This study aimed to investigate the characteristics of febrile seizure (FS) associated with Kawasaki disease (KD) using nationwide population-based data. Children aged ≤ 5 years were analyzed using claims data from the Korean Health Insurance Review and Assessment Service between 2007 and 2022. FS and KD were identified using ICD-10 codes R56.0 and M30.3, respectively. Clinical characteristics were compared between FS associated with KD (KD-FS) and FS without KD (non-KD-FS). Of 1,230,434 children with FS, 1,683 (0.1%) had concomitant KD. Children with KD-FS were younger (1.66 vs. 1.81 years, p < 0.0001) and more likely to be male (58.8% vs. 55.9%, p = 0.0163) than those with non-KD-FS. During the coronavirus disease 2019 pandemic, the overall incidence of FS decreased markedly, whereas that of KD-FS increased. KD-FS occurred more frequently in winter and showed a distinct seasonal pattern, whereas the incidence of non-KD-FS peaked in summer. Children with KD-FS were more frequently treated in secondary or tertiary hospitals and had longer hospital stays. Chloral hydrate and acute/emergency anticonvulsants were more frequently administered in the KD-FS group; however, maintenance anticonvulsant use did not differ. Cerebrospinal fluid analysis and brain computed tomography were performed more frequently in the KD-FS group; brain magnetic resonance imaging and electroencephalography utilization and mortality rates were comparable.

KD-FS is rare and does not appear to be associated with a more severe neurological course than non-KD-FS.

• Kawasaki disease (KD) is a systemic vasculitis that can be accompanied by neurological manifestations, including febrile seizures (FS). • FS during acute KD is rare and remain insufficiently characterized in large population-based studies.

• In this nationwide study, FS associated with KD are rare but show distinct demographic and seasonal features, including younger age and winter predominance. • However, FS associated with KD are not associated with worse neurological outcomes or mortality compared with non-KD febrile seizures.

Early onset fetal growth restriction (FGR) shares pathophysiologic origins and may precede the development of Hypertensive Disorder of Pregnancy (HDP). The aim of this study was to evaluate risk factors associated with the development of HDP in individuals with early onset FGR.

This retrospective cohort included all consecutive patients who presented to our tertiary, university-affiliated medical center between 2011 and 2024 for suspected early-onset FGR, defined as onset before 32 weeks of gestation. Maternal and pregnancy information retrieved from hospital records included maternal age, BMI, smoking history, parity, gestational age (GA) at diagnosis, chronic hypertension, maternal cardiac disease, pre- or gestational diabetes, thrombophilia, chronic renal disease, history of major pregnancy complications, mode of conception, number of fetuses, premature contractions (PMC), ultrasound (US) measured abdominal circumference (AC), US measured estimated fetal weight (EFW), umbilical artery Doppler PI (UAPI) and middle cerebral artery Doppler PI (MCAPI). AC and EFW were classified as <5% and <3% respectively based on local population growth charts. UAPI and MCAPI percentiles were calculated per specific GA. We present maternal and pregnancy characteristics stratified by the development of HDP and investigated the association of these variables with development of HDP using univariate and multivariable logistic regression. The analyses were performed using R statistical software, and statistical significance was defined as p < 0.05.

During the study period 774 pregnant individuals were presented for suspected early-onset FGR. Among them, 79 (10.2%) subsequently developed HDP later in pregnancy. Using multivariate analysis UAPI above the 95^th percentile (OR 3.35, CI 1.55-7.20, p < 0.01), GA 24-28 weeks at diagnosis (OR 2.54, CI 1.20-5.36, p = 0.01) and AC below the 5^th percentile (OR 2.31, CI 1.10-4.86, p = 0.02), were significantly associated with the subsequent development of HDP.

Among pregnancies with suspected early-onset FGR, an elevated UAPI (>95th percentile) was the strongest predictor of developing HDP. Additional risk factors included earlier gestational age at FGR diagnosis and an AC below the 5th percentile. Women with these risk factors warrant intensified maternal surveillance. Future studies integrating these clinical predictors with circulating angiogenic biomarkers may further refine risk stratification.

Store-operated calcium entry (SOCE) mediated by STIM and Orai proteins is a fundamental Ca²⁺ influx mechanism that critically regulates intracellular calcium homeostasis and participates in cardiovascular pathophysiology. Upon endoplasmic reticulum Ca²⁺ store depletion, STIM1/2 activate plasma membrane Orai1/3 channels, initiating Ca²⁺ entry that drives vasoconstriction, smooth muscle proliferation, platelet activation, and cardiac hypertrophy. Dysregulated SOCE is closely associated with hypertension, atherosclerosis, pulmonary hypertension, and thromboembolic disorders. However, SOCE is not a simple binary pathway but operates within a complex regulatory network. Beyond the core STIM-Orai axis, auxiliary proteins including transient receptor potential canonical 1 (TRPC1), tetraspanin 18 (Tspan18), tropomyosin 3 (TPM3), SOCE-associated regulatory factor (SARAF), and A-kinase anchoring protein 79/150 (AKAP79/150) modulate SOCE amplitude, kinetics, and downstream signaling in a cell- and context-dependent manner. Moreover, the functional consequences of SOCE are highly heterogeneous: Orai1 protects adult cardiomyocytes but promotes pathological hypertrophy in neonatal cells, posing a therapeutic dilemma. Although preclinical studies have shown efficacy of SOCE inhibitors, clinical translation remains hindered by poor isoform selectivity, suboptimal pharmacokinetics, lack of tissue-specific delivery, disease-stage-dependent effects, and absence of validated biomarkers. Importantly, recent evidence has definitively ruled out amlodipine-induced CRAC channel activation at therapeutic concentrations, confirming it as an experimental artifact. This review systematically summarizes the molecular complexity, functional diversity, and translational barriers of STIM/Orai-mediated SOCE, aiming to inform precision therapeutic strategies for cardiovascular diseases.

Out-of-hospital cardiac arrest remains a major public health challenge worldwide, with survival largely determined by the timeliness, quality, and organization of care. The 2025 Systems saving lives guidelines of the European Resuscitation Council (ERC) emphasize that meaningful improvements in outcomes depend not on isolated interventions but on the coordinated functioning of the entire system of care. This paper, representing the position of the Hungarian Resuscitation Society, summarizes the key elements of the guideline. The recommendations focus on the concepts of the chain of survival and the formula of survival, highlighting the combined importance of scientific evidence, effective education, and local implementation. Increasing community awareness, strengthening advocacy, initiating cardiopulmonary resuscitation education at an early age, and engaging trained lay responders are essential to ensure early intervention. Organizational aspects of emergency care - particularly dispatcher-assisted cardiopulmonary resuscitation, optimization of automated external defibrillator accessibility, and the availability of adequately trained emergency medical teams - further enhance system performance. In-hospital rapid response systems, cardiac arrest centers, and structured follow-up of survivors and their families play a key role in improving long-term outcomes and quality of life. Emerging technologies, including digital tools and artificial intelligence, offer promising opportunities to support early recognition, high-quality resuscitation, and education, although their implementation requires further evaluation and appropriate legal and ethical frameworks. Adopting a comprehensive, system-based approach is essential to improve out-of-hospital cardiac arrest outcomes and to develop sustainable, effective life-saving systems at the national level. Orv Hetil. 2026; 167(30): 1175-1185.

Intracerebral hemorrhage (ICH) is a devastating neurological condition characterized by high morbidity and mortality, with limited treatment options for promoting neurological recovery. Enhancing cortical excitability has emerged as a potential strategy for promoting neurological recovery. However, the role of neuronal activation in mitochondrial regulation and axonal regeneration after ICH remains unclear. A chemogenetic approach using adeno-associated virus (AAV)-human M3 muscarinic designer receptor exclusively activated by designer drugs (hM3Dq) was employed to selectively activate cortical excitatory neurons in an ICH mouse model. Behavioral assessments, histological analyses, and molecular evaluations of mitochondrial function and axonal integrity were performed. In vitro, PC12 cells were transfected with hM3Dq and subjected to Hemin-induced injury to assess mitochondrial dynamics and neurite outgrowth. Dynamin-related protein 1 (DRP1) overexpression was used to investigate the role of mitochondrial fission in hM3Dq-mediated effects. hM3Dq activation significantly improved motor and cognitive functions in ICH mice, reduced neuronal apoptosis, and enhanced axonal regeneration. These effects were associated with restored mitochondrial membrane potential, reduced oxidative stress, increased adenosine triphosphate (ATP) production, and partially restored mitochondrial dynamics-related protein expression. In vitro, hM3Dq overexpression mitigated mitochondrial dysfunction and promoted neurite elongation in PC12 cells. Importantly, DRP1 overexpression reversed these beneficial effects, suggesting that inhibition of mitochondrial fission is critical for hM3Dq-mediated neuroprotection. Chemogenetic activation of cortical neurons promotes neurological recovery after ICH and is associated with improved mitochondrial function and enhanced axonal regeneration. Modulation of DRP1-related mitochondrial fission signaling may partially contribute to these effects, suggesting a potential neuron-mitochondria interaction that may serve as a therapeutic target for hemorrhagic stroke.

With increasing awareness of health-oriented antioxidant diets, plant-derived antioxidants (PDAs) such as polyphenolics, terpenoids, vitamins, alkaloids and saponins, are promising alternatives to synthetic antioxidants (SAs). PDAs boost human immunity and health by scavenging reactive oxygen species, activating endogenous antioxidant defenses, and reducing oxidative cell damage. As a result, they are widely used in preventing and treating oxidative stress-related chronic diseases, including neurodegenerative diseases (NDDs), viral diseases, cardiovascular diseases (CVDs), and diabetes, as well as certain cancers. Moreover, due to their antioxidant, coloring and preservative effects, PDAs are utilized in food industry to extend shelf-life, improve food quality and inhibit pathogenic microorganisms. However, obtaining high-quality PDAs remains challenging because of their low natural abundance, complex impurities, poor stability, and prone to contamination and deterioration during isolation. This review highlights recent advances in the classification, sources, antioxidation, biosynthesis and regulation, as well as extraction and refining of PDAs. Their functional applications are summarized in two aspects: (i) as food additives (e.g. antioxidants, colorants and preservatives) to reduce potential risk of SAs and enhance food value-added; and (ii) as biomedicines (with anti-inflammatory, anti-NDDs, antiviral, anticancer, anti-CVDs and anti-diabetic effects), providing new strategies for chronic-disease prevention through multi-target regulation of oxidative-stress pathways. Integration of synthetic biology, green purification and nano-delivery is envisioned to overcome industrial challenges of PDAs, offering new insights for their precise design and versatile application in the healthcare and food industries.

Adults who grow up with a parent with severe mental illness are exposed to prolonged developmental adversity, yet little is known about how this experience shapes multidimensional outcomes in adulthood. In particular, the roles of personal adaptive resources, childhood trauma, parental bonding, and morbidity in influencing quality of life, social functioning, and healthcare utilization remain insufficiently understood. This study aimed to examine the relationships between personal adaptive resources (resilience and general self-efficacy), childhood experiences (trauma and parental bonding), and adult outcomes, including quality of life, social functioning, morbidity, and healthcare utilization, as well as to examine the moderating role of resilience.

A cross-sectional quantitative design was employed.

A convenience sample of 300 adults who grew up with a parent with severe mental illness completed a self-report questionnaire which consisted of validated scales for study variables: Personal Wellbeing Index-Adult, Connor-Davidson Resilience Scale-10, New General Self-Efficacy Scale, Social Functioning Questionnaire, Parental Bonding Instrument, Childhood Trauma Questionnaire, and EUROHIS survey items for morbidity and healthcare utilization. Data were analyzed using Spearman correlations, hierarchical multiple linear regression, negative binomial regression, and moderation analysis using PROCESS.

Resilience and self-efficacy independently predicted higher quality of life. Childhood trauma and parental overprotection independently predicted poorer social functioning, while parental care did not contribute unique variance in multivariate models. Childhood trauma significantly predicted morbidity, and morbidity was associated with increased healthcare utilization. Resilience did not moderate the relationship between childhood trauma and either morbidity or social functioning, indicating independent rather than interactive effects.

Among adults who grew up with a parent with SMI, resilience and self-efficacy function as independent contributors to subjective wellbeing, while childhood adversity and morbidity shape long-term social and health outcomes. Resilience does not appear to buffer the long-term effects of trauma on health or functioning.

Drawing on the theory of gerotranscendence, this research aimed to gain a more comprehensive and nuanced understanding of the age-loneliness relationship and underlying factors. Data from the BBC Loneliness Experiment (n = 6875, 67.80% female, M_age = 49.26, Range_age 16-94) were analyzed using polynomial regression and Multi-Group Structural Equation Modeling (MG-SEM) for the quantitative data, and complemented by Latent Dirichlet Allocation (LDA) for free-text data. The results showed: (1) there was a non-linear, inverted U-shaped relationship between age and loneliness, with an inflection point at 39.2 years of age; (2) in the older age group, loneliness self-stigma and the meaning of loneliness played parallel mediating roles between age and loneliness, whereas no mediating effect was observed in the younger age group; (3) these mediating effects primarily attenuated the loneliness frequency and loneliness intensity rather than loneliness duration; (4) two overarching topics of loneliness (i.e., Limited Social Functions and Unsatisfactory Social Relationships) were identified, with differences between the two age groups. This study further enriches the understanding of gerotranscendence in the loneliness domain and provides suggestions for tailoring precision interventions (i.e., self-stigma, meaning-making) to distinct life stages and specific loneliness dimensions.

Sleep disturbances are highly prevalent in autism spectrum disorder (ASD), yet conventional single-night polysomnography (PSG) provides limited insight into dynamic sleep regulatory processes. Using the Synaptic Homeostasis Hypothesis as a conceptual framework, we quantified night-to-night changes (Δ; Night 2 - Night 1) in sleep architecture across two consecutive nights of home-based PSG and examined their association with ASD symptom severity. Seventy-nine children with ASD, stratified into mild ASD (M-ASD, n = 35) and moderate-to-severe ASD (MS-ASD, n = 44) subgroups using the Childhood Autism Rating Scale, and 30 typically developing controls (TDC) participated. Overall sleep-continuity changes were broadly comparable between ASD and TDC groups. However, sleep-architecture Δ measures showed a severity-related pattern: the M-ASD subgroup exhibited an overnight increase in rapid eye movement sleep percentage (ΔREM% = +2.6%, p = 0.002), whereas the MS-ASD subgroup showed no significant change (ΔREM% = -0.1%, p = 0.922). An adjusted pairwise comparison indicated a greater ΔREM% increase in M-ASD than in MS-ASD (adjusted mean difference = 3.4%, 95% CI: 1.2 to 5.6; Bonferroni-corrected p = 0.009). A similar exploratory difference was observed for NREM1%. ΔREM% was modestly and negatively associated with ASD symptom severity in correlation analysis (ρ = -0.234, p = 0.038) and age- and gender-adjusted regression analysis (β = -0.286, p = 0.016). Sensitivity analyses showed broadly consistent patterns, although severity-stratified overall effects were attenuated after FDR correction. These findings support further investigation of PSG-derived dynamic sleep measures as hypothesis-generating correlates of clinical heterogeneity in ASD.

Immersive natural environments in virtual reality can capture involuntary attention, thereby contributing to improved health-promoting practices according to the Attention Restoration Theory. Landscapes and waterscapes provide restorative environments that foster a sense of connection with nature and create a peaceful and relaxing atmosphere. This study investigated the health effects of VR exercise in two specific implementations: professionally produced waterscapes and self-recorded landscapes.

The study design was a randomized controlled trial conducted between September 2022 and June 2023. Forty eligible participants were randomly assigned to a waterscape group, and 32 participants were allocated to a landscape group. All participants received identical exercise program sessions of 30 min each conducted weekly for 12 weeks. The virtual reality headsets displayed two different series of non-repetitive 360° videos of professionally produced waterscapes or self-recorded landscapes. Data were collected at the pre- and post-test periods through a body composition analyzer and self-administered questionnaires.

The comprehensive and mental quality of life, skeletomuscular index, and fat-free mass of participants in the waterscape group improved, while their body mass index decreased. Participants in the waterscapes group revealed a greater experience in perceived restorativeness and less virtual reality sickness than those in the landscapes group.

Professionally produced VR waterscapes yielded superior mental and physical health outcomes compared to self-recorded landscapes. Virtual reality exercise in immersive natural environments is recommended as a restorative experience for health promotion.