Fibrosing interstitial lung diseases (F-ILD) are associated with reduced exercise capacity and functional limitations. Motor-cognitive dual-task performance refers to the ability to perform a mobility task while simultaneously completing a cognitive task, reflecting the motor-cognitive demands of everyday multitasking. Dual-task performance has not been systematically compared between patients with F-ILD and healthy individuals.

To compare motor-cognitive dual-task performance between patients with fibrosing interstitial lung disease and healthy controls, and to examine associations with clinical parameters.

Cross-sectional comparative study.

Forty-five patients with F-ILD and 45 age-matched healthy controls completed the Timed Up and Go (TUG) test under single-task and dual-task (serial subtraction) conditions. Dual-task interference (DTI) was computed as the percentage change from single-task performance. Pulmonary function tests, the six-minute walk distance (6MWT), and the Montreal cognitive assessment (MoCA) were administered. Between-group differences were assessed with the Mann-Whitney U test. Associations were examined using Spearman's correlation and multivariable regression adjusted for age, body mass index, and comorbidity count.

Compared to controls, patients with F-ILD demonstrated slower TUG dual-task performance (12.35 vs 10.21 s; p = 0.0016), reduced dual-task accuracy (66.7% vs 77.8%; p < 0.001), and increased cognitive interference (36.6% vs 10.9%; p < 0.001). Physical interference was also elevated (p = 0.0328). In ILD patients, a shorter 6MWT distance was associated with longer TUG dual-task time (ρ = -0.42, p = 0.004) and greater cognitive interference (ρ = -0.38, p = 0.009). No correlations were found with FVC, FEV₁, or MoCA. After adjusting for confounders, ILD status independently correlated with longer TUG dual-task time (p = 0.029), lower accuracy (p = 0.0003), and increased cognitive DTI (p < 0.001).

Patients with F-ILD show significant motor and cognitive dual-task impairments compared with healthy controls, partly independent of conventional lung function measures.

Not applicable.

Nontuberculous mycobacterial pulmonary disease in low-risk patients is rare and typically indolent. We report a case of Mycobacterium abscessus complex (MABC) pulmonary disease in a 71-year-old immunocompetent Italian man who presented with mild dyspnoea that markedly worsened following SARS-CoV-2 infection three months before admission. High-resolution CT showed diffuse small, irregular, predominantly consolidative opacities with peripheral bronchial thickening. Extensive investigations for tuberculosis, fungal infection, other pathogens, and malignancy were negative. Respiratory cultures subsequently yielded MABC, and molecular testing identified a functional erm(41) gene conferring inducible macrolide resistance, consistent with M. abscessus subsp. abscessus. Guideline-based multidrug therapy with intravenous amikacin, tedizolid, clofazimine, and moxifloxacin was initiated. Nephrotoxicity required substitution of intravenous amikacin with an inhaled formulation, followed by ototoxicity and further modification with tigecycline. Despite these adjustments, cultures remained persistently positive. Severe gastrointestinal intolerance and progressive weight loss ultimately led to treatment discontinuation and home oxygen therapy. One year after diagnosis, imaging revealed new cavitary lesions with advanced bilateral disease. The patient died from respiratory failure and severe cachexia. This case shows that MABC infection may follow an aggressive, life-threatening course even in immunocompetent individuals. Antimicrobial resistance combined with treatment-limiting toxicity underscores the urgent need for more effective, better-tolerated therapies and early multidisciplinary management.

Viral respiratory tract infections, particularly Human Bocavirus (HBoV) infections, are a significant global health concern. COVID-19 has provided a suitable platform for infectious diseases caused by multiple pathogens. This review highlights key aspects of the current status and future prospects of HBoV research in the Kingdom of Saudi Arabia, including global and local prevalence, clinical impact, and diagnostic challenges. It also emphasizes the need for future research, particularly in Saudi Arabia, to fill knowledge gaps, improve diagnosis, and design and develop future treatment and prevention strategies. HBoV was identified from a ten-year-old infected patient in Sweden from collected nasopharyngeal samples in 2005. It has been classified into four genotypes (1-4), and HBoV-1 causes respiratory infections requiring hospitalization. Co-infections with other viruses are well known, with the most common symptoms being pneumonia, cough, fever, and wheezing. Most studies on HBoV diagnosis have relied primarily on polymerase chain reaction techniques. Even though pediatric HBoV infections are common worldwide, due to limited HBoV research, there is a lack of awareness among healthcare providers, especially in Saudi Arabia and the Middle East & North Africa region. Expanding research and awareness on HBoV is urgently required to address the burden of respiratory infections in these regions, not only to explore long-term effects, potential treatments, and vaccine development, but also to use advanced diagnostic methods to analyze the changing epidemiology of respiratory pathogens and achieve effective infection control measures.

High-dose intravenous vitamin C (HDIVC) has been investigated as a potential adjunctive therapy in critical illness, including sepsis, acute respiratory distress syndrome (ARDS), and COVID-19. Despite a strong mechanistic rationale, clinical trials have yielded inconsistent results. From a clinical pharmacology perspective, this variability may reflect, at least in part, differences in pharmacokinetic exposure, timing of administration, and patient selection rather than a lack of biological activity. Intravenous administration enables plasma concentrations in the millimolar range (≈1-5 mM), far exceeding those achievable with oral dosing (<100 µM), thereby reaching thresholds required for pharmacodynamic effects on oxidative stress, immune signaling, and endothelial function. This exposure-dependent transition distinguishes vitamin C as a pharmacological agent rather than a nutritional supplement in critically ill populations. Therapeutic response may be influenced by timing relative to disease progression, with earlier administration representing a biologically plausible strategy that warrants prospective evaluation rather than a clinically established therapeutic window. Interindividual variability in transporter function, redox status, and genetic background may further contribute to heterogeneous responses. Biomarkers such as interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer, and markers of endothelial injury provide a framework for patient stratification and monitoring of pharmacodynamic effects. Integrated with pharmacokinetic principles, these markers support a shift toward biomarker-guided, precision-based therapeutic strategies. This review synthesizes current clinical and mechanistic evidence through an exposure-response conceptual framework, framing HDIVC as a context-dependent pharmacological intervention and advancing a shift toward biomarker-guided, precision-based therapeutic strategies in critical illness.

Diagnosis of Pneumocystis jirovecii pneumonia (PCP) relies on lower respiratory tract sampling, often requiring bronchoscopy. Given its invasive nature, non-invasive diagnostic methods are desirable. In this retrospective case-control study, we evaluated the diagnostic performance of serum P. jirovecii PCR and β-D-glucan for PCP diagnosis. Adult patients with hematologic malignancies and positive P. jirovecii PCR in lower respiratory tract samples were included as cases and classified as PCP or colonization. Controls had negative BAL PCR. Stored serum samples were analyzed by P. jirovecii PCR and β-D-glucan. Forty-one cases (29 PCP, 12 colonization) and 36 controls were included. Serum P. jirovecii PCR was positive in 20/41 cases (49%) and in 15/29 patients with PCP (52%), while no controls were serum PCR-positive. For PCP diagnosis, serum PCR had a sensitivity of 52% and a specificity of 89%. For detection of P. jirovecii in the lower respiratory tract, sensitivity was 49% and specificity 100%. Detectable serum P. jirovecii DNA was associated with higher P. jirovecii load in respiratory tract samples and higher β-D-glucan levels, but not with the presence or severity of pneumonia. Serum P. jirovecii PCR is a highly specific marker of P. jirovecii in the lower respiratory tract and may serve as a useful initial non-invasive test in patients with suspected PCP, prior to invasive respiratory sampling.

Background: Bronchiectasis is a chronic respiratory condition characterised by irreversible airway dilation and recurrent infections, resulting in significant symptom burden and frequent healthcare utilisation. Although nurses are central to chronic respiratory disease management, their specific roles and responsibilities in outpatient bronchiectasis care remain poorly defined. Understanding these roles is imperative to support workforce planning, optimise multi-disciplinary collaboration, and improve patient outcomes. Aim: This scoping review aimed to map and synthesise existing evidence on the roles and responsibilities of nurses involved in the outpatient management of adults with non-cystic fibrosis bronchiectasis. Methods: A scoping review was conducted. Six databases were systematically searched (MEDLINE, CINAHL Complete, Central, Web of Science, and ProQuest Dissertations and Theses Citation Index). Records describing nursing roles, responsibilities, or models of care within outpatient bronchiectasis settings were included (any design). Data was analysed descriptively and thematically. Results: Five studies and two international clinical practice guidelines published between 2002 and 2025 were included. Nurses were shown to play roles across five key domains: 1. clinical assessment and monitoring, 2. self-management support and patient education, 3. care co-ordination and multi-disciplinary collaboration, 4. patient advocacy and communication, and 5. leadership and service development. Evidence on measurable outcomes and standardised role definitions remains limited. Conclusions: This review mapped five domains within which nurses may contribute to outpatient bronchiectasis care; however, most identified roles and responsibilities were derived from multi-disciplinary recommendations rather than explicit descriptions of nursing practice. Further research is required to better define nursing roles and responsibilities and evaluate nurse-led models of care in bronchiectasis outpatient care settings.

Severe treatment-resistant asthma (STRA) in children is often sustained by type 2 inflammation and eosinophil-dependent airway disease that persists despite optimized inhaled therapy and the mitigation of modifiable factors. This review summarizes the clinical and translational evidence on monoclonal antibodies targeting the interleukin-5 (IL-5) axis (anti-IL-5 and anti-IL-5Rα) available in pediatric severe asthma. PubMed/MEDLINE was searched up to January 2026 for English-language studies in patients aged 0-18 years addressing mepolizumab and benralizumab, including randomized trials, high-quality observational studies, meta-analyses, and international guidance. Mepolizumab has the most robust pediatric data, showing consistent reductions in exacerbations and blood eosinophils, and improvements in symptom control and quality of life, with safety broadly comparable to adults. The pediatric evidence for benralizumab is more limited but shows rapid eosinophil depletion, improved outcomes in selected children, and acceptable safety; further trials are ongoing. Overall, IL-5-directed biologics represent a key add-on option for carefully selected children with severe eosinophilic asthma, while pediatric-specific predictors of response, comparative effectiveness, and standardized long-term monitoring and stopping criteria remain priorities.

Paraquat (PQ) poisoning causes high mortality via acute lung injury (ALI) driven by excessive reactive oxygen species (ROS) in pulmonary microvascular endothelial cells. We developed BR@Lipo-CerTP, a lung-targeted nanotherapeutic using C16-ceramide-binding peptide-modified bilirubin liposomes, to enhance endothelial delivery and treat PQ-induced ALI.

BR@Lipo-CerTP was characterized for physicochemical properties and cellular uptake in pulmonary microvascular endothelial cells (PMVECs). In vitro efficacy was assessed via cytotoxicity, apoptosis, ROS, antioxidant capacity, and mitochondrial function assays in PQ-exposed PMVECs. Multi-omics analysis elucidated therapeutic mechanisms. In vivo efficacy and biosafety were evaluated in a PQ-induced ALI mouse model through survival, histopathology, edema, and toxicity assessments.

BR@Lipo-CerTP exhibited uniform ~120 nm spherical morphology, narrow size distribution, excellent stability, and enhanced PMVEC uptake versus non-targeted liposomes. In vitro, it significantly attenuated PQ-induced cytotoxicity, apoptosis, and ROS accumulation while restoring antioxidant capacity and mitochondrial function. Multi-omics revealed it disrupts a vicious cycle of glutathione depletion, ferroptosis, and NF-κB/NLRP3-driven inflammation, resetting pathological crosstalk between redox homeostasis, regulated cell death, and immune activation. In vivo, BR@Lipo-CerTP markedly improved survival, alleviated pulmonary damage and edema, suppressed oxidative stress and inflammation, with no systemic toxicity.

Pulmonary endothelial-targeted bilirubin delivery effectively mitigates PQ-induced ALI by coordinately regulating redox balance, cell death, and inflammation. This strategy offers a promising nanotherapeutic for PQ poisoning and other ROS-driven pulmonary diseases, highlighting targeted nanomedicine's potential in toxicological emergencies.

This study examined changes in anti-Spike (anti-S) antibodies (Abs) and type I interferon (IFN-I) following the BNT162b2 vaccine in people living with HIV (PLWH) and analyzed the impact of demographic and immunological factors. In total, 75 PLWH and 28 healthy donors were followed at baseline (T0), at the second dose (T1), after the second dose (T2), and more than 1 year later (T3). Anti-S Abs were assessed by chemiluminescence and vesicular stomatitis virus (VSV)-based pseudo virus-neutralization assay, while IFN-α2, IFN-β, and IFN-ω mRNA levels were measured by RT-Real Time PCR. PLWH showed an increase in anti-S Immunoglobulin G (IgG) levels comparable to healthy donors (p < 0.001) and an induction of anti-S neutralizing Abs (p < 0.014 for T2 vs. T3). Age, gender, CD4⁺ T cell count, exposure to combined antiretroviral therapy (cART) and IFN-I levels at T0 did not affect the anti-S IgG production. IFN-I gene expression showed temporal changes, with a decrease at T2 (p < 0.01) and a subsequent increase at T3 (p < 0.001, for IFN-α2 and IFN-ω). A multivariable model revealed no overall change in the IFN-I response over time, except for IFN-β, which was lower at T3 than at T1 (p = 0.032). CD4⁺ T cell count was positively correlated with the IFN-I response (p < 0.05). These results suggest that mRNA vaccination can elicit an effective anti-S response and modulate the IFN-β gene expression in PLWH, with CD4⁺ T cell count being a key determinant of vaccine-induced changes in IFN.

In total, 1 147 respiratory specimens were collected from severe acute respiratory infection (SARI) cases at three sentinel hospitals in Huangpu District, Shanghai Ctiy, between 2015 and 2024. Multiplex polymerase chain reaction (PCR) assays were performed to detect eight major respiratory viruses: influenza A virus (Flu A), influenza B virus (Flu B), human parainfluenza virus (HPIV), respiratory syncytial virus (RSV), human adenovirus (HAdV), enterovirus/human rhinovirus (EV/HRV), human coronavirus (HCoV), and human metapneumovirus (HMPV). The results showed that the overall positive rate of the eight respiratory viruses was 11.60% (133/1147). The viruses with the highest detection rates were EV/HRV (32/1147, 2.79%), HPIV (31/1147, 2.70%), and Flu A (29/1147, 2.53%). The overall positive rates in male and female cases were 10.63% (68/640) and 12.82% (65/507), respectively, with no statistically significant difference (P>0.05). The positive rate of HAdV in the 14-64-year age group was 1.44% (5/347), which was higher than that in the≥65-year age group (0.13%, 1/800), and the difference was statistically significant (P=0.011). A total of 12 cases (1.05%) with mixed detection were identified, all of which were dual-positive.