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Disease Outbreaks Research Papers - 2026-01-18
18/01/2026
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West Nile virus (WNV) is among the most widespread arboviruses and has become a seasonal threat in temperate regions. Sustained in an enzootic bird-mosquito cycle, with humans and horses as incidental hosts, its geographic range has expanded in recent decades due to ongoing climatic and ecological changes. While most infections are asymptomatic or mild, a minority progress to neuroinvasive disease with high morbidity and long-term sequelae. This review summarizes current knowledge on epidemiology, pathogenesis, clinical spectrum, diagnostic challenges, therapeutic options, prevention, and research gaps.
Lineages 1 and 2 co-circulate in Europe, where repeated large outbreaks highlight WNV adaptability to warmer summers, altered rainfall, and expanded mosquito habitats driven by recent ecological shifts. After inoculation, replication occurs in keratinocytes and dendritic cells, amplification in lymph nodes, and dissemination to visceral organs and the central nervous system. Neuroinvasion depends on viral proteins and host immune responses. Severe disease is associated with advanced age, immunosuppression, comorbidities, and genetic susceptibility. Clinical manifestations range from febrile illness to meningitis, encephalitis, or acute flaccid myelitis. Persistent neurological and functional sequelae are common, adding to disease burden. Diagnosis relies on molecular and serological tests, limited by short viremia and cross-reactivity with other flaviviruses. No approved antiviral therapy exists; management is supportive. Experimental antivirals, monoclonal antibodies, and interferon have shown mixed results. Vaccine candidates have progressed to phase 1-2 trials, but none are licensed for humans. Prevention relies on integrated vector control, veterinary surveillance, and donor screening, framed within a One Health approach.
WNV exemplifies the impact of global ecological change on zoonotic diseases. Strengthening surveillance, refining diagnostics, and advancing antivirals and vaccines through multidisciplinary collaboration are essential to mitigate future outbreaks.
In recent years, Boston has attempted to increase housing options and reduce overdose risk through the implementation of harm reduction housing (HRH) sites. Despite numerous harm reduction resources available to HRH residents, drug checking services are absent. Studies suggest that drug checking may prevent negative experiences associated with unexpected adulterants. Drug checking offers a window into concerning supply shiftsand helps monitor disruptions in the supply due to environmental changes, such as encampment clearings. Few studies have explored drug checking's application in housing programs. The establishment of the Massachusetts Drug Supply Data Stream, a statewide community drug checking program, allowed us to pilot real-time drug checking at HRH sites.
From September 2023 to February 2024, we administered surveys to 106 HRH residents. From September 2023 to March 2025, we conducted longitudinal interviews (baseline, 3-month, 6-month) with a subset of 28 survey respondents. In response to drug supply shifts and resident demand, starting on May 20, 2024, we implemented real-time drug checking services at three HRH sites located in Boston. Residents were asked to provide approximately 5 mg of their remnant substance in order to receive immediate test results using FTIR spectroscopy and immunoassay test strips. Survey responses pertaining to drug checking provision and real-time, on-site drug checking sample results were analyzed using descriptive and bivariate statistics. Longitudinal interviews and field notes collected during real-time, on-site service provision were analyzed to further contextualize resident experiences.
Resident engagement with drug checking services was considerable, with fifty-five drug samples collected across nine site visits over three months. The services generated an increase in xylazine awareness among residents and provided chances to address concerns about the changing drug market amid heavy policing. Engagement with residents confirmed the need for on-site drug checking alongside other provided harm reduction services, and a consensus vocalized concerns with the local drug supply.
Real-time, on-site drug checking in low-barrier housing programs is a promising harm reduction approach for detecting shifts in the drug supply and can complement transitional housing interventions. Residents engage with these services with the intention of intervening upon personal, community, and market-level norms.
Kidney renal clear cell carcinoma (KIRC), as the major type of renal cell carcinoma, remains challenging due to its rapid malignant progression and poor prognosis. Adhesion-regulating molecule 1 (ADRM1) has been implicated in tumor development, yet its specific role in KIRC is poorly understood.
ADRM1 expression was analyzed using TCGA datasets and the CPTAC database. The differences in ADRM1 expression and its association with survival outcomes were investigated. The correlation of genetic alteration status with ADRM1 expression was studied. The effect of ADRM1 on immune infiltration was examined using R packages. Clinical samples were validated via qPCR and Western blot. In vitro functional assays assessed proliferation of KIRC cells. Transcriptional factors that regulated ADRM1 was confirmed by luciferase reporter gene assay. GSEA and experimental confirmation explored molecular pathways.
ADRM1 expression was significantly upregulated in KIRC, compared to normal tissues. The expression of ADRM1 was associated with high stages and poor prognosis of KIRC patients. The methylation level was positively associated with the expression of ADRM1 and indicated better survival outcomes. Overexpression of ADRM1 significantly promoted the proliferation of KIRC cells, while ADRM1 knockdown inhibited the proliferation of KIRC cells. ADRM1 expression was regulated by transcriptional factor CTCF. Moreover, ADRM1 promoted the proliferation of KIRC cells via ERK pathway. Immune analysis showed ADRM1 positively correlated with immune checkpoint genes (CTLA-4 and LAG3) and influenced Treg cells.
ADRM1 is transcriptionally regulated by CTCF and promotes KIRC proliferation through ERK pathway and has prognostic predictive value. It may become a novel therapeutic target for KIRC patients.
The association between vaccine efficacy (VE) and force of infection (FoI) remains incompletely understood. Previous analyses have been primarily based on trial-level summary data-not accounting for the effect of time and constrained by the number of trials. Here, we leverage individual-level data from three phase 3 randomized, placebo-controlled COVID-19 vaccine trials-the COVE trial (Moderna, CoVPN3001), the AZD1222 trial (AstraZeneca, CoVPN3002), and the ENSEMBLE trial (Janssen/Johnson & Johnson, CoVPN3003)-and contemporaneous geographic-location-specific SARS-CoV-2 surveillance data from the start of the pandemic through November 14, 2021 (including the blinded follow-up periods of the trials) to conduct five cohort- and vaccine-specific analyses: COVE (U.S.), AZD1222 overall (U.S. + non-U.S.), AZD1222 U.S., ENSEMBLE overall (U.S. + non-U.S.), and ENSEMBLE U.S. In AZD1222 U.S., higher VE was associated with higher FoI (p = 0.01). In ENSEMBLE overall, lower VE was marginally associated with higher FoI (p = 0.21), further supported by a region-specific analysis. In COVE, AZD1222 overall, and ENSEMBLE U.S., no VE-FoI association was found. These findings highlighted a new perspective: the VE-FoI association appears complex, potentially influenced by FoI levels, with patterns suggesting an inverted U-shaped relationship, showing a positive association at low FoI levels and a negative association at high levels.
Call for action to implement special interest groups regarding planetary health within pediatric research societies Pointing out the role and responsibility of pediatricians and pediatric researchers in times of climate crisis Raising awareness about research gaps, e.g., regarding mitigation strategies Focusing on the carbon footprint of conferences, hospitals and, laboratories Recommendations for sustainable medical and research practice.
Very early onset inflammatory bowel disease presents a rare condition with an enrichment of monogenic disorders. This cohort study aims to investigate the prevalence of IBD-like monogenic disorders as well as genotypic and phenotypic characteristics in an Iranian cohort of VEO-IBD patients.
Patients with VEO-IBD diagnosed between September 2019 and May 2023 were evaluated retrospectively. Clinical data were collected, and whole exome sequencing (WES) was performed on patients. Biological therapy was given to 10 patients (52%), and three underwent intestinal surgery.
Among the 19 patients, 7 (36%) had Crohn's disease, 3 (15%) had ulcerative colitis, and 9 (47%) had unclassified IBD. Monogenic disorders were identified in 8 patients (42%), including variants in IL10RB, DKC1, FERMT1, GUCY2C, NLRC4, and a susceptibility gene variant in the MEFV gene. We identified a novel heterozygous duplication on chromosome 6 by karyotype and SNP-array analysis but the relevance of the genetic findings remains elusive and further functional testing is required. Four patients were considered for HSCT, and the patient with the MEFV variant responded well to colchicine.
The study revealed that 42% of VEO-IBD patients had underlying monogenic disorders. Early identification of causative mutations is crucial for improving prognosis and treatment strategies.
VEO-IBD is a rare condition with a high prevalence of monogenic disorders. Early detection of causal mutations is crucial for improving prognosis and selecting optimal treatment strategies. In our cohort study, eight patients were found to have five known and three novel pathogenic variants in five different genes. We also identified a de novo duplication of the 6q22 region. Allogeneic HSCT provides a curative treatment for IL-10R-deficient patients, while colchicine treatment resulted in sustained remission in a patient with an MEFV mutation. Our study indicates that early genetic diagnosis of immune-related IBD-like monogenic disorders is essential for effective patient management.
Whilst COVID vaccines proved to be effective in preventing severe COVID disease, they failed to control the emergence of variant viruses and antibody responses waned quickly. We report the findings of a recombinant β-SARS-CoV-2 variant virus-like particle (VLP) vaccine composed of the viral spike (S), membrane (M) and envelope (E) proteins produced in Vero cell factories. The β-SARS-CoV-2 VLP vaccine formulated with Addavax or MF59 produced strong antibody and CD4 + T cell responses and was protective in mice against pulmonary infection with Beta, Delta and Omicron BA.5 variant viruses. Multiplex RBD-ACE2 binding inhibition assay was performed as a surrogate virus neutralisation test and revealed immune sera from immunised mice produced low-titre broad-inhibitory anti-RBD-ACE2 antibodies (sNAb) to Alpha, Delta, Beta, Gamma, Mu, Omicron BA.1, BA.2, BA.5 and XBB1.5. However, microneutralisation assays did not show the presence of sNAb. The β-SARS-CoV-2 VLP is strongly immunogenic producing broad antibody and T cell responses and is protective against infection with SARS-CoV-2 variant viruses.
Breast cancer remains the leading cause of cancer morbidity and mortality among women worldwide. Approximately 5-10% of cases involve pathogenic BRCA1/2 variants, typically associated with early-onset, aggressive disease. This study aimed to determine the frequency and spectrum of BRCA1/2 mutations among Kazakhstani breast cancer patients and to analyze their associations with clinicopathological features and survival outcomes. A total of 186 patients aged 21-90 years were examined between December 2023 and June 2024 using next-generation sequencing and retrospective chart review. The median age was 44 years for BRCA1, 48 for BRCA2, and 51 for BRCA-negative patients. Advanced disease (stages III-IV) was more common among mutation carriers (p < 0.001). Pathogenic BRCA1 and BRCA2 variants were found in 22% and 9% of cases, respectively; BRCA1 tumors were predominantly triple-negative (88%), whereas BRCA2 tumors were mainly hormone receptor-positive (65%). Both subtypes were largely poorly differentiated (61% and 53%, respectively). The median progression-free survival was 34, 12, and 8 months for BRCA-negative, BRCA1-, and BRCA2-positive groups, respectively (p = 0.001). To our knowledge, this is the first comprehensive analysis of BRCA1/2 mutation profiles among Kazakhstani women, highlighting distinct genotype-phenotype correlations and supporting the need for personalized therapeutic strategies in this population.
Smc5/6 is an essential genome maintenance complex that interacts with double-stranded (ds) DNA, single-stranded (ss) DNA, and ss-dsDNA junctions. DNA association underlies Smc5/6's functions in managing intermediates generated during genome replication and repair. However, the mechanisms of this activity are not fully understood. Here, we report a single-molecule study examining Smc5/6 association with a dsDNA substrate containing a ssDNA gap with defined 3' and 5' junctions. We found that Smc5/6 associates with both 3' and 5' junctions but prefers the 3' junction in the presence of the ssDNA-binding complex RPA. Further, Smc5/6's junction association frequency and dwell time are regulated by two non-SMC subcomplexes and DNA binding residues of Smc6. Moreover, Smc5/6 prefers binding to junction sites free of the sliding clamp PCNA over those occupied with it. These results suggest that Smc5/6 utilizes its multiple structural modules to associate with junction sites in coordination with other genome maintenance factors.
Brucellosis has long been a major public health concern in western pastoral areas. This study aimed to explore the spatiotemporal dynamic evolution of human brucellosis in northern Xinjiang and analyze the spatial heterogeneity of factors influencing its incidence in different counties and districts.
The JPR (Joinpoint regression model) and spatial autocorrelation analysis were employed to capture the potential spatiotemporal distribution changes of human brucellosis in northern Xinjiang from 2015 to 2023. Multiscale Geographically Weighted Regression (MGWR) was established to analyze the spatiotemporal correlation between the incidence of human brucellosis and relevant influencing factors.
The incidence of brucellosis in northern Xinjiang from 2015 to 2023 showed a trend of first decreasing and then increasing, with a turning point in 2020. The incidence decreased from 47.92 per 100,000 in 2015 to 14.20 per 100,000 in 2020, with an average annual decrease of 21.68%. Subsequently, it increased to 38.70 per 100,000 in 2023, with an average monthly increase of 39.97%. The results of the MGWR model indicated that a higher regional gross output value of animal husbandry was associated with a higher incidence of human brucellosis, which was more prominent in Hami City and Turpan City. Regions with longer sunshine hours had a higher incidence of brucellosis, especially in the Ili Kazakh Autonomous Prefecture and Bortala Mongolian Autonomous Prefecture. A higher beef production was related to a higher incidence of human brucellosis, which was more evident in Turpan City, Hami City, and the Bayingolin Mongolian Autonomous Prefecture. A higher average regional temperature was associated with a higher incidence of human brucellosis. An increase in GDP had a significant protective effect on the incidence of human brucellosis.
Human brucellosis remains a serious problem in northern Xinjiang, and its incidence has been on the rise in recent years. Meteorological and social factors influence the incidence of brucellosis spatially heterogeneously, with the direction and magnitude of their effects varying significantly across specific geographic locations in Northern Xinjiang. Consequently, we recommend a shift from uniform policies to zonal management, prioritizing interventions based on local dominant risk factors (e.g., sheep population control in Bayingolin, occupational protection in high-livestock-production areas) to optimize resource allocation and control effectiveness.
To identify predictors of decisional conflict among women with a BRCA pathogenic variant (PV) who were eligible for risk reducing salpingo-oophorectomy (RRSO) who had not made a decision to have surgery at least one year after receiving genetic test results.
Women with a BRCA1 or BRCA2 PV between the ages of 35 and 70 years old, who had not elected for RRSO at least 12 months after receipt of genetic test results, were administered self-report questionnaires investigating demographic variables, decisional conflict (Decisional Conflict Scale), cancer-related distress (Impact of Event Scale) and cancer risk perception. Decisional conflict scores were generated and a multivariable linear regression was conducted to identify variables associated with decisional conflict.
A sample of 107 women completed questionnaires. Overall, 44 participants (41%) had a high decisional conflict score (greater than 37.5) related to the RRSO decision. Higher education (β = 11.40, 95% C.I: 0.59, 22.20; p = 0.039), non-white race (β = 11.12, 95% C.I: 0.66, 21.57; p = 0.037), and having children (β = 22.89, 95% C.I: 10.07, 35.71; p < 0.001) were significantly associated with higher decisional conflict. Lower decisional conflict was significantly associated with genetic testing more than 3 years prior (β = -13.14, 95% C.I: -23.27, -2.99; p = 0.012).
Many women with a BRCA PV who have not elected for RRSO are experiencing high levels of decisional conflict related to the decision regarding RRSO. Interventions that target decisional conflict are needed to increase the uptake of RRSO which will result in a reduction of the risk of ovarian cancer in women with BRCA1 or BRCA2 PV.
The study examines whether tetrahydrocannabinol (THC) use alone affected sustainability of weekly take-home methadone medication among a small sample of 33 patients attending a single opioid treatment program, under special exception by state and federal governments during the Covid-19 pandemic. Kaplan Meier analyses of survival rates in months of eligibility for take-home methadone showed that the majority of patients with continuing THC use remained eligible for 10 months despite continued THC use. Majority were employed, insured, and housed stably, but Log Rank Tests on these predictor variables showed no statistical significance. The socioeconomic stability of the cohort may indicate THC use alone may be less important in restricting take-home methadone and warrants further research.
While previous research has primarily focused on nanoparticles larger than 20 nm for promoting migrasome formation, this study shifts the emphasis to nanoparticles smaller than 10 nm. Our findings reveal the significant impact of these sub-10 nm carbon-based quantum dots, specifically carbon quantum dots (CQD), graphene quantum dots (GQD), and graphitic oxide quantum dots (GOQDs), on migrasome formation, mitochondrial integrity, and platelet function. We establish a clear correlation between the application of these nanoparticles and the induction of migrasomes. Furthermore, our results indicate that CQD, GQD, and GOQDs enhance migrasome formation by upregulating phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2), cholesterol, and GTP-RhoA. Additionally, these nanoparticles provide mitochondrial protection through a process called mitocytosis and promote increased platelet aggregation. This study represents a pioneering effort to connect various types of nanoscale graphene materials with the dynamic behavior of migrasomes, thereby advancing our understanding of nanoscale materials and their biological implications.
The gut microbiota plays an important role in defending against infectious diseases. However, data on the clinical implications of the microbiome profiles in patients with candidemia remain limited. In this study, we investigated the association between the intestinal microbiome and mortality in patients with candidemia.
This prospective, observational, pilot cohort study enrolled adult patients with culture-confirmed candidemia. Fecal samples were collected within 5 days of diagnosis and analyzed using 16 S ribosomal RNA gene sequencing for microbiota profiling and gas chromatography-mass spectrometry for metabolomic analysis. Multivariate logistic regression was used to identify predictors of in-hospital mortality, defined as death during hospitalization.
Fifty-nine patients with candidemia were analyzed, and the in-hospital mortality rate was 40.7%. The median Shannon diversity index of the gut microbiota was significantly lower in non-survivors than that in survivors (P = 0.009). Linear discriminant analysis revealed 11 bacterial species that differed significantly between the two groups. Among the 111 fecal metabolites, only 3-isopropoxy-hexamethyl-tetrasiloxane differed significantly between the survivors and non-survivors (P = 0.007). Septic shock (adjusted odds ratio: 10.59; 95% confidence interval, 1.70-65.97), underlying malignancy (7.79 [1.41-43.10]), and Shannon diversity index (0.40 [0.19-0.84]) were significant predictors of in-hospital mortality.
Low gut bacterial diversity is independently associated with mortality in patients with candidemia. These preliminary findings warrant confirmation through larger, well-powered studies.
Alabama, like other states in the Deep South, lacks comprehensive testing for novel psychoactive substances (NPS) and adulterants like xylazine, leaving gaps in the detection of drug supply changes. From August 2024 to July 2025, we implemented an active testing approach at an emergency department (ED) in central Alabama among people with active illicit fentanyl use. Testing residual biological specimens collected as part of health care offers a potentially useful window into the prevalence of NPS in the drug supply, particularly in communities where traditional drug checking services might be impermissible or difficult to resource. In this study, we used liquid chromatography-quadrupole time of flight mass spectrometry (LC-QTOF-MS) to test the participants' residual biological specimens (blood, urine) coupled with a survey focused on demographics and drug use. We enrolled 37 participants who completed surveys, and 31 who completed LC-QTOF-MS testing. 84% of participants were white (n = 31), 51.4% were male (n = 19), 54.1% were homeless (n = 20), and 45.9% resided in rural areas (n = 17). In participants with comprehensive toxicology testing (n = 31, 83.8%), we detected xylazine in 25 (80.6%). We identified the first confirmed case of medetomidine exposure in the state of Alabama. We also identified a high proportion of samples with the NPS o-methylfentanyl (n = 9, 29.0%), the first published identification of this substance in the region to our knowledge. Among participants with toxicology testing, 59.3% (n = 16) had previously heard of xylazine and 41.9% (n = 13) had knowingly used it in the past. This pilot study demonstrated the feasibility and practical utility of ED-based residual biological specimen illicit drug surveillance. This approach has the potential to identify new emerging substances in the unregulated drug supply.
The Metabolic Score for Visceral Fat (METS-VF) is a novel index reflecting visceral adiposity and metabolic dysfunction, but its association with incident cardiovascular disease (CVD) in adults with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0-3 remains unclear. This study aimed to explore this association and quantify the mediating effect of estimated glucose disposal rate (eGDR).
Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), we prospectively followed 3,815 adults with CKM syndrome stages 0-3 (baseline 2015) until 2020. The METS-VF profiles comprised baseline METS-VF, cumulative METS-VF, and change patterns identified by latent class growth modeling (LCGM). To investigate associations and underlying mechanisms, Cox proportional-hazards regression, weighted quantile sum (WQS) regression, and mediation analysis were employed. Sensitivity analyses (stratification by CKM syndrome stage and demographics, inverse probability weighting [IPW], Fine-Gray model) were used to support the robustness of the results.
Over a mean 4.4-year follow-up, 18.7% of participants developed CVD. In the fully adjusted model, elevated METS-VF profiles were associated with an increased risk of CVD: baseline METS-VF in the fourth quartile (HR = 1.615, 95% confidence interval (CI): 1.243-2.097), cumulative METS-VF in the fourth quartile (HR = 1.824, 95% CI: 1.397-2.381), and stable high-level METS-VF (Class 3) (HR = 1.288, 95% CI: 1.033-1.610). All associations remained significant following false discovery rate (FDR) correction. Stratified analyses showed stronger associations between METS-VF profiles and incident CVD in late-stage (vs. early-stage) CKM syndrome, with the association more pronounced in males-females only had significant associations in the highest quartile. WQS regression identified Metabolic Score for Insulin Resistance (METS-IR) as the primary contributing factor, with weights of 0.397 in 2011 and 0.375 in 2015. Mediation analysis indicated that eGDR mediated 65.38% of the baseline and 56.72% of the cumulative effects (both P < 0.001). Supplementary mediation analysis using body mass index (BMI)-based METS-VFBMI produced consistent findings.
METS-VF profiles are independently associated with incident CVD in CKM syndrome stages 0-3, more strongly in late stages. eGDR significantly mediates this relationship, supporting the "obesity-metabolism-vascular" axis. METS-VF may aid CVD risk stratification in CKM syndrome populations, and targeting insulin sensitivity may mitigate CVD risk.
Missing values occur in almost all real-world medical data. Sometimes, more information is available for the missing values due to technical measurement limits. This was also the case for some sports medical data set where several laboratory measurements below a lower limit of quantification (LLOQ) were faced and supposed to be used in a multiple linear regression model. When studying the literature, the problem arises in several disciplines (environmental epidemiology, pharmacokinetic studies etc.) and different statistical methods are suggested. However, only very limited work on a method comparison is available, especially in the multivariable linear regression settting.
Therefore, we compare statistical methods for addressing values below a LLOQ in multiple linear regression modeling by a simulation study. We consider both the case that the variable below the LLOQ is among one of the independent variables and that it is the dependent variable in the regression model. We also vary different underlying assumptions, such as distributions, sample sizes, proportions of missing values, correlations, or linearity assumptions.
Overall, the two compartment model showed the best performance in terms of bias and coverage when the LLOQ occurred in the independent variable and no big collinearity issue was present. When the variable subject to the LLOQ is the dependent variable, tobit showed the lowest bias and highest coverage for censoring proportions up to 0.8.
When facing a data set with values below a lower limit of quantification and a multiple linear regression model is chosen as analysis model, a conscious choice for dealing with those left-censored data should be made. In this article, we provide guidance on the performance of different established methods.
To evaluate the clinical outcomes of vagal nerve stimulation (VNS) in children with drug refractory epilepsy (DRE) in a Sub-Saharan setting.
We retrospectively reviewed the data of 93 paediatric patients with DRE who underwent VNS insertion between January 2008 and December 2022. Patient demographics, aetiology of epilepsy and seizure data were analyzed. Seizure outcomes were measured using the Engel, McHugh, and Hague scores. Statistical analysis was performed using the Chi-square test, T-tests, and Spearman's correlation.
Of the 93 patients who underwent VNS implantation 60% achieved a seizure reduction of at least 50%. Demographic factors associated with improved seizure control included age at implantation (p < 0.001) and shorter duration from first reported seizure to implantation (p < 0.001). The mean time to response was 6.9 months. The McHugh scale showed a significant association between the length of follow up and VNS response. Adverse effects of VNS insertion were limited. Our outcome data and complication rates were in line with previous studies from the developed world. Challenges unique to our population included delay from diagnosis to referral; on average, there was a 5-year period from diagnosis of DRE to referral to our center. In addition to the large population and our extensive geographic referral pattern, we identified that a key factor in delayed referral to our center was due to a poor awareness, amongst both caregivers and referring clinicians of VNS as a treatment option for DRE.
VNS is a safe and effective adjunctive treatment for children with DRE in the Sub-Saharan population, with results comparable to centers in the developed world. In our cohort of patients, the McHugh scale appeared to be a more sensitive tool for assessing and tracking VNS response.
The detection of Japanese encephalitis virus (JEV) genotype V (GV) in humans in Korea in 2015 has raised concerns regarding its potential public health impact. Current JEV vaccines, based on genotype Ⅲ (GⅢ) strains, exhibit suboptimal neutralizing activity against JEV GV, thereby underscoring the need for genotype-specific vaccines. To address this, we developed the KNIH (GV) vaccine strain optimized for enhanced production efficiency. We evaluated its neutralizing activity and protective efficacy in a murine model. The currently available GⅢ-based vaccine (Beijing-1 strain) exhibited limited neutralizing efficacy against JEV GV. Conversely, the KNIH-based vaccine elicited strong neutralizing responses against JEV GV but exhibited reduced cross-neutralization against JEV GⅢ. In conclusion, the K15P38-KNIH strain represents a promising vaccine candidate for mitigating the risk associated with JEV GV reemergence. Future studies will focus on evaluating the efficacy of bivalent vaccination strategies against other circulating JEV genotypes in Korea.
Bronchopulmonary dysplasia (BPD) remains a significant complication in very preterm infants (< 32 weeks gestational age). Risk factors may differ between mild and moderate-to-severe BPD, but stratified analyses are limited.
To compare risk factors for mild versus moderate-to-severe BPD in very preterm infants (< 32 weeks gestational age).
This retrospective study analyzed data from very preterm infants (< 32 weeks gestational age) admitted to a tertiary neonatal intensive care unit between January 2017 and December 2024. BPD was classified as mild, moderate, or severe according to the 2001 NICHD/NHLBI criteria. Maternal, perinatal, and postnatal variables were compared between no-BPD, mild BPD, and moderate-to-severe BPD groups.
Among 486 very preterm infants (< 32 weeks gestational age), 213 (43.8%) had no BPD, 147 (30.2%) had mild BPD, and 126 (25.9%) had moderate-to-severe BPD. After multivariate analysis, lower gestational age (aOR 1.92, 95% CI 1.63-2.26), male sex (aOR 1.68, 95% CI 1.14-2.48), and prolonged mechanical ventilation (aOR 1.21, 95% CI 1.14-1.29) were risk factors for both mild and moderate-to-severe BPD. However, histological chorioamnionitis (aOR 2.35, 95% CI 1.54-3.59), pulmonary hypertension (aOR 3.12, 95% CI 1.87-5.21), and postnatal sepsis (aOR 2.15, 95% CI 1.43-3.24) were significantly associated only with moderate-to-severe BPD.
Risk factors for BPD in very preterm infants (< 32 weeks gestational age) differ by disease severity. Identifying severity-specific risk factors may help develop targeted prevention strategies and improve outcomes.
