Lung ischemia-reperfusion (I/R) injury is a common complication following lung transplantation and cardiac surgery. This study aimed to investigate the role and underlying mechanisms involving Neurogenic locus notch homologue protein 1 (Notch1) signalling and microRNA-485 (miR-485) of hypoxia-inducible factor 1-alpha (HIF1α) in protecting pulmonary microvascular endothelial cells (PMVECs) against I/R-induced injury. We found that overexpression of HIF1α significantly increased cell viability and decreased apoptosis in hypoxia/reoxygenation (H/R)-treated PMVECs, while knockdown or inhibition of HIF1α had the opposite effects. Moreover, HIF1α overexpression activated the Notch1 signalling pathway by upregulating Hes1 mRNA expression and Hes1 promoter activity. Conversely, HIF1α knockdown or inhibition inhibited Notch1 signalling. Furthermore, HIF1α overexpression alleviated H/R-induced mitophagy and mitochondrial dysfunction. On the other hand, HIF1α knockdown or inhibition aggravated mitophagy and mitochondrial dysfunction. We also found that HIF1α transcriptionally activated the expression of miR-485. Overexpression of miR-485 reversed the detrimental effects of HIF1α knockdown or inhibition on cell viability, apoptosis, Hes1 expression and mitophagy levels in H/R-treated PMVECs. Additionally, we identified NUMB endocytic adaptor protein (Numb) mRNA as a direct target of miR-485, and miR-485 overexpression suppressed Numb expression in PMVECs. In conclusion, these results suggest that targeting the HIF1α-miR-485-Numb axis may be a potential therapeutic strategy for attenuating lung I/R injury.

Inherited cardiac conditions (ICCs) are an umbrella group of genetic disorders affecting the heart. They are life-long conditions that are often diagnosed through family screening or after cardiac events. For many years, it has been customary practice to restrict physical activity (PA) in children to prevent ventricular arrhythmia or sudden cardiac death. This scoping review aims to identify and analyse the current literature on the impact that having a diagnosis of an ICC has on a young person's PA and quality of life (QoL). This scoping review follows the methods of Arksey and O'Malley. Studies concerned with QoL and PA published between 1957 and 2025 were included. Literature searches were conducted across the following databases: Medline (Ovid), Scopus, Web of Science, Embase (Ovid) CINAHL, and PsycINFO. The data was extracted and charted focussing on aims, study populations, measures, and results. Data was then summarised with a descriptive summary as well as visual mapping and descriptive statistics. The review was conducted using the Preferred Reporting Items for Scoping Reviews guidelines. From a total of 1358 identified articles, 27 articles were included in the final review. There were twenty quantitative articles, three mixed method, and four qualitative studies included. Reduced QoL and mental health issues were common in this cohort. Children with ICCs had lower reported and measured PA in comparison to healthy peers. Lower PA was associated with reduced QOL amongst patients with ICCs. Themes identified in qualitative studies included activity restriction, fear of cardiac events, a need for improved communication by healthcare professionals, re-orientation, and coping.

 Children and young people with ICCs appear to have poorer QoL and engage in less PA than healthy peers. Empowering them to safely engage in PA should be a priority for healthcare providers. Consistent outcome measure across future studies would improve wider applicability of the findings.

• Children and young people with inherited cardiac conditions are subject to physical activity restrictions. • Being affected by an inherited cardiac condition is associated with poorer heatlth related quality of life.

• Children and young people have lower reported and measured PA in comparison to healthy peers (in excess of that advised by restrictions). • Lower Physical Activity is associted with reduced Quality of life amongst young people with ICCS.

We report a case of a 56-year-old male with alcohol-associated liver cirrhosis presenting with septic and obstructive shock due to spontaneous bacterial peritonitis and pericarditis with tamponade. Imaging revealed ascites, pleural and pericardial effusion requiring drainage. Escherichia coli with identical resistance patterns was cultured from all drained fluids. Scintigraphy confirmed a peritoneal-pericardial connection. After initial treatment, fluid recurrences prompted evaluation for transjugular intrahepatic portosystemic shunt (TIPS) placement, which was unfortunately complicated by severe bleeding, ultimately leading to multi-organ failure and death. This case highlights the exceptional occurrence of pericardial effusion and spontaneous bacterial pericarditis as well as peritonitis as a complication of decompensated cirrhosis, with confirmed connection between the pericardium and the abdominal cavity by nuclear tracer study, as well as microbiological evidence. Based on an overview of all published cases management includes diuretics, paracentesis and in refractory cases, TIPS. Liver transplantation remains the definitive treatment.

Micro- and nanoplastics (MNPs) and the tire-derived transformation product 6-PPD-Quinone (6-PPD-Q) have emerged as pervasive environmental pollutants with critical implications for cardiopulmonary health and ecosystem integrity. This review identifies tire wear particles (TWPs) as a primary source of both airborne and waterborne MNPs, as well as 6-PPD, which readily oxidizes into the highly toxic 6-PPD-Q. These contaminants have been detected across diverse environmental compartments including air, soil, water, and remote ecosystems highlighting their global distribution and persistence. Human exposure occurs primarily through inhalation, ingestion, and dermal contact. Although mechanistic studies remain limited, available evidence indicates that MNPs and 6-PPD-Q induce oxidative stress, inflammation, mitochondrial dysfunction, apoptosis, and endothelial damage, particularly in pulmonary and cardiovascular tissues. Their detection in human tissues and excreta raises urgent public health concerns. Beyond human health, these toxicants adversely affect soil microbial communities, aquatic organisms, and crop productivity, underscoring their broader ecological footprint within a One Health framework. Regulatory oversight remains limited, especially for nanoplastics and tire-derived compounds, emphasizing the need for standardized detection methods and globally coordinated research and policy initiatives. This review underscores the urgency of implementing comprehensive mitigation strategies, including environmental monitoring, occupational safeguards, and public education, to address the growing threat posed by TWPs, MNPs, and 6-PPD-Q.

Energy drinks are stimulant-containing beverages, primarily formulated with caffeine and marketed to enhance mental and physical performance. Unlike coffee, tea, or caffeinated soft drinks, these products are specifically designed as functional stimulants.

This study aimed to assess university students' awareness of energy drinks and evaluate their consumption patterns, associated side effects, and reasons for use.

This cross-sectional observational study was conducted from April to August 2023 at three major universities in Kabul, Afghanistan: Kabul University of Medical Sciences, Kabul Education University, and Kabul University. We distributed 401 questionnaires to students across these institutions, achieving a response rate of 96.76% (n = 379 completed questionnaires). Thirteen students (3.24%) did not return their questionnaires. All collected data were entered and analyzed using SPSS software (version 21).

All participants were male, with ages ranging from 17 to 29 years (mean = 21.1 years; SD = 3.9). Energy drink consumption was reported by 89.97% of participants, of whom 41.34% were occasional users (less than one drink per week) and 56.59% were habitual consumers (3-4 drinks per week). Higher consumption (more than one can) was significantly associated with living alone (P = 0.000) and daily coffee intake (P = 0.005). The primary reasons for consumption included needing energy (33.66%, n = 169), enjoying the taste (24.90%, n = 125), and increased use during exams to improve alertness (12.35%, n = 62). There were no significant differences in energy drink consumption across academic years (P > 0.05). Most students recognized caffeine (86.8%) and sugar (89.97%) as key ingredients. Habitual consumers reported reducing sleep hours more frequently than occasional consumers (34.89% vs. 18.18%; P < 0.05) and were more likely to use it to aid studying/major projects (83.28% vs. 14.66%; P < 0.05). Adverse effects were reported by 67.44% (n = 230), primarily palpitations (44.54%) and insomnia (21.56%).

This study identifies frequent energy drink consumption among university students, driven primarily by the desire to boost energy, enjoy the taste, and enhance exam-time alertness. Over half of participants reported adverse effects, such as palpitations and insomnia. These results suggest a role for targeted educational programs to increase awareness of health risks. Further, policymakers may need to evaluate existing regulations on energy drink marketing and availability to address potential public health concerns.

Tuberculosis (TB) is the leading cause of death among people living with HIV. Global estimates among people living with HIV demonstrate that more incident cases and more deaths due to TB occur among women than men. Simultaneously, women experience higher levels of under and unpaid work compared to men. Given that poverty is an established determinant for TB, the aim of this study is to characterize the role of HIV-related employment discrimination and legal protections on TB outcomes for women living with HIV.

The People Living with HIV Stigma Index 2.0 study was implemented in 11 countries across sub-Saharan Africa, including Angola, Benin, Burkina Faso, Cote D'Ivoire, Ghana, Kenya, Mauritania, Nigeria, Lesotho, Togo and Zimbabwe. Study design and implementation were led by networks of people living with HIV in each country between 2020 and 2022. Interviewer-administered questionnaires were used to collect self-reported socio-behavioural measures among cisgender adult women living with HIV. Multilevel logistic regression models were used to estimate associations between economic instability and employment discrimination exposures and recent TB diagnoses in the context of varying discrimination protections for women living with HIV.

Among 10,718 participants, 7.5% (n = 807) reported a recent TB diagnosis. Among women in countries without non-discrimination protections, recent TB diagnosis was negatively associated with current employment (aOR: 0.72; 95% CI: 0.62, 0.85) compared to no employment; and positively associated with being refused employment or income due to HIV status (aOR: 1.80; 95% CI: 1.36, 2.39) and ever being refused promotion (aOR: 2.00; 95% CI: 1.37, 2.91) compared to those who have not reported these experiences. Among women in countries with non-discrimination protections, recent TB diagnosis was associated with lower current employment (aOR: 0.72; 95% CI: 0.56, 0.92) but not associated with employment discrimination.

The presence of social protections may modify the associations between employment discrimination and TB diagnosis. Employment discrimination was associated with TB diagnosis in settings without social protections but not in settings with those protections in place-highlighting a potential vulnerability among people living with HIV in settings without non-discrimination protections. Given the role of poverty in driving TB epidemics, social protections focused on employment, economic instability and opportunity may support TB prevention and control.

One in seven adolescents has a mental disorder, accounting for 15% of the disease burden in this group. Identifying factors that are associated with adolescent help-seeking is essential for designing effective and sustainable mental healthcare. Family dynamics-particularly parental roles-are key determinants; however, these associations may evolve as adolescents become more independent. The present study aimed to identify family predictors of adolescents' use of specialized mental health services and to examine potential age effects. We addressed these aims by analyzing four waves of biennially collected data (ages 12-18) from two birth cohorts in Trondheim, Norway (n = 822), utilizing clinical interviews and questionnaires, and accounting for potential confounders. The results of an autoregressive cross-lagged panel model revealed that, across ages 12-18, adolescents' use of specialized mental health services at one time point consistently predicted continued use two years later. However, family functioning, parents' perception of social support, and interparental conflict did not predict service use when controlling for multiple potential confounders (including prior service use, gender, parental occupation, cohabitation status, parental depression and anxiety, perceived need for help, indicators of adolescents' emotional and behavioral problems, impairment, and stressful life events). The present findings indicate no evidence of a prospective association between these family factors and adolescents' receipt of mental-health services. Future research should investigate which specific factors drive help-seeking and how these interact within different service systems to support more sustainable and equitable access to mental health care.

Experience-dependent modulation of the visual evoked potential (VEP) can be used as a non-invasive human correlate of invasive measurements of long-term potentiation (LTP)-type neuroplasticity in animal research. However, conventional electroencephalogram (EEG) recording is high burden and time consuming, hindering adoption. Further, reliability of participant-level VEP modulation measures, even in highly controlled conditions, has been disappointing. To increase the practicality and utility of the assessment we trialled a short (11-min) paradigm with wireless dry-EEG headset and applied multiscale frequency-domain analyses to extract more precise measures of neuroplasticity. This approach was tested in healthy participants in laboratory (n = 17) and Phase 1 clinical studies (n = 33). Typical session duration was < 30 min. Test-retest reliability of VEP waveforms were compared to literature on full-length paradigms with wet-EEG hardware. Group-level time-domain event-related potential (ERP) analyses showed post-modulation P1 amplitude increase in both groups (Cohen's d = 0.77, 0.78, respectively) and N1b amplitude decrease in clinical study group (Cohen's d = - 0.52). Timeseries-based test-retest reliability of the VEP modulation effect was low but was substantially improved to moderate levels (some intraclass correlation ≥ 0.5) with a wavelet-based analysis. This suggests that VEP modulation assessments could be employed across multiple sites to objectively measure experience-dependent plasticity in real-world clinical trials of central nervous system therapies.

Housing is a critical social determinant of health for migrant and refugee populations in high-income countries; however, the causal pathways linking housing affordability to health outcomes remain underexplored. This study aimed to examine the relationship between housing affordability stress and both mental and general health, and to assess the role of economic deprivation as a mediator of this relationship.

This study uses data from the five waves (2013-2018) of the Building a New Life in Australia study, which followed 2399 humanitarian migrants who arrived in Australia or were granted a permanent protection visa in 2013. Causal mediation analyses using marginal structural models were conducted to decompose the total effect of housing affordability stress on mental and general health into the natural direct effect and natural indirect effect mediated through economic deprivation.

The total effect of housing affordability stress on mental health was 1.56 (95% CI 1.26 to 1.92). Economic deprivation mediated 37% (95% CI 19.5% to 68.8%) of the total effect, and 79.6% (95% CI 60.3% to 113.9%) of the total effect could potentially be eliminated by intervening on economic deprivation. For self-rated general health, the total effect of housing affordability stress was 1.43 (95% CI 1.15 to 1.74). Economic deprivation accounted for 27.7% (95% CI 5.3% to 62.6%) of the total effect, and 65.9% (95% CI 29.9% to 101.9%) of the total effect could potentially be eliminated by intervening on economic deprivation.

The findings demonstrate that housing affordability stress leads to elevated psychological distress and poor self-rated general health among humanitarian migrants. A substantial portion of this impact occurs through economic deprivation, which could be attenuated by targeting economic deprivation as a key intervention point during early years of resettlement.

Opioid use disorder (OUD) remains a significant public health challenge, exacerbated by the rise of potent, synthetic opioids like fentanyl in the illicit drug supply. Buprenorphine, a partial opioid agonist, is an evidence-based treatment for OUD. While evidence suggests that higher buprenorphine doses (>16 mg/day) improve treatment retention and reduce overdose, many providers hesitate to prescribe these doses.

This study analyzed buprenorphine dosing patterns and treatment outcomes among Medicaid-insured individuals with OUD in Philadelphia from 2017 to 2023. Data were obtained from Community Behavioral Health (CBH), Philadelphia's Medicaid behavioral health managed care organization. The study included individuals with OUD who received buprenorphine through a prescription filled by a pharmacy, and are grouped into 3 dosage groups: ≤8 mg, 9-16 mg, and 17-24 mg. We examined demographic characteristics, co-occurring conditions, and outcomes such as emergency department visits and detoxification and rehabilitation stays across these dosage groups.

We identified 5760 individuals with OUD who were prescribed buprenorphine in 2023. The proportion of prescriptions for 17-24 mg doses increased from 12.05 % in 2017 to 40.51 % in 2023 (p < 0.0001). Higher doses were associated with improved treatment outcomes compared to those on lower doses: individuals on higher dosing levels were less likely to have detoxification and rehabilitation stays (39.16 % for 17-24 mg; 60.75 % for ≤8 mg and 49.93 % for 9-16 mg; (p < 0.0001) and were more likely to remain in care (90.2 vs. 205.3 days of buprenorphine supplied on <8 mg vs. >24 mg, respectively, (p < 0.0001). Black individuals were more likely to receive lower doses compared to white patients.

Higher buprenorphine doses are associated with better treatment outcomes, including reduced detoxification and rehabilitation stays. Racial disparities in dosing highlight the need for equitable access to evidence-based OUD treatment. Addressing provider hesitancy and systemic barriers to higher doses is crucial in improving outcomes, particularly in the context of fentanyl-contaminated drug supplies.