Search Results (11,997)

Background/Objectives: A sub-anesthetic dose of ketamine has shown promise in reducing craving, withdrawal symptoms, and use of drugs such as alcohol, cocaine, and opioids among individuals with substance use disorders. Ketamine’s therapeutic potential for tobacco use is unknown. Here, we investigated a single sub-anesthetic dose among adults with tobacco use disorder who were not interested in changing their smoking behavior. Methods: Utilizing a randomized, within-subject crossover, double-blinded, counter-balanced, midazolam-controlled design, participants (n = 18) received a 0.71 mg/kg infusion of ketamine and a 0.025 mg/kg infusion of midazolam (i.e., active placebo) at least two weeks apart. Participants were asked to abstain from smoking after the infusions until the post-infusion sessions, 1 day following infusion, where participants completed measures of smoking behavior, craving, and withdrawal symptoms. Participants continued to record their smoking behavior over the 7 days following infusion. Participants also completed a semi-structured qualitative interview regarding their experiences. Results: Compared to midazolam, ketamine infusion led to a non-significant reduction (p = 0.10, ƞ_p² = 0.153) in the number of cigarettes smoked during the requested abstinence period. Following this period, there were no significant differences in ad lib smoking. Ketamine showed no effect on craving or withdrawal symptoms. Participants reported more intense psychological experiences following ketamine infusion (p < 0.001, ƞ_p² = 0.830) and about half reported it felt easier to abstain from smoking after the ketamine infusion. Conclusions: While well tolerated, these findings suggest ketamine has little to no direct effect on quantitative measures of cigarette smoking, craving, or withdrawal. However, the qualitative measures suggest ketamine improves mood and reduces craving in some individuals for several days. Future studies should investigate whether ketamine can indirectly support smoking cessation among individuals with comorbid psychiatric indications for ketamine treatment. Full article

We co-modified layered double hydroxide (LDH) in water using phosphocreatine (PC) and dodecylphosphoric acid (DPA) to obtain a highly dispersible LDH. Embedding this LDH in epoxy enabled V-0 at 7 wt% and lowered HRR, THR and TSP, attributed to a dense char and PC-DPA synergy. SEM, WAXS, and TGA characterised the structure and thermal behaviour of the functionalised LDHs. These modified LDHs were then loaded into the epoxy resin (EP) to develop flame-retardant nanocomposites. Compared to unmodified LDH (NO₃-LDH) and PC-modified LDH (PC-LDH), PC-DPA-LDH showed superior dispersion and compatibility within the epoxy matrix. As a result, PC-DPA-LDH/EP achieved a UL-94 V-0 rating at only 7 wt% loading, while NO₃-LDH/EP had no rating, and PC-LDH/EP reached only V-2. Moreover, PC-DPA-LDH/EP demonstrated significant decreases in peak heat release rate (46.4%), total heat release (34.5%), and total smoke production (59.7%) compared with neat EP. These improvements were attributed to the synergistic flame-retardant effects of PC and DPA, as well as to the formation of a compact char layer that effectively insulated the underlying material and suppressed volatile emissions. This work highlights the potential of bio-based, aqueous-synthesised nanohybrids for high-efficiency, eco-friendly flame-retardant epoxy systems. Full article

Background: Asthma is one of the leading chronic inflammatory respiratory conditions affecting children under 5 years of age, especially those who reside in socio-economically disadvantaged and densely populated low- and middle-income communities. Methods: A cross-sectional analytical study was conducted to ascertain the prevalence of factors influencing asthma and wheeze among young children attending early childhood development centres in Alexandra Township. Data were collected using a self-administered modified International Study of Asthma and Allergies in Childhood questionnaire. The analysis was performed utilising STATA version 19. The study sample comprised 3265 young children and their parents or guardians. Results: The findings reveal that the prevalence of asthma and current wheeze was 17.52% and 35.56%, respectively, while the prevalence of a history of wheeze was 64.36%. In the multivariate analysis, a family history of asthma was identified as a risk factor for asthma (p < 0.001) and for current wheeze (p < 0.001) and historical wheeze (p < 0.001). Additionally, the use of pain medication and passing of public transport were seldom identified as risk factors for both asthma and wheeze. Furthermore, exposure to second-hand tobacco smoke (p = 0.025) was found to influence the occurrence of asthma. Conclusions: This study highlights the impact of individual, household, and environmental factors on asthma. The findings are critical for the implementation of preventive environmental health measures to address this issue, particularly in low- and middle-income countries with limited curative resources. Full article

Background: Implant-related mechanical failure remains a clinically relevant concern following posterior decompression and fusion in elderly patients with lumbar spinal stenosis (LSS). The relative contribution of host-related versus construct-related factors to failure risk requires further clarification. Methods: This retrospective single-center cohort study included 118 patients aged ≥65 years who underwent single-level hemilaminectomy with posterolateral fusion (PLF) for isolated L4–5 central LSS, with a minimum follow-up of 48 months (mean 51.0 ± 2.0 months). All procedures were performed using a standardized posterior technique with uniform 6.5-mm titanium rods and 6.5-mm pedicle screws. Mechanical failure was defined as revision surgery due to radiographically and clinically confirmed hardware-related complications in the absence of infection. Exploratory univariable analyses were conducted to evaluate associations between baseline variables and mechanical failure. Clinical outcomes were assessed using validated patient-reported outcome measures. The Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ), and Visual Analog Scale (VAS) for pain were recorded. Results: Overall revision rate was 13.6% (16/118), including 14 cases (11.9%) of implant-related mechanical failure and 2 cases (1.7%) of infection-related revision. Higher age (p = 0.005), higher body mass index (BMI) (p = 0.005), lower bone mineral density (BMD) (p < 0.001), active smoking (p < 0.001), and diabetes mellitus (DM) (p = 0.023) were significantly associated with mechanical failure. Functional outcomes (ODI, RMDQ, VAS) improved significantly at final follow-up (all p < 0.001). Conclusions: Mechanical failure following hemilaminectomy with PLF appears to be predominantly influenced by host-related factors rather than construct characteristics when a standardized surgical technique is applied. Bone quality and modifiable systemic risk factors may play a critical role in long-term construct durability. Full article

Background/Objectives: Early diagnosis of hypertension (HTN) is critical, but most screening models do not simultaneously distinguish phenotypes based on systolic or diastolic patterns. We developed and temporally validated a multinomial model to predict normotension and three phenotypes of undiagnosed hypertension in Peru. Methods: We used ENDES 2017–2019 for development (final analytic n = 62,091) and ENDES 2021–2024 for temporal validation (final analytic n = 77,372), excluding 2020 due to COVID-19 disruptions. We included adults aged ≥18 years without self-reported HTN. The outcome was classified as normotension, isolated diastolic hypertension (IDH), isolated systolic hypertension (ISH), or systolic–diastolic hypertension (SDH). Eight nonlaboratory predictors were used: age, BMI, sex, residential altitude, smoking, alcohol consumption, vegetable intake, and fruit intake. Results: The model achieved an AUC of 0.789 (95% CI: 0.783–0.795) in training and 0.776 (95% CI: 0.770–0.781) in temporal validation. The prevalence of undiagnosed hypertension was 11.6% in the training set and 12.6% in the validation set. At a prespecified cutoff of 0.1004, sensitivity and specificity were 79.0% and 63.2% in training and 78.7% and 60.9% in validation, respectively (NPV 95.8% and 95.2%). Decision curve and clinical impact analyses suggested a positive net benefit and plausible referral volumes across a range of thresholds. Conclusions: This model could help prioritize confirmatory blood pressure measurements in resource-limited settings. Full article

Background/Objectives: Preterm birth (PTB) is a major public health concern worldwide, which may lead to detrimental maternal and neonatal outcomes. Maternal nutritional status, gestational weight gain (GWG), and lifestyle factors are potentially modifiable determinants of adverse pregnancy outcomes. This study examined the association between PTB and maternal GWG and assessed whether maternal dietary habits and lifestyle factors were related to GWG in women delivering preterm versus at term. Methods: A retrospective case–control study was conducted at a tertiary center in Hungary (MANOR Study, 2019). The case group included n = 100 women with PTB, while n = 200 matched term deliveries served as controls (1:2 ratio). Data were collected using a self-administered questionnaire and medical records. Pre-pregnancy body mass index (BMI) was categorized using standard definitions, while GWG was classified as inadequate, recommended, or excessive according to the US 2009 Institute of Medicine guidelines. A 7-item dietary index score was calculated based on gestational dietary habits. Results: Pre-pregnancy BMI distribution did not considerably differ between groups (p > 0.05); over one-third of women in both groups were overweight or had obesity (38.7% vs. 36.7%). Previous PTB (p < 0.001) and gestational hypertension (GHT) (p = 0.003) were more common among current PTB cases, while smoking, alcohol consumption, and gestational diabetes mellitus (GDM) showed negligible differences (p > 0.05)—28.0% of cases, and 34.5% of controls were classified as having healthy dietary habits, based on the dietary index score calculated. Inadequate GWG was more prevalent among PTB cases (49.0% vs. 26.8%), whereas excessive GWG was less frequent among cases (21.9% vs. 38.4%). Being within the recommended GWG range and the manifestation of gestational hypertension were associated with lower (aOR: 0.39; 95% CI: 0.18–0.87; p = 0.020) and higher (aOR: 3.43; 95% CI: 1.44–8.19; p = 0.005) odds of PTB, respectively. Conclusions: Inadequate GWG was more common in PTB, while excessive GWG was more frequent in term pregnancies. Fast-food consumption was associated with excessive GWG among term births. Optimizing GWG and improving maternal diet quality should be included as key, cross-cutting interventions targeting the improvement of antenatal care. Full article

(1) Background: Polyphenols are believed to prevent the development of various diseases by counteracting inflammation and oxidative stress. However, polyphenols are difficult to quantify in foods and show substantial variability in intake and epidemiological evidence on their relationship with lung cancer remains limited. This study explored the association between dietary polyphenols and lung cancer in two prospective cohorts. (2) Methods: Data from the UK Biobank and the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study were used. The Phenol-Explorer^® database was used to assess the total and subtypes of dietary polyphenols. Lung cancer cases were identified using The International Classification of Diseases, 10th revision. Cox proportional hazards models were employed to estimate the association by hazard ratios (HRs) and 95% confidence intervals (CIs) among overall participants and in stratified analysis by smoking status and sex, which were further meta-analyzed. The associations of polyphenol compounds and food sources with lung cancer were also examined. (3) Results: A total of 177,971 and 57,971 participants from the UK Biobank and the JACC Study, respectively, were included. Wines and fruits were identified as the primary dietary sources of stilbenes. Dietary stilbenes were associated with a lower risk of lung cancer in fully adjusted models for both UK Biobank (HR: 0.849, 95% CI: 0.723–0.996) and JACC Study (HR: 0.803, 95% CI: 0.648–0.996), as well as in the meta-analysis (HR: 0.832, 95% CI: 0.732–0.946). (4) Conclusions: Considering pharmacokinetic properties and biological plausibility, our findings suggest that stilbenes may serve as markers of polyphenol-rich foods lowering lung cancer risk. Further biomarker-based and interventional studies are warranted to clarify causality and elucidate the underlying mechanisms. Full article

Background: Bushfire smoke exposure (BFSE) is associated with adverse pregnancy and neonatal outcomes; however, the specific impact of BFSE on pregnancies complicated by asthma is not well characterised. Methods: A retrospective cohort study analysed data from 22,166 pregnant women who gave birth in the Illawarra Shoalhaven region between January 2017 and December 2022. Women with asthma were identified by the ICD-10-AM code for asthma during hospital admission for birth. Exposure was defined using a fixed time-window assumption. Women were considered exposed to bushfire smoke if they experienced at least 4 weeks of their pregnancy between 25 October 2019 and 4 February 2020. Results: Prevalence of asthma in the total population was 8.31%. In the control cohort, outcomes for pregnant women with asthma were poorer than those without. Pregnant women with BFSE had increased odds of postpartum haemorrhage (OR 1.603; 95% CI 1.42–1.81), and decreased odds of gestational hypertension (OR 0.615; 95% CI 0.49–0.77), gestational diabetes mellitus (OR 0.703; 95% CI 0.63–0.79) and preterm birth (OR 0.813; 95% CI 0.67–0.98). Maternal asthma did not confound the relationship between BFSE and any of the primary study outcomes. Conclusions: This study emphasises the independent effects of asthma on pregnancy outcomes. The impact of BFSE on pregnant women with asthma remains unclear. Further research is needed to characterise the true effect of BFSE on pregnancies, uncomplicated and complicated by asthma. Full article

Background/Objective: Smoking is known to be associated with reflux-related mucosal damage and deleterious esophageal outcomes, yet no non-invasive imaging biomarkers of smoking-induced esophageal remodeling have been identified. We aimed to compare cervical esophageal ultrasound morphology between habitual smokers and non-smokers, in terms of esophageal wall thickness, number of sonographically discernable wall layers, and esophageal diameter, and investigate whether smoking is an independent predictor of these findings. Methods: In this cross-sectional study, 60 participants (30 smokers, 30 non-smokers) underwent high-resolution B-mode ultrasound of the cervical esophagus. Examinations were performed in transverse and longitudinal planes. Outcomes included esophageal wall thickness (mm), number of discernible wall layers, and esophageal diameters in transverse and longitudinal planes. Group comparisons used independent t-tests and chi-square tests. Multiple linear regression assessed independent associations with smoking status (adjusting for age and weight). Within smokers, Pearson correlation evaluated relationships between smoking duration and ultrasound outcomes; exploratory subgroup analyses compared smoking modalities. Results: Smokers were older and had higher weight and BMI than non-smokers. Compared with non-smokers, smokers had greater wall thickness (3.06 vs 2.61 mm), more discernible wall layers (5.03 vs 3.60), and larger transverse (11.68 vs 7.87 mm) and longitudinal (12.90 vs 8.26 mm) diameters (all p < 0.001). In regression analysis, smoking status independently predicted wall thickness (B = 0.411 mm, 95% CI 0.243–0.578; p < 0.001). Smoking duration showed significant correlations with the number of visible layers (r = 0.82; p < 0.001) and wall thickness (r = 0.42; p = 0.021). Conclusions: High-frequency ultrasound detected significant differences in cervical esophageal morphology between smokers and non-smokers. Smoking was independently associated with differences in the diameter, thickness, and number of visible layers of the cervical esophagus. Further studies with larger sample sizes, improved exposure assessment, and use of reference standards are needed. Full article

Objective: This study examined age- and sex-specific correlates of arterial stiffness, assessed by the cardio–ankle vascular index (CAVI), in apparently healthy Chinese adults using an anthropometric–metabolic–inflammatory framework, and descriptively compared subgroup association patterns across these domains. Methods: In this cross-sectional study, 525 apparently healthy Chinese adults aged 20–78 years were included. Regression models with age-by-indicator interaction terms were used to test whether the age–CAVI association varied across anthropometric, metabolic, and inflammatory indicators. Sex-adjusted analyses were applied to the overall sample, sex-stratified analyses were used to characterize sex-specific patterns, and the Benjamini–Hochberg false discovery rate correction was applied for multiple interaction tests. Results: CAVI increased progressively with age, with a steeper age–CAVI association after 50 years (p < 0.05). Notably, females showed a transient midlife elevation. Association patterns appeared to differ by sex. In the sex-stratified interaction analyses, anthropometric signals were more prominent in men, particularly for height (p < 0.01), whereas metabolic-related interaction signals were more evident in women, with triglycerides providing the clearest corresponding signal and low-density lipoprotein cholesterol (LDL-C) showing a weaker accompanying pattern; the C-reactive protein (CRP)-related contrast was not retained after additional adjustment for blood pressure and smoking. Conclusions: CAVI increased with age, with a steeper rise after midlife and a transient midlife elevation in women. The association patterns across anthropometric, metabolic, and inflammatory indicators appeared to differ by sex, with signals from the anthropometric domain appearing more evident in men and metabolic-related signals appearing more evident in women. These findings suggest that age- and sex-specific interpretation of CAVI may be informative in preventive health check-up settings. Full article

Levels of glyphosate and their metabolite AMPA were measured in urine of farmers and their spouses that lived in intensively farmed area in Morocco. The levels were used as proxies to determine the exposure of these target population to herbicides. Determinants of exposure to glyphosate were also assessed. Urine was collected from 104 farmers, 50 spouses and 50 people from the general adult population and information from sociodemographic characteristics and occupational exposure was collected from questionnaires administrated to farmers and spouses. The detection frequency was 67% for glyphosate and 62% for AMPA among farmers, and 56% for glyphosate and 48% for AMPA among spouses, with the mean concentration of 1.22 μg L⁻¹ and 0.85 μg L⁻¹ among farmers, and 0.58 μg L⁻¹ and 0.50 μg L⁻¹ among spouses, respectively. Nevertheless, mean values of glyphosate and AMPA for general population were below the reported quantification limits. Multiple regression analysis showed that smoking status, applying glyphosate in the last 7 days, and glove use are the most important contribution to urinary levels of glyphosate and AMPA among farmers, and proximity of home to spraying area, and herbicides drift enters house are the main predictors of urinary glyphosate and AMPA exposure among spouses. The GMs of estimated daily intake were 1.26 and 1.39 µg/kg BW/day for glyphosate and AMPA among farmers, and 0.56 and 0.96 µg/kg BW/day for glyphosate and AMPA among spouses, respectively. This study provides further evidence on factors associated with glyphosate and AMPA exposure, especially in developing countries. Full article

Explosive ordnance (EO), including AXO (abandoned explosive ordnance), IEDs (improvised explosives devices), and UXO (unexploded ordnance), are widely recognised for their blast and fragmentation hazards, but they also represent a persistent and under-addressed source of occupational chemical exposure for explosive ordnance disposal (EOD) personnel. EOD core activities liberate mixed metals and energetic chemicals, resulting in exposures that are multi-route (inhalation of dusts and fumes, dermal loading amplified by sweat and glove occlusion, and ingestion via hand-to-mouth transfer during eating, drinking, or smoking) and multi-temporal (repeated low-dose background plus task-driven spikes), as well as chemically complex. Clinically, this can present as syndromic overlap across acute and chronic domains, with symptoms that are easily misattributed to heat stress, dehydration, infection, or fatigue. Acute effects of concern include neurotoxic presentations (headache, dizziness, confusion, tremor, and seizure), respiratory and mucosal irritation following dust or fume events, gastrointestinal symptoms, and patterns suggestive of acute hepatic or renal stress, particularly when high-intensity tasks occur in hot environments that compound physiologic strain. Chronic outcomes relevant to repeatedly exposed EOD personnel include renal function decline, neurocognitive effects that can degrade operational decision making and safety, persistent haematologic abnormalities, and endocrine disruption signals, with long-latency risks requiring cautious interpretation given sparse longitudinal data and confounding co-exposures. This review synthesises the current evidence base through an EOD lens and translates it into pragmatic clinical and programmatic actions: task-based exposure characterisation; tiered biomonitoring and medical surveillance aligned to operational tempo; incident-triggered assessment pathways after high-residue events; and prevention strategies that work under field constraints, including contamination control zones, hygiene enforcement, glove and respiratory protection optimisation, tool and vehicle decontamination, and measures to prevent secondary transfer and take-home exposure. The central takeaway is practical: EOD programs can reduce morbidity and improve readiness by treating explosive ordnance as a chemical mixture exposure problem, adopting mixture-aware clinical triage, and embedding surveillance and controls that match how EOD work is actually performed. Full article

Background and Clinical Significance: Alpha-1 antitrypsin deficiency (AATD) is an autosomal codominant disorder caused by pathogenic variants in the SERPINA1 gene, resulting in reduced circulating alpha-1 antitrypsin (AAT) or production of dysfunctional protein. AAT is the principal inhibitor of neutrophil elastase, and its deficiency leads to unchecked proteolytic activity, progressive destruction of lung parenchyma, and increased susceptibility to infections. Severe deficiency, particularly in individuals homozygous for the Z allele (PI*ZZ), predisposes to early-onset panacinar emphysema, chronic airflow obstruction, and liver disease. Despite its clinical relevance, AATD remains markedly underdiagnosed and is frequently misclassified as smoking-related chronic obstructive pulmonary disease (COPD), delaying access to disease-modifying therapy, genetic counselling, and preventive strategies. Early recognition is therefore essential to improve outcomes. Case Presentation: We report the case of a 68-year-old ex-smoker with a long-standing diagnosis of “COPD” who presented with acute-on-chronic type 2 respiratory failure and community-acquired pneumonia. Spirometry revealed severe airflow obstruction, and high-resolution computed tomography demonstrated extensive basilar panlobular emphysema, raising suspicion for AATD. Serum AAT concentration was critically low at 26.8 mg·dL⁻¹, and isoelectric focusing confirmed a PI*ZZ phenotype. Next-generation sequencing identified homozygosity for the SERPINA1 c.1096G>A (Z) variant, with no additional pathogenic alleles. Cascade family screening revealed multiple heterozygous PI*MZ relatives. Before augmentation therapy could be initiated, the patient developed severe Legionella pneumophila pneumonia with secondary bacterial superinfection, progressing to refractory septic shock and death. Conclusions: This case illustrates how AATD can masquerade as smoking-related COPD for years, leading to missed opportunities for timely intervention. It underscores the importance of testing all adults with COPD or refractory asthma at least once, regardless of age or smoking history. Early diagnosis enables initiation of augmentation therapy, targeted vaccination, lifestyle modification, and genetic counselling, ultimately improving prognosis and reducing preventable morbidity and mortality. Full article

Preserved ratio impaired spirometry (PRISm) is increasingly recognized as a clinically important non-obstructive spirometric phenotype associated with excess all-cause, respiratory, and cardiovascular mortality. PRISm is variably defined across studies and should be distinguished from pre-COPD and restrictive spirometric pattern, particularly in LMIC settings where diagnostic context may differ. Although most evidence has been generated in high-income settings, PRISm may be especially relevant in low- and middle-income countries (LMICs), where the phenotype appears to arise within a markedly different exposure environment. Rather than reflecting predominantly the smoking–obesity–metabolic profile commonly described in wealthier populations, PRISm in LMICs may more often emerge from the cumulative effects of tuberculosis, household biomass smoke, ambient particulate air pollution, poverty-related undernutrition, impaired lung growth, and other adverse life-course exposures. These factors may contribute both to low-volume lung-function impairment and to increased cardiovascular risk through shared pathways of chronic low-grade inflammation, immune activation, oxidative stress, endothelial dysfunction, and metabolic dysregulation. In this context, PRISm may represent a measurable interface between environmental and infectious lung injury, social disadvantage, and systemic vascular vulnerability. The emerging literature further suggests that PRISm in LMICs may include distinct leaner, poverty-related, and infection-linked phenotypes that differ from the obesity-associated patterns more often described in high-income cohorts. This perspective has important clinical implications, as PRISm may identify individuals at elevated risk of cardiometabolic comorbidity, heart failure, stroke, and cardiovascular death who may otherwise remain unrecognized within current respiratory care pathways. Although direct causal evidence remains limited, the convergence of epidemiological, mechanistic, and clinical data supports the view that PRISm in LMICs should be considered a meaningful cardiopulmonary risk state rather than a benign spirometric abnormality. Further LMIC-focused longitudinal, mechanistic, and implementation research is needed to refine phenotyping, clarify causal pathways, and inform integrated prevention strategies. Full article

Background: Post-COVID-19 condition (PCC) affects many survivors, with evidence of sex-specific differences in prevalence and symptom profiles. However, few prediction studies have examined whether sex-stratified models improve prediction or generalize across sexes. This study aimed primarily to develop and compare sex-stratified machine learning models for PCC prediction using routinely available baseline variables, and secondarily to assess cross-sex generalizability and adversarial robustness. Methods: We analyzed a prospective longitudinal cohort of 1006 adults hospitalized with COVID-19 at Sechenov University Hospital Network (Moscow, Russia). Demographics, smoking status, and pre-existing comorbidities were extracted from medical records, and PCC status was assessed at 6-month follow-up. Machine learning models—including classical algorithms and graph-based neural networks—were trained separately for males and females. Cross-sex validation evaluated generalizability, variable importance aided interpretation, and adversarial perturbations assessed model robustness. Results: PCC prevalence was higher in females (53.9%) than males (39.1%). Overall predictive performance was modest across all models, with AUC values ranging approximately 0.50–0.61. Graph-based models achieved the highest discrimination, with the best AUC reaching approximately 0.61, while classical approaches provided limited predictive value. Cross-sex validation showed minor asymmetry: models trained on male data performed slightly better on female cases than vice versa. Adversarial testing revealed sensitivity of all models to input perturbations. Conclusions: Demographics and comorbidities alone provide insufficient information for reliable PCC prediction. Modest sex-specific differences in model generalizability suggest distinct, sex-associated PCC phenotypes, but richer multimodal data—including clinical biomarkers, wearable-derived measures, and patient-reported outcomes—will be required to develop clinically useful and equitable predictive models. Sex-stratified approaches should be considered in future post-viral syndrome prediction studies. Full article