Search Results (91,057)

Background: Long-acting monoclonal antibodies have become an important strategy for preventing respiratory syncytial virus (RSV) disease in infants. Nirsevimab is the first product for which substantial post-licensure implementation data are available, whereas real-world evidence on clesrovimab remains limited. Although nirsevimab has demonstrated high efficacy, its uptake varies considerably across countries, healthcare systems, delivery settings, and population subgroups. This World Association for Infectious Diseases and Immunological Disorders (WAidid) consensus document examines the policy, organizational, economic, and equity-related determinants that shape real-world implementation of long-acting monoclonal antibodies for infant RSV prevention. Methods: This study was conducted as a structured narrative review and WAidid expert consensus document. A structured literature search was performed in PubMed and Embase for English-language publications relevant to nirsevimab uptake and implementation, complemented by targeted review of surveillance reports, policy documents, and public health guidance from the ECDC, UKHSA, and CDC, as well as reference lists of selected publications. Eligible sources included observational and real-world implementation studies, systematic reviews and meta-analyses, economic evaluations, guidelines, policy statements, surveillance reports, and relevant narrative reviews. Evidence was synthesized qualitatively according to policy frameworks, financing and reimbursement, delivery pathways, demographic and socioeconomic determinants, and healthcare-system factors influencing uptake. No statistical software was used because no quantitative re-analysis or meta-analysis was performed. Results: Nirsevimab uptake was strongly influenced by national RSV prevention policies, particularly whether countries adopted universal infant monoclonal antibody programs, maternal RSV vaccination strategies, dual maternal–infant approaches, or targeted risk-based models. Universal, publicly funded programs integrated into neonatal care achieved the highest and most homogeneous coverage, especially when administration occurred before hospital discharge and was supported by registry-based recall systems for infants born outside the RSV season. In contrast, fragmented, outpatient-only, insurance-dependent, or partially reimbursed models were associated with lower, delayed, or more variable uptake. Additional determinants included product cost, reimbursement pathways, provider practices, caregiver awareness and health literacy, insurance status, income, race and ethnicity, geographic deprivation, and access to primary pediatric care. Most available evidence comes from high-income countries, limiting generalizability to low- and middle-income settings, where RSV burden is greatest and implementation constraints may differ. Conclusions: Successful implementation of long-acting monoclonal antibodies for infant RSV prevention requires more than regulatory approval and demonstrated efficacy. Equitable uptake depends on clear national recommendations, sustainable public financing, reliable product supply, integration into neonatal and primary pediatric care, proactive identification and recall of eligible infants, and targeted strategies to reduce socioeconomic and geographic disparities. Although many determinants identified in high-income settings are likely relevant globally, their feasibility, relative importance, and impact require dedicated evaluation in low- and middle-income countries. Full article

Salix songarica Andersson (S. songarica), a medicinal plant endemic to Xinjiang, exhibits high polyphenol content in its floral tissues. Although it shows anti-inflammatory potential, the underlying mechanisms remain unclear. This study investigated the therapeutic effects of polyphenol-enriched S. songarica flower extract (SSFP) on inflammation and dyslipidemia in high-fat, high-cholesterol diet (HFHCD)-fed ApoE^−/− mice. SSFP administration significantly improved serum lipid profiles, hepatic function, and systemic inflammatory biomarkers in these mice, while also attenuating histopathological inflammation in the liver, kidney, and colon. Furthermore, SSFP treatment upregulated the expression of GPR120 and β-arrestin-2 and suppressed NLRP3 inflammasome activation. In vitro experiments further showed that the anti-inflammatory effect of LPC18:1 was consistent with SSFP. Together, our results demonstrate that SSFP alleviates inflammation through the LPC18:1/GPR120/β-arrestin-2/NLRP3 signaling axis, supporting its potential application as a natural functional food ingredient. Full article

Psychological resilience is a key protective factor for mental health. Reducing inequalities in access to childhood experiential activities may foster resilience across socioeconomic backgrounds. However, Japan limits policies ensuring equitable access to such activities before entering elementary school. This cross-sectional study examined the association between exposure to experiential activities before entering elementary school and psychological resilience in Japanese individuals aged 15–39 years (n = 8000). Experiential activities were classified into nature-related, social, and cultural domains and by number and combination (none, any single, any two, and all three types). Psychological resilience was assessed using the 14-item Resilience Scale (Japanese version). Multivariable linear regression models were adjusted for demographic and socioeconomic covariates with Benjamini–Hochberg (BH) correction. Exposure to one or two activity domains was significantly associated with higher psychological resilience, except for the nature-related plus social activities combination. Exposure to all three domains showed the strongest association (β = 8.06, 95% confidence interval [6.73, 9.38], BH-adjusted p < 0.001). Therefore, early childhood experiential activities may promote psychological resilience, with persistent long-term effects. Implementing social policies to reduce the disparity in access may be a key strategy for promoting psychological resilience among Japanese individuals aged 15–39 years. Full article

Mpox has emerged as a global public health concern, highlighting the limitations of traditional vaccinia-based vaccination strategies and the urgent need for precision vaccinology approaches. Advances in structural virology and immunoinformatics have enabled the identification of conserved immunodominant antigens from both mature virion and extracellular virion forms, supporting the development of multivalent antigen combinations capable of inducing broad neutralizing antibody (nAb) responses. Emerging delivery technologies including mRNA-lipid nanoparticles, viral vectors, and self-assembling protein nanoparticles offer rapid scalability, enhanced immunogenicity, and improved safety compared with conventional live-attenuated vaccines. Addressing antigenic evolution, vaccine supply limitations, and population-specific immune variability will be crucial for optimizing vaccine effectiveness. This review synthesizes current evidence on antigen design, vaccine delivery platforms, and immunological correlates of protection to outline a framework for next-generation mpox vaccines. Precision vaccinology therefore represents a transformative strategy for developing durable, clade-specific mpox vaccines and strengthening preparedness against future orthopoxvirus outbreaks worldwide. Full article

Background: Classical reverse transcriptase (RT) drug resistance mutations (DRMs) are primary determinants of antiretroviral treatment failure, but polymorphisms within the RT connection and RNase H domains may also influence RT inhibitor susceptibility. These regions remain poorly characterised in HIV-1 subtype C (HIV-1C), the predominant subtype in sub-Saharan Africa. This study investigated RT connection and RNase H polymorphisms in treatment-experienced people with HIV (PWH) experiencing virologic failure (VF) in Botswana. Methods: Seventeen plasma samples from the Botswana National HIV Drug Resistance Programme with documented VF (viral load >200 copies/mL) and prior Sanger resistance results were selected. One sample was excluded because of insufficient Oxford Nanopore Technologies (ONT) sequencing coverage, leaving 16 samples for analysis. Samples were amplified using the DeepChek^® HIV-1 Full PR/RT/INT assay and analysed using the HIVgenomeR™ v2.0 ONT pol DRM pipeline. ONT-derived RT resistance profiles were compared with historical Sanger results, and RT connection and RNase H polymorphisms were characterised. Results: ONT identified additional RT DRMs in five sequences previously classified as lacking classical RT DRMs. Of the remaining six sequences without classical DRMs, four harboured minority RT variants. RT connection polymorphisms were common, including G335D (13/16) and T377M (9/16). Recurrent mutation combinations included T377M–T470A, A371V–E399D, T377M–E399D, and T377M–A360T. Conclusions: The extended HIV-1 pol genotyping assay enabled characterisation of the RT connection and RNase H domains while improving detection of classical RT DRMs and minority variants. These findings support further investigation of extended RT sequencing for HIV-1C molecular surveillance. Full article

Tripartite motif-containing protein 21 (TRIM21/Ro52) is a pivotal E3 ubiquitin ligase and cytoplasmic fragment crystallizable receptor (FcR). It plays a crucial role in viral infections, autoimmune disorders, and cancers by regulating multiple cell signaling axes, including the NF-κB, RIG-I-like receptor (RLR), cGAS-STING, and Toll-like receptor (TLR) pathways. Type I interferon (IFN-I), a pleiotropic cytokine, is produced via these immune signaling pathways, which are often triggered by viral components. TRIM21 both activates IFN-I signaling and mediates its negative feedback through post-translational modification of key immune signaling proteins, thereby maintaining immune homeostasis. In recent years, TRIM21 has been found to dually regulate autophagy and IFN-I in the context of virus–host interplay. Herein, we systematically summarize the functional roles of TRIM21 in virus-triggered intracellular immunity, aiming to provide insights for researchers and inspire further investigation in this area. Full article

Background/Objectives: Primary healthcare in Hungary faces acute physician shortages; in the Heves district, eight general practices are permanently vacant, leaving 11,191 residents without continuous care. In September 2025, the Hungarian Charity Service of the Order of Malta launched the Heves Haziorvosi Pilot (HHP), combining on-site nurse triage with remote telemedicine consultations. This study qualitatively evaluated its implementation and early operation. Methods: Three focus group discussions were held in two rounds, before and after implementation, with all 19 professionals delivering the programme (10 practice nurses, 4 general practitioners, 5 degreed professionals). Verbatim Hungarian transcripts were analysed in NVivo 15 (Lumivero, Denver, CO, USA) using the thematic analysis framework of Braun and Clarke with hybrid deductive-inductive coding by three independent researchers until full consensus. Results: Daily physician availability rose from approximately 2 to 8 h, and one remote physician concurrently supported four practices. Participants reported reduced professional isolation among nurses, longer and more focused consultations, and perceived, though unquantified, decreases in non-urgent ambulance use. Implementation was constrained by duplicate paper and digital documentation, patients’ limited familiarity with triage, and unresolved software interoperability and IT ergonomic problems. Conclusions: The hybrid model was perceived as operationally feasible; national scaling would require nursing curriculum reform, administrative simplification, interoperable medical software, and community health literacy programmes. Full article

Background/Objectives: Certain strains of Lactobacillus acidophilus are widely used as probiotics. However, their functional potential for female reproductive tract health remains insufficiently characterized. While most studies have focused on individual strains, the distribution of putative probiotic-associated genes across the species remains unclear. This study aimed to evaluate the vaginal probiotic potential of Lb. acidophilus using population genomic analysis and comparative phenotypic characterization. Methods: Pan-genomic analysis was performed on 109 Lb. acidophilus genomes (107 public genomes and 2 vaginal isolates). Putative probiotic-associated gene clusters were identified by functional annotation, categorized into functional modules, and compared among ecological-origin groups. Two vaginal isolates (strains A2 and A3) were characterized in vitro for growth under different pH conditions, cell surface hydrophobicity, lactic acid and hydrogen peroxide production, antimicrobial activity, hemolysis, and antimicrobial susceptibility. Results: The Lb. acidophilus pan-genome was closed, with 1782 of 1902 gene clusters (93.69%) classified as core. Thirty-six putative probiotic-associated gene clusters were identified and grouped into four modules: environmental tolerance, adhesion/colonization, exopolysaccharide/biofilm synthesis, and nutrient metabolism/microbial competition. Thirty-four of the 36 gene clusters were present in all 109 genomes, and no general ecological origin-specific distribution pattern was observed. Three bacteriocin-related gene clusters were conserved across all genomes. A2 and A3 exhibited similar lactic acid production and growth patterns at pH 4–6. Both produced relatively low amounts of hydrogen peroxide compared with the reference strains. A3 showed higher cell surface hydrophobicity and moderate inhibition against Gardnerella vaginalis, while A2 showed no inhibition of this organism. Both isolates were non-hemolytic, and were susceptible to vancomycin and linezolid, resistant to clindamycin, and non-susceptible to daptomycin. No acquired antibiotic resistance genes were detected. Conclusions: Most putative probiotic-associated gene clusters were conserved across the Lb. acidophilus population, whereas A2 and A3 showed strain-dependent phenotypic differences. These findings support combining population genomic analysis with strain-level phenotypic testing when selecting Lb. acidophilus candidates for bacterial vaginal infections. Full article

Coffee is deeply embedded in Saudi culture and is among the most consumed beverages worldwide. However, contamination by toxic heavy metals may represent an underrecognized public health concern, particularly in regions already burdened by diabetes mellitus and cardiovascular disease. This study evaluated concentrations of lead (Pb), cadmium (Cd), arsenic (As), chromium (Cr), and nickel (Ni) in 21 commercial coffee samples representing seven product categories marketed in Saudi Arabia. Samples were prepared using EPA Method 3050B acid digestion and analyzed by inductively coupled plasma mass spectrometry (ICP-MS). Health risks were assessed through estimated daily intake (EDI), hazard quotient (HQ), hazard index (HI), and incremental lifetime cancer risk (ILCR) using USEPA exposure parameters and Saudi-specific coffee consumption data. All metals were detected in every sample. Mean concentrations (mg/kg dry weight) were 1.638 for Pb, 0.560 for Cd, 0.622 for Cr, 0.536 for Ni, and 0.034 for As. Cadmium exceeded the European Union maximum limit for roasted coffee in all samples, while elevated Pb levels were observed in dark roast and Yemeni coffees. Although the overall non-carcinogenic risk remained below the accepted threshold (HI = 0.438), the combined ILCR for As, Cd, and Pb was 5.84 × 10⁻⁵. Inclusion of a conservative screening-level chromium contribution, calculated by assuming that all measured total Cr was present as Cr(VI), increased the upper-bound total ILCR to 9.38 × 10⁻⁵. This value remained within, but approached the upper boundary of, the risk-management range applied in this study. These findings highlight the need for strengthened monitoring and regulatory control of coffee products in Saudi Arabia. Full article

Background: Children with Down syndrome often have co-occurring physical conditions affecting well-being, and respiratory issues remain a leading cause of hospitalization and death among people with Down syndrome. Parents of children with Down syndrome experience stressors associated with respiratory illness and challenges navigating healthcare access. No prior qualitative study has examined parental perspectives on respiratory health specifically among children with Down syndrome. Identifying parental concerns can help in the development of strategies to mitigate respiratory ailments in children with Down syndrome. Methods: One-hour, semi-structured interviews were conducted among 24 families of children with Down syndrome to understand respiratory concerns. Findings were identified through codebook thematic analysis. Results: The themes identified included persistent concerns about respiratory health, repeated impact from acute and chronic respiratory issues, a rapid and unexpected decline in health during respiratory illness, insurance coverage concerns, and a lack of confidence in assessing air quality which could impact respiratory health. Conclusions: Insights gained from interviews of parents of children with Down syndrome can help policy makers identify opportunities to prevent and mitigate respiratory health problems. Findings underscore the importance of clinician responsiveness to parental concern about rapid deterioration and suggest that insurance coverage policies for this high-risk population warrant further research and policy consideration. Full article

Lead contamination remains a significant environmental and public health concern, creating a demand for analytical platforms that combine sensitivity, simplicity, and long-term stability. In this work, a graphene-containing molecular membrane matrix was developed for the fabrication of single-piece all-solid-state potentiometric sensors for Pb(II) detection. The sensing membrane consisted of poly(vinyl chloride), plasticizers, a Pb(II)-selective ionophore, lipophilic ionic sites, and dispersed graphene nanostructures, forming an integrated molecular sensing interface. Within the membrane phase, selective complexation of Pb(II) ions by the ionophore was coupled with graphene-assisted ion-to-electron transduction, enabling efficient signal generation without the need for a separate solid-contact layer. The influence of graphene incorporation and membrane thickness on sensor performance was systematically investigated. Among the tested configurations, a membrane prepared from 40 µL of sensing cocktail provided the best overall performance, combining high electrical capacitance, favorable surface properties, and superior potential stability. SEM imaging revealed a homogeneous membrane morphology without large graphene agglomerates, indicating effective dispersion of graphene within the polymer matrix. The optimized sensor exhibited a near-Nernstian slope of 30.3 mV dec⁻¹, a linear response range from 1.0 × 10⁻⁷ to 1.0 × 10⁻² M, a detection limit of 6.3 × 10⁻⁸ M, and a potential drift of only 0.35 mV h⁻¹. These results demonstrate that direct incorporation of graphene into an ion-selective membrane is an effective strategy for constructing robust and scalable single-piece potentiometric sensors for Pb(II) monitoring and highlight the potential of developed membrane materials for electrochemical sensing applications. Full article

Background/Objectives: Diet is a key modifiable determinant of mental health; however, the prospective association between dietary patterns and new-onset suicidal ideation remains poorly elucidated. Methods: We enrolled 7480 participants from demolition resettlement communities in Jining, Zoucheng, and Weifang in Shandong Province, China, during 2021–2023. Data were used from two waves (baseline and 1-year follow-up) in this study. Dietary patterns were determined using principal component analysis based on food frequency questionnaire data. Incident suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Multivariable logistic regression, stratified analysis, and sensitivity analysis were used to examine associations of different dietary patterns with the risk of incident suicidal ideation. Results: Among participants, 193 (2.58%) reported incident suicidal ideation. After full multivariable adjustment, the livestock–poultry–seafood dietary pattern was significantly inversely associated with incident suicidal ideation (Q3 vs. Q1; odds ratio = 0.67; 95% confidence interval: 0.45–0.97), whereas no significant association was identified when the pattern score was modelled continuously (OR = 0.92; 95% CI: 0.79–1.06; p = 0.239). Stratified analyses revealed stronger inverse associations among men, older adults, overweight individuals, and participants who did not use dietary supplements, but all interaction p-values exceeded 0.05, with no statistically confirmed subgroup disparities. After excluding participants with baseline depression, participants with baseline anxiety, and individuals with missing covariates in sensitivity analysis, the inverse association remained statistically stable. Conclusions: Our findings suggested a modest inverse association between higher adherence to the livestock–poultry–seafood dietary pattern and new-onset suicidal ideation in this observational cohort. Full article

Land-based Indigenous food practices are integral to cultural identity and ancestral knowledge, and provide medicine for health and wellbeing. We surveyed Indigenous-specific grey literature, guided by Elder knowledge, from public information sources to identify the scope of Indigenous traditional foods in Canada and how food use aligned with major food groups. We analyzed extracted data using summary statistics and graphical display. We identified 96 resources reporting 401 distinct food items incorporated into Indigenous food practices across Canada. Prevalent food groups were meat/proteins (39%), vegetables (20%), berries/fruits (12%), and a mixed group (21%); grains were rarely reported (1%). We found 28 unique plant foods reported to have multiple uses. Across sources, the top 15 most common food items were various berries, fish and wild game. The total count of food items and diversity with food groups categories varied by Indigenous group and region. This research documents the breadth and depth of traditional Indigenous food knowledge throughout Canada, demonstrating a consumption pattern focused on wild meat, berries and foods from plant and tree leaves, roots and stems. This overview of Indigenous food knowledge can support Indigenous individuals and communities, researchers and healthcare providers to improve health and wellbeing of Indigenous people. Full article

Highly pathogenic avian influenza H5N1 virus (H5N1 HPAIV) has long circulated in wild waterfowl and poultry and continues to cross species barriers, posing sustained threats to livestock productivity and public health. The 2024 outbreak of H5N1 HPAIV in dairy cattle across multiple U.S. states represents the first recognized large-scale transmission event of this virus in ruminants, reshaping our understanding of its host range and transmission ecology. This review summarizes recent advances in the epidemiology, virological characteristics, transmission, pathogenesis, surveillance, and control of dairy cattle-associated H5N1. The initial multistate outbreak was dominated by clade 2.3.4.4b genotype B3.13, whereas subsequent independent introductions of genotype D1.1 demonstrated that repeated avian-to-cattle spillover also contributes to the evolving outbreak ecology. A defining feature is efficient replication in bovine mammary epithelial cells, resulting in high viral titers in milk, supporting milk-associated exposure and milking-related contamination as plausible components of transmission, although the relative contribution of different routes remains unresolved. Infected cattle typically show reduced feed intake, a marked decline in milk production, abnormal milk, and mild systemic signs, whereas severe respiratory disease and mortality are uncommon. Mutations such as PB2-M631L, PA-K497R, and changes in NP and NS1 may promote replication and immune evasion in bovine cells, while genotype-specific PB2 adaptations highlight the potential for further mammalian adaptation. Human infections reported to date have been predominantly mild and associated with occupational exposure, with no evidence of sustained human-to-human transmission. Experimental vaccine studies have begun to demonstrate immunogenicity in cattle, although protection against mammary infection, viral shedding, and transmission remains to be established. Future priorities include clarifying mammary tropism and transmission dynamics, while strengthening diagnostics, farm biosecurity, vaccination, evaluating cattle vaccination strategies, and integrated One Health surveillance. Full article

Antimicrobial resistance (AMR) in Salmonella enterica from aquatic animals represents an emerging food safety and public health concern, yet the global distribution patterns and trends remain insufficiently understood. Here, we performed a global genomic survey of Salmonella from aquatic animals using 2911 genomes collected from 67 countries across six continents between 1974 and 2025. These genomes represented 194 serovars and 364 sequence types. Notably, the dataset exhibited unbalanced geographical sampling, with Asian isolates accounting for 69.98% of all strains, which may limit the generalizability of our global trends. Globally, resistance to WHO-recommended clinically important antimicrobials showed substantial variation among antibiotic classes, with resistance rates for azithromycin (2.10%), cefepime (2.89%), cefotaxime (2.71%), ceftazidime (2.71%), and ceftriaxone (0.62%). Geographical differences were observed, with isolates from Asia exhibiting higher resistance levels, particularly for ciprofloxacin (13.50%) and doxycycline (18.02%). AMR temporal trends differed across geographical regions. A total of 111 acquired ARGs and 10 resistance-associated chromosomal mutations were identified, accompanied by changes in the distribution of resistance determinants. Collectively, this study provides a global genomic perspective on priority AMR in Salmonella from aquatic animals and highlights the importance of integrating aquaculture, environmental, and public health surveillance to monitor and mitigate AMR risks within the One Health framework. Full article