Aspiration pneumonia (AP) remains a clinical problem in long-term care facilities. However, evidence regarding modifiable care-related factors influencing swallowing remains inconsistent. We used a nationwide survey of residents in Japanese long-term care facilities to examine associations between oral frailty-related conditions, meal positioning strategies, and AP.

This cross-sectional study analyzed nationwide survey data from residents at high risk of malnutrition in Japanese long-term care facilities. AP status was determined based on facility medical records. Oral frailty-related conditions and meal positioning factors were assessed using routine records. Logistic regression analyses evaluated associations with AP. Cumulative analysis examined associations between abnormal oral condition item counts and AP prevalence.

Among 1204 residents, 8.1% (n = 97) reported AP. After full adjustment, inability to gargle (OR = 1.991; 95% CI: 1.139-3.479) and unclear speech (OR = 1.752; 95% CI: 1.085-2.829) remained significantly associated with AP. During meals, reclining angles of 0°-30° (OR = 4.024; 95% CI: 1.006-16.106) and 30°-60° (OR = 1.890; 95% CI: 1.074-3.327) were associated with AP. AP prevalence increased from 2.9% in residents with 0-1 abnormal oral frailty-related items to 13.1% in those with ≥ 4 items.

AP was associated with cumulative oral frailty-related conditions and meal positioning among residents at high risk of malnutrition in long-term care facilities. Monitoring routine oral signs and optimizing seating angles may help reduce AP occurrence.

Anti-aging foods not only benefit elderly individuals but also drive the development of safe and effective natural drugs. Here, we report that the addition of total flavonoids of litchi seed (TFL) delays replicative senescence and stress-induced senescence. TFL alleviates the senescence-associated secretory phenotype (SASP) and reduces the degree of DNA damage caused by bleomycin (BLM). TFL also counteracts stress-induced pulmonary senescence and fibrosis. TFL reduces the protein level of p21 in mouse lung and alleviates pulmonary fibrosis. Transcriptome profiling further reveals that TFL plays a key role in its anti-aging mechanism by inhibiting the SASP. Mechanistically, TFL suppresses p65 protein expression, thereby inhibiting IL-1α and IL-1β and delaying cellular senescence. Gut microbiome analysis reveals that the abundance and functions of the mouse gut microbiome change after BLM exposure and that TFL treatment reverses these changes. Overall, we provide a theoretical basis for the future application of TFL as a potential anti-aging product.

Social drivers of health (SDOH) impact health outcomes for children with asthma. Advances in geocoding enable better SDOH measurement in research. We aimed to: 1) examine relationship between three SDOH composite indices-Social Vulnerability Index (SVI), Childhood Opportunity Index 3.0 (COI), Area Deprivation Index (ADI)-and asthma patient disposition from emergency room; and 2) determine which index most closely correlates with admission rates.

Retrospective cohort study, patients 2-18 years presenting for asthma, defined using computational phenotype requiring: asthma diagnostic code, ≥2 doses nebulized albuterol, and ≥1 systemic steroid dose within 24 h of presentation. Data obtained 2021-2024 from Indiana Network for Patient Care, a state-wide health information exchange. Exposures included three SDOH indices. Mixed effects multinomial logistic regression to evaluate associations with patient disposition and recurrent emergency room encounters.

Total 5895 asthma encounters (4485 patients), with 27.85% resulting in admission (57.3% ward, 42.6 ICU). Female gender, chronic illness, "other" preferred language, >1 year since last outpatient visit increased admission likelihood. Black race and preferred language Spanish were associated with lower likelihood (vs. white, English-speaking reference). No SDOH indicator provided superior differentiation of patient disposition. However, census tract-level random effects were meaningful across all three models.

Gender, race, language, chronic comorbidity, and preventive healthcare access are associated with emergency and repeat hospital use in pediatric asthma. Geographic context plays a meaningful role in patients' clinical disposition, but the geographic component driving this association is not meaningfully captured by any of the three SDOH indices studied.

The COVID-19 Pandemic not only posed a global health crisis but also intensified public divisions over vaccination, with conspiracy theories emerging as a significant obstacle to health communication. This study investigates the psychological and informational foundations of vaccine conspiracy beliefs using a five-wave longitudinal panel survey conducted annually in Japan between 2020 and 2024 (N=2,000 in 2020; N=600 in 2024). A factor analysis of an eight-item scale identified two distinct dimensions of conspiracy thinking: institutional conspiracy beliefs, which reflect distrust toward governments and pharmaceutical companies, and implausible conspiracy beliefs, which involve extreme claims such as microchip implantation. Latent growth modelling revealed that institutional conspiracy beliefs were associated with lower reliance on mass media, persistent and growing scepticism toward mainstream media, and younger age. These findings suggest that institutional conspiracy beliefs reflect enduring orientations of distrust rather than temporary reactions to pandemic-specific information. In contrast, implausible conspiracy beliefs were endorsed by only a small minority of respondents. This study makes three contributions. First, it demonstrates the need to distinguish institutional distrust-based conspiracies from fringe implausible narratives. Second, it provides longitudinal evidence clarifying how stable predispositions and changing attitudes jointly shape conspiracy beliefs. Third, it extends the literature by examining the Japanese context, adding cultural variation to a field dominated by Western-centric data.

Chronic pain is increasingly recognized in individuals with cystic fibrosis (CF), especially as survival improves. However, the coexistence of CF and fibromyalgia-a centralized pain syndrome-has not been previously reported and presents a unique diagnostic challenge..

A 26-year-old woman with confirmed CF presented with chronic, widespread musculoskeletal pain unresponsive to CF-specific treatment. Evaluation revealed neuropathic features and positive findings on fibromyalgia screening tools. Management included duloxetine, pregabalin, Pilates-based rehabilitation, and reflexology-based manual therapy. With consistent care, the patient achieved significant symptom control and improved quality of life.

Our case highlights the importance of individualized, multimodal pain management in CF, particularly when symptoms suggest overlapping centralized pain syndromes. Clinicians should consider fibromyalgia in CF patients presenting with persistent, widespread pain unresponsive to standard treatment.

Seasonal influenza continues to cause severe disease among older adults in the United States despite enhanced vaccine recommendations, driven by immunosenescence and vaccine mismatch with circulating influenza viruses. mRNA-based influenza vaccines (mRNA-1010), addressing some of these challenges, have been developed for this population. A previous trial found mRNA-1010 demonstrated superior immunogenicity compared to enhanced high-dose influenza vaccination. As no direct evidence exists comparing mRNA-1010 efficacy to currently available enhanced influenza vaccines (EVs), we aimed to indirectly compare the effectiveness of mRNA-1010 and licensed EVs against medically attended influenza infection among adults ≥65 years in the US.

We conducted an anchored indirect treatment comparison (ITC) using the Bucher method to estimate the relative vaccine effectiveness (rVE) of mRNA-1010 vs EV, with standard-dose egg-based influenza vaccine as the anchor, using individual patient-level data from adults ≥65 years from a real-world Optum claims-based analysis and the pivotal mRNA-1010-P304 clinical trial. Target trial emulation and inverse probability weighting (IPW) were implemented to address potential bias due to cross-population differences. Sensitivity analyses were conducted using alternative outcome definition, alternative weighting approaches and US trial sites only.

Assessments of post-IPW supported a comparable common anchor for the ITC. Among adults ≥65 years, the indirect rVE of mRNA-1010 vs. enhanced vaccines against medically attended influenza was 12.82% (95% CI: -36.91%, 44.49%). Sensitivity analyses also supported these findings.

mRNA-1010, a new mRNA-based influenza vaccine, was shown to be comparable to currently licensed EVs among older adults ≥65 years against medically attended influenza outcomes. Consistency of findings across sensitivity analyses support the robustness of these results. Newer influenza vaccine modalities, including mRNA-based vaccines provide an additional comparable option to existing EVs to help further reduce severe influenza disease burden among older adults ≥65 years for whom enhanced vaccines are recommended.

Mycoplasma pneumoniae (MP) infection is associated with refractory severe clinical course, and steroid therapy has been suggested as an effective treatment for refractory MP pneumonia.

A total of 53 patients with MP pneumonia and 9 patients with viral pneumonia patients were enrolled. Point mutations at residues 2063, 2064, and 2067 in domain V of 23S rRNA gene were analyzed, and serum levels of interferon (IFN)-γ, interleukin (IL)-6, TNF-α, IL-10, and IL-1β were measured before and after steroid treatment.

There was no significant difference in serum cytokine concentrations between the MP pneumonia group and the viral pneumonia group. The A2063G point mutation was identified in 72% (18/25) of tested MP pneumonia patients. IFN-γ and IL-6 levels showed significant positive correlations with the duration of hospitalization, fever after admission and duration of steroid treatment. The macrolide-resistant MP (MRMP) group tended to have higher IFN-γ levels than the macrolide-sensitive MP group (P = 0.055). Notably, all patients (n = 9) with the highest IFN-γ levels (ranked in descending order) belonged to the MRMP group. Steroid treatment significantly reduced IFN-γ and IL-6 levels, suggesting effective modulation of excessive immune responses. LDH and AST levels were also correlated with IFN-γ and IL-6.

Therefore, IFN-γ may serve as a valuable biomarker for predicting a refractory clinical course of MP pneumonia. In addition, LDH and AST levels, which showed the closest correlation to IFN-γ and IL-6, may also be proposed as indicators of disease severity.

Variants involving TBX4 are associated with ischiocoxopodopatellar syndrome with or without pulmonary arterial hypertension (ICPPS; also known as small patella syndrome), pulmonary arterial hypertension (PAH), and lethal lung developmental disorders. The variability of penetrance and expressivity of TBX4 variants remains a prominent challenge in understanding their genotype-phenotype correlations. We investigated a five-generation family with 12 affected individuals presenting with isolated ICPPS, lung-related manifestations with features of ICPPS, and other milder abnormalities. Whole-genome sequencing was used to identify the causative and putative modifying variants. Wefound a complex genomic rearrangement (CGR) involving the TBX4 promoter and its 5 ^' untranslated region that segregated in the family. This CGR consists of an ~38 bp insertion, an ~24 bp deletion, an ~2.4 kb deletion, and an ~235 bp inversion. Computational analyses in the proband's mother with pulmonary and skeletal manifestations revealed 27 candidate modifying noncoding SNVs in the TBX4 lung-specific super-enhancer and 45 SNVs within its topologically associating domain (TAD), including seven variants within the TBX4 promoter. To explain the variable expressivity of this CGR, we propose that one or more of the variants within the TBX4 lung-specific super-enhancer or TAD may act in trans with the pathogenic CGR, modulating TBX4 expression from the intact allele.

Civil society organisations (CSOs) can play an important role in crisis management and facilitate effective communication and crisis response. To improve capacity for intercultural health communication in future health crises, it is crucial to learn from CSOs' experiences during the COVID-19 (SARS-CoV-2) pandemic and from their cooperation with healthcare systems. This study aims to gain insights into CSOs' experiences of intercultural health communication during the pandemic in two disadvantaged areas in Stockholm, Sweden. We also wanted to explore healthcare staff's experiences of collaboration with CSOs.

We conducted a qualitative thematic analysis of interviews with informants from 15 CSOs with substantial local pandemic activity. Additionally, we conducted a secondary analysis of qualitative interview data from 21 informants involved in delivering intercultural health crisis communication during the pandemic.

CSOs emphasised the importance of effective and trusted communication, which requires more than translation. They highlighted the need for a deep understanding of how language, cultural frameworks and lived experiences shape the reception of public health messages. From the perspective of healthcare staff, the collaboration with CSOs was both necessary and transformative. The partnership with CSOs was a process of "joining forces, "in which mutual learning and shared responsibility strengthened the overall intercultural communication strategy.

In times of crisis, CSOs have the capacity to act as community-based knowledge brokers by strengthening trusted, understandable intercultural communication and fostering a sense of community. However, CSOs are not just an extension of the public health authorities, but independent actors with a unique ability to communicate and build trust. Collaborative structures between CSOs and healthcare need to be firmly established well ahead of future health crises. Our results emphasise the importance of culturally and linguistically adapted communication as an integral part of inclusive crisis communication. These findings position CSOs as community-engagement actors in inclusive emergency preparedness.

This study analyzed SARS-CoV-2 surveillance results in the urban wastewater of Zhengzhou, central China, to explore its association with community COVID-19 incidence and evaluate its early warning performance across different SARS-CoV-2 variant epidemic phases.

Weekly monitoring was conducted at five representative wastewater treatment plants from May 2024 to July 2025, yielding 325 samples. Viral loads of the ORF1ab and N genes were quantified using RT-qPCR, with statistical analyses performed included Spearman correlation, ANOVA, and cross-correlation function.

The two target genes showed high consistency and significant positive correlation with 14-day cumulative COVID-19 incidence. However, significant variant and marked heterogeneity was observed across variant periods and gene targets, with the N gene outperforming ORF1ab in stability. Wastewater viral signals preceded clinical cases by one week.

These findings supported the application value of wastewater-based epidemiology in post-pandemic COVID-19 surveillance, indicate its potential early warning capacity, and reveal notable heterogeneity in surveillance performance across viral variants and target genes.