-compliance, and potential health risks, underscoring the urgent need for stricter quality control and accurate labelling in the dietary supplement industry.