Women living in urban slums may face social, gender-related, and structural barriers that influence participation in community-based tuberculosis (TB) screening. Understanding these factors is important for designing gender-responsive active case finding (ACF) strategies in high-burden settings.

To explore the enablers and barriers influencing women's participation in community-wide systematic TB screening in urban slums of Delhi.

A qualitative exploratory study was conducted in selected urban slums of Delhi where community-wide TB screening interventions using ultra-portable chest X-ray units with computer-aided detection were being implemented. In-depth interviews were conducted among women who participated in screening, women who did not participate, and frontline workers including Accredited Social Health Activists (ASHAs) and Anganwadi Workers (AWWs). Interviews were conducted until thematic saturation was attained. Data were transcribed verbatim and analysed thematically using an inductive-deductive approach and interpreted using the Socio-Ecological Model.

Women perceived community-based TB screening as convenient, time-saving, and financially accessible. Proximity of screening camps, trusted community spaces, involvement of frontline workers, and collective participation emerged as key enablers for participation. Major barriers included low perceived need for screening among asymptomatic women, domestic responsibilities, mobility constraints, dependence on accompaniment, social visibility, and inflexible service timings. Women's participation was shaped by interactions between individual, interpersonal, community, and structural factors. Subtle forms of social observation and stigma surrounding TB-related follow-up were also evident within communities.

Community-based TB screening was perceived as accessible and acceptable when services aligned with women's social realities and daily routines. Gender-responsive approaches that prioritise flexible delivery, trusted community spaces, frontline worker engagement, and peer-supported participation may improve women's engagement with TB screening programmes.

Increased atopy prevalence has been reported in human immunodeficiency virus (HIV)-infected adults. Previous studies in our laboratory demonstrated that there was no increased prevalence of atopy in perinatally HIV-infected children compared with the general population. This has not been studied in uninfected children. This study investigates the prevalence of asthma and atopy (i.e., allergic rhinitis, atopic dermatitis, urticaria, general allergies) in perinatally HIV-exposed, uninfected compared with HIV-unexposed, uninfected children.

Retrospective chart review identified patients (F/M, 0 to 21 y/o) seen at an academic center between the years 2005-2025. Patients were either perinatally HIV-exposed but uninfected (N=62) or control group (N=60) (HIV-unexposed, uninfected). Using SAS v9.4.3, prevalence of asthma/atopy by HIV exposure was analyzed.

Prevalence of atopy was higher in perinatally HIV-exposed, uninfected versus HIV-unexposed, uninfected children (P=<0.0001). Asthma prevalence was higher in HIV-unexposed, uninfected children compared with controls (P=0.0198). Of asthmatic children, the prevalence of atopy was higher in HIV-exposed, uninfected children (P=0.0030) (Fisher's Exact test).

The increased prevalence of allergy and atopy in perinatally HIV-exposed, uninfected children may be linked to dysregulated inflammatory processes in association with intrauterine/perinatal HIV exposure.

To describe the distribution and day-to-day variability of EuroQol Visual Analogue Scale (EQ-VAS) values and to estimate a minimal important difference (MID) in adults with post-COVID-19 condition (PCC).

Secondary analysis of pooled EQ-VAS data from both arms of a 12-week randomised, placebo-controlled trial (PYCNOVID) of Pycnogenol (200 mg/day) versus placebo in adults with PCC.

Single centre study in Switzerland between June 2023 and July 2024.

Adults with PCC with at least one of the following symptoms: fatigue, post-exertional malaise, dyspnoea or brain fog.

EQ-VAS ratings over 7 consecutive days before baseline (randomisation) and at follow-up (after 12 weeks). Weekly mean EQ-VAS values and within-person SDs (wpSD) were calculated. The MID was estimated using distribution-based and anchor-based methods with prespecified correlation criteria, using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) instrument as the primary anchor, along with additional anchors.

Among 153 participants, baseline EQ-VAS values were low, with a median of 48.7 on a 0-100 scale. Day-to-day variability was considerable, with a median wpSD of 6.4. Distribution-based MID estimates ranged from 5.9 to 8.9 points. FACIT-Fatigue was the only anchor meeting the correlation threshold (ρ≥0.30), yielding an anchor-based MID of 8.96 points. Triangulation of these estimates supported a final MID estimate of 8 EQ-VAS points.

Adults with PCC reported markedly impaired and highly variable health status. Weekly aggregation of daily EQ-VAS ratings likely provides a more robust estimate than single-day assessments. A PCC-specific EQ-VAS MID of 8 points, derived from a chronic, fatigue-predominant PCC population, facilitates interpretation of meaningful change and improves outcome definition and sample size planning in future studies. Applicability to earlier-stage or non-fatigue-predominant PCC populations warrants further investigation.

NCT05890534.

Respiratory viral infections (RVIs) in allogeneic hematopoietic cell transplant (allo-HCT) recipients can cause airflow obstruction (AFO). Despite this risk, the impact of community-acquired RVI on PFTs in pediatric patients after allo-HCT remains unclear.

The study determines the role of RVI in the development of AFO post-transplant among survivors of allo-HCT.

This retrospective study analyzed St. Jude patients undergoing allo-HCT between 2003-2020. AFO was defined by z-scores and forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio expressed as lower limit of normal (LLN). Baseline parameters were obtained before allo-HCT, and Year 1 parameters within 425 days post allo-HCT. Spirometry measures were calculated using the global lung function Initiative (GLI) calculator. Bivariate and multivariate logistic regression identified risk factors for AFO following allo-HCT.

A total of 397 patients were included, with a median age of 12.7 years. RVI occurred in 13% of patients within the first 100 days after transplantation. AFO developed in 12% of patients. Among those with AFO, 68% had a baseline FEV1/FVC ratio above the LLN, and 11% had a history of lower respiratory tract infection (LRTI) (p < 0.05). The median time from transplant to RVI was shorter in patients with AFO (12 vs. 34 days). A baseline LLN value was a significant predictor of AFO. However, after adjusting for known covariates, RVI was not independently associated with AFO risk.

RVIs within 100 days of allo-HCT did not significantly affect AFO following transplant in pediatric patients.

Myocardial ischemia-reperfusion (MI/R)-induced lung injury is a major pulmonary complication after cardiac surgery. We aimed to verify this phenomenon in rats and to investigate whether electroacupuncture (EA) pretreatment at bilateral Feishu (BL13) and Zusanli (ST36) acupoints (once daily for 3 days) exerts protective effects. In an MI/R-induced lung injury model in SD rats, EA pretreatment significantly improved lung function and reduced pathological damage (p < 0.05 and p < 0.01, respectively). It also attenuated the pulmonary inflammatory response and decreased the expression of high mobility group box 1 (HMGB1) and receptor for advanced glycation end products (RAGE) (p < 0.05 or p < 0.01). Intratracheal administration of recombinant HMGB1 (rHMGB1) to upregulate lung HMGB1/RAGE signaling impaired the pulmonary protective effect of EA (p < 0.05, p < 0.01). Together, these findings demonstrate that EA pretreatment mitigates MI/R-induced lung injury by inhibiting HMGB1/RAGE signaling.

Pulmonary cells continuously experience mechanical forces, yet the rapid expansion of mechanotransduction research has fragmented the knowledge base and obscured how research priorities have shifted over time. We therefore mapped the intellectual structure and thematic evolution of pulmonary mechanoregulation using bibliometric analysis and latent Dirichlet allocation (LDA). A total of 1896 articles and reviews published during 2000-2025 were retrieved from the Web of Science Core Collection and analysed with CiteSpace and LDA. Annual output increased from fewer than 60 publications per year before 2012 to more than 160 in 2024. Citation, co-occurrence, clustering and burst analyses showed a transition from macroscopic injury paradigms, including cyclic stretch and alveolar overdistension, towards matrix stiffness. Yes-associated protein/transcriptional coactivator with PDZ-binding motif (YAP/TAZ) signalling, mechanosensitive ion channels and mechano-immunology. LDA resolved 15 latent topics; idiopathic pulmonary fibrosis and macrophage activation was the largest topic (254 documents), while temporal modelling showed increasing prominence of macrophage-centred fibrosis and viral-associated lung injury and declining emphasis on classical mechanical stretch. These findings define major knowledge gaps at the biomechanics-immunology interface and provide a quantitative roadmap for prioritizing biomimetic models, multi-omics integration and selective mechanotherapeutic strategies.

Palmoplantar pustulosis (PPP) is a rare, disabling inflammatory skin disease with substantial unmet need. Janus kinase inhibitors (JAKi) target inflammatory pathways implicated in PPP. High smoking prevalence and rare disease status mean that a randomised controlled trial (RCT) to evaluate the efficacy and safety of JAKi in PPP may be challenging.

To determine the feasibility of a future RCT of JAKi therapy in PPP and generate an exploratory estimate of treatment effect.

This open-label, assessor-blinded feasibility trial, conducted at a UK national specialist dermatology centre, enrolled adults (≥18 years) with moderate-to-severe PPP and treated them with upadacitinib 30 mg once daily for 8 weeks (15 mg for higher-risk individuals). Primary feasibility endpoints were recruitment (consent rate), adherence (≥80% of days covered), and acceptability ('completely acceptable'/'acceptable' on post-treatment 5-point Likert scale). Secondary outcomes included change from baseline in Palmoplantar Pustulosis-Psoriasis Area and Severity Index (PP-PASI) and safety. Study procedures were harmonised with a previous RCT in PPP, permitting comparison with historic placebo data. Analyses were descriptive with baseline-adjusted PP-PASI change estimated with a linear (Gaussian) mixed-effects model.

All prespecified feasibility criteria were met. Of 67 contacted individuals, 28 consented (41.8%), and 20 started treatment (71.4%; mean age 46.0 years; 85% female). Adherence ≥80% was achieved by 19/20 participants (95%), with a mean proportion of days covered of 95.7% (SD 9.7). 18/19 participants (94.7%) viewed treatment as acceptable. Mean PP-PASI decreased from 20.3 (SD 10.6) at baseline to 4.6 (SD 4.5) at week 8 with upadacitinib, versus 18.0 (SD 10.4) to 15.4 (SD 10.1) with historic placebo. Baseline-adjusted PP-PASI change at week 8 for upadacitinib relative to historic placebo was -12.3 (95% CI -15.8 to -8.9) in favour of upadacitinib. PP-PASI50 and PP-PASI75 responses with upadacitinib relative to historic placebo were 100% vs 16.1% and 65.0% vs 3.2%. The most common adverse events were headache, acne, and upper respiratory tract infections.

This study demonstrates that a definitive trial of JAK inhibition in PPP is feasible and identifies an encouraging exploratory efficacy signal. The findings support progression to a multicentre active-comparator randomised controlled trial.

Tuberculosis (TB) continues to be a major public health challenge in India, contributing significantly to mortality, morbidity, and long-term disability. Although TB is considered a curable disease, people with TB frequently experience substantial physical, psychological, social, and spiritual suffering throughout the disease trajectory. Drug-resistant tuberculosis (DR-TB), recurrent TB, HIV-associated TB, severe extrapulmonary disease, and post-tuberculosis lung disease (PTLD) are associated with particularly high symptom burden and impaired quality of life. Traditionally, palliative care has been associated with advanced cancer and end-of-life care; however, emerging evidence suggests that palliative care should be integrated early into TB care to relieve suffering, improve treatment adherence, and support people affected by TB and caregivers. Palliative care for people with TB has several distinctive considerations, including the need to integrate symptom relief and psychosocial support with ongoing disease-directed treatment and, where relevant, communicable-disease-control measures. India's National TB Elimination Programme (NTEP) already incorporates several patient-support mechanisms, including nutritional support, counselling, peer support, and community-based interventions. However, comprehensive palliative care services remain underdeveloped within TB care pathways. This review discusses the need for palliative care in tuberculosis, examines distinctive considerations in TB palliative care, assesses implementation challenges in India, and proposes feasible models for integration within the Indian healthcare system. The review advocates for a person-centred, multidisciplinary, and decentralized approach aligned with the WHO End TB Strategy and emerging national guidance documents.

Even after microbiological cure is achieved, a considerable proportion of patients treated for tuberculosis continue to experience lasting respiratory impairment - a condition now termed post-tuberculosis lung disease (PTLD). This randomized controlled trial (RCT) tested whether a structured pulmonary rehabilitation (PR) program, augmented with inspiratory muscle training (IMT), could improve exercise tolerance, inspiratory muscle strength, and health-related quality of life (HRQoL) in adults with confirmed PTLD, relative to standard care.

We enrolled 120 adults with microbiologically confirmed PTLD and spirometric evidence of ventilatory impairment (FEV1/FVC below 70%, or FVC below 80% predicted). Participants were randomly assigned in equal numbers to a 12-week supervised PR program that included IMT (n = 60), or to standard pharmacological management paired with a sham IMT device (n = 60). Three endpoints were designated co-primary: 6-min walk distance (6MWD), maximal inspiratory pressure (MIP), and total score on the St. George's Respiratory Questionnaire (SGRQ). Additional endpoints comprised FEV1, FVC, the modified Medical Research Council (mMRC) dyspnea scale, post-walk-test Borg dyspnea ratings, and the PRAISE self-efficacy index. Outcomes were captured at enrollment, 12 weeks, and 24 weeks.

By the 12-week mark, participants receiving rehabilitation had gained considerably more ground than controls on 6MWD (adjusted difference 87.4 m; 95% CI 74.2-100.6; p < 0.001), MIP (adjusted difference 18.6 cmH2O; 95% CI 15.1-22.1; p < 0.001), and SGRQ total score (adjusted difference -14.8; 95% CI -17.3 to -12.3; p < 0.001). These advantages held through the 24-week assessment. Spirometric values also diverged between arms (FEV1 +0.21 L; FVC +0.29 L), as did dyspnea ratings. The trial recorded no serious adverse events.

A 12-week, physiotherapy-led rehabilitation program incorporating IMT produced improvements in exercise capacity, inspiratory muscle function, and quality of life that were both statistically robust and clinically durable in a PTLD cohort. The findings support considering rehabilitation-based care as part of routine post-tuberculosis management in India.

For many years, the management of cystic fibrosis has had a personalised character. We have now entered an era of therapy based on a patient's specific genotype. Clinical trials have confirmed the efficacy and safety of cystic fibrosis transmembrane conductance regulator modulator therapies, including ivacaftor as monotherapy and triple-drug combinations, such as elexacaftor/tezacaftor/ivacaftor and vanzacaftor/tezacaftor/deutivacaftor. These therapies result in substantial and sustained improvements in lung function, a reduction in the frequency of bronchopulmonary exacerbations, enhanced nutritional status, and an improved quality of life. These clinical outcomes have been correlated with a marked reduction of sweat chloride values.

Early initiation of therapy is crucial to halt disease progression or even reverse disease-related complications, which have even been observed in children aged six to twelve years. Initiating treatment in even younger children before the onset of clinical symptoms offers the possibility of a much later disease manifestation or even absence of symptoms. Nevertheless, careful evaluation of these therapies' long-term effects on the respiratory system and other organs remains necessary.

According to current knowledge, patients continue to require regular follow-up by a multidisciplinary care team and ongoing adjustment of both modulator and symptomatic therapies to meet individual needs.

As patient life expectancy continues to increase, comorbidities such as arterial hypertension, hypercholesterolaemia, cardiovascular disease, and malignancies will assume greater clinical importance. Selecting optimal therapeutic strategies remains a significant clinical challenge due to the numerous potential interactions between modulators and other medications.