Search Results (11,945)

Background/Objectives: Radiation therapy for left-sided breast cancer exposes the heart and lungs to incidental radiation, increasing long-term risk of cardiopulmonary morbidity. This study evaluated the dosimetric impact of DIBH compared with free breathing (FB) and explored patient- and treatment-related predictors of benefit. Methods: We retrospectively analyzed 90 patients with left-sided breast cancer or chest wall irradiation planned under both FB and DIBH. Dosimetric parameters included mean heart dose (MHD), mean lung dose (MLD), heart V5, and lung V20. Univariable analyses assessed associations between dose reductions (Δ%) and clinical factors (age, BMI, fractionation, boost, nodal fields, and smoking). Multivariable regression identified independent predictors. Results: DIBH significantly reduced mean doses to the heart (FB 4.25 ± 1.47 Gy vs. DIBH 2.64 ± 1.28 Gy; Δ −1.60 Gy, p < 0.001, and Cohen’s d = 2.46) and lung (FB 14.00 ± 3.45 Gy vs. DIBH 11.64 ± 3.32 Gy; Δ −2.36 Gy, p < 0.001, and Cohen’s d = 2.73). Similarly, heart V5 (median Δ −10.5%, p < 0.001) and lung V20 (median Δ −5.5%, p < 0.001) were significantly improved. Higher BMI was independently associated with smaller relative reductions in MHD (−1.4% per unit, p < 0.001) and MLD (−0.31% per unit, p = 0.019). Hypofractionation was linked to greater MHD and MLD reductions (+8.9%, p = 0.007), (3.7%, p = 0.035), respectively. Supraclavicular field irradiation increased lung exposure, while internal mammary chain fields elevated both lung and heart doses. Age showed no significant influence. Conclusions: DIBH provides robust and consistent reductions in cardiac and pulmonary radiation doses during left-sided breast irradiation. The degree of sparing is modulated by BMI, fractionation, and nodal field inclusion. Full article

Background: Distal femur fractures remain among the most challenging injuries in orthopedic trauma, particularly in elderly or osteoporotic patients and in cases involving periprosthetic or highly comminuted distal femur fracture patterns. Modern fixation strategies include retrograde intramedullary nails, locking plates, and, more recently, combined nail–plate constructs (NPC). However, the optimal fixation method remains debated, and high-quality comparative evidence is limited. This systematic review evaluates clinical outcomes, union rates, and complications associated with single versus combined fixation constructs in distal femur fractures. Materials and Methods: A systematic review was performed according to PRISMA guidelines using PubMed/MEDLINE, EMBASE, and the Cochrane Database up to June 2025. Original studies reporting surgical management of distal femur fractures, including periprosthetic distal femur fractures, with postoperative outcomes were included. Ten retrospective studies met the inclusion criteria, comprising 397 patients. Methodological quality was assessed using the Modified Coleman Methodology Score (mean: 56.5). Data collected included patient demographics, fracture type, surgical technique, union rates, complications, and follow-up duration. Descriptive statistics were used to summarize trends due to study heterogeneity. Results: Among the included fractures, 304 involved the distal femur and 55 were periprosthetic. Combined nail–plate fixation was used in 203 patients, while 185 received single-implant fixation. Across studies, union rates were consistently higher in the NPC group, with several reporting 100% union, compared with more variable results in single-construct cohorts (72–96.7%). The most frequent complication in the NPC group was infection (12 cases), whereas delayed union predominated in single-implant constructs (19 cases). Patient comorbidities, such as diabetes or smoking, were inconsistently reported but may have influenced complication patterns. Follow-up periods ranged from 5.15 to 20 months, and operative details were included in several studies. Due to heterogeneity and retrospective design, no meta-analysis was performed, but descriptive trends were consistently observed. Conclusions: Nail–plate constructs appear to offer mechanical advantages in complex or high-risk distal femur fractures, achieving superior union rates compared with single implants. However, this benefit is counterbalanced by a higher incidence of postoperative infections, likely related to greater surgical invasiveness. Single constructs remain appropriate for simpler fracture configurations or better-quality bone. High-quality prospective research with standardized radiographic and functional outcomes is needed to clarify indications and optimize fixation strategies for distal femur fractures. Full article

Cytisine is a plant-derived quinolizidine alkaloid found, among other sources, in the seeds of the common laburnum (Laburnum anagyroides). It has properties that enable it to act as a partial agonist of brain nicotinic α4β2 receptors, which play a key role in the development and maintenance of nicotine addiction. Clinical studies have shown that cytisine is a more effective smoking cessation aid than nicotine replacement therapy and at least as effective as varenicline in treating tobacco cigarette addiction. It may also be an effective agent in treating addiction to electronic cigarettes. Cytisine is also significantly cheaper than other anti-nicotine medications. This is of great importance for the population of smokers in developing countries, who cannot afford anti-nicotine treatment. In recent years, the role of cytisine in the pharmacotherapy of nicotine addiction worldwide has increased significantly. This drug is becoming available in an increasing number of countries, and in 2025 the World Health Organization (WHO) added cytisine to the list of essential medicines. The need for further development of the drug poses additional challenges for scientists, including the creation of new pharmaceutical forms, optimization of dosing regimens, and expansion of indications to include the treatment of nicotine addiction supplied into the body in forms other than traditional tobacco products. This review describes the use of cytisine in the treatment of nicotine addiction, the drug’s mechanism of action, pharmacokinetics, efficacy, safety of use, and the available pharmaceutical preparations. It also presents research directions on cytisine related to the development of innovative pharmaceutical products, new dosing regimens, and new indications associated with the treatment of addiction to various nicotine-containing products. Conclusions indicate that cytisine has a difficult dosing regimen, which is why patients do not adhere to it, limiting the effectiveness of the therapy. This necessitates optimizing the dosage of existing capsules and tablets or introducing, for example, new extended-release forms of the drug containing cytisine. Full article

Background: Congenital heart disease (CHD) represents a major cause of perinatal morbidity and mortality, and fetal echocardiography is essential for its early diagnosis and management. Maternal smoking has been suggested as a potential teratogenic factor affecting fetal cardiovascular development; however, findings regarding its association with CHD remain inconsistent. This study aimed to evaluate the relationship between maternal smoking during pregnancy and the risk of CHD. Methods: A total of 2715 pregnant women and 2784 fetuses who underwent fetal echocardiography at ≥20 weeks’ gestation between 1 January 2024 and 1 November 2025 were analyzed. Pregnancies complicated by known chromosomal or syndromic abnormalities, significant teratogenic exposure, duplicate assessments, or nonstandard examinations were excluded. Maternal smoking status during pregnancy was recorded and categorized according to daily cigarette consumption. The prevalence of CHD and the distribution of CHD subtypes were evaluated and compared according to smoking status. Fetal cardiac diagnoses were classified based on the classical morphological classification system. Results: A total of 2715 pregnancies (2784 fetuses) were analyzed, including 2530 fetuses in the non-smoking group and 254 in the smoking group. Congenital heart disease was detected in 12.5% of fetuses in the non-smoking group and 14.2% in the smoking group, with no statistically significant difference (p = 0.442). According to the classical morphological classification, the distribution of fetal echocardiographic pathologies did not differ significantly between groups (p = 0.607). Septal defects were the most common subtype in both groups. Although conotruncal defects were proportionally more frequent in the smoking group, this difference did not reach statistical significance. After reclassifying daily cigarette consumption into four exposure categories, no association was detected between maternal smoking and CHD risk (OR = 1.04; 95% CI: 0.86–1.26; p = 0.691). Conclusion: In this cohort referred for fetal echocardiographic evaluation, no association was detected between maternal smoking during pregnancy and the risk of congenital heart disease or alterations in CHD subtype distribution. No consistent dose–response relationship was observed. These findings suggest that no association was detected between maternal smoking exposure and CHD. Further large-scale prospective studies are needed to clarify phenotype-specific associations. Full article

The effect of cold smoking on the physicochemical, microbiological, and aromatic properties of Formaella-type cheese has not been previously investigated. In this study, experimental Formaella-type hard cheeses (≤38% moisture) were produced using a multistep high-temperature cooking process and subjected to weak (20 min) and intense (60 min) cold smoking, alongside an unsmoked control. Cheeses were analyzed before and after smoking and during refrigerated storage (up to 90 days). Smoking significantly influenced pH, water activity, and colour parameters, with intensively smoked cheeses exhibiting lower pH, reduced lightness (L*), and increased redness (a*) and yellowness (b*). Microbiological analyses revealed low viable counts across all samples, attributed to severe cooking steps and vacuum storage. Smoking, particularly at high intensity, significantly reduced total mesophilic counts and enterococci, while Enterobacteriaceae, staphylococci, yeasts, and moulds were not detected after manufacture. The dominant microbiota consisted mainly of lactic acid bacteria, identified by MALDI-TOF MS, including Enterococcus durans, Ent. faecium, Leuconostoc lactis, Leuconostoc mesenteroides, Streptococcus thermophilus, Lacticaseibacillus rhamnosus, and Lactobacillus curvatus. Headspace-SPME-GC-MS analysis identified 75 volatile compounds, with free fatty acids, ketones, aldehydes, and lactones as the predominant groups. Smoking introduced characteristic phenolic and furan derivatives associated with smoky aroma. Overall, smoking intensity modulated microbial dynamics and aroma development without compromising microbiological quality. Full article

Background: Past workplace exposure to asbestos in combination with tobacco smoking has increased the risk of lung cancer for some residents in an area within the Friuli Venezia Giulia region, Northeast Italy. In light of studies showing that lung cancer screening (LCS) with low-dose computed tomography (LDCT) can reduce mortality, local stakeholders and decision-makers decided to assess the potential benefits, harms and cost-effectiveness of a single round of LCS with LDCT versus standard care among people aged 55 to 80 who were formerly exposed to asbestos and with at least 10 pack-years of smoking. Methods: An economic model was developed using a decision tree connected to a Markov cohort model. The primary outcome was the incremental cost per additional quality-adjusted life year (QALY). Other outcomes included the number of life years saved, the number of deaths averted and overdiagnosis. Results: Per 10,000 people screened, the intervention led to 395 additional QALYs (95% credible interval: 129 to 831) and incremental total costs of EUR 1,086,345 (95% credible interval: −852,607 to 2,155,826). The incremental cost per QALY gained was EUR 2750. There was a probability of cost-effectiveness of 99.5% relative to a threshold of EUR 25,000. Conclusions: The model estimated that the intervention was cost-effective. The model’s simplifications and limitations should be considered when interpreting the findings in relation to policy-making decisions. Further research could include the costs and benefits of incidental findings and could assess the cost-effectiveness of repeated rounds of screening for the same population. Full article

Background/Objectives: Ovarian function suppression (OFS) is part of endocrine therapy treatment for high-risk premenopausal women with hormone receptor-positive (HR+) breast cancer (BC). Incomplete OFS may occur and compromise treatment efficacy. Methods: We conducted a retrospective single-center cohort study of premenopausal patients with HR + BC treated with OFS therapy at the Centre des maladies du sein (CMS) of the CHU de Québec (Québec, Canada). Ovarian function suppression failure was defined as either biochemical failure (estradiol (E2) levels within the premenopausal range according to local immunoassays used) or clinical failure (return of menstrual bleeding). Patients’ characteristics, treatment specifics and side effects, timing and type of OFS failure, recurrence, and mortality were analyzed. Results: Among 208 included patients, 17 (8.2%) experienced at least one episode of OFS failure during a median follow-up of 62.6 months. Most failures occurred early, with 76.2% occurring within the first year of treatment. No significant differences were observed between patients with and without OFS failure regarding age, body mass index (BMI), or prior chemotherapy exposure. Patients with OFS failure had a significantly younger age at first pregnancy and higher rates of active smoking. No BC recurrence or death occurred among patients with OFS failure. Treatment-related side effects were common, and 23.0% of OFS regimens were discontinued due to adverse effects. Conclusions: In this study, OFS failure occurred in fewer than 10% of premenopausal patients. Younger age at first pregnancy and active smoking may be associated with OFS failure, but further data are needed to validate these exploratory associations. These findings reinforce the need for larger prospective studies to better assess OFS failure and develop standardized monitoring strategies to optimize treatment efficacy. Full article

Medication-related osteonecrosis of the jaw (MRONJ) represents a major clinical challenge for oral and maxillofacial surgery departments as well as dental practices. With increasing life expectancy and the more frequent use of medications associated with osteonecrosis, the incidence of MRONJ continues to rise. To date, there are no uniform treatment standards with scientifically proven effectiveness for this condition. To evaluate the impact of platelet-rich fibrin (PRF) on the outcomes of MRONJ treatment and to identify factors that may influence the effectiveness of PRF therapy, we conducted a comparative prospective study including 22 patients divided into two groups: patients treated with PRF and patients treated without PRF. PRF was prepared according to the PRF Duo Quattro Process protocol for PRF (Nice, France). The study was registered at ClinicalTrials.gov (NCT07464678). The following parameters were assessed: age, smoking status, gender, lesion location, body mass index (BMI), C-reactive protein (CRP) concentration, pain intensity, presence or absence of fistulas, soft tissue healing and radiological findings. Patients were evaluated preoperatively and postoperatively at 14 days, 6 weeks, and 6 months. The study demonstrated a reduction in pain after surgery among patients treated with PRF. In addition, the use of PRF resulted in improved healing outcomes in patients with elevated CRP. Higher BMI was associated with poorer therapeutic response to PRF. Improvements in soft tissue healing and disease stage were observed in the PRF group; however, these differences did not reach statistical significance. All findings should be interpreted with caution due to the limited sample size. There is still no standardized treatment for MRONJ. The use of platelet-rich fibrin as an inexpensive and safe adjunctive therapy may provide clinical benefits for patients, particularly through a significant reduction in pain. Further large-scale, multicenter studies are required to confirm these findings. Full article

Objective: To characterize the distribution of FCR severity across survivorship time intervals in bladder cancer survivors. Methods: A cross-sectional study of 79 patients utilized the validated 9-item FCR Inventory-Short Form (FCRI-SF) to assess overall FCR severity. Primary analysis employed Spearman’s correlation coefficient to evaluate the relationship between time elapsed since the first procedure and total FCR scores. Patients were stratified into four temporal groups (<1, 1–2, 2–5, and >5 years). Inter-group variability in FCR scores was assessed using Levene’s test for equality of variances. Subgroup analyses compared FCR scores across clinical subgroups, including tumor grade and smoking history, using the Mann–Whitney U test. Multivariate logistic regression identified independent predictors of clinically significant FCR (total score ≥13). Results: Median patient age was 72.0 years (IQR 66.0–78.0), with a median of 24.0 months post-diagnosis. Clinically significant FCR (score ≥13) was prevalent in 55.7% of the cohort. Spearman correlation analysis revealed no significant relationship between months elapsed and FCR severity (rho = 0.068, p = 0.552). Patients in the 12–24 month window exhibited the highest variability (Levene’s test, p = 0.058), representing a period of clinical divergence. High-Grade disease and smoking cessation motivated by diagnosis were associated with higher FCR scores. In the multivariate logistic regression model, history of tumor recurrence was the sole independent predictor of clinically significant FCR (aOR 3.28, 95% CI 1.11–9.68, p = 0.031), whereas age and gender were not significantly associated. Conclusions: FCR severity did not demonstrate a significant association with time elapsed since diagnosis in this cross-sectional sample. The 1–2 year interval demonstrated greater inter-individual variability in FCR scores. Findings highlight the need for long-term, structured survivorship support, particularly targeting the 12–24 month post-diagnosis window. Full article

Cigarette smoking contributes to vascular aging through oxidative stress, inflammation, and extracellular matrix (ECM) remodeling. Cellular senescence has been recognized as an important mechanism linking tobacco exposure to vascular dysfunction, but effective pharmacological strategies targeting this process remain scarce. In this study, we examined whether Rapalink-1, a dual inhibitor of mechanistic target of rapamycin complex 1 and complex 2 (mTORC1 and mTORC2), modulates smoke condensate (SC)-induced senescence in vascular cells. Human umbilical vein endothelial cells (HUVECs) and vascular smooth muscle cells (SMCs) were exposed to SC with or without Rapalink-1. SC increased intracellular reactive oxygen species, induced DNA damage, and promoted senescence-associated changes, including increased senescence-associated β-galactosidase (SA-β-gal) activity, reduced Lamin B1, and elevated p21 expression. These effects were accompanied by increased expression of inflammatory and matrix-remodeling genes associated with the senescence-associated secretory phenotype (SASP). Rapalink-1 co-treatment reduced oxidative stress and DNA damage, attenuated senescence markers, and partially normalized SASP-related and ECM-associated gene expression. Mechanistically, SC activated nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling and increased downstream mTOR pathway activity, whereas Rapalink-1 dampened these signaling responses. Together, these findings indicate that dual mTORC1/2 inhibition by Rapalink-1 mitigates smoke condensate-induced senescence and inflammatory responses in vascular cells. Full article

Background and Objectives: Percutaneous coronary intervention (PCI) has markedly improved outcomes in coronary artery disease through the implantation of bare-metal stents (BMS) or drug-eluting stents (DES). However, in-stent restenosis (ISR) remains a significant complication, often necessitating repeat interventions. This study aimed to identify risk factors associated with ISR in patients with ST-elevation myocardial infarction (STEMI) who underwent PCI. Materials and Methods: We conducted a retrospective, non-randomized observational study of 107 STEMI patients treated with PCI between January 2016 and December 2019 who subsequently underwent clinically indicated (predominantly symptom-driven) follow-up coronary angiography within 12 months. ISR was defined as ≥50% luminal narrowing at follow-up angiography. Time-to-event analysis was performed using Cox regression models, incorporating clinical, biochemical, and angiographic variables. Results: In this selected cohort of patients undergoing follow-up angiography, ISR of any degree was identified in 87% of patients, and 52% had restenosis >70%. Advanced age, prior cardiovascular events, diabetes mellitus, chronic kidney disease, and history of stroke significantly increased the hazard of ISR. Smoking, dyslipidemia, and hypertension were prevalent in patients with severe ISR. Women presented with more severe clinical profiles (higher Killip class and troponin levels). DES showed slightly better TIMI flow than BMS, but stent type, dimensions, and number did not significantly impact restenosis risk. Thrombolytic therapy was associated with a significantly reduced ISR hazard. Mortality was 6% in patients with severe ISR. The highest restenosis incidence occurred in the LAD and RCA territories. Conclusions: ISR is a multifactorial process influenced by demographic, clinical, and procedural factors. Despite technological advances, ISR remains a prevalent issue, particularly in high-risk groups undergoing clinically indicated follow-up angiography. Secondary prevention strategies, optimized stent deployment, and targeted therapies addressing inflammation and vascular remodeling are essential to improving long-term PCI outcomes. Full article

Objective: This study investigates the prognostic value and clinical utility of the neutrophil percentage-to-albumin ratio (NPAR) in patients with resected non-small-cell lung cancer (NSCLC). Methods: We retrospectively included 335 patients with NSCLC who underwent lung resection at our institution between January 2017 and October 2018. Optimal cutoffs for preoperative and postoperative day 1 (D1) NPAR were determined using X-tile (version 3.6.1; Yale University, New Haven, CT, USA) to define high and low groups. Overall survival (OS) was evaluated using Kaplan–Meier analysis and Cox proportional hazards models. A perioperative NPAR trajectory (low–low, low–high, high–low, high–high) was constructed to characterize dynamic risk patterns. To mitigate potential bias associated with postoperative measurements, a D1 landmark analysis was performed. A nomogram was developed based on the multivariable model and assessed by calibration at 1, 3, and 5 years. Incremental clinical value beyond TNM stage and surgical approach was evaluated using decision curve analysis (DCA), as well as by 5-year continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results: The optimal cutoffs for preoperative and postoperative D1 NPAR were 14.5 and 23.1, respectively. In univariate analyses, sex, smoking history, preoperative NPAR, postoperative D1 NPAR, pathologic type, TNM stage, surgical approach, and adjuvant therapy were associated with OS (all p < 0.01). In multivariable Cox regression, high preoperative NPAR (HR 1.896, 95% CI 1.135–3.168; p = 0.014) and high postoperative D1 NPAR (HR 1.905, 95% CI 1.097–3.305; p = 0.014) were independent risk factors, along with TNM stage (Stage II: HR 2.824, 95% CI 1.209–6.595; p = 0.016; Stage III: HR 9.470, 95% CI 4.935–18.171; p < 0.001) and open surgery (HR 2.350, 95% CI 1.341–4.117; p = 0.003). Trajectory analysis further stratified risk, with the high–high group showing the poorest survival (adjusted HR 3.48, 95% CI 1.43–8.47; p = 0.006). The association of postoperative NPAR persisted in the D1 landmark analysis (HR 1.836, 95% CI 1.071–3.148; p = 0.027). Adding NPAR to TNM stage and surgical approach improved 5-year risk reclassification (continuous NRI 0.377, 95% CI 0.094–0.659; IDI 0.028, 95% CI −0.002–0.054) and increased net benefit on DCA. The nomogram demonstrated acceptable calibration at 1, 3, and 5 years. Conclusions: This study demonstrates that NPAR serves as an independent prognostic marker for long-term outcomes in patients with NSCLC. The use of NPAR offers clinicians a comprehensive and precise tool for assessing patient prognosis. Full article

Fine particulate matter PM_2.5 continues to pose a critical public health risk in Northern Thailand, particularly in Chiang Mai, where traditional filtration methods often face limitations in cost and efficiency for large-scale applications. This study introduces a novel “Evaporator Condensation Growth Particle Scrubber (ECGP)” designed to enhance the collection efficiency of sub-micron particles by enlarging their physical size through a pressure-driven growth mechanism. The ECGP system utilizes synergistic effects between solid nuclei, high relative humidity, and mechanical pressure modulation. The ECGP system integrates solid nuclei, ~95% relative humidity and mechanical pressure modulation within a single chamber. Using incense smoke as a PM surrogate, the process utilizes controlled adiabatic cycles to induce stable heterogeneous condensation. The results indicate that the integrated process effectively shifts particle size distribution, reducing the PM_2.5/PM₁₀ mass ratio from 1.00 to 0.83. This indicates that approximately 17.5% (with a standard deviation < 1% across 10 trials, p < 0.05) of the fine mass successfully transitioned into the larger, more filterable PM₁₀ fraction and exhibited high physical stability and resistance to re-evaporation, effectively overcoming the low-efficiency threshold (typically <10%) of standard mechanical scrubbers and cyclones for sub-micron dust. This study concludes that ECGP technology offers a promising, cost-effective alternative for improving indoor air quality in large public infrastructures by leveraging particle inertia for enhanced removal, providing a scalable solution to the persistent smog crisis. Full article

Background/Objectives: The aim of this study was to analyze and quantify the independent effects of tooth mobility and furcation involvement on the probability of tooth loss in a large patient cohort, after controlling for patient-level confounding factors. Methods: This retrospective cohort study utilized data from 16,756 patients. Primary predictors were tooth mobility and furcation involvement. The primary outcome was tooth loss. A multivariable logistic regression model, adjusting for confounders (age, gender, smoking, diabetes), was developed to calculate Odds Ratios (OR) and 95% confidence intervals (CI). Results: A significant dose–response relationship was observed between the severity of both mobility and furcation involvement and the rate of tooth loss (p < 0.001). After multivariable adjustment, both remained statistically significant predictors (p < 0.001). Compared to no mobility, the odds of tooth loss for Class 3 mobility were 3.99 times higher (OR = 3.99; 95% CI: 3.58–4.45). Compared to no furcation involvement, the odds for Grade 3 involvement were 2.50 times higher (OR = 2.50; 95% CI: 2.19–2.85). Diabetes, smoking, male gender, and increasing age were also significant risk factors. Conclusions: Tooth mobility and furcation involvement are independent predictors of future tooth loss. These findings highlight the critical importance of thoroughly assessing mobility and furcation defects for patient risk assessment, prognosis, and treatment planning. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD), and related fibrosis are increasingly prevalent conditions. The relation of the American Heart Association’s (AHA) cardiovascular health (CVH) metric Life’s Essential 8 (LE8) with MASLD, MetALD, and hepatic fibrosis remains unclear. We aimed to investigate the associations of CVH with MASLD, MetALD, and hepatic fibrosis. Methods: We defined significant hepatic fibrosis as a liver stiffness ≥8.2 kPa measured by vibration-controlled transient elastography. MASLD was defined as steatosis (controlled attenuation parameter of ≥274 dB/m) with ≥1 cardiometabolic risk factor and mild alcohol intake (≤140 g/week [women]; ≤210 g/week [men]). MetALD was defined as steatosis with ≥1 cardiometabolic risk factor and moderate alcohol intake (141–350 g/week [women]; 211–420 g/week [men]). Data from 2962 participants in the Framingham Heart Study (mean age 59 years, 57% women) were used in multivariable-adjusted logistic regression models, accounting for demographic and clinical covariates to relate CVH and liver outcomes. Results: Our study included 2704 participants with mild and 258 with moderate alcohol use. MASLD and MetALD prevalence was 34% and 40%, respectively, and 9% had significant hepatic fibrosis. Each 10-point increase in LE4 score (composite of diet, sleep health, physical activity, and smoking) was associated with 16% lower odds of MASLD (Odds Ratio [OR] 0.84; 95% CI: 0.80–0.90; p < 0.001) but not MetALD. Each 10-point increase in LE8 score was associated with 17% lower odds of hepatic fibrosis (OR 0.83; 95% CI: 0.78–0.89; p < 0.001). Conclusions: Better CVH is related to lower odds of MASLD and significant hepatic fibrosis. Full article