An analytical, numerical and experimental study of in-vitro SARS-CoV-2 evolution in Vero B4 cells

We derive a numerical model representing the emergence and evolution of SARS-CoV-2 variants, informed by data from in-vitro passaging experiments in Vero B4 cells. We compare our numerical simulation results against probabilistic derivations of the expected probability of and time until the fittest variant becomes fixed in the population. Contrary to literature surrounding DNA viruses and eukaryotes where probabilities of fitness extremes are often modelled by exponential decaying tail, we show that above wildtype fitness differences for SARS-CoV-2 are actually best modelled by a heavy-tailed Fréchet distribution. Furthermore, we find that SARS-CoV-2 variants evolve through an essentially deterministic process rather than a diffusional one, with the dynamics driven by the fitness difference between the top variants rather than by the sampling/dilution process. An interesting consequence of this setting is that the number of variant virions, rather than their proportion, is a better predictor of the probability of fixation for a given variant.

Preliminary analysis of the role of small hepatitis B surface proteins mutations in the pathogenesis of occult hepatitis B infection via the endoplasmic reticulum stress-induced UPR-ERAD pathway

A growing body of evidence has shown that hepatitis B surface antigen (HBsAg) mutations can influence the occurrence of occult hepatitis B infection (OBI), particularly amino acid substitutions in small hepatitis B surface proteins (SHBs). The mechanistic basis for these results, however, remains unclear. This study was designed to explore the potential impact and mechanisms of OBI-related SHBs mutations on serum HBsAg. Huh7 and HepG2 cells were transfected with plasmids encoding wild-type (WT) or OBI-related SHB mutation-containing sequences, after which a chemiluminescence approach was used to detect HBsAg levels in cell culture supernatants. Western blotting was further used to assess HBsAg and endoplasmic reticulum stress (ERS)-related protein levels in lysates prepared from these cells, while the localization of HBsAg within cells was assessed via immunofluorescent staining. Cells transfected with OBI-related SHB mutation-encoding plasmids exhibited lower supernatant HBsAg levels than cells transfected with WT plasmids. Intracellular and extracellular HBsAg levels in these mutant plasmid-transfected cells were lower relative to those for WT plasmid-transfected cells, and HBsAg accumulation within the ER was detected via immunofluorescent staining in cells transfected with OBI-related SHB mutation-encoding plasmids, ERS-related protein content was also significantly increased in mutant plasmid-transfected cells as compared to those in the WT group. These results suggest that proteins harboring OBI-related mutations may tend to accumulate in the ER, thereby triggering an ERS response and impairing the transcription and translation of HBsAg via the activation of the unfolded protein response and ER-associated protein degradation pathway. These effects ultimately reduce the overall assembly of HBV virions in the ER and their associated secretion.

SARS-CoV-2 vaccination influence in the development of long-COVID clinical phenotypes

Although SARS-CoV-2 vaccination reduces hospitalization and mortality, its long-term impact on Long-COVID remains to be elucidated. The aim of the study was to evaluate the different development of Long-COVID clinical phenotypes according to the vaccination status of patients. Clinical and demographic characteristics were assessed for each patient, while Long-COVID symptoms were self-reported and later stratified into distinct clinical phenotypes. Vaccination was significantly associated with the avoidance of hospitalization, less invasive respiratory support, and less alterations of cardiopulmonary functions, as well as reduced lasting lung parenchymal damage. However, no association between vaccination status and the development of at least one Long-COVID symptom was found. Nevertheless, clinical phenotypes were differently associated with vaccination status, as neuropsychiatric were more frequent in unvaccinated patients and cardiorespiratory symptoms were reported mostly in vaccinated patients. Different progression of disease could be at play in the different development of specific Long-COVID clinical phenotypes, as shown by the different serological responses between unvaccinated and vaccinated patients. A higher anti-Spike (S) antibody titre was protective for vaccinated patients, while it was detrimental for unvaccinated patients. A better understanding of the mechanism underlying the development of Long-COVID symptoms might be reached by standardized methodologies and symptom classification.

Evaluation of Prenatal Transportation Stress on DNA Methylation (DNAm) and Gene Expression in the Hypothalamic-Pituitary-Adrenal (HPA) Axis Tissues of Mature Brahman Cows

Background/Objectives: The experience of prenatal stress results in various physiological disorders due to an alteration of an offspring's methylome and transcriptome. The objective of this study was to determine whether PNS affects DNA methylation (DNAm) and gene expression in the stress axis tissues of mature Brahman cows. Methods: Samples were collected from the paraventricular nucleus (PVN), anterior pituitary (PIT), and adrenal cortex (AC) of 5-year-old Brahman cows that were prenatally exposed to either transportation stress (PNS, n = 6) or were not transported (Control, n = 8). The isolated DNA and RNA samples were, respectively, used for methylation and RNA-Seq analyses. A gene ontology and KEGG pathway enrichment analysis of each data set within each sample tissue was conducted with the DAVID Functional Annotation Tool. Results: The DNAm analysis revealed 3, 64, and 99 hypomethylated and 2, 93, and 90 hypermethylated CpG sites (FDR < 0.15) within the PVN, PIT, and AC, respectively. The RNA-Seq analysis revealed 6, 25, and 5 differentially expressed genes (FDR < 0.15) in the PVN, PIT, and AC, respectively, that were up-regulated in the PNS group relative to the Control group, as well as 24 genes in the PIT that were down-regulated. Based on the enrichment analysis, several developmental and cellular processes, such as maintenance of the actin cytoskeleton, cell motility, signal transduction, neurodevelopment, and synaptic function, were potentially modulated. Conclusions: The methylome and transcriptome were altered in the stress axis tissues of mature cows that had been exposed to prenatal transportation stress. These findings are relevant to understanding how prenatal experiences may affect postnatal neurological functions.

Toscana virus: A comprehensive review of 1381 cases showing an emerging threat in the Mediterranean regions

BACKGROUND

Toscana virus (TOSV) is a sand fly-borne phlebovirus causing central nervous system (CNS) infection in Mediterranean countries, during summer season. However, clinical aspects of the disease caused by this virus are poorly known by clinicians, so that its prevalence is probably underestimated due to a lack of diagnosis.

STUDY DESIGN

The data was gathered from all available case series and retrospective studies identifying TOSV as the causative viral agent. The informations of age, sex, clinical characteristics, laboratory findings, imaging results and clinical outcomes of TOSV infection were recorded and analyzed.

RESULTS

A total of 95 articles including TOSV infections resulting in a total of 1381 cases, were analyzed. Our findings indicate that TOSV affects individuals across various age groups, with a median age of 44.45 years. A notable disparity in infection rates between genders, with men being significantly more likely to present symptoms due to TOSV than women, with a sex ratio of 2.0. The clinical presentation of TOSV infection encompasses a range of symptoms, including fever, headache, retro-orbital pain, neurological and muscular manifestations with less common reports of cutaneous and gastrointestinal symptoms. To date, six fatalities have been attributed to TOSV infections, with a median age of 76 years. Diagnostic evaluation of TOSV infections often involves the analysis of cerebrospinal fluid, where findings may include an elevated white blood cell count.

CONCLUSIONS

These findings underscore the diverse clinical manifestations of TOSV infections including flu like symtomps. TOSV is an emerging infectious threat that warrants inclusion in the diagnostic protocols for patients presenting with CNS, particularly within the Mediterranean basin or for those with recent travel history to endemic regions during warmer months when sand flies are actively circulating.

Psychosocial and mental health status among older adults in China during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. During the virus's spread and subsequent lockdowns, older adults faced heightened risks and significant mental health challenges.

METHODS

A cross-sectional study was conducted in Shandong Province, China, using a custom-designed demographic questionnaire, a COVID-19-related survey, and the Symptom Checklist-90 Revised (SCL-90-R). Correspondence analysis and multiple linear regression models were employed to examine factors influencing the mental health of older adults.

RESULTS

Among 3363 older adults, the total SCL-90-R score was 153.11 ± 36.98, with an average score of 1.70 ± 0.41. Both scores were lower than the Chinese norm and pre-pandemic levels. Factors significantly affecting older adults' mental health included place of residence, age, educational attainment, marital status, fear of COVID-19, understanding of COVID-19 transmission routes, and awareness of preventive measures.

CONCLUSIONS

Greater attention is needed to address the mental health of older adult males, individuals of advanced age, employed individuals, those with lower educational backgrounds, and those without a spouse. Policymakers should implement targeted policies and interventions to enhance mental health support for older adults.

Case fatality rate of zoonotic SARS.CoV2 and associated risk factors in the Libyan population

Background

Infectious zoonotic viral respiratory diseases have dramatically emerged and reemerged globally, with high socioeconomic and public health impacts. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak was first reported in China as a transmissible disease among animals and humans with great universal public concern. Later, it slipped across the world as a pandemic with a high significant case fatality rate (CFR).

Aim

This study was conducted to estimate the CFR and potentially associated risk factors among animals and the Libyan population.

Methods

This retrospective cohort study assessed the CFR of coronavirus disease 2019 (COVID-19) and investigated the potentially associated risk factors (socio-demographic data, animal reservoir, household characteristics, and health status) among the Libyan population from July 2020 to January 2021. A total of 3,000 respiratory specimens (nasopharyngeal swabs) were screened by real-time reverse transcription polymerase chain reaction to detect SARS-CoV-2. Descriptive analyses, frequency, and percentage were measured for numerical data and numbers, and rate for qualitative data. The level of the association among variables at the significance level (p < 0.05) was investigated using SPSS version 22.

Results

The present study reported a variable degree of association with the investigated risk factors included in this study: sociodemographic data, household characteristics, and health status. The overall CFR showed significant differences in vitamin D, Blood group system (ABO), health status, and comorbidity.

Conclusion

The CFR seems to have been underestimated; however, our result reported a relatively high CFR in Libya, at least in the surveyed region (targeted population). The risk factors measured in this study potentially significantly influenced the CFR. Among these potential risk factors were animal welfare, vitamin D levels, the ABO system, lymphocyte count (level), and healthy status. In contrast, the results showed that other risk factors were not significantly associated with the CFR. The results highlighted the potential risk of fatalities in the country. A large set of prospective studies is required to enhance our understanding of the CFR associated with zoonotic COVID-19 in Libya.

Trends in Neonatal Vaccination: A Ten-year Retrospective Study in a Large Delivery Center

BACKGROUND

Newborns are at increased risk of vaccine preventable morbidity and mortality. The American Academy of Pediatrics recommends administering the birth dose of the hepatitis B vaccine (HBV) between 0 and 30 days of life [based on birth weight (BW) < 2000 g vs. ≥ 2000 g], followed by several vaccines at 2 months of age (regardless of the BW) including the first dose of the pneumococcal vaccine (PCV). However, adherence to these guidelines is often suboptimal, resulting in incomplete or delayed vaccination.

METHODS

This is a 10-year retrospective, single-center observational study examining the rates and timeliness of HBV and PCV vaccination of infants admitted to the mother-baby unit and neonatal intensive care unit (NICU) from 2013 to 2023. Multinomial logistic regression was used to examine factors associated with vaccination status.

RESULTS

HBV vaccination of infants admitted to the neonatal intensive care unit (n = 4935) was significantly more likely to diverge from American Academy of Pediatrics recommendations versus HBV vaccination of infants admitted to the mother-baby unit (n = 49,857). Factors associated with higher relative risk of delayed HBV vaccination included administration in the pre-COVID prepandemic era, prematurity, BW ≥ 2000 g and Black/African American race, with the latter two also being associated with incomplete vaccination at discharge. For PCV, Hispanic patients were more likely to be discharged with incomplete vaccination compared with non-Hispanic patients.

CONCLUSIONS

Postpandemic, there were lower rates of delayed vaccinations, possibly reflecting increased vaccine awareness among parents and providers. Preterm status was a key factor influencing HBV vaccination timeliness. Perceptions and attitudes toward early-life vaccination, including potential racial biases, should be examined as potential contributors to differing vaccine administration practices.

Molecular characteristics and pathogenicity analysis of infectious laryngotracheitis virus isolated in China from 2015 to 2019

The aim of this study was to investigate the molecular characteristics and pathogenicity of recently isolated ILTV strains from China, thereby augmenting our understanding of its prevalence. The complete genome sequences of seven ILTV strains obtained from China between 2015 and 2019 were determined by high-throughput sequencing. Phylogenetic analysis showed that six isolates (SD2015, GD2017, SYB2018, HB201812, HB201806, and TJ2019) were classified together with CEO vaccine strains, while only one isolates LN2018 belonged to the wild-type cluster. Recombination analysis revealed compelling evidence of probable recombination events existing in SD2015, HB201806, and LN2018. Compared to TJ2019 and LN2018, chickens infected with HB201806 exhibited more severe conjunctivitis symptoms and tracheal damage, as well as higher viral load and viral shedding in the trachea. These findings will provide valuable references for further understanding the epidemiological status of ILTV and developing effective control measures.

Lessons learnt on infectious bronchitis virus lineage GI-23

Infectious bronchitis virus (IBV) is the first coronavirus discovered in the world in the early 1930s and despite decades of extensive immunoprophylaxis efforts, it remains a major health concern to poultry producers worldwide. Rapid evolution due to large poultry population sizes coupled with high mutation and recombination events and the reliance of the antiviral immune response on specific antibodies against the epitopes of the S1 glycoprotein, render the control of IBV extremely challenging. The numerous and rapidly evolving genetic and antigenic IBV types are currently classified based on the whole S1 gene sequence, into 36 lineages clustered in eight genotypes. Most lineages (29) are grouped in genotype I (GI). "Variant 2" (Israel/Variant 2/1998) is the prototype strain of lineage GI-23 and, since this lineage emerged during the mid-1990s in the Middle East, it has evolved into numerous genetically related strains and disseminated to five continents. The hallmarks of IBV Variant 2-like strain infections are high virulence and remarkable nephrotropism and nephropathogenicity; however, the molecular mechanisms of these traits remain to be elucidated. Limited protection from previously utilized vaccine strains and accumulated losses to poultry producers have urged the development and implementation of homologous Variant 2-like vaccine strains. The latest avian coronavirus biology with specific emphasis on the cumulative knowledge about IBV "Variant 2" and emergence of related strains, characteristics and control are reviewed.

Overexpression of Acetylation-Defective Heat Shock Protein 60 Inhibits the Proliferation of Nucleopolyhedrovirus in Bombyx mori

Heat shock protein 60 (Hsp60), abundantly presents in mitochondria, is a highly conserved chaperone that maintains the stability and functionality of mitochondrial proteins, while also participating in the regulation of various cellular processes. As a member of the heat shock family, Hsp60 significantly influences viral proliferation. However, limited research is available on its role in the proliferation of entomopathogenic baculoviruses, particularly Bombyx mori nucleopolyhedrovirus (BmNPV). Our previous proteomics results showed a significant decrease of Hsp60 acetylation levels after BmNPV infection. To investigate the impact of Hsp60 deacetylation on viral proliferation, site-direct mutagenesis was performed to generate a deacetylated (K/R) mimic of Hsp60. We found that the acetylation level of lysine 362 (K362) decreased after BmNPV challenge. Furthermore, overexpression of deacetylation-mimicking Hsp60 reduced the chaperone activity of Hsp60, leading to impaired mitochondrial function, including increased reactive oxygen species (ROS) levels, decreased mitochondrial membrane potential, and reduced substrate protein Manganese-containing superoxide dismutase (Mn-SOD) activities, ultimately leading to inhibition of viral proliferation. This study establishes lysine 362 acetylation of Hsp60 as a model for Posttranslational modifications induced by host-virus interactions, providing new insights into potential antiviral strategies.

In Vitro Inhibitory Effect of Berberine Against Rotavirus

Although berberine (BBR) is well known as an active constituent in traditional medicines used in the treatment of gastrointestinal diseases, its potential against viral gastroenteritis has not been specifically reported. This study aims to investigate the antiviral activity of BBR against rotavirus and evaluate its cytotoxicity and pharmacological efficacies, including antioxidant and anti-inflammatory activities in vitro. Using ultraviolet-visible absorption spectroscopy, the saturation concentration of BBR was determined as 2261 μg/mL, indicating that BBR is a poor water-soluble compound. The inhibition rate of nitric oxide (NO) production of BBR solution at a concentration of 283 μg/mL was similar to that of Cardamonin 0.3 μM with a cell viability of 92.46±0.35 %, revealing the anti-inflammatory activity of BBR. The cytotoxicity of the BBR solution depended on its concentration, whereby the 50 % cytotoxicity concentration (CC50) of BBR after 96 h exposure was 664 μg/mL. Investigation of cytopathic effects (CPEs) of MA104 cells treated with BBR and BBR-incubated rotavirus indicates that BBR could effectively inhibit the replication of rotavirus. CPEs were not observed in the cells inoculated with rotavirus (100TCID50) which was pre-incubated with BBR for 96 hours at a BBR concentration of 283 μg/mL. Therefore, the study provides reliable results to demonstrate the ability of BBR to inhibit the replication of rotavirus.

Targeting Cytokines: Evaluating the Potential of Mesenchymal Stem Cell Derived Extracellular Vesicles in the Management of COVID-19

The Coronavirus Disease 2019 (COVID-19), caused by virus SARS-CoV-2, is characterized by massive inflammation and immune system imbalance. Despite the implementation of vaccination protocols, the accessibility of treatment remains uneven. Furthermore, the persistent threat of new variants underscores the urgent need for expanded research into therapeutic options for SARS-CoV-2. Mesenchymal stem cells (MSCs) are known for their immunomodulatory potential through the release of molecules into the extracellular space, either as soluble elements or carried by extracellular vesicles (EVs). The aim of this study was to evaluate the anti-inflammatory potential of EVs obtained from human adipose tissue (ASC-EVs) against SARS-CoV-2 infection. ASC-EVs were purified by size-exclusion chromatography, and co-culture assays confirmed that ASC-EVs were internalized by human lung cells and could colocalize with SARS-CoV-2 into early and late endosomes. To determine the functionality of ASC-EVs, lung cells were infected with SARS-CoV-2 in the presence of increasing concentrations of ASC-EVs, and the release of cytokines, chemokines and viruses were measured. While SARS-CoV-2 replication was significantly reduced only at the highest concentrations tested, multiplex analysis highlighted that lower concentrations of ASC-EV sufficed to prevent the production of immune modulators. Importantly, ASC-EVs did not contain detectable inflammatory cytokines, nor did they trigger inflammatory mediators, nor affect cellular viability. In conclusion, this work suggests that ASC-EVs have the potential to attenuate inflammation by decreasing the production of pro-inflammatory cytokines in lung cells following SARS-CoV-2 infection.

Dissecting Henipavirus W proteins conformational and fibrillation properties: contribution of their N- and C-terminal constituent domains

The Nipah and Hendra viruses are severe human pathogens. In addition to the P protein, their P gene also encodes the V and W proteins that share with P their N-terminal intrinsically disordered domain (NTD) and possess distinct C-terminal domains (CTDs). The W protein is a key player in the evasion of the host innate immune response. We previously showed that the W proteins are intrinsically disordered and can form amyloid-like fibrils. However, structural information on W CTD (CTDW) and its potential contribution to the fibrillation process is lacking. In this study, we demonstrate that CTDWS are disordered and able to form dimers mediated by disulfide bridges. We also show that the NTD and the CTDW interact with each other and that this interaction triggers both a gain of secondary structure and a chain compaction within the NTD. Finally, despite the lack of intrinsic fibrillogenic properties, we show that the CTDW favors the formation of fibrils by the NTD both in cis and in trans. Altogether, the results herein presented shed light on the molecular mechanisms underlying Henipavirus pathogenesis and may thus contribute to the development of targeted therapies.

Navigating the complex landscape of waterborne disease research

Waterborne pathogens and associated diseases continue to pose a significant global health challenge, requiring effective monitoring, detection, and treatment strategies. This review examines the current state of waterborne pathogen management, highlighting persistent issues and recent advancements. Here, we review cutting-edge detection methods and treatment technology, emphasizing their roles in water safety and outbreak prevention. The impact of climate change on waterborne pathogen dynamics is explored, alongside a discussion of interdisciplinary research approaches. We also aimed to investigate the crucial relationship between waterborne disease control and Sustainable Development Goals (SDGs), focusing on community engagement, well-being, water sanitation, public health policies, and international cooperation. The PRISMA protocol systematic process was used to filter papers for this study and carry out the review process. Machine learning and remote sensing techniques are promising features in the pathogen detection field. SDGs 3, 6, 11, 13, and 17 are the most closely interrelated with waterborne diseases. This review provides an in-depth overview of waterborne pathogen management, contributing to improved global water quality and public health strategies. This integrated approach aims to enhance health outcomes and promote resilience against waterborne diseases, particularly for vulnerable communities.

Antimicrobial efficacy of an experimental UV-C robot in controlled conditions and in a real hospital scenario

BACKGROUND

Among no-touch automated disinfection devices, ultraviolet-C (UV-C) radiation has been proven to be one of the most effective against a broad spectrum of micro-organisms causing healthcare-associated infections.

AIM

To evaluate the antimicrobial efficacy of an experimental UV-C robotic platform, under controlled conditions and in a real hospital scenario, when used to implement the standard cleaning operating protocol (SOP).

METHODS

In vitro, following dose calibration tests, bactericidal and virucidal efficacy were tested in accordance with American Society for Testing and Materials International Standard E3135-18. In hospital settings, 12 high-touch surfaces were sampled after healthcare activity (dirty condition), after SOP alone, and after SOP + UV-C treatment, with a total of 180 samples.

FINDINGS

In vitro, <4 mJ/cm2 was required to remove Staphylococcus aureus and Pseudomonas aeruginosa completely, 194 mJ/cm2 was required to inactivate adenovirus HadV5 completely, and 38.8 mJ/cm2 was sufficient to inactivate coronavirus 229E completely. In the real hospital scenario, the mean UV-C dose emitted on the sampled surfaces was 29.31 mJ/cm2. A significant difference was found after SOP alone (P=0.022) and after SOP + UV-C treatment (P=0.007) compared with the dirty condition. The average percentage reduction in the total viable count (TVC) was 67% after SOP alone and 96% after SOP + UV-C treatment.

CONCLUSIONS

Comparison of the tests conducted in vitro and in the real hospital scenario showed that the efficacy of the UV-C robot was reduced in the hospital setting, as a higher dose was needed to obtain a reduction in the TVC.

Low Neutralization of SARS-CoV-2 Omicron BA5248, XBB15 and JN1 by Homologous Booster and Breakthrough Infection

Immunity against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can be induced through either infection with the virus or vaccination, providing protection against reinfection or reducing the risk of severe clinical outcomes. In this study, we recruited 172 volunteers who received different vaccination regimens, including 124 individuals who had recovered from breakthrough infections caused by the Omicron variant (27 with 2 doses, 49 with 3 doses, and 48 with 4 doses) and 48 healthy donors who did not experience breakthrough infections (all of whom received a fourth dose during the infection wave). We measured neutralizing antibody levels against Omicron BA.5.2.48, XBB.1.5, and JN.1 and found no significant differences in neutralizing antibody titers between natural infection and homologous booster vaccination at 6 months (p > 0.05), with geometric mean titers declining by over 100-fold for some variants relative to the prototype strain.

The effect of COVID-19 pandemic on new-onset adult diabetes and its one-year follow-up

AIMS

Bidirectional detrimental relationships between COVID-19 infection and diabetes have been described globally. However, new-onset diabetes in adults and its follow-up during the pandemic have not been sufficiently investigated. In this study, new-onset autoimmune and type 2 diabetes cases during the pandemic were compared to those before the pandemic, and the clinical course of new-onset diabetes during the pandemic was examined.

METHODS

In this single-center retrospective cohort study, clinical and laboratory characteristics of new-onset diabetes patients before the pandemic (n = 161) and during the pandemic (n = 144) were evaluated between March 2018 and March 2022.

RESULTS

A 1.85-fold increase in new-onset adult diabetes cases was observed during the pandemic compared to pre-pandemic period (p = 0.010), while the proportion of autoimmune and type 2 diabetes (T2D) did not change. During the pandemic, there was a 6.2-fold increase in autoimmune diabetes presented with DKA (p = 0.003). Insulin was preferred 1.7 times more frequently as initial treatment during the pandemic (p = 0.014), and mean HbA1c (p = 0.003) and C-peptide (p = 0.010) were higher. Clinical and laboratory data did not differ between PCR (+) and PCR (-) patients. At one-year follow-up, while only HbA1c decreased in the autoimmune diabetes; in T2D group fasting glucose, HbA1c, C-peptide, and lipid profile were significantly improved.

CONCLUSIONS

The pandemic led to increased new-onset adult diabetes presented with DKA. However, clinical and laboratory features were similar between PCR positive and negative cases. PCR-confirmed COVID-19 may not adversely affect the medium-term clinical course of new diabetes in adults.

Prevalence of Toscana Virus Antibodies in Residents of Bulgaria: A Nationwide Study Following the Pandemic of COVID-19

Introduction: Toscana virus (TOSV) is an arthropod-borne virus transmitted by sandflies and is mainly found in countries around the Mediterranean basin. In this article, we present the findings of a seroprevalence study on TOSV in Bulgaria. We aim to assess the current epidemiological situation regarding TOSV in the country and raise clinical awareness. Methods: Serum samples (n = 1892) were collected in December 2023. Serological tests were performed using a commercial anti-TOSV ELISA kit. Results: Specific immunoglobulin G (IgG) antibodies were detected in 6.4% (121/1892) of the participants. A significantly higher seropositivity rate was found in the age group over 65 years compared with the age groups 18-29 and 40-64 (11.8% vs. 3.9% vs. 3.4%), as well as in males compared with females (8.0% vs. 5.3%). The seroprevalence rates in districts ranged from 0% to 18.5%. Higher seropositivity was found in the southern and northern regions. Conclusions: The seroprevalence rate of TOSV in Bulgaria, found in this study, is a significant decrease compared with the seropositivity rate of 24.5% reported in the country in 2018. The reasons for this are unknown and could possibly be related to the COVID-19 pandemic and the constantly changing environmental conditions. There is also a possibility that the higher seropositivity detected in 2018 together with the rise in clinical cases reported from endemic countries around that time might have been due to an unrecognized TOSV outbreak taking place in this period. Continued clinical awareness and surveillance are necessary for recognition and management of potential cases of TOSV neuroinfection, especially during summer.

Bacillus coagulans alleviates intestinal barrier injury induced by Klebsiella pneumoniae in rabbits by regulating the TLR4/MyD88/NF-κB signalling pathway

Probiotics effectively alleviate host diarrhoea, but the specific mechanism is not clear. Therefore, we explored the protective mechanism of Bacillus coagulans (BC) on intestinal barrier injury induced by Klebsiella pneumoniae (K. pneumoniae) in rabbits by HE, immunofluorescence and 16S rRNA. The results showed that BC pretreatment alleviated the changes in average daily gain, average daily feed intake and FCR caused by K. pneumoniae in rabbits. Moreover, BC alleviated the inflammatory cell infiltration, intestinal villus reduction, crypt deepening and goblet cell reduction caused by K. pneumoniae in rabbits. Further research revealed that BC improved the intestinal barrier by improving the mechanical barrier, chemical barrier, immune barrier and microbial barrier. Specifically, BC improved the intestinal mechanical barrier by improving the intestinal structure, increasing the protein expression of PCNA, increasing the number of goblet cells, and altering the expression of occludin, claudin-1 and ZO-1. BC improved the intestinal chemical barrier by regulating the expression of MUC1 and MUC2 and inhibited the TLR4/MyD88/NF-κB signalling pathway by altering the expression levels of the inflammatory factors IL-1β, IL-6 and TNF-α, thus optimizing the intestinal immune barrier. In addition, adding BC to the diet improved the intestinal microbial barrier of rabbits by reducing the abundance of harmful bacteria and increasing the abundance of beneficial bacteria. In summary, BC protects against K. pneumoniae-induced intestinal barrier damage by improving intestinal morphology, mitigating the inflammatory response and regulating the microbial composition. Among the pretreatments, the pretreatment effect of 1 × 106 CFU/g was the best. This study provides a theoretical basis for the use of BC to prevent and treat diarrhoea caused by K. pneumoniae in rabbits.

COVID-19 infection in children with blood cancer: A systematic review

BACKGROUND

Blood cancer is the most common type of cancer and the leading cause of death by disease past infancy among children. Children with blood cancer are vulnerable population to viral infections such as coronavirus disease 2019 (COVID-19).

OBJECTIVES

To estimate the incidence of COVID-19 in children with blood cancer and analyse the demographic parameters, clinical characteristics and treatment outcomes in children with blood cancer with COVID-19 illness.

METHODS

We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature for studies on the development of COVID-19 in children with blood cancer, published from December 1, 2019 to April 30, 2023, with English language restriction.

RESULTS

Of the 3077 papers that were identified, 155 articles were included in the systematic review (83 case report, 54 cohort and 18 case-series studies). Studies involving 1289 children with blood cancer with confirmed COVID-19 were analysed. Leukaemias (1141 cases) were the most frequent types of blood cancer observed in children who developed COVID-19, followed by non-Hodgkin's lymphomas (59 cases), Hodgkin's lymphomas (36 cases), Langerhans cell histiocytosis (7 cases), myelodysplastic syndrome (7 cases) and myeloid neoplasm (1 case). Among all 1289 blood cancer paediatric cases who transmitted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), some children were documented to be admitted to the intensive care unit (ICU) (n = 175, 13.6%), intubated and placed on mechanical ventilation (MV) (n = 111, 8.6%), suffered acute respiratory distress syndrome (ARDS) (n = 144, 11.2%) or died (n = 111, 8.6%). Overall, COVID-19 in children with different types of blood cancer resulted in no or low severity of disease in 78.6% of all included cases (COVID-19 severity: asymptomatic = 238, mild = 601, or moderate = 171). Treatment for COVID-19 was not necessary in a small number of children with blood cancer (n = 94, 7.3%). Fatality in children with blood cancer with COVID-19 was reported in any of the included blood cancer categories for leukaemias (n = 99/1141, 8.7%), non-Hodgkin's lymphomas (n = 7/59, 11.9%), Hodgkin's lymphomas (n = 2/36, 5.5%), myelodysplastic syndrome (n = 1/7, 14.3%) or myeloid neoplasm (n = 1/1, 100%). Fatality rate in children with blood cancer infected with SARS-CoV-2 was the highest in patients with Hispanic ethnicity (n = 44/111, 39.6%) and COVID-19-related fatality was highest in male patients (76.5% of deceased patients). Most studies reported to alter the intensity and regimen of anticancer treatment in children with blood cancer during course of SARS-CoV-2 infection, however, many studies have reported to successfully treat COVID-19 without any changes to the anticancer treatment.

CONCLUSION

Globally, leukaemias were the most prevalent and myeloid neoplasms were the least prevalent blood cancer types in children who developed SARS-CoV-2 infection. Children with blood cancer infected with SARS-CoV-2 may experience higher rates of ICU admission and mortality in comparison with the healthy pediatric populations. Mortality in children with blood cancer and infected with SARS-CoV-2 was highest in cases belonging to male gender and Hispanic ethnicity. However, children with blood cancer tend to have milder COVID-19 symptoms and are less likely to be hospitalized and have better prognosis when compared to adults. Continuation of anticancer treatment in individual paediatric blood cancer patients with COVID-19 seems to be possible.

Viruses and the Brain-A Relationship Prone to Trouble

Neurological disorders, some of which are associated with viral infections, are growing due to the aging and expanding population. Despite strong defenses of the central nervous system, some viruses have evolved ways to breach them, which often result in dire consequences. In this review, we recount the various ways by which different viruses can enter the CNS, and we describe the consequences of such invasions. Consequences may manifest as acute disease, such as encephalitis, meningitis, or result in long-term effects, such as neuromuscular dysfunction, as occurs in poliomyelitis. We discuss evidence for viral involvement in the causation of well-known chronic neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, as well as vascular dementia in the elderly. We also describe the approaches currently available to control a few of the neural viral infections. These include antivirals that are effective against human immunodeficiency virus and herpes simplex virus, as well as vaccines valuable for controlling rabies virus, poliomyelitis virus, and some flavivirus infections. There is an urgent need to better understand, at a molecular level, how viruses contribute to acute and, especially, chronic neurological diseases and to develop more precise and effective vaccines and therapies.

Impact of COVID-19 on preexisting comorbidities

COVID-19 is a highly contagious viral disease caused by SARS-CoV-2, leading to a tragic global pandemic, where it was ranked in 2020 as the third leading cause of death in the USA, causing approximately 375,000 deaths, following heart disease and cancer. The CDC reports that the risk of death increases with age and preexisting comorbidities such as such as hypertension, diabetes, respiratory system disease, and cardiovascular disease. this report will delineate and analyze the paramount comorbidities and their repercussions on individuals infected with SARS-CoV-2.

Subcellular determinants of orthoflavivirus protease activity

Orthoflaviviruses are small, enveloped, positive-sense RNA viruses that cause over 500 million infections globally each year for which there are no antiviral treatments. The viral protease is an attractive target for therapeutics due to its critical functions throughout infection. Many studies have reported on the structure, function, and importance of orthoflavivirus proteases; However, the molecular determinants for cleavage of intracellular substrates by orthoflavivirus proteases and how these factors affect viral fitness are unknown. In this study, we used our fluorescent, protease-activity reporter system to investigate the subcellular determinants involved in orthoflavivirus protease cleavage. By modifying our reporter platform, we identified endoplasmic reticulum (ER) subdomain localization and membrane proximity of the substrate cut site as two previously uncharacterized molecular determinants for cleavage. We also altered the amino acid composition of the reporter cut site to introduce sequences present at the cytoplasmic junctions within orthoflavivirus polyproteins and found that each protease processed the sequence located at the junction between NS4A and the 2K peptide least efficiently. Live-cell imaging revealed that cleavage of the NS4A|2K sequence is significantly delayed compared to the capsid cleavage sequence. We further determined that introducing a more efficient cleavage sequence into the NS4A|2K junctions of orthoflavivirus infectious clones abolished virus recovery. Overall, this study identifies ER subdomain localization and membrane proximity of the cut site as molecular determinants for cleavage by orthoflavivirus proteases and provides insight into the role that sequence specificity plays in the coordinated processing of the viral polyprotein and establishing productive infections.

Importance

Orthoflaviviruses are the most prevalent and dangerous arthropod-borne viruses (arboviruses) leading to over 500 million global infections annually. Orthoflavivirus infection can cause severe pathologies, including hemorrhagic conditions and neurological disease, that lead to hundreds of thousands of deaths each year. The viral protease complex, responsible for processing the viral polyprotein into its functional subunits, is an attractive target for antiviral therapeutic development. Despite extensive research efforts on these viral protein complexes, all protease inhibitor candidates have fallen short of clinical efficacy, highlighting a considerable gap in knowledge of the viral protease's complex intracellular activity. The significance of our research is in characterizing the subcellular determinants associated with orthoflavivirus protease cleavage efficiency and how these factors can influence viral fitness. These findings contribute to closing this gap in knowledge of the mechanisms of orthoflavivirus proteases which can ultimately lead to the successful development of targeted antivirals.

Prediction of influenza A virus-human protein-protein interactions using XGBoost with continuous and discontinuous amino acids information

Influenza A virus (IAV) has the characteristics of high infectivity and high pathogenicity, which makes IAV infection a serious public health threat. Identifying protein-protein interactions (PPIs) between IAV and human proteins is beneficial for understanding the mechanism of viral infection and designing antiviral drugs. In this article, we developed a sequence-based machine learning method for predicting PPI. First, we applied a new negative sample construction method to establish a high-quality IAV-human PPI dataset. Then we used conjoint triad (CT) and Moran autocorrelation (Moran) to encode biologically relevant features. The joint consideration utilizing the complementary information between contiguous and discontinuous amino acids provides a more comprehensive description of PPI information. After comparing different machine learning models, the eXtreme Gradient Boosting (XGBoost) model was determined as the final model for the prediction. The model achieved an accuracy of 96.89%, precision of 98.79%, recall of 94.85%, F1-score of 96.78%. Finally, we successfully identified 3,269 potential target proteins. Gene ontology (GO) and pathway analysis showed that these genes were highly associated with IAV infection. The analysis of the PPI network further revealed that the predicted proteins were classified as core proteins within the human protein interaction network. This study may encourage the identification of potential targets for the discovery of more effective anti-influenza drugs. The source codes and datasets are available at https://github.com/HVPPIlab/IVA-Human-PPI/.

Genotype-driven sensitivity of mice to tick-borne encephalitis virus correlates with differential host responses in peripheral macrophages and brain

BACKGROUND

Tick-borne encephalitis (TBE) is the most common tick-borne viral infection in Eurasia. Outcomes range from asymptomatic infection to fatal encephalitis, with host genetics likely playing a role. BALB/c mice have intermediate susceptibility to TBE virus (TBEV) and STS mice are highly resistant, whereas the recombinant congenic strain CcS-11, which carries 12.5% of the STS genome on the BALB/c background, is more susceptible than BALB/c mice. In the present study, we employed these genetically distinct mouse models to investigate the host response to TBEV infection in both peripheral macrophages, one of the initial target cell populations, and the brain, the terminal target organ of the virus.

METHODS

TBEV growth and the production of key cytokines and chemokines were measured and compared in macrophages derived from BALB/c, CcS-11, and STS mice. In addition, brains from these TBEV-infected mouse strains underwent in-depth transcriptomic analysis.

RESULTS

Virus production in BALB/c and CcS-11 macrophages exhibited similar kinetics 24 and 48 h post-infection (hpi), but CcS-11 macrophages yielded significantly higher titers 72 hpi. Macrophages from both sensitive strains demonstrated elevated chemokine and proinflammatory cytokine production upon infection, whereas the resistant strain, STS, showed no cytokine/chemokine activation. Transcriptomic analysis of brain tissue demonstrated that the genetic background of the mouse strains dictated their transcriptional response to infection. The resistant strain exhibited a more robust cell-mediated immune response, whereas both sensitive strains showed a less effective cell-mediated response but increased cytokine signaling and signs of demyelination, with loss of oligodendrocytes.

CONCLUSIONS

Our findings suggest that variations in susceptibility linked to host genetic background correspond with distinct host responses, both in the periphery upon virus entry into the organism and in the brain, the target organ of the virus. These results provide insights into the influence of host genetics on the clinical trajectory of TBE.

Correlation of diabetes and adverse outcomes in hospitalized COVID-19 patients admitted to a tertiary hospital in China during a small-scale COVID-19 outbreak

Background

The aim of this study was to investigate the impact of diabetes on mortality and adverse outcomes in COVID-19 patients and to analyse the associated risk factors.

Methods

This is a retrospective cohort study in 500 hospitalized patients with COVID-19 infection (214 with diabetes and 286 without diabetes) admitted to a tertiary hospital in China from December 2022 to February 2023. Demographic information, clinical characteristics and outcomes were collected. Survival status was investigated at discharge and at 6 months after discharge.

Results

The mortality rate of COVID-19 patients with diabetes was higher than the rate of non-diabetic COVID-19 patients, both at discharge, and at 6 months after discharge. Body mass index (BMI), C-reactive protein (CRP), pH, D-dimer, blood osmotic pressure, serum creatinine, white blood cell count, creatine kinase and hospitalization expenses were significantly different between diabetic group and non-diabetic group (p < 0.05). Compared with the survivors, non-survived COVID-19 patients with diabetes had worse diabetes control indicators, with random blood glucose increased by 3.58 mmol/L (p < 0.05), and fasting blood glucose increased by 2.77 mmol/L (p < 0.01). In addition, there were significant differences in age, heart rate, CRP, pH, potassium (K+), serum creatinine, white blood cell count, creatine kinase, the proportion with diabetic complications, treatment in ICU and mechanical ventilation between survivors and non-survivors of COVID-19 patients with diabetes. By multivariate logistic regression analysis, the death of COVID-19 patients with diabetes is positively correlated with age and CRP (p < 0.05), and has a trend towards significance with fasting blood glucose (p < 0.1).

Conclusion

Infection with COVID-19 on the basis of diabetes can significantly increase mortality, which was further associated with diabetes control indicators.

Insight into the Life Cycle of Enterovirus-A71

Human enterovirus 71 (EV-A71), a member of the Picornaviridae family, is predominantly associated with hand, foot, and mouth disease in infants and young children. Additionally, EV-A71 can cause severe neurological complications, including aseptic meningitis, brainstem encephalitis, and fatalities. The molecular mechanisms underlying these symptoms are complex and involve the viral tissue tropism, evasion from the host immune responses, induction of the programmed cell death, and cytokine storms. This review article delves into the EV-A71 life cycle, with a particular emphasis on recent advancements in understanding the virion structure, tissue tropism, and the interplay between the virus and host regulatory networks during replication. The comprehensive review is expected to contribute to our understanding of EV-A71 pathogenesis and inform the development of antiviral therapies and vaccines.

RNA elements required for the high efficiency of West Nile virus-induced ribosomal frameshifting

West Nile virus (WNV) requires programmed -1 ribosomal frameshifting for translation of the viral genome. The efficiency of WNV frameshifting is among the highest known. However, it remains unclear why WNV exhibits such a high frameshifting efficiency. Here, we employed dual-luciferase reporter assays in multiple human cell lines to probe the RNA requirements for highly efficient frameshifting by the WNV genome. We find that both the sequence and structure of a predicted RNA pseudoknot downstream of the slippery sequence-the codons in the genome on which frameshifting occurs-are required for efficient frameshifting. We also show that multiple proposed RNA secondary structures downstream of the slippery sequence are inconsistent with efficient frameshifting. We also find that the base of the pseudoknot structure likely is unfolded prior to frameshifting. Finally, we show that many mutations in the WNV slippery sequence allow efficient frameshifting, but often result in aberrant shifting into other reading frames. Mutations in the slippery sequence also support a model in which frameshifting occurs concurrent with or after ribosome translocation. These results provide a comprehensive analysis of the molecular determinants of WNV-programmed ribosomal frameshifting and provide a foundation for the development of new antiviral strategies targeting viral gene expression.

Contact Lenses in Therapeutic Care: A Comprehensive Review of Past Innovations, Present Applications, and Future Directions

Contact lenses have become integral tools in the realm of ocular therapeutics, extending beyond their primary function of refractive correction to encompass a diverse array of therapeutic applications. This review explores the evolving role of contact lenses in managing various ocular conditions, highlighting their efficacy in enhancing patient outcomes. Initially developed to correct refractive errors, contact lenses now serve as effective vehicles for delivering medications directly to the ocular surface, offering targeted treatment for conditions such as dry eye syndrome and corneal ulcers. Their ability to provide sustained moisture and facilitate drug absorption makes them indispensable in promoting corneal healing and managing chronic ocular surface diseases. Specialized contact lenses designed for irregular corneas, such as those affected by keratoconus, provide both optical correction and structural support, significantly improving visual acuity and patient comfort. Additionally, orthokeratology lenses have shown promise in controlling myopia progression in children by reshaping the cornea overnight, thereby reducing reliance on corrective eyewear during waking hours. In post-surgical settings, therapeutic contact lenses aid in epithelial regeneration and minimize discomfort, accelerating recovery and improving surgical outcomes. They also play a crucial role in protecting the cornea from external irritants and promoting a stable tear film, crucial for maintaining ocular health. Looking ahead, ongoing advancements in contact lens materials and designs promise further innovation in ocular therapeutics, paving the way for personalized treatment strategies and improved patient care. As such, contact lenses continue to evolve as essential therapeutic tools, offering tailored solutions for a spectrum of ocular conditions and contributing to enhanced quality of life for patients worldwide.

Analysis of Structures of SARS-CoV-2 Papain-like Protease Bound with Ligands Unveils Structural Features for Inhibiting the Enzyme

The COVID-19 pandemic, driven by the novel coronavirus SARS-CoV-2, has drastically reshaped global health and socioeconomic landscapes. The papain-like protease (PLpro) plays a critical role in viral polyprotein cleavage and immune evasion, making it a prime target for therapeutic intervention. Numerous compounds have been identified as inhibitors of SARS-CoV-2 PLpro, with many characterized through crystallographic studies. To date, over 70 three-dimensional (3D) structures of PLpro complexed ligands have been deposited in the Protein Data Bank, offering valuable insight into ligand-binding features that could aid the discovery and development of effective COVID-19 treatments targeting PLpro. In this study, we reviewed and analyzed these 3D structures, focusing on the key residues involved in ligand interactions. Our analysis revealed that most inhibitors bind to PLpro's substrate recognition sites S3/S4 and SUb2. While these sites are highly attractive and have been extensively explored, other potential binding regions, such as SUb1 and the Zn(II) domain, are less explored and may hold untapped potential for future COVID-19 drug discovery and development. Our structural analysis provides insights into the molecular features of PLpro that could accelerate the development of novel therapeutics targeting this essential viral enzyme.

Machine learning based prediction models for the prognosis of COVID-19 patients with DKA

Patients with Diabetic ketoacidosis (DKA) have increased critical illness and mortality during coronavirus diseases 2019 (COVID-19). The aim of our study was to develop a predictive model for the occurrence of critical illness and mortality in COVID-19 patients with DKA utilizing machine learning. Blood samples and clinical data from 242 COVID-19 patients with DKA collected from December 2022 to January 2023 at Second Xiangya Hospital. Patients were categorized into non-death (n = 202) and death (n = 38) groups, and non-severe (n = 146) and severe (n = 96) groups. We developed five machine learning-based prediction models-Extreme Gradient Boosting (XGB), Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), and Multilayer Perceptron (MLP)-to evaluate the prognosis of COVID-19 patients with DKA. We employed 5-fold cross-validation for model evaluation and used the Shapley Additive Explanations (SHAP) algorithm for result interpretation to ensure reliability. The LR model demonstrated the highest accuracy (AUC = 0.933) in predicting mortality. Additionally, the LR model excelled (AUC = 0.898) in predicting progression to severe disease. This study developed a machine learning-based predictive model for the progression to severe disease or death in COVID-19 patients with DKA, which can serve as a valuable tool to guide clinical treatment decisions.

Advanced progress in the genetic modification of the oncolytic HSV-1 virus

The use of replication-competent viruses for selective tumor oncolysis while sparing normal cells marks a significant advancement in cancer treatment. HSV-1 presents several advantages that position it as a leading candidate for oncolytic virotherapies. Its large genome can accommodate insertions over 30 kb or deletions of multiple virulence genes without compromising lytic replication in tumor cells. Additionally, anti-herpes drugs can inhibit its replication during accidental infections. Importantly, HSV-1 does not integrate into the host genome and cause mutations. The HSV-1 genome can be modified through genetic engineering in two main ways: first, by reducing infectivity and toxicity to normal cells via limited replication and assembly, altered protein-virus receptor binding, and minimized immune evasion; second, by enhancing anticancer activity through disruption of tumor cell metabolism, induction of autophagy, improved immune recognition, and modification of the tumor microenvironment. In this mini-review, we systematically examine genetic modification strategies for oncolytic HSV-1 while highlighting advancements from these modifications. Certain genetic alterations have shown efficacy in improving clinical outcomes for HSV-1-based therapies. These modifications include silencing specific genes and inserting exogenous genes into the HSV-1 genome. The insertion of exogenous genes has increasingly been used to develop new oncolytic HSV-1 variants. Finally, we discuss limitations associated with oncolytic virotherapy at the conclusion of this review. As more clinical trials explore newly engineered therapies, they are likely to yield breakthroughs and promote broader adoption for cancer treatment.

Activation and evasion of inflammasomes during viral and microbial infection

The inflammasome is a cytoplasmic multiprotein complex that induces the maturation of the proinflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18) or pyroptosis by activating caspases, which play critical roles in regulating inflammation, cell death, and various cellular processes. Multiple studies have shown that the inflammasome is a key regulator of the host defence response against pathogen infections. During the process of pathogenic microbe invasion into host cells, the host's innate immune system recognizes these microbes by activating inflammasomes, triggering inflammatory responses to clear the microbes and initiate immune responses. Moreover, microbial pathogens have evolved various mechanisms to inhibit or evade the activation of inflammasomes. Therefore, we review the interactions between viruses and microbes with inflammasomes during the invasion process, highlight the molecular mechanisms of inflammasome activation induced by microbial pathogen infection, and highlight the corresponding strategies that pathogens employ to evade inflammasome activity. Finally, we also discuss potential therapeutic strategies for the treatment of pathogenic microbial infections via the targeting of inflammasomes and their products.

Epstein-Barr Virus (EBV) and Human Papilloma Virus (HPV) in Gastric Cancers, with Special Reference to Gastric Cancer at a Young Age-A Pilot Study in Poland

Gastric cancer (GC) is one of the most common cancers in the world. It is a multi-factorial disease influenced by both genetic and environmental factors such as diet, obesity, radiation exposure, and infectious agents. Viral infections usually lead to chronic inflammation, which can initiate the development of cancers. To date, only a few studies have been published about Epstein-Barr virus (EBV) and human papillomavirus (HPV) infections in the context of the development of GC. In particular, research on the development of cancer among people under 45 years of age, including the impacts of EBV and HPV, is rare, and clear results have not been obtained. The aim of this study was to analyze the frequency of occurrence of EBV and HPV in GC, particularly in early-onset gastric cancer (EOGC). Tissue material from 135 patients with GC, including 84 men and 51 women, was examined. RT-PCR was performed to detect EBV, and PCR was performed to detect HPV. There were no significant impacts of EBV and HPV infections on any subtype of GC. There was also no statistically significant dependence of gender and location of the tumor on any subtype of GC. Further research on the impacts of infectious agents such as EBV and HPV on GC should be conducted using larger populations.

Nanodiagnostics in global eradication of hepatitis C virus

Hepatitis C, caused by the hepatitis C virus (HCV), is a prevalent liver disease with severe outcomes, including cirrhosis and hepatocellular carcinoma. Traditional diagnostic methods primarily detect antiviral antibodies (anti-HCV) or viral RNA, but these approaches have limitations. Anti-HCV antibodies may take 2-4 weeks to develop in acute cases and can be absent in some individuals, leading to undiagnosed early-stage infections. This poses significant challenges for public health, particularly in resource-limited settings where early detection is crucial. This article explores the development of biosensors engineered to directly detect HCV surface antigens, such as envelope proteins. These biosensors provide a promising solution for earlier and more accurate diagnosis by identifying viral components at the initial stages of infection. By focusing on direct detection of viral antigens, these innovations could enhance early diagnosis, facilitate timely intervention, and reduce virus transmission. We evaluate the advancements in biosensor technology over the past decade and their potential to improve HCV detection in clinical and field settings, ultimately supporting global efforts to eliminate HCV as a public health threat.

Clinical Characteristics, Laboratory Parameters, and Molecular Epidemiology of Neuroinvasive Flavivirus Infections in a Hotspot Region of Eastern Croatia

Neuroinvasive flaviviruses such as tick-borne encephalitis virus (TBEV) and West Nile virus (WNV) are widely distributed in continental Croatian regions. We analyzed clinical characteristics, laboratory parameters, and molecular epidemiology of neuroinvasive flavivirus infections in eastern Croatia. A total of 43 patients with confirmed flavivirus infection hospitalized from 2017 to 2023 were included in the study. Reverse-transcription polymerase chain reaction (RT-qPCR) was used to detect flavivirus RNA in clinical samples (cerebrospinal fluid; CSF, urine). ELISA was used for IgM and IgG antibody detection in serum and CSF with confirmation of cross-reactive samples by virus neutralization test. WNV was detected more frequently (74.4%) than TBEV (25.6%). A statistically significant age difference was found between WNV patients (median 65 years) and TBEV patients (median 36 years). Comorbidities were more frequently detected in WNV patients (hypertension 56.3 vs. 18.2%; diabetes 31.3 vs. 0%). Meningitis was the most common clinical presentation in both TBE and WNV neuroinvasive disease (WNND; 63.6 and 59.4%, respectively). In addition, some rare clinical presentations of WNND were also detected (cerebellitis, polyradiculoneuritis). No significant differences in the frequency of clinical symptoms were observed between WNV and TBEV-infected patients (fever 93.7 vs. 100%; malaise 78.1 vs. 100%; headache 75.0 vs. 100%; nausea 50.0 vs. 63.6%; vomiting 34.4 vs. 54.6%). Comparative analysis of total and differential leukocyte blood count showed similar results. However, CSF pleocytosis was higher in TBE patients, with a significant difference in the neutrophil and lymphocyte count (WNND median 48.5% and 51.5%; TBE median 10.0 and 90.0%, respectively). The length of hospital stay was 12 days for WNND and 9 days for TBE. Phylogenetic analysis of detected WNV strains revealed the presence of WNV lineage 2 in eastern Croatia.

Vitamin D: Evidence-Based Health Benefits and Recommendations for Population Guidelines

Vitamin D offers numerous under-recognized health benefits beyond its well-known role in musculoskeletal health. It is vital for extra-renal tissues, prenatal health, brain function, immunity, pregnancy, cancer prevention, and cardiovascular health. Existing guidelines issued by governmental and health organizations are bone-centric and largely overlook the abovementioned extra-skeletal benefits and optimal thresholds for vitamin D. In addition, they rely on randomized controlled trials (RCTs), which seldom show benefits due to high baseline 25-hydroxyvitamin D [25(OH)D] concentrations, moderate supplementation doses, and flawed study designs. This review emphasizes the findings from prospective cohort studies showing that higher 25(OH)D concentrations reduce the risks of major diseases and mortality, including pregnancy and birth outcomes. Serum concentrations > 30 ng/mL (75 nmol/L) significantly lower disease and mortality risks compared to <20 ng/mL. With 25% of the U.S. population and 60% of Central Europeans having levels <20 ng/mL, concentrations should be raised above 30 ng/mL. This is achievable through daily supplementation with 2000 IU/day (50 mcg/day) of vitamin D3, which prevent diseases and deaths. Furthermore, a daily dose between 4000 and 6000 IU of vitamin D3 to achieve serum 25(OH)D levels between 40 and 70 ng/mL would provide greater protection against many adverse health outcomes. Future guidelines and recommendations should integrate the findings from observational prospective cohort studies and well-designed RCTs to improve public health and personalized care.

Deformed wing virus coopts the host arginine kinase to enhance its fitness in honey bees (Apis mellifera)

BACKGROUND

Deformed wing virus (DWV) is a major honey bee pathogen that is actively transmitted by the parasitic mite Varroa destructor and plays a primary role in Apis mellifera winter colony losses. Despite intense investigation on this pollinator, which has a unique environmental and economic importance, the mechanisms underlying the molecular interactions between DWV and honey bees are still poorly understood. Here, we report on a group of honey bee proteins, identified by mass spectrometry, that specifically co-immunoprecipitate with DWV virus particles.

RESULTS

Most of the proteins identified are involved in fundamental metabolic pathways. Among the co-immunoprecipitated proteins, one of the most interesting was arginine kinase (ArgK), a conserved protein playing multiple roles both in physiological and pathological processes and stress response in general. Here, we investigated in more detail the relationship between DWV and this protein. We found that argK RNA level positively correlates with DWV load in field-collected honey bee larvae and adults and significantly increases in adults upon DWV injection in controlled laboratory conditions, indicating that the argK gene was upregulated by DWV infection. Silencing argK gene expression in vitro, using RNAi, resulted in reduced DWV viral load, thus confirming that argK upregulation facilitates DWV infection, likely through interfering with the delicate balance between metabolism and immunity.

CONCLUSIONS

In summary, these data indicate that DWV modulates the host ArgK through transcriptional regulation and cooptation to enhance its fitness in honey bees. Our findings open novel perspectives on possible new therapies for DWV control by targeting specific host proteins.

Evaluating the Efficacy and Safety of Hepatitis E Vaccination in Reproductive-Age Women: A Systematic Review and Meta-Analysis

BACKGROUND

Hepatitis E virus (HEV) infection presents a significant health risk in endemic regions, especially for pregnant women, who face higher risks of severe complications, including maternal and fetal mortality. The recombinant HEV vaccine, HEV239, has demonstrated high efficacy in the general population, yet data on its safety and efficacy in women of a childbearing age remain limited. This systematic review and meta-analysis aim to evaluate the safety and effectiveness of HEV239 in this specific population, with a focus on pregnancy-related outcomes.

METHODS

A comprehensive search was conducted in PubMed, Embase, Cochrane Library, and Scopus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported outcomes on HEV239's safety or efficacy in women of childbearing age, with data being extracted and analyzed for immunogenicity, HEV incidence, and maternal adverse events. The risk of bias was assessed using the Cochrane and Newcastle Ottawa Scales, and a random-effects meta-analysis was performed.

RESULTS

Three studies, enrolling over 23,000 participants, were included in the current systematic review, with two meeting the criteria for meta-analysis. HEV239 demonstrated high efficacy in preventing hepatitis E infection, with no significant increase in adverse pregnancy outcomes such as stillbirth or elective termination. However, there was an elevated risk of miscarriage (odds ratio [OR], 1.60; 95% confidence interval [CI], 0.99-2.57). The analysis revealed high heterogeneity for miscarriage outcomes (I2 = 67%), reflecting variability in study designs and populations.

CONCLUSIONS

HEV239 is effective in preventing HEV infection among women of childbearing age, although caution is advised when administering the vaccine near conception due to potential miscarriage risks. Future studies should focus on understanding the biological mechanisms and timing-specific safety to guide vaccination recommendations.

Epstein-Barr Virus in the RIVERA Case-Control Study of Acute Febrile Illness: Acute Mononucleosis Nearly Absent as an Etiology in the Peruvian Amazon

Large diagnostic panels allow for pathogens with high or low likelihood of causing attributable illness to be tested simultaneously. Infectious mononucleosis (IM) due to primary infection with Epstein-Barr virus (EBV) is a common cause of acute febrile illness (AFI) in case series from high-income countries, though its contribution to AFI in tropical low-income settings is unclear. As part of a case-control study using multiplex quantitative polymerase chain reaction (qPCR) diagnostics, we set out to determine if primary EBV infection was an underrecognized cause of AFI in the Peruvian Amazon. Presence of EBV DNA in whole-blood samples was equally prevalent among febrile cases and afebrile controls (34.6% [247/714] versus 35.7% [248/695]) and was not correlated with classic IM symptoms. Given the clear lack of clinical significance of the whole-blood PCR results, additional testing was pursued to ascertain the true prevalence of IM among cases of AFI in this population. The presence of EBV DNA in plasma, a marker of active EBV-related processes, was detected in 7% (5/68). Anti-EBNA-1 IgG, a late marker of prior infection, was tested via ELISA and detected in 4/5 of the plasma-positive patients, thereby excluding an acute primary EBV infection in all but one patient. Infectious mononucleosis due to primary infection with EBV was not an important etiology of AFI in the Peruvian Amazon, despite high rates of initial test positivity.

Exploring Demographic Factors Influencing Indian Nursing Students' Willingness to Volunteer

OBJECTIVE

To investigate the demographic determinants influencing nursing students' intentions to volunteer during health emergencies in India, providing insights that can inform policy and educational interventions to enhance their engagement and effectiveness in crisis situations.

METHODS

A comprehensive cross-sectional survey was conducted among final-year nursing students, utilizing an online self-administered questionnaire developed through an extensive review of existing literature. The collected data were analyzed using the SPSS software tool.

RESULTS

Four hundred nursing students participated in the study. The analysis showed that age, marital status, location, family income, educational program, and district strongly influence volunteer inclinations. Although they face challenges, nursing students' desire to help during emergencies shows their dedication and importance within health care. Strategic assistance, flexible training, and recognition can increase volunteerism. Giving nursing students resources and support makes them confident, equipped, and motivated to respond to emergencies, improving community resilience and emergency health care.

CONCLUSIONS

This study enhances our understanding of demographic influences on volunteerism and informs strategies to foster a more robust and willing nursing workforce in India for future health emergencies. Future research should focus on understanding psychological factors in other states of India.

Efficacy of a reduced-dosage PRRS MLV vaccine against a NADC34-like strain of porcine reproductive and respiratory syndrome virus

Introduction

After being discovered for the first time in China in 2017, porcine reproductive and respiratory syndrome virus (PRRSV) NADC34-like strains have become the prevalent strain of PRRSV in certain regions of China. Our previous study showed that reduced Ingelvac PRRS MLV vaccination dosages against NADC30-like CF PRRSV had a better protection effect than the normal dosage. However, the protective effect of reduced dosages vaccination of Ingelvac PRRS MLV against NADC34-like PRRSV is unclear. Therefore, this study compared the effectiveness of 0.1 and 1 dosages against a NADC34-like PRRSV infection using commercial PRRSV vaccines, Ingelvac PRRS MLV, which have been widely utilized in China.

Methods

In this study, we immunized piglets with two different dosages of the MLV vaccine and infected piglets within a nasal way with NADC34-like CF PRRSV at 42 days post-vaccination. We observed the changes in growth performance before and after the NADC34-like PRRSV DX strain challenge and the protective effect of different vaccine dosages through multiple assays.

Results

After the challenge, the piglets from the challenge control group displayed clinical signs typical of PRRSV infection, including transient fever, high viremia, mild clinical symptoms, and histopathological changes in the lungs and lymph nodes, which indicates DX is a virulent virus. Without the challenge, the average daily gain of the non-immunized group at 5 weeks after the vaccination is greater than that of the 0.01 dosage group than that of the 1 dosage group, which proved that the commercial MLV vaccine has a negative effect on the growth performance of pigs and this effect may be dose-dependent. After the NADC34-like PRRSV challenge, there was no difference in average daily gain between the immunized pigs and pigs from the challenge control group. From the perspective of clinical score, gross lung lesions, and microscopic lesions, immunization with MLV vaccine can indeed relieve symptoms and lesions caused by the virus, and 0.1 dosage vaccination has a better effect in these aspects. Also, both dosages of MLV immunization shortened viremia with similar effects.

Discussion

Our research suggests that the MLV vaccine can provide piglets with some protection against NADC34-like PRRSV and the 0.1 dosage Ingelvac PRRS MLV vaccination showed greater benefits in our study. Therefore, considering the cost, side effects, and subsequent protective effects, we can adjust the immune dosage appropriately after further investigation to ensure safety, improve production efficiency, and reduce immunization costs.

The role of genetic diversity, epigenetic regulation, and sex-based differences in HIV cure research: a comprehensive review

Despite significant advances in HIV treatment, a definitive cure remains elusive. The first-in-human clinical trial of Excision BioTherapeutics' CRISPR-based HIV cure, EBT-101, demonstrated safety but failed to prevent viral rebound. These outcomes may result from the interplay of several factors. Growing evidence indicates that intricate epigenetic modifications play a major role in the persistence of HIV latency, presenting a significant barrier to eradication efforts and causing viral rebound after ART discontinuation. Current strategies to purge the latent reservoir involve LRAs that reactivate latent proviruses. However, their clinical success is hindered by the heterogeneity of HIV reservoirs and the virus's diverse pathways. Additionally, RNA modifications like N6-methyladenosine (m^6 A) methylation influence HIV biology beyond transcriptional control, affect RNA stability, splicing, and translation, which could enhance therapeutic efficacy. The regulatory framework of chromatin dynamics is also key to understanding viral latency and reactivation, such as Vpr's role in reactivating latent HIV by targeting HDACs. Sex-specific factors were also shown to play an important role with females, showing stronger early immune responses and higher representation among elite controllers. This review addresses the multifaceted challenges of HIV cure research, focusing on genetic diversity, epigenetic regulation, RNA modifications, chromatin remodeling, and sex-specific factors. By integrating insights into these aspects, this paper aims to advance our understanding of HIV cure strategies and highlight directions for future research.

DPPX antibody-mediated disease mimicking Wernicke's encephalopathy

Anti-dipeptidyl-peptidase-like protein 6 antibody-mediated disease is a rare autoimmune encephalitis typically presenting with diarrhoea and/or weight loss, central nervous system hyperexcitability and cognitive dysfunction. We present a case of a young woman with 10 days of diplopia and unsteadiness in the context of dysthymia and significant weight loss over 2 months. Initial examination demonstrated mixed dysconjugate nystagmus and ataxic gait. Presumed diagnosis was Wernicke's encephalopathy and intravenous thiamine was given, resulting in partial improvement. Subsequent examination revealed hyperekplexia with ocular flutter, cervical dystonia and startle myoclonus. Cerebrospinal fluid indirect immunofluorescence on primate cerebellum revealed granular layer pattern of staining, prompting testing for anti-dipeptidyl-peptidase-like protein antibodies, which returned strongly positive. Given the phenotypic overlap, it is important to consider this rare disorder in the differential diagnosis of Wernicke's encephalopathy. In this case, the emergence of ocular flutter, startle myoclonus and the specific type of nystagmus made it clear there was an alternative diagnosis.

Open Innovation or Traditional Patenting Strategies to Efficiently Address Health Emergencies: How Patent Information was used Towards Effective Treatments for COVID-19

INTRODUCTION/OBJECTIVE

During the 1150 days of COVID-19 pandemic there were great efforts to develop efficient treatments for the disease. After this long time, some drugs emerged as treatment for COVID-19. Some of them are new drugs, most of them, known drugs. These developments were triggered by information already available in patent documents. Pharmaceutical companies, therefore, rushed to conduct drugs evaluations and trials in order to deliver to the world a reasonable treatment that could reach the majority of its population. However, it is not immediately clear how companies operated to reach their goals. The ability of open innovation to achieve results assertively and faster than closed innovation strategies is questioned and therefore, it is questioned whether pharmaceutical companies use open innovation to face COVID-19.

METHODS

In this work, data available on patent databases were mined to inform about the scientific and technological panorama of selected drugs tested for COVID-19 treatment and to understand the perspectives of such developments during the pandemic.

RESULTS

This study evidenced that most treatments were based on known drugs, that some of the initially promising drugs were abandoned during the pandemic, and that it was able to inform if open innovation and collaborations were explored strategies.

CONCLUSION

This study evidenced that the developments during COVID-19 were not based on open innovation by revealing a patent race towards the treatment development, but with practically no collaborations or information exchange between companies, universities, and research facilities.

Narrative review of factors associated with SARS-CoV-2 coinfection in Middle Eastern countries and the need to vaccinate against preventable diseases

This review evaluated the frequency of, and outcomes associated with, bacterial, fungal, and viral coinfection with SARS-CoV-2 in Middle Eastern countries via a PubMed search through February 2023. Ninety articles reported bacterial (n = 57), fungal (n = 32), and viral (n = 32) coinfections. High frequencies of coinfection with COVID-19 were identified, with rates and outcomes varying by setting, pathogen, surveillance/detection method, population characteristics, and drug-resistance status. Mortality rates were higher in patients with community-acquired (10.0 -42.9 %) and hospital-acquired (51.5 -66 %) bacterial coinfection versus those without (10.5 -21.7 %). Outcomes were worse with than without fungal coinfection, and fatality rates with mucormycosis coinfection reached 66.7 %. Outcomes with viral coinfection were highly variable; however, some data suggested a positive corelation between COVID-19 severity and influenza A and adenovirus coinfection. The negative outcomes associated with bacterial, fungal and some viral coinfections in individuals with COVID-19 support regular vaccination against vaccine-preventable diseases caused by these pathogens, especially among at-risk populations.

Latin America's Dengue Outbreak Poses a Global Health Threat

Dengue fever, caused by the dengue virus (DENV), poses a significant global health challenge, particularly in tropical and subtropical regions. Recent increases in indigenous DENV cases in Europe are concerning, reflecting rising incidence linked to climate change and the spread of Aedes albopictus mosquitoes. These vectors thrive under environmental conditions like temperature and humidity, which are increasingly influenced by climate change. Additionally, global travel accelerates the cross-border spread of mosquito-borne diseases. DENV manifests clinically in a spectrum from asymptomatic cases to severe conditions like dengue hemorrhagic fever and dengue shock syndrome, influenced by viral serotype and host factors. In 2024, Brazil experienced a fourfold increase in dengue cases compared to 2023, accompanied by higher mortality. Conventional control measures, such as vector control, community engagement, and vaccination, proved insufficient as climate change exacerbated mosquito proliferation, challenging containment efforts. In this regard, our review analyzes prevention measures and therapeutic protocols during the outbreak while addressing DENV transmission dynamics, clinical presentations, and epidemiological shifts. It also evaluates diagnostic strategies combining clinical assessment with serological and molecular testing, providing information to improve diagnostic and preventive measures. The global expansion of dengue-endemic regions, including outbreaks in Europe, highlights the urgent need for enhanced surveillance, proactive interventions, and international collaboration to mitigate the growing threat of Dengue and other arboviruses like West Nile, Zika, Chikungunya, Oropouche, and Yellow Fever viruses.

Investigating the Prevalence of Bacterial Infections in Patients with Coronavirus Disease 2019 Hospitalized in Intensive Care Unit and Determining their Antibiotic Resistance Patterns

BACKGROUND

COVID-19 patient hospitalization, particularly in intensive care units, exposes them to bacterial and fungi co-infections, which can have very serious consequences, including increased mortality. In addition, antibiotic resistance among pathogens is a hidden threat behind COVID-19.

METHODS

In the period from 2020 September to 2021 August, bacterial isolates from COVID- 19 patients admitted to the ICU of Sina Hospital in Hamadan, Iran, were collected and identified based on standard biochemical tests. COVID-19 cases were confirmed based on clinical symptoms, computed tomography, and polymerase chain reaction. Antimicrobial susceptibility tests were conducted using disc diffusion and broth microdilution methods.

RESULTS

In total, 207 bacterial isolates were collected, with Klebsiella pneumoniae accounting for 69 (33.33%) and Acinetobacter baumannii accounting for 59 (28.15%). The frequency and percentage of isolated bacteria were as follows: Alcaligenes species 28 (13.59%), Staphylococcus aureus 18 (8.73%), Pseudomonas aeruginosa 15 (7.28%), Escherichia coli 11 (5.33%), Stenotrophomonas maltophilia 3 (1.45%), Enterococcus species 3 (1.45%), and Serratia species 1 (0.48%). About 95.38% resistance to ceftazidime and cefotaxime and 92.31% resistance to ciprofloxacin and cefepime were found in K. pneumoniae isolates. A. baumannii isolates were 100% resistant to cefotaxime, ceftriaxone, and cefepime. About 22.22% resistance to vancomycin and 66.67% resistance to clindamycin, erythromycin, and cefoxitin were seen in S. aureus isolates.

CONCLUSION

Knowledge of bacterial co-infections and their antibiotic resistance pattern in COVID-19 patients can help in choosing effective antibiotics for the treatment and prevention of antibiotic resistance.