[This corrects the article DOI: 10.3389/fimmu.2026.1818028.].

Most trials in long COVID rehabilitation included only previously hospitalised patients and omitted outcome measures such as mobility, an important outcome for assessing life impact. The primary objective was to investigate whether an 8-week tele-rehabilitation programme for individuals with long COVID improves functional mobility compared with usual care.

This was a randomised controlled trial involving individuals with long COVID and persistent symptoms of reduced mobility, muscle weakness, dyspnoea or fatigue. Participants were randomised to either an individualised 8-week tele-rehabilitation programme plus usual care or usual care. In both groups, usual care was supplemented with generic guidance on physical activity and symptom management. The primary outcome was activity measure for post-acute care (AM-PAC) mobility. The secondary outcomes were dyspnoea, fatigue, quality of life, physical function, mental health, acceptability and adverse events.

132 participants were randomised (65 intervention; 67 control; 48±11.8 years; 75% female), with 78% not previously hospitalised. Adherence was high (96%), although 39% of intervention participants were unable to progress their exercises. No significant between-group differences were found in AM-PAC mobility (mean difference (MD) 0.61; 95% CI -0.91-2.13). The intervention group showed greater improvements in EQ-5D-5L pain (MD -0.36; 95% CI -0.70- -0.03), health status (MD 7.74; 95% CI 1.05-14.43), fatigue (MD -0.90; 95% CI -1.78- -0.02) and dyspnoea (MD 1.24; 95% CI 0.10-2.37). No serious adverse events occurred.

In the context of limited evidence around exercise in non-hospitalised individuals with long COVID, our study offers important insights into feasibility, safety and clinical relevance.

The incidence of end-stage kidney disease (ESKD) is rising, particularly among adults aged 65 and older, who account for over half of new cases in Europe. While older adults consistently prioritize quality of life (QoL), it is rarely a primary endpoint in clinical trials and remains underemphasized in clinical decision making. Health-related QoL (HRQoL) captures only part of the broader QoL concept, which may contribute to inconsistencies across studies. We examined determinants of overall QoL and its relationship to HRQoL using comprehensive assessments.

We conducted a cross-sectional study of adults ≥65 receiving in-center hemodialysis at four hospitals in Flanders, Belgium. Data included sociodemographic and treatment-specific information, a comprehensive geriatric assessment, Groningen Frailty Indicator, Brussels Integrated Activities of Daily Living Inventory, and HRQoL measures [EuroQol 5-Dimension 3-Level Questionnaire (EQ-5D-3L), Quality of Life Questionnaire-Core 30 (QLQ-C30), and Quality of Life Questionnaire-Myeloma Module]. Overall QoL was assessed with the Anamnestic Comparative Self-Assessment (ACSA). We conducted descriptive, univariate, multivariate, and cluster analyses.

We included 111 patients (64.9% male; mean age 78.1 ± 7.4 years; median dialysis vintage 36.0 months [interquartile range 11.0-65.8]). Overall QoL was moderately positive (ACSA mean 1.97 ± 2.05; range -5 to 5). The EQ-5D utility index was not correlated with the ACSA (ρ = -0.052, P = .591). Multivariate analysis identified "cognitive functioning" (QLQ-C30), "usual activities" (EQ-5D-3L), hospital admissions, "subjective health status" (EQ-5D-3L), and "social functioning" (QLQ-C30) as independent predictors, explaining 31% of the variance in the ACSA. Cluster analysis identified three subgroups: a relatively resilient subgroup (n = 59), a functioning-impaired subgroup (n = 36), and a psychologically frail subgroup (n = 12).

Focusing on cognition, usual activities, and social functioning may improve outcome relevance, identify vulnerable subgroups, and support more effective resource allocation for older adults with ESKD.

Suicidal behaviour refers to a spectrum of actions and thoughts focused on intentionally ending one's own life, ranging from ideation and planning to suicide attempts. The study aims to (i) estimate the prevalence rate of suicidal behaviour among youths diagnosed with depression and anxiety disorders, using the Suicidal Behaviour Questionnaire (SBQ-R), (ii) evaluate the psychometric properties and factor structure of the SBQ-R as a measurement tool in the clinical population, (iii) identify the social, demographic and clinical factors which are associated with suicidal behaviour among youths with depression and anxiety in a multi-ethnic outpatient population in a tertiary hospital setting.

379 participants who were seeking treatment for depression and anxiety disorders were recruited. The SBQ-R was used to identify the risk of suicidal behaviour. Data on socio-demographic variables, clinical variables, smoking status and alcohol status were also collected. Confirmatory factor analysis (CFA) was performed to establish the underlying factor structure of the SBQ-R. Multiple logistic regression were used for analyses.

The prevalence of suicidal behaviour in the past year was 84.4% in the sample. A CFA on the four items of the suicidal behaviour - indicated that the model fit the data well. The regression model showed that those of Indian ethnicity (vs Chinese ethnicity) were less likely to have suicidal behaviour, while current smokers (vs non-smokers), who had experienced childhood abuse (vs no childhood abuse), and those with PHQ-9 score of 10 and above were more likely to have suicidal behaviours.

This study found that the SBQ-R has adequate psychometric properties for use among outpatients with depression and anxiety disorder in a tertiary hospital in Singapore. The high prevalence of suicidal behaviour in patients with depression and anxiety highlights the need for early intervention and targeted suicide prevention strategies in clinical settings.

Interpersonal difficulties are a core challenge experienced by people who have borderline personality disorder (BPD). Relationships where one person has BPD are often rated lower in satisfaction than others due to their tumultuous and unstable nature. Interpersonal difficulties not only cause distress but may also catalyse crises for people with BPD. The ability to sustain emotionally positive attachments is fundamental for recovery in BPD. The aim of this study was to understand how couples, where one partner has BPD, experience their intimate relationships and make sense of their success.

Through semi-structured interviews, we explored the role of attachment in the context of these romantic relationships and identified constructive behaviours that contribute to their longevity and satisfaction. In-depth interviews were conducted individually with six couples engaged in long-term (>1 year) relationships.

Interpretative Phenomenological Analysis (IPA) was used, and two key themes were identified - a) navigating the impacts of the disorder and b) safe base and secure attachment.

Our findings suggest that reorientation of interpersonal transactions, where the partner without BPD serves as a stable base, enables open communication. As a result, people with BPD feel secure, promoting emotion regulation, remission from symptoms, and an ability to sustain a long-term, satisfying relationship.

Adverse childhood experiences (ACEs) are linked to various behavioral and psychological issues. This study explored the relationship between ACEs and social media addiction (SMA), examining the mediating role of quality of life (QoL) and the moderating effect of occupational status.

Overall, 1,247 adults (55.4% females), aged 19 to 65 yr, were recruited through convenience sampling in Kerman, southeast Iran. Validated Persian versions of the ACE-ASF, WHOQOL-BREF, and Bergen Social Media Addiction Scale were used. Structural equation modeling (PLS-SEM) assessed direct, indirect, and moderated pathways.

ACEs were significantly associated with higher SMA (β=0.088, P=0.002) and lower QoL (β = -0.234, P<0.001). QoL was inversely related to SMA (β = -0.225, P<0.001), and partially mediated the ACE-SMA relationship (β=0.053, P < 0.001). Occupational status moderated the effects of ACEs on both QoL (β=0.066, P=0.021) and SMA (β= -0.055, P=0.046), Higher job levels reduced adverse effects. However, no significant moderation was found in the QoL-SMA path.

ACEs significantly increase the risk of SMA, partly through reduced QoL. Improving occupational status and QoL can reduce the long-term behavioral effects of childhood adversity.

Functional neurological disorder (FND) is a common and disabling condition for which effective treatments remain limited. Clinical outcomes are often variable, particularly in chronic and comorbid presentations. Ketamine and esketamine are increasingly used across a range of neuropsychiatric conditions. This review aimed to synthesise the existing evidence regarding their use in FND.

A systematic review of PubMed, PsycINFO and Google Scholar was conducted up to December 2025. Studies reporting clinical outcomes following (Es)ketamine administration in functional neurological symptoms were included. Owing to substantial clinical and methodological heterogeneity, findings were synthesised narratively.

Thirteen studies were identified, predominantly comprising case reports and small case series. Across the included studies, some patients were reported to experience improvement in functional motor symptoms, functional dissociative seizures, and other functional presentations following ketamine or esketamine administration. Interpretation of these findings is limited by the uncontrolled nature of the evidence base, heterogeneity of diagnoses and outcomes, and the potential influence of publication and expectancy bias. Adverse effects were variably reported and were generally described as transient in supervised clinical settings.

The current evidence base is limited to predominantly uncontrolled and highly heterogeneous studies and is insufficient to establish the efficacy of (Es)ketamine for FND. Although improvements in functional symptoms have been reported across several FND presentations, it remains unclear whether these reflect direct effects on functional symptoms, indirect benefits arising from psychiatric improvement, or other non-specific therapeutic factors. While no firm conclusions regarding efficacy can be drawn, the existing data suggest that further investigation is justified, and prospective controlled trials are needed to clarify the potential role of (Es)ketamine in FND.

Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique with demonstrated efficacy in the treatment of multiple psychiatric and neurological disorders. ExoTMS represents an evolution in TMS system design, developed to optimize focused brain stimulation while enhancing patient comfort and operational efficiency. By leveraging established neuroplastic mechanisms in a more patient-centered format, ExoTMS may represent a scalable advancement when compared to conventional TMS systems. This review examines the technological characteristics, safety profile, and therapeutic implications of ExoTMS, with particular attention to patient-reported outcomes, treatment comfort, and safety.

Eight studies were included, comprising 182 active-treated participants who received stimulation at effective intensity levels. Treatment protocols consisted of 4 to 6 sessions, with follow-up assessments conducted at 1 month and, in studies reporting extended follow-up, at 3 months post-treatment. Data collected included mapping time for coil positioning and setup, incidence of adverse events, and patient-reported outcomes. Subjective measures assessed treatment satisfaction and perceived comfort using questionnaires.

Patients reported high satisfaction with ExoTMS treatment, with improvements observed immediately post-treatment, and further increases at follow-up. Improvements were noted across multiple domains, including overall well-being, mood, perceived stress, and mental energy. Treatment tolerability was high, with 93.3% of participants reporting the therapy as comfortable and associated with minimal to no pain. No serious adverse events were reported.

ExoTMS appears to be a well-tolerated TMS-based intervention characterized by favorable treatment comfort, minimal pain, and the absence of serious adverse events. Patient-reported outcomes suggest improvements in well-being and self-regulatory domains that persist beyond the immediate treatment period. Compared with conventional TMS systems, ExoTMS may offer practical advantages, including reduced treatment burden and improved clinical workflow efficiency.

Quantification of [¹¹C]CURB, an irreversible positron emission tomography (PET) radiopharmaceutical used to image fatty acid amide hydrolase (FAAH), requires invasive arterial sampling. Developing a non-invasive approach for [¹¹C]CURB is challenging, since traditional reference region models are not directly applicable and the ubiquitous brain expression of FAAH complicates the identification of a ligand-free reference region. This study aimed to introduce and validate the irreversible reference tissue model (IRTM) used in conjunction with a data-driven, clustering-based white matter (WM) pseudo-reference region.

IRTM was implemented using a coupled-fit approach to estimate a common k 2 ' , resulting in two independent parameters per volume-of-interest: R₁ and k_f . Primary quantification was performed using the macroparameters R i = K i / K 1 ' = R 1 ⁢ k 3 / k f (relative net influx) and R ⁢ k 3 = λ ⁢ k 3 / K 1 ' = R 1 ⁢ k 3 / k 2 (relative trapping index). Simulations characterized the sensitivity of IRTM to differences in cerebral blood volume between target and reference tissues. The model was validated against the gold standard arterial input function (AIF)-based quantification using retrospective [¹¹C]CURB PET data from 10 healthy participants. A partition-based clustering algorithm was used to extract the centermost WM time-activity curve as a pseudo-reference region.

In the IRTM validation study with human data, R_i emerged as a more robust metric than Rk ₃, with the latter exhibiting high between-subject variability. Although simulations identified systematic biases in IRTM estimates driven by blood volume asymmetries, IRTM-derived R_i estimates showed strong concordance with AIF-based R_i (R ² = 0.96), λk ₃ (R ² = 0.90), and K_i (R ² = 0.96). Mean errors in R_i ranged from -11.2 ± 9.9% in the frontal lobe to -3.1 ± 10.4% in the amygdala. Voxel-wise parametric maps demonstrated high image quality and signal-to-noise ratio at the individual subject level.

This study provides a validated, fully non-invasive framework for [¹¹C]CURB PET quantification. Combined with a partition-based clustering approach to select a data-driven WM pseudo-reference region, IRTM achieved excellent concordance with AIF-based measurements, supporting the feasibility of IRTM for non-invasive FAAH imaging.

Critically ill infants and children often need prolonged sedation to support life-saving therapeutic interventions. Although advances in pediatric intensive care (PICU) have substantially improved survival, an increasing body of evidence indicates that many survivors experience persistent neurocognitive and neurobehavioral impairments. These outcomes arise from a complex interplay between pre-morbid status, critical illness related physiological stressors and iatrogenic exposures during periods of brain development. Evidence consistently links benzodiazepines to increased risk of delirium, sleep fragmentation, withdrawal, and adverse cognitive trajectories in pediatric populations. In contrast, α ₂-adrenergic agonists such as dexmedetomidine may be associated with a lower risk of delirium, improved sleep architecture, and potential neuroprotective effects in preclinical and early clinical studies, although human evidence is conflicted with limited data in PICU. Although several studies have evaluated the long-term neurocognitive effects of inhaled anesthetics after general surgical anesthesia, their increasing use for PICU sedation remains understudied. This narrative review synthesizes preclinical and clinical literature examining the associations between sedation practices in PICUs and subsequent neurocognitive outcomes. We focus on potential modifiable contributors, including sedative class selection, sedative polypharmacy, sleep disruption, and delirium, while acknowledging non-modifiable risk factors such as developmental stage at illness onset, acute neurological injury, systemic inflammation, and non-clinical social determinants of health.