Lung squamous cell carcinoma (LUSC) is an aggressive malignancy with a poor prognosis. Given the association between mitochondrial dysregulation and LUSC, the aim of the present study was to identify mitochondrial unfolded protein response (UPR^mt)‑related candidate genes associated with LUSC and to explore their potential functional relevance. In the present study, differential expression, univariate Cox and survival analyses were combined to identify a UPR^mt‑associated key gene in LUSC. Gene set enrichment analysis was then performed, and overexpression (OE) and knockdown cell lines were used to clarify its function using western blotting, Cell Counting Kit‑8, colony formation and Transwell^® invasion assays. Using bioinformatics tools and a review of the literature, PTEN‑induced kinase 1 (PINK1) was singled out as a key gene in LUSC samples. Elevated PINK1 expression was associated with worse survival outcomes. A total of 117 pathways were enriched by PINK1, with the top 5 including 'focal adhesion' and 'mitogen‑activated protein kinase signaling pathway'. Using experimental analysis, it was observed that PINK1 significantly enhanced the proliferative, migratory, invasive and colony forming abilities of tumor cells, thereby exacerbating LUSC. Furthermore, these enhancements were diminished by the application of focal adhesion kinase (FAK) inhibitor. It was also noted that the expression levels of protein kinase B (AKT), p‑AKT, Ras homolog family member A (RhoA) and vinculin were all elevated in OE‑PINK1 cells. Collectively, these findings indicated that PINK1 exerted its influence on LUSC through the FAK/AKT/RhoA/vinculin pathway. The present study identified PINK1 as a key gene in LUSC, exerting its influence through the FAK/AKT/RhoA/vinculin pathway, thereby presenting a potential novel therapeutic target for the treatment of LUSC in the future.

Chronic obstructive pulmonary disease (COPD) and obesity are major US public health conditions that frequently coexist. Despite adverse respiratory and cardiometabolic effects of obesity, an apparent "obesity paradox," whereby obesity has been associated with lower mortality in some patients with COPD, has been described. National mortality trends involving concurrent COPD and obesity remain poorly characterized. We examined temporal, demographic, and geographic patterns from 1999 to 2023. We conducted a retrospective, population-based analysis of the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database. Deaths among adults aged ≥25 years listing COPD (International Classification of Diseases, 10th Revision: J40-J44) and obesity (International Classification of Diseases, 10th Revision: E66) were identified. Age-adjusted mortality rates per 100,000 were calculated using direct standardization to the 2000 US population. Joinpoint Regression Program version 5.3.0.0 estimated annual percent changes (APCs) and average annual percent changes with 95% confidence intervals (CIs). Analyses were stratified by age, sex, race/ethnicity, region, urbanization, and state. Among 1,30,958 deaths, the age-adjusted mortality rate increased from 0.78 (95% CI: 0.74-0.82) in 1999 to 2.63 (95% CI: 2.57-2.68) in 2023 (average annual percent change: +5.14%; 95% CI: 4.09-6.21; P < .001). After increasing significantly through 2013, mortality increased nonsignificantly during 2013 to 2018 (APC: +2.11%; 95% CI: -0.39 to 4.67), rose markedly during 2018 to 2021 (APC: +17.45%; 95% CI: 10.18-25.19), and declined significantly through 2023 (APC: -13.47%; 95% CI: -18.32 to -8.34). Males and adults aged ≥65 years had higher mortality burdens, with variation across racial/ethnic groups, urbanization levels, regions, and states. Interpretation is limited by unavailable individual-level factors, including smoking, COPD severity, comorbidities, and socioeconomic characteristics. Mortality involving concurrent COPD and obesity increased substantially from 1999 to 2023, with marked demographic and geographic variation and an increase during the COVID-19 pandemic. These population-level associations do not establish causality. Integrated pulmonary and metabolic care, targeted prevention, and improved access in underserved communities may help address observed disparities.

Adipokines regulate metabolic and inflammatory pathways and may be altered during critical illness. We explored sequential serum adipokine concentrations and their associations with nutritional and clinical variables in critically ill COVID-19 patients. This prospective observational, exploratory study included 30 critically ill COVID-19 patients and 10 age- and sex-matched healthy controls. Serum adiponectin, resistin, GLP-1, visfatin, IGF-1, leptin, and acylated ghrelin were measured at intensive care unit admission and on day 7. Biomarker-clinical correlations were analyzed using Spearman correlation, and the Benjamini-Hochberg false discovery rate procedure was applied to account for multiple biomarker comparisons. After false discovery rate correction, longer time to nutrition initiation remained inversely associated with day-7 adiponectin (ρ = -0.464, q = 0.027), GLP-1 (ρ = -0.568, q = 0.015), IGF-1 (ρ = -0.488, q = 0.022), leptin (ρ = -0.539, q = 0.015), and acylated ghrelin (ρ = -0.503, q = 0.021). Several adipokines showed exploratory associations with nutrition-initiation time in this small cohort of critically ill COVID-19 patients. These observational findings do not establish that earlier nutritional support causes changes in adipokine concentrations and require validation in larger, adequately controlled studies.

Preventive oral health care and education are essential for soldiers' health and military readiness. This study investigated oral health behaviors, dental service utilization, oral health perceptions, and educational needs among enlisted South Korean Army soldiers during the coronavirus disease 2019 pandemic. A cross-sectional survey was conducted among 313 enlisted soldiers who visited military dental clinics in Gyeonggi-do, Republic of Korea, from March 24 to April 16, 2021. Descriptive statistics and Pearson's χ2 tests were performed. Overall, 60.4% of participants did not use oral care products, mainly because they did not perceive a need for them (62.9%). Furthermore, 71.9% had not undergone routine dental examinations, 63.6% had not received dental treatment after enlistment, and 91.4% had no oral health education experience during military service. Video-based education was the preferred method (40.6%), and halitosis prevention and management was the most preferred topic (20.4%). Preferred educational methods did not differ significantly according to age, military rank, educational level, or smoking status (all P > .05). Military rank was significantly associated with perceived adequacy of oral care time (P < .001) and the place of dental treatment (P = .048). Routine dental examinations, dental treatment experience, and oral health education experience showed no significant differences according to participants' general characteristics. Preventive oral health services and education were insufficient among enlisted South Korean Army soldiers. Tailored programs reflecting soldiers' needs and preferred learning methods should be developed and evaluated.

While the association between serum albumin and eosinophils has been investigated in adult asthma, its role in any pediatric atopic triad - asthma, allergic rhinitis, or atopic dermatitis - remains unclear. We assessed the association between serum albumin and blood eosinophil counts in adolescents presenting with any atopic triad, using data from a 2-year National Health and Nutrition Examination Survey (NHANES) cycle. We analyzed data from 658 participants aged 12-18 years with any atopic triad condition from the 2005-2006 NHANES cycle. Multivariate linear regression models were employed to assess the potential association between serum albumin levels and blood eosinophil counts (BEOC). Trend tests, smooth curve fitting, and threshold effect models were applied to confirm this relationship, and stratified analyses were conducted to assess its consistency across subgroups. A significant negative association was observed between serum albumin and BEOC in the fully adjusted model (β = -0.08 × 103 cells/µL, 95% CI: -0.15, -0.01, P = .018). Moreover, curve fitting and threshold effect analyses confirmed a nonlinear relationship between serum albumin and BEOC, with an inflection point for threshold and saturation effects of 4.4 g/dL, beyond which the association attenuated. Stratified analyses confirmed robustness across key subpopulations. Our study identified a nonlinear association between serum albumin levels and BEOC in adolescents with any atopic triad, exhibiting an L-shaped relationship. These findings highlight albumin as a potential biomarker for nutritional-immunological interplay in allergic inflammation and support targeted nutritional strategies in at-risk pediatric populations.

Chronic cough significantly impacts patients' quality of life, yet validated Arabic-language tools for its assessment are lacking. This study aimed to translate, culturally adapt, and validate the Arabic version of the Leicester Cough Questionnaire (LCQ-A) among Arabic-speaking patients. This cross-sectional study involved the translation, cross-cultural adaptation, and psychometric validation of the LCQ among Arabic-speaking patients with chronic cough. Participants completed the LCQ-A and the COPD Assessment Test (CAT). Internal consistency was assessed using Cronbach's α, test-retest reliability using intraclass correlation coefficients, and convergent validity via Spearman's correlation with the CAT cough item. A total of 56 adult patients with chronic cough were recruited with a mean age of 28.5 ± 4.8 years. Clinical causes or conditions associated with chronic cough included postinfection cough (26.8%), sinusitis (17.9%), asthma (14.3%), and an unknown cause (41.1%). The mean LCQ-A total score was 16.9 ± 3.7, with subdomain scores of 5.3 ± 1.3 (physical), 5.9 ± 1.2 (psychological), and 5.8 ± 1.5 (social). Cronbach's α demonstrated excellent internal consistency across domains (physical, 0.870; psychological, 0.882; social, 0.925; total, 0.952). Test-retest reliability of the LCQ-A in participants with no change in cough symptoms was excellent, with intraclass correlation coefficient values ranging from 0.859 to 0.944 for single measures and 0.924 to 0.971 for average measures (all P < .001). Strong interdomain correlations were observed (ρ = 0.877-0.957, P < .001), indicating high internal coherence. However, LCQ-A scores did not significantly correlate with the CAT cough item (ρ = -0.030 to 0.057, P > .05). The LCQ-A demonstrates excellent reliability and strong internal consistency, confirming its suitability for assessing cough-related quality of life in Arabic-speaking populations. While convergent validity with the CAT cough item was not observed, the LCQ-A provides a culturally adapted and psychometrically robust instrument for clinical and research use.

The ready-made garments (RMG) industry is a crucial component of Bangladesh's economy, using over 4 million workers from low-income backgrounds who often neglect their health care needs. Historically, this sector has faced criticism for labor exploitation, unsafe working conditions, and rights violations, as highlighted by tragic accidents resulting in loss of life. Compliant factories may uphold higher labor standards, but many noncompliant factories expose workers to poor conditions, increasing health risks. The COVID-19 pandemic intensified vulnerabilities, leading to widespread factory closures and job losses, increased health risks, and left millions of workers without wages. Although the government attempted to provide some relief, it fell short in offering job security, social protection, health services, and emergency assistance. Limited access to technology due to digital literacy gaps further hinders these workers, who primarily use basic mobile phones for communication rather than accessing health or emergency services. Thus, there is a pressing need to develop a sustainable system that capitalizes on their existing technological familiarity.

Our goal was to gain a deep understanding of RMG workers' experiences, focusing on their work environments, technological interactions related to health care management, and the impacts of COVID-19 on their circumstances. This understanding aims to inform the design of a technology-based framework that is both sustainable and contextual.

In phase 1, we conducted in-person interviews with 55 RMG workers, comprising 32 female and 23 male participants from urban and suburban areas of Dhaka and Gazipur, before the pandemic. Participants were aged between 18 and 40 years. In phase 2, we reconnect with 12 phase 1 participants during the pandemic and also consulted 3 stakeholders from RMG factories via phone. Each interview, conducted in Bengali, was recorded with consent, totaling 846 minutes of discussion that were translated and transcribed. Thematic analysis was used to analyze the results.

Insights gathered revealed variations in working conditions, personal experiences, perceptions of health care, lifestyle choices, and technology use tied to factory compliance. Workers at compliant factories had better health care support and used technology more effectively than those in noncompliant settings. The pandemic drastically altered the landscape for all workers, heightening health and safety concerns and shortages of emergency assistance. The RMG sector faces significant challenges, highlighting the urgent need for targeted emergency relief and health services.

This research examined the challenges and technology use among RMG workers during the pandemic, with a focus on health care perspectives. Based on our findings, we proposed a technology-based framework called VOICE (Virtual Outlet for Integrated Community Engagement) that connects workers with service providers through a simplified interface. This aims to assist marginalized communities during emergencies and enhance their overall well-being.

HIV-associated pulmonary arterial hypertension (HIV-PAH) is rare and understudied. We pooled 12 right heart catheterization-confirmed cohorts (n = 537, 1986-2021) and found that HIV-PAH presents with severe hemodynamics and advanced functional limitation, with only 64% receiving PAH-targeted therapy at diagnosis. Survival improved progressively over three decades alongside increasing therapy use. These findings highlight persistent treatment gaps and support consideration of contemporary combination PAH therapy in people with HIV-PAH.

For long-term residents of skilled nursing facilities (SNFs), greater use of telemedicine for specialist care may improve access to and overall quality of care. Although policy changes during the COVID-19 pandemic facilitated greater use of telemedicine, such use now is rare, and it is unclear why.

To examine SNF clinical leaders' perceptions of telemedicine use and explanations of lower use among long-term residents.

This survey study was conducted online and via postal mail from February 7 to July 28, 2025, among directors of nursing of SNFs, the central decision-makers for daily clinical operations. A probability-based sample was drawn from a listing of all 14 084 SNFs in the US, stratified to ensure reach to facilities of different sizes and varying telemedicine utilization.

This study measured the perceptions of key factors associated with quality of care in SNFs. Telemedicine use for specialist care and reasons for telemedicine use and disuse were solicited from SNFs' directors of nursing. The demographic characteristics of SNFs surveyed were weighted to Centers for Medicare & Medicaid Services benchmarks to reflect the profile of SNFs nationally.

Among 1001 directors of nursing sent invitation letters, 379 (39%) participated in this study. Most directors of nursing whose residents used telemedicine confirmed its proposed advantages: respondents said a top reason for using telemedicine is that it helped less-mobile patients get appointments (77%; 95% CI, 71%-82%) and that it helped improve patients' quality of care (73%; 95% CI, 67%-78%). Top reasons for not using telemedicine among less-frequent users and nonusers were: telemedicine visits were not frequently offered by specialists (73%; 95% CI, 67%-79%) and telemedicine did not offer higher quality of care over normal practices (62%; 95% CI, 56%-68%). A majority of directors of nursing who use telemedicine (60%; 95% CI, 54%-65%) also reported that telemedicine placed additional time burdens on nursing staff.

This survey study found that frontline clinical leaders view specialist telemedicine care as a useful tool for SNFs, particularly for patients with low mobility. However, they reported that telemedicine is offered too infrequently by specialists and adds to nurses' schedules. Policy and payment reforms should include incentives for specialists to offer telemedicine and reimbursement for nursing staff time.

This study investigated the impact of daily weather conditions on sleep architecture and assessed whether these effects vary according to the severity of suspected sleep-disordered breathing.

We analyzed 236,115 nights of home-based sleep data, collected over one year from 1,067 users of the SleepRoutine® mobile application in South Korea. Each night's data was paired with contemporaneous weather data from Seoul. Apnea-hypopnea index (AHI) values were classified on a nightly basis into low (< 15) and high (≥ 15) groups.

Elevated temperature was associated with decreased sleep efficiency (SE), total sleep time (TST), and deep sleep ratio (all p < 0.001), along with increased sleep latency (SL), and wake after sleep onset (WASO) (all p < 0.001). Higher humidity correlated with lower SE and light sleep ratio (p < 0.001, 0.004), and with longer WASO (p = 0.02, < 0.01). Longer sunshine duration was linked to greater TST, WASO, and REM sleep ratio (all p < 0.01) and to a decrease in sleep latency and light sleep ratio (p < 0.01). Relative to spring, summer demonstrated the poorest sleep quality, whereas autumn and winter showed variable effects. Importantly, temperature and sunshine duration demonstrated significant interactions with AHI group. In nights with higher AHI, weather-associated changes in SE, TST, and WASO were diminished. Seasonal interactions with AHI also significant across multiple sleep stages.

Temperature, humidity, and sunshine duration were significantly associated with sleep structure. These effects may be less pronounced in individuals with sleep-disordered breathing.