Childhood overweight and obesity are prevalent in Chile and globally. Health care responses typically emphasise biomedical and risk-focused approaches, with limited attention to children's own perspectives.

This study explored how children clinically classified as overweight or obese understand health, growth and weight within health contexts.

Participants were recruited from primary care clinics in two municipalities in Santiago, Chile. Semi-structured online interviews were conducted with 18 children aged 10-12 years during COVID-19 restrictions, incorporating visual tools such as body silhouettes and body mapping to facilitate discussion. Data were analysed using reflexive thematic analysis.

Three major themes were identified: Translating Fatness: everyday words and the softening of body labels; Body shapes, shame, and the making of 'unhealthy' bodies; and Making Sense of Measurement: Receiving, Interpreting and Negotiating Medical Labels.

The study highlights that children actively interpret and negotiate weight-related messages, drawing on emotional, social, and cultural frames rather than biomedical ones. Clinical encounters can heighten body awareness and stigma. Clinical practice should prioritise non-stigmatising communication, value children's perspectives, and adopt approaches that support wellbeing during growth and identity development.

Pneumococcal disease, respiratory syncytial virus (RSV), influenza, and COVID-19 place a significant burden on France's population health, health system, and economy. Older adults and adults in clinical risk groups are recommended to receive vaccination against these illnesses, although RSV is not reimbursed.

A benefit-cost analysis was conducted to assess the societal return on investment from adult vaccination by estimating benefit-cost ratios (BCRs) and net benefits (NBs). Health outcomes were monetized using established methods. Program costs included all direct vaccination-related expenditures. Scenario and sensitivity analyses assessed alternative program specifications and tested the robustness of the model.

France's age-based respiratory immunization programs generate a BCR of €2.0 to €8.7 per €1 spent over the lifetime, depending on mortality risk reduction monetization. This corresponds to NBs of €9.7 to €72.6 billion. Introducing adult RSV vaccination with a similar uptake to that in the US could increase NBs by approximately 6%-7% compared to the status quo. Achieving aspirational coverage targets across all programs would increase NBs by 138%-175%.

France's adult respiratory vaccination programs generate positive socioeconomic returns. Including adult RSV vaccination and increasing vaccination uptake would further increase their societal benefits. Realizing these gains requires adequate public investment.

Chronic rhinosinusitis is the leading cause of olfactory dysfunction in adults. Although mechanical obstruction and type 2 inflammation remain important explanations for smell loss in chronic rhinosinusitis, emerging multi-omics studies suggest that disruption of the olfactory cleft microenvironment may also contribute to olfactory dysfunction. In this review, we propose the microbiota-metabolite-immune (MMI) axis as an integrative framework linking microbial dysbiosis, metabolite perturbation, and local immune remodeling in CRS-associated olfactory dysfunction. We systematically examine four interconnected domains. First, several studies have reported dysbiosis within the olfactory niche, including enrichment of Acinetobacter johnsonii in one CRS-OD cohort together with depletion of putative commensals. Second, altered metabolite profiles in CRS-OD have been associated with disturbed purine metabolism, uric acid accumulation, and reduced levels of the potentially protective metabolite indole-3-acetic acid. These changes may contribute to innate inflammatory signaling, including Toll-like receptor 4/nuclear factor kappa-light-chain-enhancer of activated B cells (TLR4/NF-κB)-related pathways. Third, Staphylococcus aureus superantigens may promote T helper 2 (Th2) polarization, alter regulatory T-cell function, disrupt tight junction integrity, and impair olfactory neurogenesis, thereby sustaining bidirectional immune-microbial crosstalk. Fourth, emerging microbiota-targeted therapeutics, including xylitol irrigation, probiotics, and Interleukin-4 receptor alpha (IL-4Rα) blockade, offer novel intervention strategies. Throughout this review, we distinguish olfactory cleft-specific evidence from broader sinonasal data and acknowledge the current predominance of association studies over causal validation. Taken together, the MMI axis provides a useful framework for understanding CRS-associated OD and for identifying testable therapeutic hypotheses.

This study aimed to evaluate the safety and immunogenicity of a novel diphtheria, tetanus, and pertussis (acellular, three components) combined vaccine, adsorbed (DTcP) vaccine compared to the existing co-purified DTaP vaccine in China. In this partially randomized, blinded, controlled Phase III trial, we assessed a DTcP vaccine against two controls: a licensed co-purified DTaP and a DTaP-IPV-Hib vaccine. A total of 1,140 infants (3 months old) received a 3-dose primary series at 3, 4, and 5 months. Both of DTcP and co-purified DTaP had lower incidences of overall adverse reactions than the DTaP-IPV-Hib vaccine (17.99%/18.08% vs. 21.96%). The DTcP vaccine demonstrated non-inferiority and superiority over the co-purified DTaP for anti-PT and anti-FHA immunogenicity. In addition, the DTcP achieved a 98.16% seroconversion rate for anti-FHA, versus only 14.29% for the co-purified DTaP. Besides, DTcP vaccine also induced high antibody level in GMC results. Specifically, the anti-PT GMC was 85.10 in the DTcP group versus 49.86 in the DTaP group (P < 0.001) and 74.25 in the DTaP-IPV-Hib (P = 0.001). For anti-FHA, the GMC was 108.28 in the DTcP group compared to only 10.69 in the DTaP group. In conclusion, DTcP vaccine induces a significantly more robust immune response to key pertussis antigens --compared to the co-purified DTaP, with a comparable safety profile. These data support the potential optimization of China's immunization strategy by transitioning from co-purified to component-based acellular pertussis vaccines to address waning immunity and the ongoing pertussis resurgence.

ClinicalTrial.gov, identifier NCT05951725.

To observe the effect of electroacupuncture (EA) on olfactory function and the olfactory mucosa toll-like receptor 4 (TLR4)/NOD-like receptor thermal protein domain associated protein 3 (NLRP3)/Caspase-1/gasdermin D (GSDMD) signaling pathway in rats with allergic rhinitis (AR) and olfactory dysfunction (OD), so as to explore the mechanism of EA in improving olfactory function.

The AR rat model was established using the ovalbumin sensitization method. Rats with OD were screened using the buried food pellet test (BFPT) and randomly divided into a model group and an EA group, with 3 rats in each group. Three normal SD rats were taken as the control group. Rats of the EA group received EA at bilateral "Yingxiang" (LI20) for 10 min each time, once daily for 14 d. After EA intervention, nasal symptom scores were assessed in each group;BFPT was used to evaluate olfactory function;HE staining was used to observe the morphological changes of the olfactory mucosa;ELISA was used to detect serum contents of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-18;immunohistochemistry was used to detect the positive expressions of TLR4, NLRP3, GSDMD, phosphorylated nuclear factor-κB (p-NF-κB) p65, Caspase-1, and olfactory marker protein (OMP) in the olfactory mucosa.

In the model group , the olfactory mucosal epithelium exhibited thinning with a reduced number of cell layers, mucosal cell necrosis and exfoliation, structural disruption, disorganized arrangement, and significant inflammatory cell infiltration. Compared with the control group, nasal symptom score was increased (P<0.01), olfactory function was decreased (P<0.01), serum levels of TNF-α, IL-1β, and IL-18 and the expressions of TLR4, NLRP3, GSDMD, p-NF-κB p65, and Caspase-1 in the olfactory mucosa were increased (P<0.01), while OMP expression was decreased (P<0.01) in the model group. After EA intervention, the EA group showed increased thickness of the olfactory epithelium and number of cell layers, reduced necrosis and shedding of mucosal cells and structural damage, and no significant inflammatory cell infiltration. Compared with the model group, the EA group showed a reduction in nasal symptom score (P<0.05), improvement in olfactory function (P<0.01), decreased serum contents of TNF-α, IL-1β, and IL-18, as well as reduced expressions of TLR4, NLRP3, GSDMD, p-NF-κB p65, and Caspase-1 in the olfactory mucosa (P<0.05, P<0.01), along with increased expression of OMP (P<0.01).

EA may improve olfactory function in AR rats with OD by inhibiting the release of inflammatory factors and regulating pyroptosis mediated by the TLR4/NLRP3/Caspase-1/GSDMD pathway.

Primary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder typically inherited in an autosomal recessive pattern. Pseudo-dominant inheritance is exceptionally uncommon and remains poorly characterized in PCD.

We conducted a clinical and genetic study of a non-consanguineous Chinese PCD pedigree with four affected individuals across two generations. Whole exome sequencing and Sanger sequencing were performed to identify pathogenic variants.

Two variants in DNAAF1, c.1930A>T (p.Arg644Ter) and c.1022_1023del (p.Gln341ArgfsTer10), were identified and shown to co-segregate with the disease in a pseudo-dominant pattern. The proband, her brother, and her two naturally conceived sons were all affected, with her parents and husband being unaffected carriers. Transmission electron microscopy revealed absence of both outer and inner dynein arms, and high-speed video analysis demonstrated immotile or severely reduced ciliary beating. Intrafamilial phenotypic variability was notable, including distinct laterality defects (situs inversus, heterotaxy, and situs solitus) and varying degrees of pulmonary involvement.

Our report provides the first description of pseudo-dominant inheritance in PCD and expands the knowledge of the disease by offering detailed clinical and ciliary phenotyping.

Influenza A viruses (IAVs) remain a persistent global threat because of rapid antigenic change, frequent genetic reassortment, and cross-species transmission. Swine act as key "mixing vessels," permitting co-infection with avian and human strains and accelerating viral diversification and zoonotic risk. Effective veterinary surveillance is therefore critical for detecting viral evolution within swine populations and for providing early warning at the animal-human interface. Taiwan, home to approximately 5.5 million pigs and 23.4 million people, offers a representative case for examining how swine influenza surveillance has evolved in response to these challenges. This review describes the development of veterinary surveillance strategies from fragmented, event-driven monitoring to a coordinated One Health governance framework incorporating routine whole-genome sequencing, targeted serological surveillance, and coordinated data exchange across sectors. Key historical milestones include mass vaccination and culling programs, the 2009 pandemic response and recent zoonotic detections of H1N2v in humans (2021-2023), collectively evidencing ongoing bidirectional viral exchange. Episodes of severe human seasonal influenza activity, including H3N2-associated outbreaks, further highlighted the importance of coordinated surveillance across human and animal health sectors. By focusing on surveillance practices applied to animals, this review highlights the practical value of integrating molecular epidemiology, veterinary field monitoring, artificial intelligence (AI)-enabled technologies and cross-sector communication under a One Health framework. The Taiwanese experience demonstrates how strengthened veterinary surveillance can improve the sensitivity for detecting reassortment events, enhance traceability of viral spread, and support timely risk assessment in intensive livestock systems. These lessons offer a practical, replicable pathway for other countries aiming to overcome swine influenza surveillance fragmentation and strengthen pandemic preparedness under a One Health framework.

To synthesize recent evidence on how environmental exposures influence stroke risk, with emphasis on air pollution, thermal stress, circadian and occupational disruption, built and social environments, and selected toxicants.

Long-term and episodic air pollution, especially fine particulate matter with aerodynamic diameter ≤ 2.5 μm (PM₂.₅) and wildfire smoke, remain most consistently associated with stroke risk. Extreme heat combined with heat-humidity metrics is emerging as an important acute stroke trigger. Noise, artificial light at night, shift work, and long working hours show smaller but plausible associations, while greener and more walkable environments may be modestly protective. Social and structural disadvantage clusters, multiple exposures and inequities play an integrated role in risk and prevention. Environmental determinants are increasingly relevant to stroke risk. The strongest current links are realted to pollution, heat, sleep, and work disruption, as well as environmental inequity. Future research should move beyond single-exposure models toward combined-exposure as well as intervention-focused approaches.

Fine particulate matter (PM2.5) is a modifiable risk factor for stroke, yet the long-term trajectory of PM2.5-attributable hemorrhagic stroke in China-and its standing among G20 nations-remains inadequately characterized. We quantified this burden (1990-2023), examined its drivers, and projected trends through 2050.

Using Global Burden of Disease 2023 data, we analyzed PM2.5-attributable hemorrhagic stroke deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). We evaluated temporal trends using estimated annual percentage changes (EAPCs), quantified demographic and epidemiological drivers via decomposition analysis, and projected future burden using Bayesian age-period-cohort models.

In 2023, China remained among the most heavily burdened G20 nations, with the burden disproportionately concentrated in older males. From 1990 to 2023, China's age-standardized death and YLL rates declined steeply (EAPCs: -3.93 and - 4.18), whereas the YLD rate declined more modestly (EAPC: -1.29). Decomposition revealed that substantial epidemiological improvements successfully offset the upward pressure driven by rapid population aging and growth. Projections to 2050 indicate that while mortality metrics will continue declining, the disability (YLD) trajectory remains highly uncertain.

Despite severe demographic headwinds, China achieved substantial reductions in PM2.5-attributable hemorrhagic stroke mortality. The divergence between the steep decline in age-standardized mortality and the more modest decline in the age-standardized disability burden is consistent with several non-mutually-exclusive hypotheses, including improved acute survival that increases the surviving pool of disabled patients, changes in case-mix and disability ascertainment, and slower progress in post-stroke rehabilitation; the ecological design of this study does not permit these mechanisms to be distinguished. Sustaining progress requires combining strict environmental PM2.5 control with strategically expanded post-stroke rehabilitation capacity.

This study evaluates whether indocyanine green (ICG) fluorescence during hypothermic oxygenated machine perfusion (HOPE) can predict early allograft dysfunction (EAD) after liver transplantation.

Seventeen donor livers underwent HOPE before transplantation. After one hour, ICG was administered via the portal line. Perfusate samples were collected every five minutes for 50 min; liver tissue and bile samples were obtained during perfusion and after reperfusion. Fluorescence intensity (FI) was quantified using standardized microplate analysis. Associations with donor characteristics and clinical outcomes were analyzed.

EAD occurred in 29.4% of recipients and primary non-function in 5.9%. Perfusate FI differed significantly between EAD and non-EAD grafts at 40 and 45 min (p = 0.006; p = 0.05). FI in post-reperfusion liver biopsies was higher in dysfunctional grafts (p = 0.01). Bile fluorescence showed no predictive value. ROC analysis demonstrated strong discrimination for perfusate samples at 40 and 45 min (AUC 0.875; 0.889) and for post-reperfusion tissue (AUC 0.886). Donor variables did not correlate with ICG kinetics.

In this exploratory pilot study, perfusate fluorescence measurements during HOPE were associated with EAD. These findings suggest that fluorescence- based assessment during machine perfusion may provide functional information on graft quality.