Prostate cancer progression is influenced by the tumor microenvironment. Bone marrow mesenchymal stem cells (BMSCs) can modulate tumor behavior, but the role of their lncRNA PVT1 is unclear.

To investigate whether lncRNA PVT1 in BMSCs regulates the malignant phenotype of prostate cancer cells through miR-122 and elucidate its mechanism of action in the tumor microenvironment.

Rat BMSCs were isolated and cultured and a Transwell co-culture system was established with human prostate cancer cell lines (PC-3). RT-qPCR was used to detect the expression of PVT1 and miR-122 in BMSCs and cancer cells. PVT1 was overexpressed and knocked down in BMSCs to observe its effects on cancer cell proliferation (CCK-8), apoptosis (flow cytometry) and cell cycle (PI staining) in the co-culture system. The targeting relationship between PVT1 and miR-122 was validated using a dual-luciferase reporter assay. Rescue experiments were performed by simultaneously manipulating PVT1 and miR-122 in BMSCs.

In prostate cancer patient tissues and cell lines, PVT1 expression was downregulated while miR-122 expression was upregulated. In the co-culture system, overexpression of PVT1 in BMSCs significantly inhibited cancer cell proliferation, arrested the cell cycle at the G0/G1 phase and promoted apoptosis. Conversely, knockdown of PVT1 in BMSCs promoted the malignant phenotype of cancer cells. Mechanistically, PVT1 directly targeted and negatively regulated miR-122. Overexpression of miR-122 reversed the inhibitory effect of PVT1 overexpression in BMSCs on cancer cells.

BMSCs exert a tumor-suppressive effect in the prostate cancer microenvironment through the PVT1/miR-122 axis, which may serve as a novel therapeutic target for prostate cancer.

Hepatocellular carcinoma (HCC) progression involves epithelial-mesenchymal transition (EMT) and glycolytic reprogramming induced by TGF-β1. The role of exosomal circular RNAs in coordinating these processes remains unclear. This study aims to investigate whether exosomal circ-ZNF652 is associated with TGF-β1-induced mesenchymal marker induction and glycolysis in HCC and elucidate the underlying mechanism. Exosomes were isolated from SMMC-7721 cells and characterized by TEM, NTA, and CD63 western blot. RT-qPCR measured circ-ZNF652 expression. Cell viability, migration, cycle, and apoptosis were assessed by MTT, wound healing, and flow cytometry. EMT and glycolysis proteins were detected by western blot. Glucose uptake, lactate, and HK/LDHA activities were measured. In vivo xenograft and rescue experiments with AKT/HIF-1α inhibitors were performed. TGF-β1 stimulation upregulated circ-ZNF652 in SMMC-7721 cells and their exosomes. Exosomal circ-ZNF652 was internalized by HCC cells and further enhanced TGF-β1-induced upregulation of EMT markers (Twist1, N-cadherin, vimentin, MMP-9). It also promoted cell proliferation, migration, S-phase entry, reduced apoptosis and Caspase-3 activity. Moreover, Exos circ-ZNF652 augmented TGF-β1-induced glycolysis as evidenced by increased glucose uptake, lactate secretion, HK/LDHA activities, and Glut-1/HIF-1α expression. In vivo, circ-ZNF652 overexpression significantly increased tumor volume (1286.5 vs 452.8 mm³) and weight (1.32 vs 0.48 g), along with elevated Ki-67, N-cadherin, HIF-1α, and p-AKT. Rescue experiments showed that AKT or HIF-1α inhibition reversed circ-ZNF652-mediated EMT and glycolysis. All differences were statistically significant (P<0.05). To sum up, exosomal circ-ZNF652 is associated with TGF-β1-induced mesenchymal phenotype acquisition and glycolysis via the AKT/HIF-1α pathway, promoting HCC progression. It represents a potential non-invasive biomarker and therapeutic target for HCC.

Cancer stem cells (CSCs) are a therapy-refractory subpopulation that drives tumor persistence, recurrence, and metastasis. A defining characteristic of CSCs is their ability to reversibly exit the cell cycle and enter a quiescent state, thereby escaping cytotoxic therapies that primarily target proliferating cells. Although numerous reviews have examined CSC dormancy and quiescence, less attention has been devoted to recently identified regulators and to the molecular events associated with the transition into quiescence. This narrative review consolidates current knowledge on CSC-specific entry regulators, including the pRb/RBL2-E2F1/4-GCN5 axis, Fbxw7-c-Myc pathway, PML-PPARδ-FAO axis, ID1/ID3-p21 network, JARID1B-mediated G₀-like states, CDH1-SIRT5-Cyclin F axis, and AP-1/ETS network, alongside emerging evidence on epigenetic regulation, circadian influences, and immune-mediated signals. We critically evaluate the exhaustion hypothesis, delineate a therapeutic framework that distinguishes between prevention of quiescence entry, elimination of dormant CSCs, and forced reactivation, and identify key knowledge gaps. By integrating recent advances within a structured perspective, this review provides a framework for understanding how CSCs exploit quiescence for survival and therapy resistance and informs strategies to target this resilient population.

Background Whether pulmonary sequelae persist 5 years after COVID-19 pneumonia remains unknown. Purpose To evaluate 5-year pulmonary abnormalities in survivors of COVID-19 pneumonia with use of longitudinal chest CT, inspiratory-expiratory quantitative CT, pulmonary function testing, and hyperpolarized xenon 129 (¹²⁹Xe) ventilation MRI and to compare findings with those in matched healthy controls. Materials and Methods This prospective longitudinal study performed a 5-year follow-up from September to December 2025, enrolling survivors of severe and nonsevere COVID-19 pneumonia along with age-, sex-, and body mass index-matched healthy controls. Survivors underwent serial chest CT during the acute phase and at 6-month, 1-year, 2-year, and 5-year follow-ups. At 5 years, participants underwent inspiratory-expiratory CT, pulmonary function testing, symptom assessment, and hyperpolarized ¹²⁹Xe ventilation MRI. Quantitative CT and ventilation parameters were compared among controls and both survivor groups with use of covariate-adjusted linear regression models, and associations of these parameters with pulmonary function and symptoms were determined with adjusted regression models. Results This study included 143 participants (mean age, 62 years ± 11.0 [SD]; 74 male; 83 survivors of severe COVID-19 pneumonia, 21 survivors of nonsevere COVID-19 pneumonia, and 39 healthy controls). After 5 years, residual lesions persisted in 35.6% of survivors (37 of 104), and abnormal diffusing capacity remained present in 25.5% (26 of 102). Prespecified comparison between 2- and 5-year follow-ups showed no evidence of change in respiratory symptoms (all P ≥ .88), pulmonary function (all P ≥ .67), or conventional CT abnormalities (all P ≥ .81) among survivors. At 5 years, ventilation defect percentage as well as parametric response mapping measures of functional small airway disease and emphysema differed among controls and both survivor groups (all P ≤ .01), with greater abnormalities generally observed in survivors of severe COVID-19 pneumonia (all P ≤ .005 vs controls). Conclusion Five years after COVID-19 pneumonia, some survivors showed persistent respiratory symptoms, abnormal diffusion capacity, and ventilation defects, with stable pulmonary function and no change in CT abnormalities between 2 and 5 years. Clinical trial registration no. ChiCTR2000038609 © RSNA, 2026 Supplemental material is available for this article.

The use of antibiotic therapy in confirmed viral respiratory tract infections is controversial, with discordance amongst guidelines.

We evaluated antibiotic usage in patients admitted with confirmed influenza A, respiratory syncytial virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, as well as factors associated with their initiation and duration.

This was a prospective observational cohort study of patients admitted to a tertiary centre with PCR-confirmed viral respiratory tract infection. Patient characteristics, antibiotic use, choice, route and duration, as well as patient outcomes were measured. Clinical and microbiological factors related to the admission were recorded. Multivariate regression analyses were used to identify factors associated with antibiotic initiation and duration.

There were 241 admissions with confirmed viral respiratory tract infections over the 2025/26 winter period. Antibiotic therapy was commenced in 208 (86%) cases, with a median 7 days of therapy given. Additional cultures were taken from 159, with positive bacterial cultures in 35 (35/159, 22%). A requirement for supplemental oxygen (OR 4.61, P = 0.02) and increased C-reactive protein at admission (OR 1.03, P < 0.001) were associated with increased likelihood to commence antibiotics, while ongoing supplemental oxygen requirement (β coefficient 0.41, P = 0.005) was associated with increased duration of antibiotic therapy. Antibiotic duration was not influenced by bacterial culture results.

We demonstrate high rates of antibiotic usage in patients admitted with confirmed viral respiratory tract infection, and identify opportunities for improved antimicrobial stewardship.

Submaximal exercise tests (SET) are used to assess respiratory health in various contexts. The diagnostic value of SETs for the assessment of asthma in the field remains uncertain.

A SET helps distinguish healthy horses and asthma phenotypes.

Twenty-six privately owned mixed-breed leisure horses of a clinical cohort. Horses were healthy (8) or diagnosed with mild (miEA) (4), moderate (modEA) (7), or severe asthma (sEA) (7) according to history, clinical examination, and bronchoalveolar lavage fluid (BALF) cytology.

Cross-sectional study using clinical data and samples from a hospital cohort. The SET included ECG, arterial blood gas, lactate, respiratory rate (RR), and heart rate (HR) analysis. Samples were taken at rest (time point (T) 0), and after defined intervals (twice 2 minutes trot (T1, T2) and gallop (T3, T4), followed by 3 minutes trot (T5) and gallop (T6)). HR and RR recovery were evaluated. Predictive values of variables towards diagnosis of asthma were estimated with ordinal models.

Arterial partial pressure of oxygen (pO2) at T0 had the strongest association with diagnosis (τ = -.513, LRT = 18.1, adj. P < .001). Hypoxemia at T6 was evident in all healthy and miEA horses. In contrast, some horses with modEA and sEA presented with increased pO2 at T6 compared to T0. Recovery lengths had no significant association with diagnosis (RR τ = .112, LRT = .805, adj. P = .493; HR τ = .174, LRT = 1.528, adj. P = .287) and demonstrated wide intra-group variation.

The SET did neither confirm diagnosis of asthma nor provide adequate results to assess respiratory health or disease in this cohort.

Large-scale quality improvement programmes (QIPs) have diverse factors that may influence their success and can undergo rapid changes throughout their lifecycle. The COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) programme has recently been implemented in primary care practices in the UK. The CONQUEST programme aims to identify patients with already diagnosed and undiagnosed COPD at high risk of COPD-related adverse outcomes and optimize their management. CONQUEST has been successful in identifying COPD patients who may represent an outsized opportunity to improve patient outcomes and healthcare utilization, whilst focusing on relatively few patients per primary care practice. This paper reviews the steps involved in implementing CONQUEST in the UK, focussing on the challenges encountered, the solutions used to overcome these challenges barriers, and the lessons learned for the implementation of QIPs more widely. Key lessons from this process include that QIPs need to be designed with the flexibility to adapt to multiple and different local contexts, that early monitoring of data across the lifecycle of a QIP allows efficient detection of issues and troubleshooting, and that planning for allocation of limited resources to a QIP is essential for real-world implementation. The problems and solutions described here are applicable to QIPs in a wide variety of high-risk diseases and different healthcare settings.

No national mental health survey was conducted in T&uuml;rkiye in the last 30 years. We implemented such a survey in a representative sample of 1.790 adults in the Turkish household population using the World Mental Health Initiative Composite International Diagnostic Interview for DSM-5 (CIDI-5). The current report presents data on 12-month and 30-day prevalence, persistence, severity and sociodemographic correlates of disorders in this Turkish World Mental Health (WMH) Survey.

Adults in a nationally representative sample of 4.067 Turkish households were selected for interview in October 2019. Fieldwork ended prematurely on March 17, 2020, due to COVID-19 pandemic travel restrictions. The 1.790 interviews completed as of that date represent a survey cooperation rate of 44.0% and a survey response rate of 25.6%.

The 12-month and 30-day prevalences of any DSM-5/CIDI disorder were 23.9% and 18.3%, respectively. Anxiety disorders (17.2%) were the most common class of disorders followed by mood disorders (12.4%). Most profiles were either severe (32.8%) or moderate (43.8%). Anxiety and mood disorders were more common among females than males, while externalizing disorders were more common among males than females. Overall disorder prevalence was associated with being female, younger age and low education.

Nearly 1 in 4 Turkish adults meet criteria for one or more common 12-month DSM-5 disorders. These results underscore the need for improved mental health services for vulnerable groups and for longitudinal research to understand the mental health effects of stressors such as the COVID-19 pandemic, forced migration, or the recent earthquakes.

The psychological impact of healthcare crises is undoubted. Anxiety has a strong impact on the perioperative patients&rsquo; well-being and their subsequent postoperative recovery. The aim of this survey was to assess preoperative anxiety and its accentuating factors in patients undergoing surgery during a healthcare crisis.

This study is a cross-sectional observational study. All adult patients undergoing elective surgery during December 2021 were assessed for eligibility. We excluded patients with any diagnosed psychiatric comorbidities. Anxiety was recorded using the modified Preoperative Anxiety Scale (mPAS), with permission by the authors [1]. mPAS consists of 4 sections: (i) demographics, (ii) baseline anxiety trait, (iii) anxiety due to general preoperative factors and (iv) anxiety due pandemic-specific factors. We summarized the results using descriptive and inferential statistics.

We included 116 patients, (60 males, 51.7% and mean age 60.6&plusmn;15.5 years) who underwent major (27,23.3%), moderate (49,42.3%), and minor (40,34.5%) surgical interventions. Six patients were excluded due psychiatric disorders. Based on American Society of Anaesthesiologists Physical Status (ASA-PS) they were mostly classified as ASA PS II (62,53.4%) and ASA PS III (29,25%). At baseline, of the 110 patients who completed the questionnaire, 30% (n=33) suffered from baseline anxiety according to mPAS. Severity of planned surgery (n=24, 21.8%) represented a major anxiety source, which was statistically significant for patients undergoing major surgery (p=0.026). However, pandemic-related factors were responsible of anxiety in 36 (32.7%) patients. The female gender and the ASA grade were significantly associated with the levels of COVID-19 anxiety.

During a healthcare crisis 30% of the patients experienced anxiety before surgery. The preoperative anxiety was further aggravated due to pandemic-related factors.

Healthcare professionals (HCPs) operate within environments of chronic occupational stress; a burden significantly amplified in Israel by the compounded pressures of the COVID-19 pandemic and active warfare. While resilience and positive affect (PA) are established protective factors, the nature of their interactive role in sustaining quality of life (QoL) during prolonged, extreme crises remains under-explored.

This study examines resilience, positive affect (PA), and quality of life (QoL) among healthcare professionals (HCPs), investigating whether PA moderates the relationship between resilience and QoL during a prolonged crisis.

A cross-sectional national online survey was conducted among 260 Israeli HCPs nationally. Participants completed validated instruments including the Brief Resilience Scale (BRS), the Positive and Negative Affect Schedule (PANAS), and the Multicultural Quality of Life Index (MQLI). Moderation analyses assessed the predictive effects of resilience and the moderating role of PA on QoL.

Both resilience and PA significantly predicted QoL. A small but significant interaction effect indicated that PA moderated the resilience-QoL relationship, with stronger benefits among HCPs with lower resilience. Specifically, resilience showed a stronger association with QoL among HCPs with lower levels of PA, whereas this association weakened at higher levels of PA.

Healthcare leaders and managers could optimize staff quality of life by implementing interventions that promote positive affect, such as peer-support systems and recognition initiatives, especially for staff with lower baseline resilience. At the policy level, institutions stand to benefit from adopting broader systemic strategies alongside individual-focused training to sustain a supportive emotional climate during prolonged crises. Furthermore, future research should utilize longitudinal designs to evaluate the long-term impact of these interventions on workforce retention.