Survivorship care plans for patients with head and neck cancer (HNC) are becoming significant with increased survival after treatment. The sequelae related to HNC survivorship are multifaceted and require a comprehensive and multidisciplinary approach to address the needs of this population and improve quality of life. This includes a special attention to preventative oral and dental care not only through dental providers but also through patient education. Providers should collaborate to address other concerns including musculoskeletal issues, functional impairments affecting speech and hearing, and psychosocial impacts like chronic mental health disorders and substance use, suicide, caregiver burnout, and financial strain.

Oral cancer survivors are at an increased risk for developing physical impairments that can adversely affect physical function and quality of life due to the cancer location and treatment that includes surgery and chemoradiation therapy. Many of these impairments can present long after completion of treatment. Surveillance, screening, and treatment of these impairments require a multidisciplinary rehabilitative team that is an integral part of the care of this fragile population. This review article addresses the assessment and treatment of physical impairments commonly encountered during and after completion of oral cancer treatment.

Huatan Huoxue decoction (HTHXD) is effective in treating polycystic ovary syndrome (PCOS); however, its underlying mechanisms of action remain unclear. Gene targets were obtained through Mendelian randomization (MR) analysis using druggable genes from public databases and genome-wide association study data for PCOS from the FinnGen R12 database. These targets were integrated with the active ingredients and protein targets of HTHXD retrieved from the TCMSP and BATMAN-TCM databases for network pharmacology analysis. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were conducted. Core targets were validated using molecular docking. Experimental validation was performed using a letrozole-induced PCOS rat model treated with HTHXD, with key targets assessed via quantitative PCR (qPCR) and immunohistochemical staining. MR analysis identified 131 proteins causally related to PCOS, of which 52 with strong associations remained after quality control. Network pharmacology analysis revealed 549 gene targets and 243 active ingredients in HTHXD. The intersection of these datasets identified four core targets for HTHXD in PCOS treatment (CA2, CASP3, SNCA, and TSPO). Molecular docking identified tanshindiol B, 4-methylenemiltirone, and danshenol B in Danshen and crocetin in leech as key active components. HTHXD substantially ameliorated polycystic ovarian morphology and reduced corpora lutea in PCOS model rats. CA2 expression was significantly upregulated in PCOS ovarian tissue (P < 0.0001), and markedly reduced after HTHXD treatment, consistent with immunohistochemical findings. CA2 may serve as a potential candidate gene associated with the therapeutic response to HTHXD in PCOS, with tanshindiol B and crocetin as major active components.

Cystic fibrosis (CF) is a progressive, life-limiting condition affecting more than 160 000 people worldwide. Despite major therapeutic advances that have extended life expectancy, people living with CF continue to experience substantial physical, emotional and social symptom burdens that impair quality of life (QOL). Symptoms in CF often co-occur, indicating the presence of specific symptom clustering. Different clusters of co-occurring symptoms may reflect distinct underlying biological mechanisms influenced by social determinants of health. This study aims to identify clusters of co-occurring symptoms among adults with CF, characterise the biological pathways that may underlie these clusters and examine how social and structural factors influence symptom experiences and QOL.

This is a two-site, prospective mixed-methods cohort study enrolling approximately 140 adults with CF from two academic medical centres in the Southern United States. Participants will be followed for 12 months using validated patient-reported outcome measures to assess symptoms and QOL at baseline and at 3, 6, 9 and 12 months. Clinical data will be collected through chart review, and biospecimens (plasma and exhaled breath condensate) will be obtained at baseline, 6 months and 12 months for metabolomic analysis. Qualitative interviews and healthcare experience surveys will be conducted to explore how social, structural and clinical factors influence symptom burden and care experiences. Statistical analyses will use unsupervised machine learning methods to identify symptom clusters and metabolic endotypes as well as longitudinal regression models to examine associations between symptom patterns and QOL outcomes.

This study involves human participants and was approved by the Emory University Institutional Review Board (2025P011492). All participants will provide informed consent prior to enrolment. We will publish the results of this study in a peer-reviewed journal.

Tuberculosis (TB), particularly multidrug-resistant TB (MDR-TB), continues to pose a major public health challenge in India (1). Thoracic surgery plays an important adjunctive role in selected patients with complex pulmonary TB; however, access to trained thoracic surgeons remains limited. Under the guidance of the Central TB Division, the National Institute of Tuberculosis and Respiratory Diseases (NITRD), New Delhi, in collaboration with The Union, initiated a 3-month Residential Skill Training Programme in Thoracic Surgery in 2022. This short communication describes the experiences and perceived outcomes of surgeons who participated in the programme. A descriptive qualitative programme evaluation was conducted among nine surgeons from government institutions across India who completed the training across five batches. Data were collected using structured feedback forms and narrative interviews. Participants reported perceived improvement in thoracic surgical decision-making, perioperative management and operative confidence. Training exposure included video-assisted thoracoscopic surgery (VATS), decortication, lobectomy, pneumonectomy, pleural cavity window procedures, rib resection, and diagnostic thoracoscopy. Following training, several participants initiated or expanded thoracic surgical services at their institutions, with reported surgical volumes ranging from 1 to 12 procedures per month. Major challenges identified included inadequate infrastructure, shortage of trained supporting staff, and low referral rates because of limited awareness regarding surgical indications in TB management. The programme demonstrated potential for strengthening thoracic surgical capacity and improving access to surgical care for patients with complex TB in high-burden settings.

Tuberculosis (TB) remains a major public health challenge in India, which continues to account for the highest global TB burden. Findings from the National TB Prevalence Survey highlighted a substantial proportion of asymptomatic and subclinical TB cases, emphasizing the limitations of symptom-based screening approaches and the need for more sensitive and accessible screening strategies. Recent advances in ultra-portable chest X-ray systems and artificial intelligence (AI)-assisted chest radiograph interpretation tools have created new opportunities for decentralized and point-of-care TB screening. The objective of the paper is to provide a narrative review of currently available ultra-portable handheld chest X-ray systems and AI-assisted chest radiograph interpretation tools for TB screening in India, with emphasis on their technical characteristics, operational feasibility, reported diagnostic performance, implementation readiness, and programmatic relevance. A narrative review and comparative technology assessment were conducted using information obtained from peer-reviewed literature, World Health Organization guidance documents, national programme reports, publicly available technical specifications, vendor documentation, product brochures, conference materials, and implementation reports. Technologies were reviewed using a structured comparative framework covering technical characteristics, diagnostic performance, operational feasibility, interoperability, regulatory considerations, and implementation feature relevant to decentralized TB screening. Ultra-portable chest X-ray systems demonstrated substantial variability in technical specifications, portability, detector compatibility, battery performance, and operational characteristics. Most systems were battery-operated and compatible with AI-assisted interpretation platforms, supporting their potential use in community-based and resource-constrained settings. AI-assisted chest radiograph interpretation tools demonstrated high reported sensitivity for TB screening, although specificity, validation status, and implementation maturity varied across platforms. Certain tools, including qXR and Genki, reported broader deployment, offline functionality, interoperability with health information systems, and compatibility with cloud- and edge-based workflows. However, publicly available evidence and independent validation data remained limited for several emerging technologies. Ultra-portable chest radiography combined with AI-assisted interpretation represents a promising approach for strengthening decentralized and point-of-care TB screening in high-burden settings. However, considerable heterogeneity exists across available technologies with respect to technical specifications, validation evidence, operational readiness, and implementation maturity. Further independent validation studies, standardized evaluation frameworks, implementation research, and cost-effectiveness analyses are required to guide large-scale integration into national TB screening programmes.

India bears one of the highest global burdens of tuberculosis (TB) and chronic respiratory diseases (CRDs), including chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, and post-tuberculosis lung disease (PTLD). Traditionally, TB and chronic respiratory diseases have been managed through vertical and fragmented healthcare programmes, leading to inefficiencies, delayed diagnosis, and poor continuity of care. Increasing evidence demonstrates strong epidemiological, biological, environmental, and socioeconomic intersections between TB and other lung diseases. Shared risk factors such as tobacco smoking, biomass fuel exposure, ambient air pollution, occupational hazards, poverty, malnutrition, and overcrowding amplify the burden of respiratory illness in India. Recent WHO policy frameworks advocate a transition from disease-specific programmes toward integrated, people-centred lung health services. This review examines the rationale, evidence, opportunities, and challenges for integrating TB and lung disease services in India. It discusses the role of primary healthcare strengthening, diagnostic integration, pulmonary rehabilitation, digital health innovations, workforce development, and multisectoral interventions. Lessons from the Practical Approach to Lung Health (PAL) and Indian pilot initiatives are also explored. An integrated TB-lung health strategy offers a pragmatic pathway to improve respiratory outcomes, optimize healthcare resources, strengthen health systems, and accelerate progress toward universal health coverage in India.

Community-wide systematic screening is increasingly recognized as an important strategy for accelerating tuberculosis (TB) case detection in high-burden settings. In 2025, a community-wide TB screening intervention using ultra-portable chest X-ray devices and artificial intelligence (AI)-assisted interpretation was implemented in urban slums of Delhi, India.

A concurrent mixed-methods evaluation was conducted in April 2026 across the urban slum clusters, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Quantitative data were obtained from a real-time programme management information system, an independent cluster household survey, and programme records. Qualitative data were collected through document review, field observations, and key informant interviews. Descriptive statistics and thematic analysis were used.

Between July 2025 and March 2026, 3566 screening camps were conducted and 168,568 individuals aged ≥15 years underwent chest X-ray screening. Among the 18,377 individuals with presumed TB, 16,866 (91.7%) completed molecular testing. A total of 877 bacteriologically confirmed TB cases were identified, yielding 520 cases per 100,000 individuals screened and a number needed to screen of 192. Household survey findings estimated screening coverage at 30.5% (95% CI: 24.3-36.8%). Key barriers to participation included low perceived need for screening among asymptomatic individuals and competing work responsibilities, while engagement of ASHAs and doorstep service delivery facilitated uptake. Equipment downtime was low, accounting for 3.5% of planned operational days.

Community-wide AI-assisted chest X-ray screening was feasible to implement at scale and achieved high completion across the diagnostic cascade. Strengthening community participation may enhance the public health impact of similar strategies in high-burden urban settings.

The Ni-kshay Mitra Initiative provides nutritional support to persons with tuberculosis. Since its launch under the Pradhan Mantri TB Mukt Bharat Abhiyaan in 2022, beneficiary-level awareness, utilization patterns, and operational challenges have been less explored. This study assessed the utilization patterns, beneficiary satisfaction, and challenges faced by vulnerable groups receiving crowdsourced nutritional support from a community-based organization in coastal Karnataka.

A cross-sectional implementation study was conducted among 50 persons with tuberculosis who received at least one food kit during monthly nutritional support under the Ni-kshay Mitra Initiative at this community-based organization from May 2025 to March 2026. Data regarding utilization patterns, satisfaction, self-perceived health benefits, and challenges in accessing the scheme were collected using a semi-structured questionnaire using Epicollect version 5.0 and analyzed using Jamovi version 3.6. Descriptive statistics, including mean and standard deviation, median and interquartile range, frequencies, and proportions, were used to summarize the data.

Among the 50 participants, 34 (68.0%) were men. Pulmonary tuberculosis was documented in 39 (78.0%), with 47 (94.0%) on treatment for drug-sensitive tuberculosis. The median duration between diagnosis and first food kit receipt was 31 days (IQR: 13.8-54 days). A total of 48 (96.0%) participants reported perceived health improvement, with 43 (86.0%) Persons with Tuberculosis self-reported increased energy after nutritional support. Satisfaction with the quantity and quality of the food kits was reported by 48 (96.0%) and 50 (100%) participants, respectively. The food kit lasted for at least 4 weeks among 18 (36.0%). Common challenges included 48 (96.0%) citing lack of scheme awareness and difficulty accessing services, 24 (48.0%) facing commuting challenges, and 30 (60.0%) perceiving TB-related stigma.

High satisfaction with food kit. quality and quantity was observed among patients with tuberculosis receiving crowdsourced nutritional support from a community-based organization. However, gaps persisted in awareness, timely access, transportation to the center, and perceived stigma among recipients. The findings of this study emphasize the need to strengthen early enrolment, decentralized access, and beneficiary-oriented communication within community-based nutritional support under the Ni-kshay Mitra Initiative.

The Union Territory (UT) of Lakshadweep, comprising approximately 70,000 inhabitants across ten inhabited islands in the Arabian Sea, faces logistical challenges that have historically impeded timely tuberculosis (TB) diagnosis and treatment. To accelerate progress towards TB elimination, repeated population-wide active TB screening and decentralized molecular diagnostic services were implemented between 2017 and 2024.

To describe changes in incident bacteriologically confirmed pulmonary TB notification rates following implementation of repeated population-wide active TB screening and decentralized molecular diagnostics in Lakshadweep.

Population-wide active TB screening campaigns were conducted across all inhabited islands in 2017, 2018, and annually from 2020 to 2024. Accredited Social Health Activists conducted door-to-door screening using a standardized four-symptom tool. Rapid molecular diagnostic facilities (NAAT) were established in six major islands in 2019 and expanded to the remaining inhabited islands by 2020. Chest radiography was offered to household contacts from 2020 and expanded to clinically vulnerable individuals from 2022. Trends in incident bacteriologically confirmed pulmonary TB notification rates were analyzed using routine programme data.

Population coverage ranged from 68% to 84% across seven screening rounds, resulting in approximately 362,600 screening encounters. A total of 9402 individuals were identified as having presumptive TB and underwent diagnostic evaluation. Active screening detected 43 incident bacteriologically confirmed pulmonary TB cases, representing 34.1% of all 126 incident bacteriologically confirmed pulmonary TB cases notified between 2017 and 2024. More than 90% of diagnosed individuals were initiated on treatment, and treatment success exceeded 90% annually. The incident bacteriologically confirmed pulmonary TB notification rate declined from 39.0 per 100,000 population in 2015 to 10.0 per 100,000 population in 2024, a 74% reduction.

Repeated population-wide active TB screening, supported by decentralized molecular diagnostics, was associated with a marked reduction in TB burden in Lakshadweep. Sustained high-coverage screening may accelerate progress toward TB elimination in settings with stable populations and well-defined geographic boundaries.