Multiple Sclerosis (MS) is a chronic neurological disorder, prevalent in young adults. MS leads in disability accrual, thus affecting overall patients' quality of life. Moreover, the management of MS poses significant burden on health systems worldwide. The present study delves into the impact of different health providing settings (e.g. private office/Clinic vs. specialized MS Center) on the effectiveness of MS management, as well as on patient-reported outcomes related to the quality of life (Axis A). Moreover, the study addresses their relative effectiveness in a health crisis, such as the COVID-19 pandemic (Axis B).

Data were collected based on questionnaires administered to people with MS (pwMS). Upon the pandemic and prior to the COVID-19 vaccines being available, all data were collected via online questionnaires. Since March 2021, data were collected both online and in person.

Overall, 776 pwMS participated in the study and answered Axis B questionnaire. Of those, 215 additionally answered Axis A questionnaire. Regarding Axis A, disease management by a specialized MS Center was associated with increased access to healthcare professionals (p < 0.001) and/or MRI examinations (p < 0.001) and was also linked to improved time-to-diagnosis following symptom onset, compared to the disease management in a private office/Clinic (p < 0.001). Regarding Axis B, specialized MS centers demonstrated remarkable adaptability during the pandemic, swiftly implementing remote care solutions to ensure continuity of care.

These findings suggest that care delivered in specialized MS centers is associated with improved access to healthcare services and better patient-reported outcomes, both under routine care conditions and during healthcare crises.

This study tracked the postadjustment infection rates and symptom trends within community settings. Conducted from May 2023 to May 2024 across four districts in Shenzhen, involving 3246 participants, over 80% had received at least one vaccine dose. Postpolicy adjustment witnessed three significant infection surges. Among the cohort, 63.7% reported only one Coronavirus disease 2019 (COVID-19) infection, 30.3% two infections, and 1.7% three infections, with 4.3% remaining uninfected throughout the follow-up. Older adults and those with lower IgG levels had increased reinfection risk. Notably, 3.8% (95% CI: 3.1-4.6) reported long COVID, with higher susceptibility in those with underlying conditions (adjusted odds ratio [AOR] = 3.73, 95% CI: 2.20-6.34) and reduced incidence among fully vaccinated individuals (AOR = 0.57, 95% CI: 0.36-0.90). The policy change led to widespread exposure, shifting from first infections to reinfections. These insights underscore the need for ongoing research to inform future pandemic responses.

The incidence and mortality of severe influenza complicated by invasive pulmonary aspergillosis (IPA) have risen markedly in recent years. This study aimed to evaluate the diagnostic performance of metagenomic next-generation sequencing (mNGS) for detecting IPA in patients with severe influenza.

Severe influenza patients with suspected of having IPA admitted to Xinxiang Central Hospital, Henan Province, China, from March 2020 to September 2025 were retrospectively enrolled. Bronchoalveolar lavage fluid (BALF) and blood were collected for fungal culture, galactomannan (GM) assay, and mNGS. Final classification into IPA and non-IPA groups was based on composite clinical and microbiological criteria. Sensitivity, specificity, and receiver operating characteristic curves were used to compare the diagnostic performance of the three methods.

Comparison with traditional fungal culture and GM testing, mNGS provided significantly faster results. Among 189 patients suspected of severe influenza-associated IPA, mNGS demonstrated a sensitivity of 72.1% and a specificity of 80.2%. Its sensitivity was higher than that of fungal culture (28.6%), serum GM testing (37.6%), and BALF GM testing (44.1%); however, its specificity was slightly lower than that of fungal culture (89.5%), serum GM testing (84.3%), and BALF GM testing (81.3%). The area under the ROC curve (AUC) for mNGS was 0.76, which is higher than that for BALF GM testing (0.63), serum GM testing (0.61), and fungal culture (0.59). The combined diagnostic approach yielded an AUC of 0.83.

mNGS offers a rapid, sensitive and accurate solution for invasive pulmonary aspergillosis in severe influenza patients. It outperforms conventional fungal culture and galactomannan assays. Integrating mNGS with traditional diagnostic methods could substantially improve early detection and overall yield of IPA.

Recent advances in technology and the impact of COVID-19 have expanded the adoption of digital health. Synchronous collaborative telehealth between optometry and ophthalmology has been used to expedite specialist eye care in Western Australia since 2011. Optometrists perform an in-person assessment and participate in videoconferencing with ophthalmology to facilitate shared decision-making. This study utilises existing implementation theory to assess factors influencing implementation success, sustainability and scalability of this telehealth model.

Regional, rural, and remote Western Australia.

In-depth interviews were undertaken using an interview guide based on the Consolidated Framework for Implementation Research (CFIR). Deductive analysis was used to code themes to the framework, and inductive analysis was used for themes relating to sustainability and scalability.

Sixteen clinical and non-clinical staff with experience in telehealth for eye care in rural Western Australia.

Key themes identified using the CFIR included the relative advantage of telehealth (innovation), optimising workflow and role clarification (implementation process), funding (external setting), technological infrastructure (inner setting), a champion, and ownership and adaptability (individuals). Stakeholder buy-in, resource allocation, integration into public health infrastructure, asynchronous telehealth, and artificial intelligence were themes pertaining to both sustainability and scalability.

This study proposes key considerations in the implementation and maintenance of a collaborative telehealth model for eye care in rural areas which may be used as a basis for guideline development or to replicate the model in other contexts.

To assess whether antivirals are associated with a reduced incidence of uveitis following COVID-19.

We conducted a multi-institutional, population-based retrospective cohort study of adults (≥ 18 years) diagnosed with COVID-19 between 2022 and 2024. Patients who received antiviral agents (Paxlovid, Molnupiravir, or Remdesivir) within 5 days of diagnosis were matched 1:1 with untreated controls using propensity score matching. Patients with pre-existing uveitis, early-onset uveitis within 5 days of the index date, or underlying systemic inflammatory or infectious diseases were excluded. The primary outcome was new-onset uveitis, with hazard ratios (HRs) calculated across follow-up intervals.

After matching, 438,455 patients were included in both the antiviral and non-antiviral groups. Antiviral therapy was associated with a significantly lower risk of uveitis at 3 months (HR = 0.62, 95% CI: 0.45-0.87), 6 months (HR = 0.68, 95% CI: 0.54-0.87), 1 year (HR = 0.76, 95% CI: 0.64-0.91), 3 years (HR = 0.80, 95% CI: 0.70-0.92), and all duration (HR = 0.81, 95% CI: 0.71-0.93). Subgroup analysis revealed consistent benefit across all age groups, with females experiencing greater protection than males. Significant reductions in uveitis risk were observed among patients with diabetes (HR = 0.68, 95% CI: 0.52-0.89), hyperlipidemia (HR = 0.78, 95% CI: 0.65-0.95), and heart failure (HR = 0.52, 95% CI: 0.30-0.90). Among the antivirals, Paxlovid was associated with a significant risk reduction (HR = 0.83, 95% CI: 0.71-0.96), whereas Molnupiravir and Remdesivir showed no statistically significant effect. CEV classification did not show significant improvement. Besides, the risk reduction was evident regardless of prior COVID-19 vaccination status.

Early antiviral treatment for COVID-19 such as Paxlovid, is associated with a reduced risk of uveitis. These findings suggest that, in addition to mitigating systemic disease progression, antiviral therapy may confer ocular protective effects, which could be especially meaningful for high-risk populations.

Maternal body mass index (BMI) before pregnancy and gestational weight gain (GWG) have been implicated in offspring health, yet their specific impact on the development of allergic diseases remains unclear. We aimed to evaluate associations between pre-pregnancy BMI and GWG with asthma, rhinitis, eczema, food allergy, anaphylaxis, and allergic sensitization during childhood and adolescence.

We analyzed 7280 mother-child pairs from Generation XXI, a Portuguese population-based birth cohort. Maternal BMI was categorized per World Health Organization criteria and grouped into underweight/normal weight vs. overweight/obesity. GWG was considered using Institute of Medicine (IOM) guidelines and GWG z-scores. Allergic outcomes were assessed via parent-reported physician diagnosis at 4, 7, 10, and 13 years, and allergic sensitization was determined at 10 years using ImmunoCAP. Associations were analyzed using logistic regression models adjusted for confounders.

Children of mothers with excessive GWG had increased odds of asthma at ages 7 and 13 (aOR = 1.30; 95% CI 1.01-1.66 and aOR = 1.29; 95% CI 1.01-1.65, respectively), and rhinitis at 4 (OR = 1.48; 95% CI 1.10-1.98). Higher GWG z-score group was associated with increased odds of asthma (aOR = 1.33; 95% CI 1.03-1.72), rhinitis (aOR = 1.54; 95% CI 1.13-2.09), and sensitization (aOR = 1.44; 95% CI 1.05-1.97). Lower GWG z-score group was associated to higher eczema odds at 13, while higher reduced eczema odds at age 4. Maternal overweight/obesity was associated with lower odds of eczema at age 13 (aOR = 0.73; 95% CI 0.60-0.88). Apart from eczema, maternal BMI showed no significant associations with others allergic diseases.

Higher GWG is associated with increased odds of childhood asthma, rhinitis, and sensitization. In contrast, maternal overweight/obesity is linked to lower odds of eczema, suggesting condition-specific effects of maternal weight on childhood allergy risk.

Flexible bronchoscopy is an indispensable tool in respiratory medicine. In the context of an aging society and increasing life expectancy, the number of elderly, often multimorbid patients is growing. This raises important questions regarding the safety of flexible bronchoscopy in this population.

In this retrospective study 1841 flexible bronchoscopies performed at two sites of Charité Universitätsmedizin Berlin in the years 2022 and 2023 were assessed and classified into two age groups: patients ≥ 70 years (elderly group) and patients < 70 years (non-elderly group). Safety was assessed by the occurrence of complications, and in a GEE-analysis potential risk factors of complications were identified.

In total, 466 bronchoscopies in the elderly group and 1375 bronchoscopies in the non-elderly group were assessed. Bronchoscopies in the elderly group were performed more frequently under endotracheal intubation than in the non-elderly group (81.8% vs. 70.0%; p < 0.001). The overall complication rate was 2.3% with no significant differences between bronchoscopies of the elderly (1.7%) and non-elderly group (2.5%; p = 0.345). The most common complications were pneumothorax (0.9%) in the elderly group and hypoxia (0.8%) in the non-elderly group. Transbronchial forceps biopsy (p < 0.001; OR = 3.99) and endobronchial valve implantation (p = 0.002; OR = 6.44) were significantly associated with an increased risk of complications independent of age.

In our study, flexible bronchoscopy proved to be a safe procedure with low complication rates in elderly and non-elderly patients. Age was also not associated with an increased risk of complications. Invasive interventions such as transbronchial forceps biopsies and endobronchial valve implantations were identified as risk factors independent of age. This underscores the importance of individualized risk minimizing strategies, in particular for complex and invasive procedures.

Meeting recruitment targets in an expeditious manner is essential to the successful completion of any research project. However, despite the high prevalence and debilitating nature of Long COVID (LC), recruitment of participants into some LC studies has been challenging.

We aimed to a) identify factors influencing participation in LC research among individuals who were infected by SARS-CoV-2 but had declined participation in a LC study and b) to compare these factors to those previously recognized.

Using a semi-structured guide, we interviewed thirteen people about their thoughts, experiences, and attitudes concerning participation in LC research. We imported interview transcripts into Nvivo 14 and analyzed them using thematic analysis. For coding, we used Charmaz's coding scheme of open and focused coding within an application of the constant comparative method. Basic descriptive statistics were also deployed to supplement our qualitative analysis.

Fifteen factors describe the facilitators and barriers mentioned by participants. The top three facilitators were Personal and social motivation, Incentives, and Familiarity and credibility of institutions involved with COVID-19; the top three barriers were Invasiveness, Social and political context, and Lack of time. Skepticism and infringement on participants' daily lives served as major obstacles to participation while trust, personal factors, and administrative factors encouraged participation. The facilitators and barriers identified are similar to those recognized previously except that in the politically charged atmosphere surrounding the COVID-19 pandemic, trust was especially vital.

Many factors affect people's decisions to participate in LC research but only some are modifiable by researchers. Building trust, offering incentives participants value, and removing logistical barriers may improve recruitment rates.

The production of antibodies against viral structural proteins such as the spike (S) and the nucleocapsid (N) is a hallmark of SARS-CoV-2 infection. The N protein contains several immunogenic regions. In this work we analysed epitope specificity and avidity of anti-N antibodies in COVID-19 patients. Eighty-nine COVID-19 patients were recruited. IgG, IgA, IgM antibodies to recombinant N protein and to 6 different peptides containing predicted B epitopes were measured by ELISA. Antibody avidity was evaluated by chaotropic ELISA. Anti-N IgG, IgA, and IgM were detected in 59%, 41% and 30% respectively; in 11% cases anti-N IgG are the only antibodies present in COVID patients. IgG and IgA anti-N antibodies levels correlate with levels of IL-6 and inversely with PaO₂/FiO₂ ratio (p < 0,005). Anti-N IgG displayed medium avidity in 51% and high avidity in 49% COVID patients; anti-N avidity was negatively correlated with PaO₂/FiO₂ (p < 0,05). Median anti-N antibody levels were similar in discharged or deceased patients and antibody avidity was not correlated with outcome. Among peptides, N_366-388 is the most frequently recognized by IgG, IgA and IgM antibodies followed by N_380-400, bound by patients IgG and IgA but anti-N_380-400 IgG display higher avidity than anti-N_366-388 IgG. These results indicate that anti-N antibodies are characterized by medium-high avidity and preferentially bind the COOH-terminus of the nucleoprotein. Anti-N antibodies, especially directed towards specific epitopes, might be relevant for the course of the infection, and their induction might improve current vaccination strategies.

Intranasal inflammatory polyps are commonly reported in cats but are rarely described in dogs. A pug dog was presented with chronic upper airway obstruction consistent with brachycephalic obstructive airway syndrome (BOAS). Computed tomographic examination of the skull revealed intranasal soft-tissue masses causing marked airflow obstruction. Surgical correction of BOAS was completed, including removal of the intranasal obstructive tissue. Histopathologic examination confirmed inflammatory polyps. Clinical signs improved markedly following surgery. This case highlights intranasal inflammatory polyps as an uncommon and potentially underrecognized comorbidity in dogs with BOAS and emphasizes the importance of considering this diagnosis in brachycephalic dogs with persistent or atypical respiratory signs. Key clinical message: Intranasal inflammatory polyps may represent an uncommon and underrecognized comorbidity in dogs with BOAS. Recognition of concurrent intranasal pathology is important, as surgical management may result in significant clinical improvement.