Olive pollen allergy, a leading cause of seasonal allergic rhinitis and asthma in Mediterranean regions, is becoming increasingly relevant worldwide due to the expansion of olive cultivation. Despite its significant public health impact, the molecular mechanisms underlying sensitization to olive pollen remain poorly understood.

In this study, RNA sequencing was used to perform transcriptomic profiling on in vitro-stimulated Peripheral Blood Leukocytes (PBLs) from both allergic patients and healthy controls, to identify gene expression changes triggered by olive pollen in allergic individuals. Validation by RT-qPCR was subsequently performed in an independent cohort to confirm the expression patterns of selected DEGs.

A total of 37 differentially expressed genes (DEGs) were found exclusively in the patient group. Validation by RT-qPCR in an independent cohort confirmed the expression patterns of selected DEGs. Functional enrichment analyses associated these DEGs with immune pathways, ossification processes, and cytokine activity. Notably, upregulated genes such as AREG, IL31RA, and IL18R1 were associated with TH₂ responses and asthma pathogenesis, while downregulated genes including GREM1 and CCL1 were related to chemotaxis and immune regulation. Protein-protein interaction (PPI) network and hub gene analyses highlighted potential molecular drivers of allergic inflammation. Chromosomal mapping revealed clustering of DEGs on chromosomes previously associated with asthma susceptibility. Furthermore, exploratory correlation analyses identified correlation between TGM2 expression and total IgE, and between SHROOM2 expression and Ole e 7-specific IgE, highlighting these genes as candidates for future evaluation.

Overall, this study provides new insights into the transcriptomic landscape of olive pollen allergy, identifying candidate biomarkers and biological pathways with translational relevance for improving diagnosis and advancing personalized treatment strategies in allergic diseases.

Hypertrophic cardiomyopathy is the most common structural myocardial disease. Based on the literature, its estimated prevalence in the adult population is 1 : 500. It is distinguished by an exceptionally heterogeneous clinical presentation and a broad spectrum of disease trajectories. The disorder is recognised in only about 10% of the patients. In 90% of cases, patients remain undiagnosed, often due to the absence of symptoms. Hypertrophic cardiomyopathy is frequently the underlying cause of sudden cardiac death. In recent years, mortality of hypertrophic cardiomyopathy has declined due to improved device and pharmacotherapies. We aim to present the epidemiological significance of the disease in line with recent international guidelines, emphasizing the importance of diagnostic awareness and multiparametric evaluation. By promoting a cardiomyopathy mindset, we aim to raise awareness of clinical red flags. Early identification of patients with suspected hypertrophic cardiomyopathy in primary and cardiology outpatient care can facilitate prompt diagnosis and timely initiation of appropriate therapy. The review provides an overview of the diagnostic pathway recommended by the 2023 European Society of Cardiology Guidelines for the management of cardiomyopathies, describes the key components of the multiparametric, multimodal evaluation and presents clinical red flags. A significant proportion of the clinical red flags emphasized in the 2023 European Society of Cardiology Guidelines for the management of cardiomyopathies can be identified at lower levels of care and in primary care settings, thereby accelerating the diagnostic process and shortening the time to treatment. The diagnostic algorithm includes performing an ECG, assessing specific laboratory parameters, searching for extracardiac symptoms and conducting a comprehensive pedigree analysis focused on age-related phenotypic features. When clinical suspicion is high, advanced multimodal imaging should be included in addition to conventional imaging modalities. Orv Hetil. 2026; 167(38): 1495-1506.

In primary mitral valve regurgitation (MR), a failing valve induces volume overload (VO) of the left ventricle (LV), triggering neurohormonal responses and myocardial remodeling. Surgical valve repair is the most effective therapy for MR, improving symptoms and in some patients reversing cardiac hypertrophy. However, at least 20% of patients develop postoperative impairment of LV function with detrimental effects on long-term outcomes, with no known cause. Many MR patients receive pharmacological treatment to alleviate symptoms, with drugs that alter cardiac function, hemodynamics, and molecular pathways that influence cardiac remodeling. To support the advancement of medical management of MR, we developed a multiscale model of cardiac hypertrophy that links ventricular mechanics, cardiovascular hemodynamics, and cardiomyocyte molecular signaling. We calibrated the model using the Markov chain Monte Carlo algorithm, a machine learning method, to integrate data from 76 studies of experimental VO in animals. The model's predictions showed good agreement with experimental data on MR in dogs, including the chronic effects of four drugs on MR-induced hypertrophy. When simulating valve repair, our model suggests that full reversal of LV hypertrophy requires both the mechanical elimination of VO and the restoration of normal neurohormonal receptor activity. Finally, we explored selecting subsets of a large pool of pre-computed simulations to personalize model predictions for a small population or individual where insufficient data are available to refit the entire model.

BACKGROUND Eisenmenger syndrome develops from untreated or late-repaired cardiac shunts, causing irreversible pulmonary-vascular remodeling and systemic symptoms. Although timely repair has nearly eradicated Eisenmenger syndrome in high-income regions, delayed diagnosis in middle-income countries, especially when combined with chronic high-altitude hypobaric hypoxia, such as at approximately 2800 m (9186 ft) in the Ecuadorian Andes, can accelerate pulmonary hypertension through hypoxic vasoconstriction and erythrocytosis. We report a case of Eisenmenger syndrome 2 decades after surgical atrial septal defect closure. CASE REPORT A 46-year-old woman living at high altitude presented with severe cyanosis and heart failure 22 years after atrial septal defect closure. She had marked hypoxemia and secondary erythrocytosis. Echocardiography showed suprasystemic pulmonary artery pressure, severe right-chamber dilation, and reduced right ventricular systolic function. Right-heart catheterization confirmed Eisenmenger physiology with severe pulmonary-vascular resistance and low cardiac index. Chest computed tomography showed marked pulmonary artery enlargement without thromboembolic disease. Multidisciplinary management included bosentan 125 mg twice daily, tadalafil 10 mg once daily, nocturnal oxygen, diuretics, and anticoagulation, resulting in symptomatic stabilization and discharge on day 4. Transplant evaluation was initiated. CONCLUSIONS Delayed atrial septal defect repair at high altitude can lead to irreversible Eisenmenger syndrome, for which current therapy is palliative. Early defect recognition and closure, congenital heart screening, and access to pulmonary vasodilators and transplant programs are imperative in resource-constrained mountainous regions.

Brain injury remains the leading cause of mortality and morbidity among patients who experience cardiac arrest and cardiopulmonary resuscitation (CA/CPR). There is an urgent need to explore simpler and cheaper biomarkers to predict post-CA neurological outcomes. The red blood cell distribution width-to-albumin ratio (RA) has been used to assess inflammatory responses and prognosis in several diseases. This study was conducted to assess the correlation between RA levels and post-CA neurological outcomes, and to determine the value of RA in predicting neurological function after CA/CPR.

We conducted a retrospective observational study on out-of-hospital cardiac arrest (OHCA) cases presenting to our hospital's emergency department between January 2023 and April 2026. All patients were divided into cohorts with good or poor neurological outcomes according to cerebral performance categories (CPCs). Cox regression models were used to estimate the correlation between RA and neurological outcomes. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the ability of RA to predict neurological outcomes in patients after CA/CPR.

In total, 80 patients were involved, of whom 10 survived to hospital discharge with good neurological function (CPC ≤ 2), while the remaining subjects showed poor neurological function (CPC ≥ 3). RA levels were significantly higher in patients with poor neurological outcomes than in those with good outcomes. The AUC for the RA was 0.90, indicating excellent predictive accuracy. The RA values were independently associated with poor neurological outcomes following CA/CPR, even after adjusting for potential confounding factors.

We found that RA is associated with post-CA neurological outcomes, and higher RA levels could serve as a predictor of worse neurological outcomes in patients who undergo CPR after experiencing CA.

Recovery of upper-limb motor function after stroke often requires intensive, repetitive, task-oriented rehabilitation. Multimodal sensory-feedback robot-assisted training has the potential to enhance patient engagement and sensorimotor integration, and thereby improve rehabilitation outcomes.

To investigate the clinical and neurophysiological effects of adding multimodal sensory-feedback robot-assisted training to conventional rehabilitation for post-stroke upper-limb recovery using functional near-infrared spectroscopy (fNIRS).

A total of 38 stroke patients were randomly assigned to a control group (conventional rehabilitation, n = 19) or an experimental group (dose-matched conventional rehabilitation plus multimodal sensory-feedback robot-assisted training, n = 19). Upper-limb motor function was assessed before and after intervention using the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE). fNIRS was used to evaluate resting-state functional connectivity (Fisher z-transformed connectivity, zFC) and task-evoked cortical activation (HbO) during shoulder, elbow, and finger flexion tasks.

No significant between-group difference in FMA-UE was observed at baseline (p > 0.05). After intervention, the experimental group showed significant improvement in FMA-UE, whereas the control group showed a smaller, non-significant improvement; the magnitude of pre-post change differed significantly between groups (p < 0.05). Resting-state fNIRS showed no significant between-group differences in zFC at baseline, whereas post-intervention analyses showed enhanced fronto-motor zFC in the experimental group, including connections involving PreM&SMC, DLPFC, and FEF. Task-fNIRS revealed channel-specific group × time interaction effects in HbO responses during the three motor tasks; post-hoc analyses showed significant post-intervention reductions in cortical activation at selected channels in the control group, whereas the experimental group showed a relatively preserved activation pattern.

Adding multimodal sensory-feedback robot-assisted training to dose-matched conventional rehabilitation may improve short-term post-stroke upper-limb motor recovery. fNIRS further revealed intervention-related changes in cortical activation and resting-state functional connectivity.

Identifier, ChiCTR2400080101.

Health-care workers' mental health is closely related to workforce stability, quality of care, and health-system resilience. In China, medical alliances are a model for integrating tertiary hospitals, secondary hospitals, and community health-service centres, but evidence on staff mental health within such systems remains limited. The primary objective was to describe the distribution and severity of depressive symptoms, anxiety symptoms, perceived stress, insomnia, and burnout dimensions; the secondary, exploratory objective was to examine adjusted associations with selected demographic and occupational characteristics.

We audited item-level data from an institution-based cross-sectional online survey conducted in 2024 among health-care workers in a Shanghai medical alliance. Exact duplicate exported records were removed. Depression, anxiety, and stress were scored separately using the DASS-21; sleep symptoms were scored with the ISI; and MBI-GS exhaustion, cynicism, and professional efficacy were analysed as separate dimensions. Internal consistency, multiplicity-adjusted subgroup comparisons, and indicator-coded multivariable models were evaluated.

The supplied file contained 669 rows; 175 were literal copies of earlier records, leaving 494 unique respondents. Descriptively, mean (SD) scores were 9.53 (8.61) for depression, 8.81 (7.95) for anxiety, 11.84 (8.71) for stress, and 9.12 (6.16) for ISI. Scores at or above the mild-symptom threshold occurred in 47.6, 48.6, and 29.4%, respectively; 51.4% scored above the ISI no-clinically-significant-insomnia range. Mean MBI-GS dimension scores were 2.58 (1.62) for exhaustion, 2.26 (1.41) for cynicism, and 3.65 (1.21) for professional efficacy. Cronbach's alpha ranged from 0.798 to 0.959. In unadjusted subgroup comparisons, only ISI differences by years of work remained statistically significant after Holm correction across 70 tests. In exploratory adjusted models, on-call work was associated with higher depression, anxiety, and ISI scores, and age was associated with ISI; these estimates did not account for institution-level clustering and should not be interpreted as causal effects.

The results indicate a substantial burden of psychological symptoms and measurable burnout dimensions in this medical alliance. Most unadjusted subgroup differences did not withstand multiplicity correction, whereas only a small number of associations were observed in exploratory adjusted models. These findings are non-causal and require confirmation with institution-clustered analyses before being used to define target groups.

Visual Snow Syndrome (VSS) is a neurological condition characterized by the persistent perception of dynamic, flickering, dot-like visual disturbances across the entire visual field, resembling television static. Increasing evidence indicates that VSS is frequently accompanied by a broad spectrum of psychiatric symptoms, including anxiety, depression, depersonalization, fatigue, and sleep disturbances, all of which substantially impair quality of life. Although the pathogenesis of VSS remains incompletely understood, Current evidence increasingly suggests that VSS may represent a multisystem neuropsychiatric network disorder involving visual cortical hyperexcitability, thalamocortical dysrhythmia, widespread abnormalities in functional connectivity, and limbic system dysfunction. Psychiatric symptoms may partly reflect intrinsic neurobiological mechanisms of the syndrome rather than being solely secondary psychological reactions to chronic visual disturbances. Current pharmacological therapies generally show limited efficacy. Preliminary evidence suggests that non-pharmacological approaches, including neuromodulation, tinted lenses, and mindfulness-based interventions, may offer therapeutic potential with relatively favorable tolerability, although larger controlled studies are still required. Future research should adopt multidisciplinary strategies integrating neurology, psychiatry, neuroimaging, and genetics to further elucidate the mechanisms underlying VSS and facilitate the development of precision diagnostic and therapeutic approaches.

Psychological distance has been extensively explored in social cognition and has recently been advanced in affective science. However, existing studies have primarily examined the effect of a single psychological distance on emotion, with less attention paid to the interaction effect of multiple psychological distances. Drawing on emotion appraisal theory, the present study focused on social distance to investigate how it moderates the effects of temporal and spatial distance on negative emotional feeling across four experiments. In these experiments, we manipulated social distance (self, friend, vs. stranger) alongside temporal or spatial distance, and measured participants' reported negative emotion to negative events. Results showed that social, temporal and spatial distance all directly influenced negative emotion, replicating previous findings. Importantly, temporal and spatial proximity elicited significantly greater negative emotion when negative events involved a close (vs. distant) social distance-that is, events affecting the self (Experiment 1) or a friend (Experiment 2) versus a stranger. These findings suggest that different dimensions of psychological distance jointly shape negative emotion, extending Construal Level Theory's multidimensional perspective to the affective domain and providing potential implications for emotion regulation by highlighting the importance of considering the social relevance of negative events to the individual.

Despite the availability of effective pharmacological therapies, glycemic control in type 2 diabetes mellitus remains suboptimal in real-world settings. Digitally enabled care models offer opportunities to enhance continuous monitoring and patient-centered management in community-based settings.

To evaluate the effectiveness of a digital health-enabled community pharmacy counseling intervention for type 2 diabetes management.

This pre-post study evaluated a 24-week intervention involving community pharmacists, integrating biweekly medication counseling, self-monitoring of blood glucose support, and structured lifestyle management through a digital health platform and connected monitoring devices. (Trial Registration: KCT0011486) RESULTS: A total of 28 patients and 17 community pharmacists were included. Mean glycated hemoglobin (HbA1c) decreased significantly from 8.12 ± 1.10% at baseline to 7.30 ± 0.86% at 24 weeks (mean difference -0.82%, p < 0.001). Significant reductions were also observed in fasting blood glucose (p = 0.021) and triglycerides (p = 0.018). Improvements in glycemic control were evident by 3 months and were sustained throughout the intervention period. Patient-reported outcomes demonstrated significant improvements in both diabetes-related awareness and self-care behaviors. Awareness improved across key domains, including HbA1c knowledge, medication use, exercise, dietary management, and complication awareness (p = 0.035, 0.017, 0.002, 0.009, and 0.031, respectively). Self-care behaviors also improved, particularly in glucose monitoring (p = 0.009), dietary habits (p = 0.009), and physical activity, including exercise frequency (p = 0.002) and duration (p < 0.001). Despite these improvements, dietary management remained the most frequently reported challenge.

A digital health-enabled community pharmacy service was associated with improvements in glycemic control and patient self-management in type 2 diabetes. These findings support the potential of digitally integrated pharmacy services as a scalable approach to chronic disease management. Further controlled studies are warranted to establish causal effects and long-term sustainability.