Search Results (1,265)

The coronavirus disease 19 pandemic disrupted pediatric respiratory infections through non-pharmaceutical interventions and altered contact patterns. Long-term comparisons across the pandemic timeline in children remain limited. In this study, we analyzed 15,657 respiratory specimens from patients ≤ 18 years at Dankook University Hospital (2007–2023) using multiplex polymerase chain reaction assays targeting 15 viruses. Age-stratified positivity rates were compared across pandemic phases. Children ≤ 6 years comprised 88.61% of the study population. Human rhinovirus showed the highest detection rate (24.06%), followed by adenovirus (12.33%), respiratory syncytial virus-subtypes A and B (RSV-A: 11.13%; RSV-B: 8.65%), human parainfluenza virus-type 3 (HPIV-3; 6.21%), human metapneumovirus (HMPV; 5.33%), and enterovirus (2018–2023; EV; 10.96%). Monthly distributions differed (p < 0.001). RSV peaked in late autumn and winter; influenza and seasonal coronaviruses in winter and spring; HMPV, HPIV-3, EV, and human bocavirus in summer and fall. Positivity declined during the pandemic, rebounding in 2023, most prominently among children aged 1–6 years (84.91%). HPIV-3 and EV increased (p < 0.001). RSV-A predominated pre-pandemic, whereas RSV-B showed a non-significant relative increase post-pandemic; no subtype differences occurred during the pandemic. Findings demonstrate pathogen-specific shifts in predominance and seasonality and support ongoing surveillance and pediatric care planning. Full article

Background/Objectives: Vaccination against respiratory viruses—such as respiratory syncytial virus (RSV), pneumococcal disease, influenza, and COVID-19—may reduce the risk of adverse outcomes in older adults with cardiovascular disease. This study conducted a scoping review of the effects of respiratory vaccines in older adults with cardiovascular disease. Methods: We included studies evaluating adults aged ≥ 60 years with cardiovascular disease who received different types of respiratory vaccines. Eligible designs comprised clinical trials, observational cohort studies, and other relevant studies. Editorials, commentaries, and non-original publications were excluded. A comprehensive and targeted literature search was conducted in PubMed, Scopus, EMBASE, and Web of Science from database inception through January 2026. Results: A total of 25 studies were included, encompassing 1,782,787 adults aged ≥ 60 years with cardiovascular disease who received various respiratory vaccines. RSV vaccines were associated with a lower incidence of cardiorespiratory hospitalization and stroke among vaccinated individuals. Pneumococcal vaccines showed that sequential dual vaccination strategies were associated with a lower risk of cardiovascular events. Influenza vaccination was associated with improved cardiovascular outcomes, lower mortality, and reduced adverse events. COVID-19 vaccines were associated with reductions in mortality and hospitalizations. These benefits are particularly relevant in an older population with a high burden of comorbidities; therefore, complete vaccination schedules, including booster doses, should be considered a central strategy for prevention and comprehensive management in this high-risk group. Conclusions: Vaccination against respiratory viruses in older adults with cardiovascular disease demonstrates an overall favorable/acceptable profile of efficacy and safety, with reductions in mortality, hospitalizations, and cardiovascular events, without a significant increase in serious adverse events. Full article

Human respiratory syncytial virus (RSV) is the predominant etiological agent responsible for lower respiratory tract infections in young children. Recurrent infections throughout an individual’s lifespan can lead to significant morbidity, particularly in the elderly and in adults, influencing the trends of hospitalization rates. Consequently, it is imperative to develop technologies that can sanitize environments from this pathogen while being compatible with human presence. Structure Resonant Energy Transfer (SRET) is the scientific principle underlying a sanitization technology that has demonstrated efficacy against several enveloped viruses, including SARS-CoV-2 and Influenza A viruses. SRET employs specific frequencies of electromagnetic waves to effectively disrupt the structural integrity of viral envelopes through dipole coupling. This disruption leads to the inactivation of the virus, rendering it non-infectious. The objective of this study is to analyse the effect of a specific SRET sanitization method on RSV. The sanitization test was conducted in aerosol form within a BSL-3 laboratory, exploring the frequency band from 8 to 16 GHz. An optimal sub-band was identified, giving an inactivation efficiency up to 99.5%. In conclusion, it has been demonstrated that the microwave non-thermal sanitization method is effective against RSV. These results confirm its potential as a viable approach for environmental decontamination. Full article

Maternal vaccination against respiratory syncytial virus (RSV) represents a major advance in early-life infection prevention. Although clinical efficacy and early real-world effectiveness are well established, sustained population-level impact depends on equitable uptake. This review synthesizes determinants influencing maternal RSV vaccination within the evolving dual-strategy landscape that includes both maternal vaccination and infant monoclonal antibody prophylaxis. A structured narrative review was conducted following PRISMA principles. PubMed/MEDLINE and Google Scholar were searched for studies published between January 2022 and February 2026. Eligible studies examined behavioral, interpersonal, structural, economic, and policy determinants of maternal RSV vaccination uptake, as well as early implementation and modelling evidence. Findings were integrated within a multilevel analytical framework. Maternal uptake is shaped by interacting determinants across individual, healthcare provider, and health system domains. Key drivers include perceived infant disease severity, vaccine safety confidence, perceived effectiveness, and prior antenatal vaccination behavior. Healthcare provider recommendation consistently emerges as the strongest facilitator. Coverage variability reflects differences in reimbursement, antenatal care integration, and national policy endorsement. The coexistence of maternal vaccination and infant monoclonal antibody strategies introduces additional comparative decision-making complexity. Early implementation data indicate heterogeneous uptake and socioeconomic gradients, while modelling demonstrates sensitivity to coverage, timing, epidemiology, and cost. Translating biological efficacy into sustained public health benefit requires coordinated behavioral, structural, and policy strategies, strong provider engagement, and context-sensitive implementation frameworks to ensure equitable coverage. Full article

NASA intends to return humans to the Moon, where partial gravity will put them at risk of musculoskeletal deconditioning. Resveratrol (RSV) is a promising nutritional countermeasure that may protect muscle health during disuse; however, its efficacy and mechanism in simulated lunar gravity are unknown. Forty adult male Wistar rats underwent 14 days of normal loading or partial weight-bearing at 20% of normal loading (PWB20). Unloaded animals received daily RSV supplementation with or without an ERα antagonist to test whether ERα was required to mediate RSV benefits. Muscle function was longitudinally assessed, and a Western blot was used to quantify key signaling proteins in the soleus muscle. PWB20 led to a significant reduction in grip strength (−14.2%) associated with marked changes in electrophysiological muscle properties. RSV-supplemented animals performed better throughout the study, but not when Erα was inhibited. RSV supplementation resulted in a greater ERα phosphorylation ratio compared to PWB20 alone (3.5 vs. 1.91). These results suggest that RSV can mitigate muscle deconditioning in a lunar gravity analog and that ERα signaling is required. Full article

Background/Objectives: Influenza, RSV, and SARS-CoV-2 co-circulate and evolve under immune and therapeutic pressures, complicating decision-making for both vaccine formulation and antiviral use. Fragmented, pathogen-specific sequencing approaches limit cross-virus comparability. Methods: We applied a standardized, multiplexed, amplicon-based next-generation sequencing (NGS) workflow to 34 diagnostic specimens (Ct < 35) positive for influenza A/B, RSV-A/B, or SARS-CoV-2. Sequencing libraries were generated and run on an Illumina MiSeq platform (2 × 250 bp). Although the wet-lab workflow is standardized across pathogens, consensus generation and annotation utilized two different analysis environments: Geneious Prime for influenza and MicrobioChek for RSV and SARS-CoV-2. Quality metrics included genome breadth and depth of coverage. Results: Near-complete genomes (mean coverage ≥98%) were recovered for all samples. Influenza A(H1N1)pdm09 sequences clustered in clade 6B.1A; A(H3N2) clustered in subclade 3C.2a1b.2a.2; and influenza B belonged to the Victoria lineage V1A.3a.2. RSV sequences were assigned to Nextclade clades A.D.5.1, A.D.1.10, A.D.2.1, and A.D.3 (RSV-A) and to B.D.4.1.3 and B.D.E.1 (RSV-B), consistent with the ON1 (RSV-A) and BA (RSV-B) genotypes prevalent in recent seasons. Clinically relevant mutations included changes in the influenza HA site and neuraminidase substitutions, RSV F-protein polymorphisms, and spike protein substitutions associated with recent Omicron sublineages (L455F/S, F456L) in SARS-CoV-2. Conclusions: A unified amplicon–NGS approach yields harmonized genomic data across respiratory viruses, enabling timely detection of antigenic drift and resistance markers while supporting integrated, cross-pathogen surveillance. Full article

Respiratory syncytial virus (RSV), a member of the genus Orthopneumovirus, is an etiological agent in infant lower respiratory tract infections (LRTIs) producing substantial global morbidity. Here, secretoglobin (Scgb1a1)-derived progenitors play a primary role in triggering innate, inflammatory, and cell state transitions in response to RSV LRTIs. Whether RSV activation of innate signaling in this epithelial sentinel population leads to chronic airway disease is unknown. To understand the role of innate signaling in Scgb1a1-derived progenitors, a model of RSV post-viral disease (PVLD) was developed and studied in the presence or absence of RelA conditional knockout (CKO). Single-cell RNA sequencing (scRNA-seq) studies showed that RSV-PVLD induced a transition of atypical, differentiation-intermediate, alveolar type 2 (aAT2) cells characterized by tumor protein 63 (TRP63), aquaporin 3 (AQP3), and Itgβ4 expression, as well as changes in PDGFRβ mesenchyme. A single-cell trajectory analysis and lineage-tracing experiments using Scgb1a1 CreER^TM X mTmG mice demonstrated that the Scgb1a1+ populations were precursors to the aAT2 population. Mechanistically, we found that the formation of the aAT2 population was prevented by RelA CKO. A differential gene expression analysis revealed that RSV-PVLD coordinately upregulates nuclear receptor subfamily 1 group D (Nr1d1/2), clock and basic helix-loop-helix ARNT-like 1 (Bmal) genes both in the aAT2 cell and in its Pdgfrα+ mesenchymal niche in a RelA-dependent manner. A systematic analysis of intercellular epithelial–mesenchymal communication in the scRNA-seq data showed that the clock-dysregulated epithelial–mesenchymal niche produces aberrant ANGPTL4 expression. ANGPTL4 upregulation was confirmed by the measurement of both its mRNA and protein. Moreover, ANGPTL4 is biologically active in the BALF of RSV-PVLD mice, inhibiting lipoprotein lipase activity. We conclude that RSV-PVLD is mediated, at least in part, by RelA signaling in Scgb1a1-derived epithelial progenitors, dysregulating ANGPTL4 signaling in an epithelial–mesenchymal niche, resulting in persistence of atypical alveolar epithelial cells with dysregulated of clock gene expression. Full article

Molecular point-of-care testing (POCT) for respiratory infections has undergone remarkable advancement over the past two decades, driven by technological innovation and urgent clinical needs highlighted by the COVID-19 pandemic. This comprehensive systematic review was conducted following PRISMA 2020 guidelines, synthesizing evidence from 254 peer-reviewed studies published between 2006 and 2026, with detailed analysis of the 30 most relevant papers selected through a rigorous four-stage screening process. The review examines the evolution of molecular POCT technologies, including reverse transcription polymerase chain reaction (RT-PCR), loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), and CRISPR-based detection systems. Key findings demonstrate that modern molecular POCT platforms achieve diagnostic performance comparable to laboratory-based testing, with sensitivities ranging from 88% to 100% and specificities from 98% to 100%, while delivering results in 15 to 80 min. These technologies enable rapid, accurate detection of major respiratory pathogens, including SARS-CoV-2, influenza A/B, respiratory syncytial virus (RSV), and atypical bacteria. The integration of microfluidic systems, portable devices, and smartphone-based analysis has expanded access to testing in resource-limited settings, emergency departments, and wearable platforms. This review provides critical insights for clinicians, researchers, and policymakers regarding the current state, clinical applications, and future directions of molecular POCT for respiratory infections. Full article

Introduction: Congenital central hypoventilation syndrome (CCHS) is a rare disorder characterized by an impaired ventilatory response to hypercapnia and hypoxia, particularly during sleep, and frequently associated with autonomic dysfunction. It is caused by pathogenic variants in the PHOX2B gene. Although CCHS is typically diagnosed in the neonatal period, milder forms may present later in infancy or childhood, often triggered by respiratory infections. Case presentation: We report the case of 16-month-old male diagnosed with CCHS following an episode of hypoxemic–hypercapnic respiratory failure during respiratory syncytial virus (RSV) infection. His medical history included neonatal respiratory distress requiring oxygen therapy and recurrent wheezing. At 15 months, he developed acute respiratory distress with severe hypercapnia (PaCO₂ 70 mmHg), requiring admission to the Pediatric Intensive Care Unit and invasive mechanical ventilation. Persistent sleep-related hypercapnia and hypoxemia prompted evaluation for central hypoventilation, confirmed by means of transcutaneous capnography and nocturnal pulse oximetry. Genetic testing revealed a de novo nonsense mutation in exon 1 of PHOX2B (p.Tyr14Ter). Brain magnetic resonance imaging showed diffuse white matter changes suggestive of gliosis. Further investigations identified early-onset systemic hypertension, requiring antihypertensive therapy. The patient was discharged on nocturnal non-invasive ventilation and enrolled in a neurodevelopmental rehabilitation program. Conclusions: This case highlights the phenotypic variability of CCHS and the importance of considering this diagnosis in children presenting with unexplained hypercapnia and sleep-related hypoxemia. It underscores the need for comprehensive autonomic evaluation, including blood pressure monitoring. The p.Tyr14Ter variant may allow partial protein function, potentially accounting for the relatively mild phenotype. Full article

To compare the respiratory lesions and nervous system damage in cotton rats and BALB/c mice following respiratory syncytial virus (RSV) infection, and to evaluate their suitability as models for RSV-related respiratory and nervous system diseases, cotton rats and BALB/c mice were infected with RSV via intranasal instillation, monitored daily for weight and temperature. At 3, 5, and 7 days post-infection (dpi), viral loads in the nasal turbinates, lungs, and brain tissues were quantified. Pathological changes and neuroinflammatory responses in the lungs and brain were assessed using hematoxylin and eosin (H&E) staining, Nissl staining, immunofluorescence, and Western blotting analysis, while the mRNA expression levels of inflammatory factors were specifically analyzed at 5 dpi. The results showed that viral loads in the nasal turbinates and lungs of cotton rats were significantly higher than those in BALB/c mice, accompanied by more extensive pulmonary inflammatory factor gene upregulation at 5 dpi and more pronounced lung histopathological alterations. In contrast, RSV RNA and antigens were detected in the brain tissues of BALB/c mice, at levels markedly lower than those in respiratory tissues, along with viral antigens primarily localized to the choroid plexus epithelium. No significant pathological or neuroinflammatory changes were observed in the brains of cotton rats at any examined time point. In conclusion, cotton rats provide advantages for modeling RSV-associated respiratory tract infection and pulmonary pathology, whereas under the experimental conditions of this study, BALB/c mice may be more appropriate for investigating RSV-associated CNS inflammatory responses, although the clinical relevance of these findings remains to be further validated. Full article

High-power ultrasound has been widely used to regulate the anti-digestibility of starch-based products, including the formation of resistant starch (RS-V) in amylopectin assemblies. This can contribute to the attenuation of postprandial hyperglycemia. However, the mechanisms by which high-power ultrasound modulates RS-V remain to be elucidated. Therefore, nano-scale Euryale ferox amylopectin (EFA) ternary assemblies were constructed under high-power ultrasound. All EFA assemblies exhibited ternary self-assembly peaks and V-type crystallinity. Combined chemometric analyses revealed that, with increasing ultrasound power, the rising self-assembly sites within B2 and C chains promoted the increase in self-assembly index but decreased semicrystalline lamellae thickness and structural fractal dimension. Consequently, a compact and ordered molecular cross-linking network was formed, contributing to increases in residual crystallinity, molecular weight, short-range order, and molecular density. This resulted in the shrinkage of digestion channel structures and optimization of the molecular gel network. As a result, the reduction in hydrolysis sites with increasing ultrasound power led to increased RS-V content (22.66–60.17%), causing a decline in the estimated glycemic index. The EFA–lauric acid–lactoglobulin assemblies prepared under 600 W ultrasound were the optimal composition and exhibited enhanced anti-digestibility relative to amylopectin assemblies derived from staple crops such as white waxy maize. The present investigation not only serves as a valuable supplement for studying the precise regulation mechanisms of nano-scale amylopectin RS-V, but also provides critical theoretical guidance for the development of foods aimed at preventing hyperglycemia. Full article

Background/Objectives: Next to malaria, respiratory viruses, particularly respiratory syncytial virus (RSV), are responsible for the hospitalization and death of thousands of young children each year in sub-Saharan Africa. During peak seasons, conducting separate tests is time-consuming and distressing. This underscores the need for efficient, rapid multiplexed diagnostic tools. This study aimed to evaluate the clinical performance of a lateral flow assay (LFA) based antigen combo rapid diagnostic test (ML Ag Combo RDT, manufactured by MobiLab) that detects RSV, influenza viruses A and B (Flu A/B), and SARS-CoV-2. Methods: The Allplex panel 1 rRT-qPCR assay was used as a reference assay to evaluate the clinical performance of the LFA Ag Combo RDT in pediatric hospital settings. It was performed using 470 nasopharyngeal swab (NPS) specimens from hospitalized children under two years of age with respiratory symptoms. Results: Based on the comparative analysis of the testing results for 470 NPS, the ML Ag Combo RDT demonstrated high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 90.06%, 98.38%, 93.67, and 97.39% for RSV, and 30%, 100%, 100%, and 95.43 for Flu A/B, respectively. Agreement with the Allplex panle1 1 rRT-qPCR was strong (κ = 0.90 for RSV) and moderate (κ = 0.45 for Flu A/B), with overall accuracies of 96.63% for RSV and 95.5 for Flu A/B. This was further supported by ROC analysis for aggregated data (RSV and, Flu A/B) with an AUC value of 0.925. As expected, in samples with high viral loads (Ct < 20), the Ag Combo RDT achieved 100% sensitivity for RSV and Flu A/B. Sensitivity declined slightly at lower viral loads (Ct > 35). Conclusions: The ML Ag Combo RDT demonstrates high specificity and diagnostic accuracy for the detection of RSV and Flu A/B in pediatric hospital settings where timely diagnosis is critical. Full article

Respiratory syncytial virus (RSV) poses a substantial global health burden, particularly in infants and the elderly. The fusion (F) protein is a key therapeutic target for inhibiting RSV entry. In this study, we performed a structure-based virtual screening of the Comprehensive Marine Natural Products Database (CMNPD) to discover novel anti-RSV agents targeting the prefusion F protein trimer. Screening of 31,561 compounds via molecular docking, followed by stringent ADMET (absorption, distribution, metabolism, excretion, and toxicity) profiling and MM/GBSA (Molecular Mechanics/Generalized Born Surface Area) binding free energy calculations, identified 11 promising candidates. Among these, manzamine alkaloids exhibited the most favorable docking scores (as low as −13.3 kcal/mol) and promising Ligand Efficiency (LE) values. These molecules primarily interact with conserved hydrophobic residues (Phe140, Phe488) through hydrophobic interactions, π-stacking, and electrostatic forces. Our study highlights marine natural products, especially manzamine alkaloids, as promising leads for the development of novel, orally bioavailable RSV fusion inhibitors, potentially offering avenues to overcome existing drug resistance. However, these computational findings require in vitro validation to confirm efficacy. Full article

Respiratory syncytial virus (RSV) is a leading cause of respiratory infections in infants and older adults, with epidemiological patterns shaped by viral evolution and diversity. To investigate the molecular epidemiology of RSV before and after the COVID-19 pandemic, we conducted genomic surveillance and phylodynamic analyses of RSV-A and RSV-B circulating in Maryland from 2018 to 2024. Whole-genome sequencing of RSV-positive samples (n = 451) was performed, and genomes were analyzed with phylogenetic and Bayesian methods to estimate evolutionary rates, population dynamics, selection pressures, and genetic diversity. RSV-A predominated in most seasons, while RSV-B showed episodic surges in 2018 and 2023. All RSV-A genomes belonged to the ON1 genotype, and RSV-B belonged to BA9, with sequential clade dominances including A.D.1, A.D.5.2, A.D.1.6, and B.D.E.1 across different epidemic seasons in Maryland. Bayesian analyses estimated evolutionary rates of 7.07 × 10⁻⁴ substitutions/site/year for RSV-A and 1.02 × 10⁻³ substitutions/site/year for RSV-B and temporal fluctuations in effective population size linked to pandemic-related disruptions. RSV-A displayed greater overall entropy, yet RSV-B evolved slightly faster. Genetic variability was concentrated in the G glycoprotein, with positively selected sites at codon 273 (RSV-A) and codon 217 (RSV-B). These findings demonstrate temporal fluctuations in RSV-A and RSV-B predominance, clade replacement, and ongoing viral adaptation throughout the COVID-19 era, underscoring the importance of integrated genomic and phylodynamic studies. Full article