Search Results (5,558)

Objectives: To determine the prognostic value of the triglyceride-glucose (TyG) index, which serves as a surrogate for insulin resistance, for heart failure rehospitalization and all-cause mortality in older adults with chronic heart failure, and to evaluate its clinical utility in risk stratification and nursing care. Methods: In this single-center retrospective cohort study, 786 patients aged ≥65 years with chronic heart failure hospitalized at a tertiary referral hospital in Central China (January 2022–January 2025) were included and divided into low vs. high TyG index groups based on the median. Baseline data were extracted from medical records. Follow-up ended in December 2025. Associations between TyG index and adverse outcomes were examined using Kaplan–Meier curves, restricted cubic spline (RCS) regression, and multivariable Cox proportional hazards models. Results: The median TyG index was 8.35. In unadjusted analyses, the high-TyG group had significantly greater cumulative risks of heart failure rehospitalization (p < 0.001) and all-cause mortality (p = 0.028). After multivariable adjustment, the TyG index remained independently associated with heart failure rehospitalization (hazard ratio [HR]= 1.63), whereas its association with all-cause mortality was attenuated and no longer significant. Restricted cubic spline analysis revealed a nonlinear dose–response relationship between the TyG index and heart failure rehospitalization, and a linear relationship with all-cause mortality. Conclusions: In elderly patients with chronic heart failure, the TyG index independently predicted heart failure rehospitalization and demonstrated a nonlinear dose–response relationship; its independent association with all-cause mortality was not significant after full adjustment. The index may nonetheless aid in risk stratification and individualized nursing in this population. Full article

Background: Cardiac telemetry monitoring represents an important aspect of in-hospital patient safety in both telemetry and critical care settings. Despite technological advancements, telemetry effectiveness may be diminished due to systemic failures including operational processes, instructional policies, and human factors. Alarm fatigue, recognized by the Joint Commission as a leading contributor to serious patient harm, lies at the forefront of these failures. Objective: This narrative review utilized and synthesized sources indexed through PubMed, PubMed Central, MEDLINE, Web of Science, Google Scholar, Directory of Open Access Journals (DOAJ), and Scopus to illustrate the factors involved in hospital related monitoring failures. We purport that alarm fatigue and telemetry monitoring failures are the result of complex systemic failures comprising technological and human failures. Through this narrative, we propose an evidence-based framework known as the Safer Telemetry Architecture (STA) to pinpoint redundancies and promote closed-loop communication regarding alarm management. Conclusions: Monitored in-hospital environments represent a key area of preventable morbidity and mortality due to systemic design flaws. Our STA framework addresses such flaws via improvements in nurse-driven protocols, alarm routing, mandatory coverage standards for backup, and increased performance auditing. Systemic improvements via such a framework may represent an important institutional strategy for hospitals with cardiac monitoring, but requires further prospective validation. Managing redundancies in alerts and sounds, improving backup and nursing telemetry protocols, and promoting closed or continuous loops targeting alarm response times and telemetry utilization are key to effectively improving patient safety. Full article

Background: The deep learning-derived retinal cardiovascular risk index (Reti-CVD) is a deep learning-derived retinal biomarker calculated from non-mydriatic fundus photographs for cardiovascular risk assessment. This study examined whether obesity phenotype, particularly central adiposity, modifies the association between Reti-CVD and coronary artery calcium score (CACS) in asymptomatic adults undergoing routine health screening. Methods: We retrospectively analyzed 237 Korean adults who underwent fundus photography for Reti-CVD assessment and cardiac computed tomography for CACS measurement. Abdominal obesity was defined as waist circumference (WC) ≥ 90 cm in men and ≥85 cm in women, and general obesity as body mass index (BMI) ≥ 25 kg/m². Multivariable linear regression models with sequential adjustment were used to evaluate the association between Reti-CVD and CACS. Effect modification was assessed using interaction terms for Reti-CVD×WC and Reti-CVD×BMI. Discriminatory performance for coronary calcification, defined as CACS > 0, was evaluated using the area under the receiver operating characteristic curve (AUC). Results: Abdominal obesity was present in 78 participants (32.9%), and general obesity in 102 (43.0%). Participants with CACS > 0 had significantly higher Reti-CVD scores than those with CACS = 0 (0.15 ± 0.09 vs. 0.09 ± 0.05; p < 0.001). Reti-CVD remained positively associated with CACS after adjustment for metabolic and lifestyle factors. In fully adjusted models, WC significantly moderated this association (interaction p = 0.0288), whereas BMI did not (interaction p = 0.5381). Overall discrimination for CACS > 0 was moderate (AUC = 0.735) and numerically higher in participants with abdominal obesity than in those with normal WC (0.787 vs. 0.695). Conclusions: Reti-CVD is independently associated with coronary calcification, and WC-based central adiposity modifies this relationship. Incorporating obesity phenotype may improve personalized interpretation of retinal biomarker-based cardiovascular risk assessment. Full article

Background/Objectives: To determine whether ESS provides superior clinical, radiologic, or perioperative outcomes compared with non-ESS surgical strategies in lumbar spondylolisthesis. Methods: We conducted a PRISMA-guided systematic review and meta-analysis comparing ESS with non-ESS strategies specifically for lumbar spondylolisthesis. PubMed, Web of Science, Scopus, and CENTRAL were searched from inception to December 2025, plus reference-list screening. Primary outcomes were mean change in VAS back pain, VAS leg pain, and Oswestry Disability Index (ODI); secondary outcomes included radiologic measures (disc height, lumbar lordosis angle, fusion rate) and perioperative outcomes (blood loss, operative time, length of stay, complications). Results: Eighteen studies (16 retrospective cohorts, 1 RCT, 1 case–control) involving 1200 patients with lumbar spondylolisthesis (2019–2025) were included. ESS showed no significant differences versus non-ESS in mean change in VAS back pain (13 studies; MD −0.07), VAS leg pain (14 studies; MD 0.08), or ODI (12 studies; MD 0.51). No statistically significant differences were detected in radiological outcomes (disc height, lumbar lordosis angle, and fusion rate). ESS was associated with reduced blood loss (MD −132.98) and shorter hospital stay (MD −2.86 days), with no difference in operative time (MD 3.96) or postoperative complications (RR 0.86). Subgroup analyses compared endoscopic fusion with MIS fusion, open fusion, and non-endoscopic decompression. Endoscopic versus MIS fusion showed lower blood loss (MD: −50.9 mL) and shorter hospital stay (MD: −1.4 days) but longer operative time (MD: +17.2 min), with no differences in clinical outcomes. Comparisons involving decompression and open fusion were limited by the small number of studies and should be considered exploratory. Conclusions: For lumbar spondylolisthesis, no statistically significant differences were detected between ESS and non-endoscopic approaches in pain, disability, radiologic outcomes, or complication rates, with potential perioperative advantages in blood loss and length of stay. However, these findings should be interpreted cautiously because the available evidence is predominantly retrospective, procedurally heterogeneous, and affected by substantial variation in follow-up duration. Full article

Non-ST-segment elevation myocardial infarction (NSTEMI) has become the predominant form of acute coronary syndrome (ACS) and is frequently associated with multivessel coronary artery disease (MVD). Patients presenting with NSTEMI and MVD represent a particularly high-risk population characterized by advanced age, comorbidities, and an increased atherosclerotic burden. Although advances in pharmacological therapy and early invasive management have improved prognosis, the optimal revascularization strategy in this setting remains uncertain. In contrast to ST-segment elevation myocardial infarction (STEMI), where randomized controlled trials consistently support complete revascularization, evidence in NSTEMI with MVD is limited and is largely derived from observational studies and registry data. This has generated ongoing debate regarding whether complete revascularization offers superior outcomes compared with culprit-only percutaneous coronary intervention (PCI), and whether non-culprit lesions should be treated during the index procedure (immediate strategy) or in a staged manner. Current data suggest that complete PCI is generally associated with reduced recurrent ischemia, reinfarction, and repeat revascularization, with potential long-term survival benefits. However, patient comorbidities, lesion complexity, and procedural risk continue to influence outcomes, highlighting the importance of individualized decision-making. This narrative review synthesizes contemporary evidence on PCI-based revascularization strategies in NSTEMI with MVD, focusing on two central aspects: the extent of revascularization (complete versus incomplete) and the timing of intervention (single-stage versus staged). By integrating findings from registries, randomized trials and guideline recommendations, the review identifies areas of consensus, persisting uncertainties, and key evidence gaps. Ultimately, it underscores the need for large, dedicated trials to guide practice and optimize outcomes for NSTEMI patients with multivessel coronary disease. Full article

Changes in vegetation phenology affect ecosystem carbon uptake and water use, thereby regulating water use efficiency (WUE). However, in alpine ecosystems of the Qinghai-Tibetan Plateau (QTP), uncertainty remains regarding the phenological information characterized by different remote-sensing data sources and its associations with WUE. Using solar-induced chlorophyll fluorescence (SIF) and MODIS normalized difference vegetation index (NDVI) data from 2001 to 2018, we derived the start of growth (SOG) and end of growth (EOG) using multiple phenology extraction methods. WUE was calculated using gross primary productivity (GPP) and evapotranspiration (ET) data. We then employed trend analysis, statistical modeling, and a machine learning interpretive framework to systematically evaluate spatiotemporal differences in phenology derived from SIF and NDVI and their associations with WUE. The results showed that: (1) WUE generally increased across the QTP at approximately 0.15 g C m⁻² mm⁻¹ decade⁻¹, with significant increases mainly in the central-eastern and southeastern regions. Both NDVI- and SIF-derived SOG advanced at rates of −1.08 and −1.14 doy decade⁻¹, respectively. In contrast, EOG showed clear data source divergence: EOG_NDVI was delayed by 0.62 doy decade⁻¹, whereas EOG_SIF advanced by −0.48 doy decade⁻¹. SOG_SIF occurred on average 6.6 days later than SOG_NDVI, EOG differences were larger, with EOG_SIF occurring 17.2 days earlier than EOG_NDVI on average. Trend consistency was also higher for SOG than for EOG, whereas opposite EOG trends accounted for 25.3%. (2) After accounting for climatic covariates, SIF- and NDVI-derived phenological indicators showed distinct model-based associations with WUE, but their explanatory contributions were generally weaker than those of key climatic variables. (3) GAM results further showed that SOG was generally negatively associated with standardized WUE in both phenological datasets, whereas the EOG–WUE partial association differed between SIF and NDVI, with positive associations for EOG_SIF and negative associations for EOG_NDVI. This study highlights the differences between SIF- and NDVI-derived phenological indicators and their model-based associations with WUE, providing complementary remote-sensing information for interpreting vegetation phenology and WUE dynamics on the QTP. Full article

Background/Objectives: High-grade B-cell lymphomas (HGBCLs) with MYC and BCL2 or BCL6 translocations, colloquially referred to as double-hit lymphomas (and abbreviated here to DHL), are aggressive malignancies. Differentiating DHL from non-DHL HGBCLs is important, as DHL patients may benefit from more intensive treatment regimes. We aimed to identify predictive clinicopathological, morphological, and immunophenotypic features that could guide selection of HGBCLs for fluorescence in situ hybridization (FISH), which is expensive and less accessible in some centers. Methods: We conducted a PRISMA systematic review and meta-analysis on 29 studies identified from four databases (PubMed (MEDLINE), Ovid (Embase), Web of Science, and Scopus). We calculated risk ratios (RRs) to compare features between DHL and non-DHL HGBCL and between MYC/BCL2 and MYC/BCL6 DHL patients. Results: DHL patients were associated with higher Ann Arbor stage (RR 1.15, p = 0.028, I² = 38.7%), International Prognostic Index (IPI) score (RR 1.27, p = 0.047, I² = 37.9%), elevated lactate dehydrogenase (RR 1.26, p = 0.012, I² = 34.0%), and germinal center B-cell-like (GCB) immunophenotype (RR 1.21, p = 0.043, I² = 35.8%) compared to non-DHL HGBCL patients. c-Myc immunopositivity, extranodal disease, and bone marrow involvement were more likely in DHL, albeit not reaching statistical significance. Extranodal disease (p = 0.015, I² = 0.0%), central nervous system involvement (p = 0.044, I² = 0.0%), and non-GCB immunophenotype (p = 0.016, I² = 71.1%) were more likely in MYC/BCL6 compared to MYC/BCL2 DHL patients. BCL2 immunopositivity, CD10 immunopositivity, and MUM1 immunonegativity were more likely in MYC/BCL2 DHL, although the differences were not statistically significant. Conclusions: Our results have associated DHL with features of aggressive disease and found GCB immunophenotype as a histopathological feature with statistically significant predictive value for MYC/BCL2 DHL. Heterogeneity within the non-DHL HGBCL group and variation in immunohistochemical cut-off values between studies limited identification of other predictive features. Larger, consistently designed, prospective cohort studies could provide further evidence for a screening strategy for DHL. Full article

Appropriate dose adjustment of renally eliminated medicines is central to safe pharmacotherapy in patients with chronic kidney disease; yet, in European primary care, it is systematically undermined not by lack of knowledge, but by structural misalignment between laboratory reporting, regulatory product information, and clinical guidelines. This Perspective argues that the core barrier to optimal renal dose adjustment is a mismatch between routinely reported indexed eGFR and dosing requirements based on absolute renal function, compounded by persistent regulatory reliance on the Cockcroft–Gault equation despite its known limitations. We show how these structural inconsistencies, together with patient-related factors such as frailty, ageing, and body size, generate uncertainty at the point of prescribing and contribute to persistent variability in dosing decisions. To address this challenge, we propose a structured, context-aware renal dosing framework designed for routine primary care. The framework integrates regulatory guidance, multiple methods of renal function estimation, and patient-specific modifiers into a stepwise decision process. Clinical vignettes illustrate how divergent renal function estimates and regulatory requirements can lead to different dosing decisions in everyday practice. By reframing renal dose adjustment as a context-driven clinical process rather than a purely equation-based task, this Perspective highlights the need for regulatory alignment and pragmatic decision tools to improve prescribing quality in patients with chronic kidney disease. Full article

This study evaluated a synergistic intervention integrating school social work and ethnic education for reducing dropout-related risk among male students in Zhuang vocational secondary schools in central Guangxi, China. Using a quasi-experimental mixed-methods design with baseline, post-intervention, and follow-up assessments, 457 students were enrolled and 435 were included in the final analysis. Compared with usual support, the intervention group showed a larger reduction in the dropout risk index at follow-up, β = −0.37, SE = 0.08, 95% CI [−0.52, −0.22], p < 0.001, and a lower likelihood of chronic absenteeism, OR = 0.56, 95% CI [0.34, 0.91], p = 0.020. The retention difference was positive but less precise, OR = 1.70, 95% CI [0.79, 3.67], p = 0.174. The intervention group also reported higher school belonging, β = 0.33, SE = 0.06, p < 0.001, and academic self-efficacy, β = 0.30, SE = 0.06, p < 0.001. Parallel mediation analysis suggested that these two protective factors accounted for part of the intervention-associated difference in dropout risk, with a total indirect effect of −0.20, 95% CI [−0.28, −0.12], p < 0.001. The findings suggest that culturally responsive practices, when combined with tiered case management and family engagement, may help strengthen protective processes and slow the accumulation of dropout-related risks. This study provides context-sensitive evidence for designing school retention interventions in vocational schools serving ethnic minority communities, while the quasi-experimental design warrants cautious interpretation. Full article

Background/Objectives: Community hospitals can be a valuable and cost-effective resource for elderly people, especially in rural areas. Their aim is to promote self-reliance, prevent unnecessary hospital admissions, and facilitate rapid recovery after acute illness. The widespread adoption of intermediate care facilities helps alleviate hospital overcrowding by preventing clinical deterioration through advanced and continuous nursing care. An intermediate care unit was established in a rural area of central Italy. This study aims to describe the impact of a community hospital on patients’ functional status from admission to discharge, describing a real-life model. Methods: This single-center descriptive study examines trends in the quality of care provided. Data were retrieved from anonymized electronic clinical records. Statistical analyses were performed using descriptive statistics, paired t-tests, and Pearson correlation coefficients. Results: A total of 532 residents (mean age 80.7 ± 13.2 years; 61% female) were admitted to the community hospital between January 2022 and September 2025. The mean length of stay was 15.2 ± 7.6 days, with a mean improvement in Modified Barthel Index score of 5.24 ± 7.95 (p < 0.05). Most patients (81.8%) were discharged home, while 6.0% required hospitalization. No readmissions were recorded in 2025. Clinical risk events occurred only in 1.2% of the total. Nursing specialization increased during the study period, correlating with improved patient outcomes (R = 0.88). Conclusions: This descriptive cross-sectional study in a rural nurse-led intermediate care unit found relatively short lengths of stay, high rates of home discharges and modest, but statistically significant, improvements in functional autonomy. Full article

Breast and prostate cancers remain among the most prevalent epithelial malignancies worldwide, and conventional treatments often lack tumor selectivity. Aloin, an anthraquinone glycoside derived from Aloe vera, has demonstrated promising anticancer properties. This study investigated the differential cytotoxic and apoptotic effects of Aloin under in vitro conditions in MCF-7 (breast cancer) and PC-3 (prostate cancer) cell lines compared with normal prostate epithelial cells (PNT-A1). Cells were treated with Aloin (1000–1500 µg/mL); cytotoxicity was assessed by CCK-8 assay, apoptotic morphology by DIC microscopy, protein expression by immunofluorescence with quantitative CTCF analysis (BAX, Caspase-3, Caspase-8, Caspase-9), and gene expression by qRT-PCR (2^−ΔΔCt method). An integrated log₂ fold change heatmap, pathway enrichment analysis across three independent databases (KEGG 2026, Reactome 2024, WikiPathways 2024), and STRING v12.0-based protein–protein interaction (PPI) network were constructed. Aloin exerted significant dose-dependent cytotoxicity in both cancer cell lines, while PNT-A1 viability exceeded 50% across all concentrations (Selectivity Index > 1.30 for MCF-7 at 48 h). Immunofluorescence and qRT-PCR confirmed significant upregulation of BAX (up to 6.14×), CASP8 (up to 15.51×), CASP9 (up to 9.27×), and CASP3 (3.03× in PC-3), indicating concurrent activation of intrinsic and extrinsic apoptotic pathways, while all genes remained unchanged in PNT-A1 cells. Pathway enrichment analysis confirmed that these genes are statistically central nodes in conserved apoptotic signaling networks (adj. p < 10⁻⁹). To the best of our knowledge, this is the first in vitro characterization of Aloin-induced pro-apoptotic activity in prostate cancer cells, establishing a mechanistic foundation for further investigation of this phytochemical in epithelial-derived cancer models. Full article

Insulin resistance (IR) is traditionally viewed within the context of type 2 diabetes. However, it increasingly appears to represent a broader systemic metabolic risk state with potential relevance for carcinogenesis. Chronic hyperinsulinemia can activate insulin-like growth factor-1-dependent pathways, including phosphoinositide 3-kinase/protein kinase B/mechanistic target of rapamycin and mitogen-activated protein kinase signaling, promoting cellular proliferation while limiting apoptosis. At the same time, IR is closely linked to oxidative stress, chronic low-grade inflammation, and epigenetic alterations, together shaping a tumor-promoting microenvironment. Epidemiological studies report consistent associations between IR and increased cancer risk, particularly for endometrial, liver, and colorectal cancers. Yet causality remains uncertain and likely varies by tumor type. Notably, metabolic dysfunction may also occur in individuals with normal body mass index (BMI), underscoring the limitations of BMI-based risk assessment. Unlike previous reviews that primarily focused on individual mechanisms or epidemiological associations, this review examines IR as a systemic metabolic risk state by integrating molecular, epidemiological, biomarker-based, and prevention-oriented perspectives. Particular emphasis is placed on strategies for earlier risk identification using integrated biomarker approaches, including fasting glucose, homeostatic model assessment of insulin resistance, triglyceride-to-high-density lipoprotein ratio, high-sensitivity C-reactive protein, and insulin-like growth factor-1. Emerging tools such as continuous glucose monitoring and hepatokine profiling may further refine risk detection. Sustained lifestyle modification—diet, physical activity, sleep, and stress regulation—remains central to prevention. Pharmacological therapies, including glucagon-like peptide-1 receptor agonists and dual incretin agents, offer additional metabolic benefits, although their long-term impact on cancer risk is still unclear. Therefore, IR is best understood not as an isolated risk factor, but as a systemic metabolic risk state that may influence cancer development, with implications for prevention and early risk stratification. Full article

Google Earth Engine (GEE) has become a central platform for planetary-scale geospatial analysis, but its rapid evolution in the last few years is not yet reflected in the existing review literature. Earlier reviews mainly describe the platform’s architecture and its initial application domains, whereas a structured bibliometric and thematic overview of the post-2022 phase of GEE is still lacking. In this more recent phase, the platform has introduced foundation models, satellite embeddings, and native links to cloud databases. Drawing on a structured bibliometric analysis of 5591 Scopus and Web of Science indexed documents published between 2011 and 2025, the results reveal sustained long-term growth, with annual publications increasing from 3 records in 2011 to 1371 records in 2025, corresponding to a compound annual growth rate (CAGR) of 54.88%, indicating a shift from exploratory testing of the platform to more operational use. Logistic growth modelling ($R^2=0.991$) suggests that GEE research is transitioning from rapid expansion towards a scientific maturity phase, where the platform increasingly functions as a normalized analytical infrastructure embedded within broader cloud-native geospatial ecosystems. The full 2011–2025 corpus is used to establish long-term bibliometric trajectories, whereas the thematic synthesis focuses on the post-2022 transition towards Geospatial Artificial Intelligence(GeoAI), satellite embeddings, and cloud-database interoperability. The review examines how new satellite embedding datasets and BigQuery integrations help close the gap between raster-centric Earth observation (EO) workflows and tabular data science. We summarise methodological changes from traditional pixel-based classifiers to multimodal fusion approaches that combine Synthetic Aperture Radar (SAR), Global Ecosystem Dynamics Investigation (GEDI), and optical sensors, and we discuss how GEE’s highly integrated ecosystem influences reproducibility and the risk of vendor lock-in. Finally, we propose a roadmap for the ongoing transition of GEE towards GeoAI, offering researchers and policymakers a transparent and reproducible framework for deploying the platform in high-impact environmental governance. Full article

Habitat alteration and biological invasions are two main drivers of biodiversity loss at the global scale. Eutrophication and invasive fish greatly disturb freshwater native communities. This is of particular conservation concern in the Iberian Peninsula (Portugal and Spain), where fish fauna display a high level of endemism. For this eco-region, there is a dearth of information on the interactions among water quality, physical condition and parasites of invasive fishes. Consequently, the aim of this study was to assess the effect of nutrient enrichment on health status and parasitological traits in the invasive mosquitofish Gambusia holbrooki inhabiting an Iberian river. Water (n = 18 replicates, three per site) and fish (n = 400 individuals, 33–34 ind. per site and year) samples were collected in September 2024 and 2025 along the River Bullaque (central Spain). Sampling effort was standardised among sites, with the following parameters consistent: seine and pond nets were used, deployed by wading; 10:00 solar time; 1.5 h duration; personnel (the same seven trained researchers); and weather/environmental conditions; ensuring methodological consistency and data comparability. Laboratory procedures were carried out near the sampling sites to minimise both fish stress and distortions to parasite communities. Morphological and parasitological parameters were compared between mesotrophic and eutrophic reaches (six sampling sites, three per reach). Body condition and health assessment index* were greater under eutrophic conditions. Fluctuating asymmetry (a measure of developmental instability) was significantly higher for eye diameter in the mesotrophic reach. Parasite taxonomic composition differed between reaches, with more digeneans and cestodes in the mesotrophic sites, whereas ciliates and monogeneans were more abundant in mosquitofish from the eutrophic reach. Parasite prevalence, abundance and index of life-cycle complexity (heteroxenous species) were lower in the eutrophic reach. These results strongly suggest that eutrophication can facilitate mosquitofish invasiveness. This is reflected in a variety of morphological and parasitological traits, such as better body condition, health status, developmental stability, parasite resistance and tolerance. Overall, these parameters indicate that mosquitofish is taking advantage of anthropogenic impacts to improve their level of establishment and subsequent spread throughout Iberian fresh waters. Full article

Background/Objectives: Italy is among the countries with the highest life expectancy and extreme longevity worldwide, yet marked regional disparities persist. This nationwide ecological study examined temporal trends in population aging and extreme longevity across the 20 Italian regions (1982–2025) and explored regional correlates non-communicable disease (NCD) mortality and contemporary behavioral/nutritional indicators, with attention to emerging southern hotspots such as Cilento. Methods: Longevity indicators (Aging Tendency, Longevity Index [LI%], Centenarity Index [CI%], 85+ and 90+ ratios) were derived from ISTAT demographic data. Age-standardized mortality rates for five major NCDs (1990–2023) were obtained from WHO HFA-DB. Behavioral and nutritional indicators for adults aged ≥65 years (2024) were extracted from HFA-Italy. Regional associations were assessed using Spearman correlations within an ecological, hypothesis-generating framework. Results: All longevity indicators increased steadily from 1982 to 2025, with northern and central regions showing the highest values. Lower long-term mortality from diabetes mellitus and cerebrovascular diseases showed the strongest regional correlations with higher LI% and CI%. Nutritional profiles were generally more favorable in northern regions. The Cilento area emerged as a notable southern hotspot, displaying longevity indicators comparable to Sardinia and above the regional average. Conclusions: Regional patterns of extreme longevity in Italy reflect the interplay of demographic dynamics, NCD mortality burden, and contemporary lifestyle profiles. While northern regions maintain a clear advantage, specific southern areas such as Cilento demonstrate that favorable longevity outcomes can emerge in diverse macro-regional contexts. These findings highlight the value of regionally tailored strategies to promote healthy aging and reduce geographical disparities. Full article