Cardiothoracic involvement by obstetric and gynecologic pathologic conditions creates a broad spectrum of clinical and radiologic manifestations, ranging from mild to critical. The authors describe the unique and often unrecognized or unexpected imaging manifestations of obstetric and gynecologic conditions in the chest. Pregnant, peripartum, and postpartum patients experience varied disorders, including eclampsia/preeclampsia, pulmonary edema, pneumonia, aspiration, acute respiratory distress syndrome, thromboembolism, other forms of embolic disease, cardiomyopathy, and metastatic gestational trophoblastic disease. Appropriate methods of imaging pregnant patients are also discussed. Gynecologic malignancies develop characteristic patterns of thoracic involvement related to the pathways of tumor spread and underlying histopathologic tumor features. Laboratory biomarkers add diagnostic value to imaging interpretation in this setting. Benign forms of gynecologic disease manifest in the chest as Meigs syndrome, thoracic endometriosis syndrome, and intravascular or metastasizing leiomyomatosis. To facilitate accurate and timely radiologic diagnosis, the authors provide a comprehensive overview of cardiothoracic imaging findings associated with benign and malignant obstetric and gynecologic conditions. ^©RSNA, 2026 Supplemental material is available for this article.

Mirvetuximab soravtansine is an antibody-drug conjugate targeting folate receptor alpha (FRα), which is used in the treatment of platinum-resistant ovarian cancer. Its administration is associated with a distinct spectrum of ocular adverse events, representing a clinically relevant limitation of therapy. The most common manifestations include keratopathy, blurred vision, and dry eye symptoms. These effects are generally reversible and manageable upon appropriate ophthalmologic monitoring. This review summarizes the current knowledge regarding the mechanisms, clinical presentation, incidence, prevention, and management of mirvetuximab-associated ocular toxicity.

The treatment of non-small cell lung cancer (NSCLC) has challenges such as drug resistance and recurrence. Concurrently, the induction of apoptosis and ferroptosis is a promising therapeutic strategy. This study aimed to investigate whether the natural product, verbascoside, induces apoptosis and ferroptosis in NSCLC cells by targeting BCAT2.

Bioinformatic analysis was used to predict the potential targets of verbascosides. Stable cell lines with BCAT2 knockdown and overexpression were constructed. The effects of verbascoside on NSCLC were evaluated in vitro and using a mouse xenograft model.

Bioinformatics screening and molecular docking identified BCAT2 as a potential target of verbascoside, with a significantly stronger binding energy (-7.8 kcal/mol) than another candidate, PARP1. In vitro and in vivo experiments confirmed that BCAT2 knockdown significantly inhibited NSCLC cell viability, induced apoptosis and ferroptosis, and induced mitochondrial damage. Conversely, BCAT2 overexpression produced opposite effects. Verbascoside treatment inhibited BCAT2 expression in a concentration-dependent manner, recapitulating the apoptotic, ferroptotic, and mitochondrial damage phenotypes induced by BCAT2 knockdown; however, BCAT2 overexpression significantly reversed these effects of verbascoside. In an animal model, treatment with verbascoside significantly suppressed tumor growth and activated apoptosis and ferroptosis in tumor tissues by downregulating BCAT2.

Verbascoside can induce apoptosis and ferroptosis in NSCLC by directly targeting and inhibiting BCAT2, leading to mitochondrial dysfunction. This finding not only reveals BCAT2 as a novel target of verbascoside but also confirms its ability to induce apoptosis and ferroptosis in NSCLC cells.

Advances in cancer diagnosis and treatment have improved patient survival significantly. However, immunosuppression and the various invasive medical interventions often involved in these treatments increase infection risks. The core concept of "Chain of Infection" is used in this article to elaborate systematically on practical infection control strategies for cancer patients in three dimensions: the susceptible host, the infectious agent, and the mode of transmission. Strategies related to the susceptible host focus on enhancing host defense mechanisms and protecting potential portals of entry through the prophylactic use of granulocyte colony-stimulating factor, appropriate vaccinations, mucosal care, and skin integrity maintenance as well as the stringent management of invasive catheters. Strategies related to infectious agent control focus on environmental and dietary source management, including the restriction of live plants, implementation of water management plans, infection-control risk assessment and protection during construction, rigorous environmental cleaning and disinfection, and adherence to food safety protocols. Strategies related to mode of transmission focus on the management of both physical infrastructure and personnel behavior, recommending that protective/isolation rooms and material selection be incorporated into facility planning and that personnel should consistently practice hand hygiene, respiratory hygiene, and cough etiquette; use personal protective equipment properly; and surveil their own health condition. In applying these multi-level and systematic strategies, the incidence of infections may be effectively reduced and treatment safety and quality of care ensured.

Persistent cardiac symptoms are common in post-COVID syndrome, even without structural heart disease. Evidence implicates immune dysregulation, endothelial dysfunction and low-grade cardiovascular inflammation. Yet no targeted treatment exists. Myoflame-19 is a multicenter, double-blind clinical trial of 279 participants with inflammatory cardiac involvement defined by cardiovascular magnetic resonance, randomized 1:1 to losartan plus prednisolone (n = 139) or matching placebos (n = 140) for 16 weeks. The modified intention-to-treat population comprised 124 and 122 participants. The primary endpoint, change in left ventricular (LV) ejection fraction, was neutral: between-group difference 0.74 percentage points (pp), 95%CI -0.14 to 1.62, p = 0.10, unpaired t-test; supportive baseline-adjusted ANCOVA 0.99, 95%CI 0.15-1.83, p = 0.021. Among prespecified secondary endpoints, several symptom and imaging measures showed numerical differences favoring intervention, including Average Symptom Score components (modified Canadian Chest Pain Scale -4.8 pp, 95%CI -17.3 to 7.6; NYHA class -8.1 pp, -20.6 to 4.3; Long COVID symptom burden -7.7 pp, -18.9 to 3.6), native T1 and T2 values (native T1 -2.46 ms, -8.35 to 3.42; native T2 -0.31 ms, -1.16 to 0.53), and LV end-diastolic volume ( + 1.45 ml/m², -0.09 to 3.00); however, confidence intervals included the null value and these findings should be regarded as hypothesis-generating.Treatment was safe and well-tolerated. These findings indicate a neutral treatment effect on the primary endpoint. They inform targeted immunomodulation and design of future trials in post-COVID syndrome and inflammatory cardiac involvement. Trial registration: EudraCT 2022-001682-12; NCT05619653.

The COVID-19 pandemic disrupted schooling worldwide. While there is evidence of declines in academic performance, the links between early vulnerabilities in school readiness, learning difficulties, and lifestyle changes during the pandemic and their impact on postcrisis academic achievement are not well understood.

This longitudinal study followed 3871 children across three time points over 6 years (50.3% boys). In 2017, teachers assessed children's school readiness at kindergarten. In 2021, parents assessed the impact of COVID-19 on their child's learning difficulties and lifestyle changes. In 2022, teachers assessed children's academic achievement.

Structural equation modeling showed that children with school readiness vulnerabilities experienced greater learning difficulties during the pandemic, but not significantly greater lifestyle disruptions. Learning difficulties partially mediated the association between school readiness vulnerabilities and lower postcrisis academic achievement. Analyses were adjusted for child sex, age, native language, and cumulative socioeconomic risk.

Support systems should monitor learning difficulties that emerge during periods of educational disruption and not rely solely on preexisting indicators of vulnerability.

Learning difficulties during the pandemic emerged as a distinct predictor of later academic achievement, emphasizing the need for timely educational support during periods of disruption.

Complicated pneumonia in children can result in an empyema. The management options include chest drain insertion with fibrinolytic therapy (CDF) and video-assisted thoracoscopic surgery (VATS) with decortication. No studies have compared the long-term cardiopulmonary impact of treatment interventions using sensitive static and dynamic assessments of lung function.

To compare long-term cardiopulmonary function outcomes in children with empyema treated with CDF with those who underwent VATS using highly sensitive static and dynamic lung function measures.

Children aged >8 years at the time of testing who were previously hospitalised with empyema and treated with either CDF or VATS were prospectively recruited. At one hospital, children were only treated by VATS, whereas CDF was used exclusively at the other site. As both sites belonged to the same network, all other aspects of treatment protocols were identical, and clinicians worked across both sites. Healthy controls were assessed as a comparison. Lung function testing included spirometry, lung volumes, multiple-breath washout (lung clearance index), oscillometry and cardiopulmonary exercise testing, all performed according to international standards.

51 children treated with CDF, 28 treated with VATS and 24 healthy controls participated in this study. Spirometry and lung clearance index were normal across all groups. However, oscillometry revealed significantly lower reactance in both treatment groups compared with controls (respiratory system reactance at 5 Hz: CDF -2.54 (0.98), VATS -4.08 (0.94), controls -0.24 (0.85)), with VATS showing greater impairment. The ratio of minute ventilation to oxygen uptake was highest in the VATS group compared with CDF and controls (39.7 (2.8), 36.8 (3.2) and 32.2 (2.7), respectively).

Long-term pulmonary outcomes following both CDF and VATS were generally reassuring. However, oscillometry and exercise testing revealed subtle differences in ventilatory strategies, with children post-VATS demonstrating mild residual impairment.

Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease in which both environmental exposures and genetic predisposition contribute to disease susceptibility. Studying the burden of rare variants in a genetically homogeneous founder population may help identify disease-associated alleles that are difficult to detect in more heterogeneous populations.

Whole exome sequencing was performed on 123 patients with IPF and 1110 unrelated controls from Sardinia (Italy). Variant prioritisations were conducted according to the American College of Medical Genetics (ACMG) guidelines. In parallel, gene burden of rare predicted loss-of-function variants was assessed using the Cohort Allelic Sums Test (CAST) algorithm to identify genes significantly enriched in IPF cases compared with controls.

Pathogenic or likely pathogenic variants in known telomere-related genes were identified in 11.4% of patients. These variants were associated with younger age at diagnosis and a higher prevalence among never-smokers. CAST analysis identified a significant enrichment of loss-of-function variants in 82 genes, including MUC5B (OR=443.1, false discovery rate=3.7E-05), functionally related to cilium organisation and motility, with a significant overrepresentation of dynein-related genes.

This study supports the contribution of telomere-related variants to IPF susceptibility and suggests a possible role for rare variants affecting mucociliary pathways. Together, these findings broaden the current understanding of IPF biology in this cohort. The distinctive genetic background of the Sardinian population may have facilitated the identification of rare or population-specific variants, underscoring the potential value of founder populations in complex disease genetics.

Tuberculosis (TB) remains underdiagnosed in many high-burden countries due to high costs and limited availability of rapid molecular tests. Globally, only half of people with TB receive a molecular test as their initial diagnostic test. Pooled testing combines sputum samples from multiple individuals into a single molecular assay, offering cost savings by optimising existing resources, particularly in resource-constrained health systems. Although pooled sputum testing has now been recommended by the World Health Organization in 2026, evidence on real-world feasibility and acceptability for people with TB and healthcare providers remains limited. This study explored multisectoral stakeholder perspectives on the feasibility and acceptability of pooled sputum testing for TB.

Multicountry qualitative study using key informant interviews and focus group discussions. Data were analysed using a framework approach guided by established feasibility and acceptability models.

Facility and community settings across seven high-TB-burden countries: Bangladesh, Brazil, Cameroon, Kenya, Malawi, Nigeria, and Viet Nam.

Thirty-eight key informant interviews and 18 focus group discussions were conducted with National TB Programme (NTP) representatives, laboratory technicians, people with TB and international experts.

Pooled testing was considered feasible and acceptable in facility and community settings with greater confidence in countries with prior implementation experience. Feasibility depended on alignment with diagnostic algorithms and laboratory workflows, biosafety, training and clear standard operating procedures.Acceptability operated at two levels: early NTP engagement with healthcare providers to secure professional buy-in and clear communication between healthcare providers and people undergoing testing to support understanding.

Pooled testing was considered feasible and acceptable in settings with robust laboratory systems and routine practices. Readiness varied across countries, with some suitable for rapid implementation and scale-up while others required system strengthening. In settings perceived as having suitable infrastructure and readiness, pooled testing was viewed as a pragmatic strategy to optimise molecular TB testing.

Antimicrobial resistance is a significant threat to healthcare worldwide. The appropriate use of antimicrobials could decrease the excess morbidity of respiratory infections and contribute to reducing the emergence of multidrug resistance. For this purpose, the European Union has funded the VALUE-Dx project to assess the value of rapid diagnostic tests in combatting antimicrobial resistance by optimising antibiotic use in community-acquired lower respiratory tract infections (CA-LRTI). In this context, the current statement aims to review the literature and current practice regarding the role of rapid diagnostic tests in managing CA-LRTI for antibiotic stewardship purpose and combatting antimicrobial resistance. In particular, the present paper evaluates the accuracy of rapid diagnostic tests for the aetiological diagnosis of CA-LRTI, the usefulness of biomarkers and clinical algorithms in the management of CA-LRTI, the differences in aetiology according to the diagnostic protocol and tests applied for CA-LRTI after the introduction of rapid diagnostic tests for a complete microbiological investigation and, finally, the role of rapid diagnostic tests in antibiotic stewardship protocols in improving clinical outcomes.