Search Results (100)

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: Contrast-associated acute kidney injury (CA-AKI) remains an important cause of morbidity and mortality in patients undergoing procedures that require intravascular contrast administration. Therefore, the early identification of high-risk individuals is paramount, above all for ST-segment elevation myocardial infarction (STEMI) patients in need of urgent percutaneous coronary intervention (PCI). Methods: This retrospective study evaluated the prognostic value of the Pan-Immune-Inflammation Value (PIV), a composite inflammatory index, in predicting CA-AKI among patients presenting with STEMI who received urgent PCI within a 12 h window from the onset of symptoms. Results: This study recruited 2325 patient. CA-AKI was defined as a >25% or ≥0.5 mg/dL increase in serum creatinine within 48–72 h after the procedure. Patients were categorized into CA-AKI (+) and CA-AKI (−) groups. PIV levels were significantly higher in patients who developed CA-AKI (502.5 ± 324.5 vs. 264.7 ± 165.8; p < 0.001). ROC analysis identified a PIV cutoff value of >320, yielding an AUC of 0.753 (95% CI: 0.740–0.787; p < 0.001), with 67% sensitivity and 66.9% specificity. Multivariate logistic regression confirmed that PIV > 320 independently predicted CA-AKI (OR 2.118; 95% CI: 1.329–3.790; p < 0.001). In multivariable analysis, age, Killip class, contrast volume, and PIV > 320 were identified as independent predictors of CA-AKI. Conclusions: Elevated admission PIV serves as an independent and practical biomarker for predicting CA-AKI in STEMI patients undergoing PCI. Full article

Background/Objectives: This study aimed to investigate the prognostic significance of the triglyceride–glucose index (TGI), triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, and inflammatory biomarkers in predicting short-term mortality among intensive care unit (ICU) patients with sepsis. Additionally, this study evaluated whether combining these indices with conventional clinical scores improves prognostic accuracy. Methods: This retrospective cohort study included 600 adult ICU patients diagnosed with sepsis according to Sepsis-3 criteria between January 2020 and April 2025. Clinical, biochemical, and hematological data were collected within the first 24 h of ICU admission. Metabolic indices (TGI, TG/HDL-C) and inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], systemic immune-inflammation index [SII], and pan-immune-inflammation value [PIV]) were analyzed. The primary outcome was 28-day mortality. Receiver operating characteristic (ROC) analyses, Kaplan–Meier survival curves, and a multivariable logistic regression model were applied to determine prognostic performance. Results: Non-survivors exhibited significantly higher levels of TGI, TG/HDL-C, NLR, SII, and PIV compared to survivors (all p < 0.001). In ROC analysis, TGI (AUC = 0.75, 95% CI: 0.71–0.79), TG/HDL-C (AUC = 0.72, 95% CI: 0.68–0.76), and PIV (AUC = 0.78, 95% CI: 0.74–0.82) demonstrated good discriminative power for predicting 28-day mortality. Multivariate logistic regression identified TGI > 8.95 (OR = 1.44, 95% CI: 1.19–1.74, p < 0.001), TG/HDL-C > 3.95 (OR = 1.31, 95% CI: 1.08–1.59, p = 0.005), and PIV > 260 (OR = 1.49, 95% CI: 1.22–1.82, p < 0.001) as independent predictors of mortality. Integrating TGI and PIV with the SOFA score improved prognostic performance (ΔAUC = +0.04). Conclusions: Both TGI and TG/HDL-C are independent predictors of short-term mortality in septic ICU patients, reflecting the contribution of metabolic dysregulation to disease severity. The PIV demonstrated comparable predictive ability to conventional severity scores. Combining metabolic and inflammatory biomarkers with established clinical indices may enhance early risk stratification and guide personalized management strategies in sepsis. Full article

Respiratory viruses such as SARS-CoV-2, influenzas A and B, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), human parainfluenza virus type 3 (HPIV-3), and rhinoviruses remain major causes of global morbidity. Their rapid evolution, high transmissibility, and limited therapeutic options, together with the absence of approved vaccines for several pathogens, highlight the need for broad-acting and pathogen-independent antiviral strategies. Nitric oxide exhibits antiviral activity through redox-dependent mechanisms, including S-nitrosylation of cysteine-containing viral proteins and disruption of redox-sensitive structural domains. Clinical studies conducted during the SARS-CoV-2 pandemic demonstrated that a nitric oxide nasal spray (NONS) rapidly reduced nasal viral load and transmission. In this study, we evaluated the in vitro virucidal activity of the NONS against a panel of clinically relevant respiratory viruses representing four major virus families. Virus suspensions of approximately 10⁴ CCID₅₀ were exposed to a full-strength NONS for contact times ranging from 5 s to 2 min at room temperature, followed by neutralization and quantification of residual infectivity using endpoint dilution assays. The NONS rapidly reduced viral infectivity across all viruses tested, achieving >3 log₁₀ reductions within 2 min. SARS-CoV-2 variants including Alpha, Beta, Gamma, Delta, Omicron BA.1, and XBB 2.0 were reduced to levels at or below the assay detection limit within 30 s to 2 min. Influenza A and B viruses showed the fastest loss of infectivity, reaching detection limits within 10–15 s. RSV, hMPV, HPIV-3, and human rhinovirus 14 were similarly inactivated within 1–2 min. These findings demonstrate that the NONS exhibits rapid and broad-spectrum virucidal activity against diverse respiratory viruses and supports its potential role in pandemic preparedness but also seasonal use. Full article

The recent literature has debunked the widespread hypothesis that viruses are primarily transmitted via droplets and not beyond 1.5 m, and transmission via contact has been downplayed. Hence, an evidence-based revision of the existing isolation guidelines for respiratory viruses was needed. Therefore, a completely new protocol for respiratory virus isolation in terms of personal protective equipment and patient room air purification was evaluated. Isolation relief criteria based on Ct values in follow-up sampling were assessed. A Ct value of <28 was employed as a proxy for potential active replication and associated transmissibility. Between 25% and 50% of patients who tested positive for RSV, HRV, hMPV, or SARS-CoV-2 continued to exhibit high viral loads on day 7 post-initial diagnosis, underscoring the potential for sustained infectivity. Hence, the discontinuation of isolation measures for these patients without follow-up testing may carry a considerable risk of ongoing viral transmission. On the contrary, only 7% of patients positive for Flu and 14% for PIV had a follow-up sample on day 7 with a Ct value of less than 28. Ct values increased more rapidly in influenza, indicating faster viral clearance compared to other respiratory viruses. Based on these results, the policy of a standard 7-day isolation period without follow-up testing could be adopted for influenza-positive patients. Full article

Background: Rapid pathogen detection is crucial for the timely containment of outbreaks, particularly for respiratory infectious diseases which are highly transmissible and possess high epidemic potential. Methods: We developed a sensitive reverse transcription recombinase-aided amplification (RT-RAA) assay for the rapid detection of six common respiratory viruses: respiratory syncytial virus type A (RSV A), influenza A virus (Flu A), influenza B virus (Flu B), human parainfluenza virus (HPIV), SARS-CoV-2 and adenovirus (ADV). The assay employs a single, standardized protocol for the on-demand detection of any one of the six targets. Its performance was validated using nucleic acid standards and clinical pharyngeal swab specimens. Results: The assay enables rapid detection within 20 min at 39 °C using a portable, self-powered device. It demonstrated high sensitivity, with detection limits below 10³ copies/mL for all targets and as low as 10¹ copies/mL for ADV. Cross-reactivity testing with 21 other pathogens confirmed excellent specificity. Validation with 85 clinical samples showed 100% concordance with RT-PCR, while offering significantly faster results and enhanced portability compared to RT-PCR. Conclusions: This sensitive, specific, and user-friendly RT-RAA assay provides a robust tool for rapid detection of respiratory viruses, particularly suitable for deployment in resource-limited settings and point-of-care testing during outbreaks. Full article

Objectives: This study aimed to evaluate the predictive value of the neutrophil percentage-to-albumin ratio (NPAR) and other inflammatory indices for contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods: This retrospective cohort study included 317 ACS patients (aged ≥18 years) undergoing PCI between May 2022 and July 2024 at a single center in Turkey. Patients were divided into two groups based on CI-AKI development: those who developed CI-AKI (n = 35, 11.1%) and those who did not (n = 282, 88.9%). Data on demographics, clinical variables, and laboratory parameters (complete blood count, biochemistry) were collected from medical records. Inflammatory indices (neutrophil percentage-to-albumin ratio [NPAR], neutrophil-to-lymphocyte ratio [NLR], systemic immune–inflammation index [SII], pan-immune–inflammation value [PIV], systemic inflammation response index [SIRI]) were calculated. CI-AKI was defined as a ≥0.5 mg/dL absolute or ≥25% relative increase in serum creatinine within 48–72 h after contrast exposure. Results: The CI-AKI group demonstrated significantly higher neutrophil counts (p < 0.001) and neutrophil percentages (p < 0.001) and lower lymphocyte counts (p = 0.024) compared to the non-CI-AKI group. Baseline creatinine was lower in CI-AKI patients (p = 0.001) but showed significantly greater post-procedural increases (p = 0.008). All inflammatory indices predicted CI-AKI development, with NPAR showing superior performance: NPAR (AUC = 0.896, sensitivity 82.9%, specificity 84.0%), NLR (AUC = 0.732), SII (AUC = 0.694), PIV (AUC = 0.674), and SIRI (AUC = 0.709) (all p < 0.001). Independent predictors of CI-AKI included NPAR >18.44 (OR = 8.511, 95% CI: 2.763–26.212, p < 0.001), SIRI > 2.4 × 10³ (OR = 2.991, p = 0.036), neutrophil count (OR = 1.707, p = 0.008), beta-blocker use (OR = 13.037, p = 0.016), and atrial fibrillation (OR = 8.042, p = 0.044). Conclusions: NPAR emerges as an accessible biomarker for predicting CI-AKI in ACS-PCI patients, which is also superior to other inflammation indices. We believe it is necessary to recommend its integration into risk stratification to improve outcomes among PCI recipients. Full article

This study investigated the long-term trends in human parainfluenza virus (HPIV) types 1, 2, and 3 in Korea by year, age group, and season. A total of 23,284 nasopharyngeal swabs collected from patients with respiratory symptoms at a tertiary hospital in Korea between 2007 and 2024 were tested for HPIV using real-time reverse-transcription polymerase chain reaction. Of the 23,284 specimens tested, 481 were positive for HPIV-1, 164 for HPIV-2, and 1102 for HPIV-3. HPIV-3 showed the highest incidence between 2010 and 2016, a decline after 2018, a sharp decline during the 2020 COVID-19 pandemic, and a resurgence in 2021. HPIV-1 and HPIV-2 incidence fluctuated between 2007 and 2019, followed by a sharp decline in 2020. HPIV-3 activity peaked in spring and summer, whereas HPIV-1 and HPIV-2 peaked in autumn. For all three types, infection rates were generally highest among children aged 1–12 years, followed by those in infants, but infection rates varied significantly by type, year, season, and age group. These findings emphasize targeted pediatric prevention, predictive modeling of seasonal peaks, and continued molecular surveillance to clarify the genetic and antigenic diversity of HPIV types after the pandemic, supporting the Sustainable Development Goals (SDG 3 for Good Health and Well-Being). Full article

We study thrust production in a single-fluid magnetohydrodynamic (MHD) thruster with Hall-type coaxial geometry and show how velocity–field alignment and magnetic topology set the operating regime. Starting from the momentum equation with anisotropic conductivity, the axial Lorentz force density reduces to $f_z={\sigma }_{\theta z}{E}_z{B}_r(\chi -1)$, with the motional-field ratio $\chi \equiv \left(u{B}_r\right)/E_z$. Hence, net accelerating force ($f_z>0$) is achieved if and only if the motional electric field $E_m=u{B}_r$ exceeds the applied axial bias $E_z$ ($\chi >1$), providing a compact, testable design rule. We separate alignment diagnostics (cross-helicity $h_c=\mathit{u}·\mathit{B}$) from the thrust criterion ($\chi$) and generate equation-only axial profiles for $\chi \left(z\right)$, $j_{\theta }\left(z\right)$, and $f_z\left(z\right)$ for representative parameters. In a baseline case $(E_z=150\mathrm{V}{\mathrm{m}}^{-1},{\sigma }_{\theta z}=50\mathrm{S}{\mathrm{m}}^{-1},u_0=12\mathrm{km}{\mathrm{s}}^{-1},B_{r0}=0.02\mathrm{T},L=0.10\mathrm{m})$, the $\chi >1$ band spans $\approx 21.2\%$ of the channel; a lagged correlation peaks at $\Delta z^{★}\approx 8.82\mathrm{mm}$$(C_{HU}=0.979)$, and ${\int }_0^L{f}_z\mathrm{d}z$ is slightly negative—indicating that enlarging the $\chi >1$ region or raising ${\sigma }_{\theta z}$ are effective levers. We propose a reproducible validation pathway (finite-volume MHD simulations and laboratory measurements: PIV, Hall probes, and thrust stand) to map $f_z$ versus $\chi$ and verify the response length. The framework yields concrete design strategies—$B_r\left(z\right)$ shaping where u is high, conductivity control, and modest $E_z$ tuning—supporting applications from station-keeping to deep-space cruise. Full article

Piperine is an alkaloid found in plants of the genus Piper, and particularly in P. nigrum. This compound has been under extensive research lately for its antimicrobial, antiviral, and also anti-inflammatory, anti-oxidant, anticancer, and positive metabolic properties. Regarding its antibacterial applications, current data show that piperine is effective against Bacillus sphaericus, Bacterioides fragilis, Escherichia coli, Mycobacterium tuberculosis, Staphylococcus aureus, Streptococcus mutans, Pseudomonas aeruginosa, and Vibrio cholerae; its antifungal potency is exerted against Candida albicans and members of the Aspergillus family; antiviral activity has been documented against MERS-CoV, SARS-CoV2, EBOV, DENV, HCV, ZKV, and HPIV; and antiparasitic activity against Leishmania spp., Plasmodium spp., Trichomonas vaginalis, and Trypanosoma spp. While such applications are promising, more research is required to elucidate the mechanisms of action and to discover new ways of administration. Full article

Background and Objectives: Despite the advances in the treatment, severe burns with total burn surface area ≥ 20% are still a major cause of mortality worldwide. Pan-immune inflammation value (PIV) is a novel and promising biomarker to predict prognosis and mortality in various diseases. The aim of this study was to evaluate the utility of PIV to predict in-hospital mortality of patients with severe burn. Materials and Methods: This retrospective cross-sectional study included ≥18 years old patients with severe burn who were admitted to hospital within 12–24 h after the burn injury between January 2007 and August 2024. The demographics, clinical and laboratory characteristics of patients were recorded from electronic hospital records. Pan-immune inflammation value was calculated as neutrophil counts x monocyte count x platelet counts divided by lymphocyte counts. The receiver operating characteristic (ROC) analysis was conducted to determine the predictive value of PIV for mortality. Results: A total of 100 patients (median age 41 (26.3–55) years; 79% male) were included in the study of whom 23 were non-survivors. The PIV was significantly higher in non-survivors when compared to survivors (p = 0.009). The ideal cut-off of PIV was 1185, with a sensitivity of 69.6% and a specificity of 66.2%. The multivariate analysis showed that high PIV along with inhalation injury, and the need for surgery were predictors of in-hospital mortality. Conclusions: This study is the first to demonstrate that the novel, comprehensive index, PIV, is a reliable immuno-inflammatory marker predicting in-hospital mortality in patients with severe burn. Full article

Background: This study investigated the epidemiology of Mycoplasma pneumoniae (MP) in children with acute respiratory tract infections (ARTIs) and explored the risk factors for severe mycoplasma pneumoniae pneumonia (SMPP) in children. Methods: A retrospective analysis was conducted on 36,380 children with acute respiratory infections who underwent multiplex real-time polymerase chain reaction (RT-PCR) assays for nine respiratory pathogens from September 2021 to November 2024. Results: A total of 36,380 children with ARTIs were enrolled in this study. The co-detection rate of MP with other pathogens was significantly higher in the post-NPIs period than in the NPIs period (36.5% vs. 25.7%, p < 0.01). Multivariate regression identified the detection of influenza A virus (InfA), InfB, human parainfluenza virus (HPIV), human bocaparvovirus (HBoV), human rhinovirus (HRV), adenovirus (ADV), human respiratory syncytial virus (HRSV), and human metapneumovirus (HMPV) as protective factors against MP epidemics (p < 0.01); meanwhile, older age, the cancellation of NPIs, and summer–autumn seasons were found to be risk factors. After adjusting for sex, age, period, season, and pathogens, InfB (OR: 3.009, 95%CI: 1.041–8.697, p = 0.042), HPIV (OR: 2.226, 95%CI: 1.170–4.235, p = 0.015), and ADV (OR: 2.035, 95%CI: 1.105–3.750, p = 0.023) were identified as independent risk factors for SMPP. Conclusions: These findings highlight post-NPI shifts in MP epidemiology and identify ADV, InfB, and HPIV as early warning markers for SMPP. Full article

Human parainfluenza viruses 3 (hPIV3) are important pathogens, responsible for acute respiratory tract diseases, especially in young children. Information on hPIV3 circulation and their diversity pattern in Russia is limited. The aim of this study was to perform a molecular and genetic characterization of hPIV3 circulating in Saint Petersburg, Russia. From October 2017 to September 2023, 14,704 swabs were screened using real-time reverse transcription-PCR. A phylogenetic analysis of the complete hemagglutinin–neuraminidase (HN) gene was performed. Out of 1334 positive hPIV cases, hPIV3 was the most common subtype. Phylogenetic analysis of the studied and previously published HN sequences revealed four distinct genetic clusters, A, B, C, and D, with Cluster D being first delineated in this study. In addition, two newly subdivided genetic lineages, C5a and C5b, were documented. Phylogenetic analysis revealed that the analyzed Russian strains grouped into Cluster C and D; further subclusters C5a, C5b, C3b, C3e, and C3a. While three strains were classified within cluster D, the majority of isolates fell within subcluster C3a, followed by C5b. Taken together, these findings demonstrate the co-circulation of hPIV3 strains during the study period. This is the first study that describes the genetic and molecular aspects of hPIV3 circulating in Russia. Moreover, our results provide an up-to-date hPIV3 phylogenetic analysis. Full article

Persistent RNA virus infections (PI) are often characterized by extended viral shedding and maintained cycles of inflammation. The innate immune Complement (C′) pathways can recognize acute infected (AI) cells and result in their lysis, but the relative sensitivity of PI cells to C′-directed killing is incompletely understood. Here, we extended our previous studies on the interactions of C′ with parainfluenza virus AI and PI A549 cells to two additional respiratory tract cell lines. AI Hep2 and H1975 cells infected with Parainfluenza virus 5 (PIV5) were found to be highly sensitive to C′ lysis. By contrast, PIV5 PI cells were highly resistant to killing by C″. Surface deposition of membrane attack complex (MAC) and C3 was also greatly reduced on the surface of PI cells compared to AI cells. PI cells had lower levels of surface viral glycoprotein expression compared to AI cells. Treatment of AI cells with ribavirin (RBV) showed a dose-dependent decrease in both viral glycoprotein expression and sensitivity to C′-mediated lysis. When surface viral glycoprotein levels were reduced in AI cells to those in PI cells, AI cells became similarly resistant to C′. While sialic acid levels on PI cell surfaces matched that of naïve cells, enzymatic removal of this sialic acid did not increase sensitivity to C′-mediated lysis. Despite their varying profiles of C′ activation and deposition, these studies indicate downregulation of viral gene expression as a common mechanism of C′ resistance across various parainfluenza virus PI cell lines. Full article

The present article offers a detailed analysis of helium jet velocity and vorticity intensity distribution using the particle image velocimetry (PIV) technique. A gaseous fuel injector featuring an interchangeable tip was implemented. The test campaign involved the use of three nozzle patterns characterized by different orifices shape and orientations. The helium was injected into a constant volume chamber (CVC) and the delivery pressure varied, as well as that inside the chamber, in order to obtain pressure ratios (PRs) ranging from 2 to 20. The synchronization system was set to record two consecutive frames at different time-instants after the start of energizing (aSOE). Green light from a dual cavity Nd:YAG laser was used for illumination and a 4-megapixel PIV-camera for image capture. Vegetable oil particles were seeded into the chamber to trace the helium jet structure and cross-correlation methodology employed to measure their instantaneous displacements. The role of orifices size and orientations has been deeply scrutinized and related to the morphological outcomes. The least-oriented nozzle (first) exhibited the highest values of jet penetration and well-defined vortex structures. In contrast, the more the orifices are oriented, the wider the regions interacting with surrounding environment. Specifically, geometry with smaller orifice sizes (third) returned an overall absence of localized significant vortex structures. This deficiency is counterbalanced by a large distribution of small vortices that were observed to replace the main rings for each condition examined. Full article