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Background: Hearing loss (HL) is the leading cause of disability worldwide, with a particularly severe impact on low- and middle-income countries and causing a huge economic burden. While child HL prevention exists, working-age adults (WAP) struggle to avoid occupational and environmental risks.

Method: Using Global Burden of Disease 2021 data, this study analyzed global HL prevalence trends in the WAP (1992-2021). Analyses included age-standardized prevalence rates (ASPR), estimated annual percentage change, and age-period-cohort (APC) modeling, stratified by gender, age, cause, severity, and Social Demographic Index (SDI).

Result: Global WAP HL prevalence significantly increased to 524 million in 2021 (a 56.9% increase since 1992), primarily due to population growth and aging. Age period cohort (APC) analysis revealed different patterns: as age increases, risk increases and cyclical effects generally increased (except in low SDI regions). The upward trend of birth cohorts in high to middle SDI countries was worrying. In addition, this study also observed that there was a gender difference in the prevalence trend of HL in WAP (male incidence rate was higher, but female growth was faster), and the patient population was gradually younger. Improved trends from 2017-2021 globally and regionally suggest a potential, albeit unexpected, positive influence of the COVID-19 pandemic on HL prevalence.

Conclusion: The global HL burden in the WAP is large and uneven, necessitating targeted interventions focusing on modifiable risks and SDI disparities. Further research is essential to understand the trends observed during the COVID-19 pandemic and to improve prevention strategies.

Background: West Nile virus (WNV) is among the most widespread arboviruses and has become a seasonal threat in temperate regions. Sustained in an enzootic bird-mosquito cycle, with humans and horses as incidental hosts, its geographic range has expanded in recent decades due to ongoing climatic and ecological changes. While most infections are asymptomatic or mild, a minority progress to neuroinvasive disease with high morbidity and long-term sequelae. This review summarizes current knowledge on epidemiology, pathogenesis, clinical spectrum, diagnostic challenges, therapeutic options, prevention, and research gaps.

Discussion: Lineages 1 and 2 co-circulate in Europe, where repeated large outbreaks highlight WNV adaptability to warmer summers, altered rainfall, and expanded mosquito habitats driven by recent ecological shifts. After inoculation, replication occurs in keratinocytes and dendritic cells, amplification in lymph nodes, and dissemination to visceral organs and the central nervous system. Neuroinvasion depends on viral proteins and host immune responses. Severe disease is associated with advanced age, immunosuppression, comorbidities, and genetic susceptibility. Clinical manifestations range from febrile illness to meningitis, encephalitis, or acute flaccid myelitis. Persistent neurological and functional sequelae are common, adding to disease burden. Diagnosis relies on molecular and serological tests, limited by short viremia and cross-reactivity with other flaviviruses. No approved antiviral therapy exists; management is supportive. Experimental antivirals, monoclonal antibodies, and interferon have shown mixed results. Vaccine candidates have progressed to phase 1-2 trials, but none are licensed for humans. Prevention relies on integrated vector control, veterinary surveillance, and donor screening, framed within a One Health approach.

Conclusion: WNV exemplifies the impact of global ecological change on zoonotic diseases. Strengthening surveillance, refining diagnostics, and advancing antivirals and vaccines through multidisciplinary collaboration are essential to mitigate future outbreaks.

Background: Transbronchial cryobiopsy (TBCB) is a minimally invasive technique that yields larger specimens than conventional transbronchial forceps biopsies (TBFB) and demonstrates superior diagnostic rates for interstitial lung diseases. However, the efficacy of TBCB compared to TBFB in evaluating peripheral pulmonary lesions (PPLs) is not well established. This study aims to examine the diagnostic performance of TBCB relative to TBFB in PPLs.

Material and methods: Between May 2021 and December 2023, patients with PPLs were enrolled and underwent TBFB followed by TBCB. These procedures were performed either in a hybrid operating room (HOR) or a standard bronchoscopy room without fluoroscopy. The study compared histopathology diagnostic yield between the two methods.

Results: The study included 84 patients. The median lesion size was 37 mm (interquartile range: 26, 54), with 16 lesions (19.0%) measuring less than 2.0 cm. Among the participants, 44 (52.4%) were diagnosed with lung cancer, and 28 (33.3%) had infectious diseases. TBCB yielded significantly larger tissue samples [60 mm³ (range: 30, 144) vs. 4 mm³ (range: 2, 6), p < 0.001] and higher diagnostic yields (94.0% vs. 77.1%, p < 0.001) than TBFB. The higher diagnostic yield for TBCB were consistent in both the bronchoscopic room (97.2% vs. 77.8%, p = 0.008) and HOR (91.5% vs. 76.6%, p = 0.033). The incidence of ≥ grade 3 bleeding was 7.1%.

Conclusion: TBCB significantly improves the diagnostic yield for PPLs, irrespective of fluoroscopic guidance, and is effective for both malignant and benign lesions. Furthermore, it is associated with minimal complications, affirming its safety and efficacy as a diagnostic procedure.HighlightsTBCB consistently provided a higher pathological yield compared to TBFB, independent of lesion size, use of fluoroscopy, or the nature of the pathology (benign or malignant)TBCB yielded larger tissue sample and had high successful rates for NGS testing.Combination of an ultrathin bronchoscope, augmented fluoroscopy, ROSE, and TBCB can lead to high diagnostic yields.

Background: Pediatric sepsis represents a significant factor in the mortality rates among children, with survivors remaining highly fragile during the period following discharge. While in-hospital and short-term mortality have been widely studied, the long-term mortality of pediatric sepsis is not adequately synthesized or appreciated. This study aims to estimate the long-term mortality associated with pediatric sepsis, providing a basis for optimizing post-discharge surveillance and care protocols.

Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251137504). Exhaustive searches were conducted in PubMed, Embase, the Cochrane Library, and Web of Science for studies published from the inception of each database to June 30, 2025. Studies reporting long-term mortality in pediatric sepsis patients diagnosed using international consensus criteria were included. After literature screening, long-term mortality was pooled using a random effects meta-analysis in R statistical software.

Results: A total of 72,065 records were identified through database searching. After removing duplicates and screening, six studies comprising 11,318 pediatric sepsis patients were included. The pooled long-term mortality in pediatric sepsis was 11% (95% CI: 7-16%), though significant heterogeneity was observed (I² = 98.2%, p < 0.001). Sensitivity analyses yielded similar results, and evidence of publication bias was limited.

Conclusion: Long-term mortality after pediatric sepsis was 11%, highlighting the persistent risk of mortality after hospital discharge. Further high-quality longitudinal studies are required to identify modifiable risk factors and guide evidence-based follow-up and personalized care.

Objective: To evaluate the awareness and understanding of breast cancer (BC) etiology among Jordanian women and identify associated demographic factors.

Materials and methods: A multiregional cross-sectional survey of 381 women was conducted via online snowball sampling. BC knowledge was assessed using a translated version of the Breast Cancer Awareness Measure. Statistical analyses included univariate and bivariate tests, followed by a multivariate ordinal logistic regression to adjust for potential confounders.

Results: Only 39.9% of participants demonstrated proficient comprehension of BC etiology. Knowledge correlated significantly with age, marital status, and expertise (p < 0.05). Awareness was highest among single pharmacy students; notably, 64.8% were single pharmacy students, potentially inflating overall scores. A misconception was identified: 66.1% believed a diagnosis in one breast reduces risk in the other. Age 41-50 (OR = 5.23) and holding a diploma (OR = 0.09) were significant predictors of knowledge compared to postgraduates, while marital status was not significant in the model.

Conclusions: Educational backgrounds significantly influence breast cancer awareness among Jordanian women. There is an urgent need for targeted, community-based training programs to address persistent clinical misconceptions and knowledge gaps, specifically focusing on married women and individuals working or studying in non-medical fields, to improve overall public health standards nationwide.

Background: Postural Orthostatic Tachycardia Syndrome (POTS) and Neurally-Mediated Hypotension (NMH) are heterogeneous syndromes characterized by dysautonomia and multisystem symptoms. Mast cell activation, often manifesting as hives, has been proposed as a contributing mechanism, but its prevalence and clinical relevance in POTS and NMH are poorly defined.

Method: Patients from the Johns Hopkins POTS Clinic completed surveys assessing hives frequency and symptom burden using the Malmö POTS, the Composite Autonomic Symptom Score (COMPASS)-31, and a pain questionnaire. Associations between hives and clinical features were evaluated among patients with confirmed POTS, NMH, or clinically diagnosed orthostatic intolerance.

Result: Among 188 respondents, 80 (42.6%) reported hives sometimes and 33 (17.6%) reported hives often or always. Increasing hives frequency was associated with higher Malmö POTS scores and greater autonomic symptom burden across multiple COMPASS-31 subdomains, including gastrointestinal, bladder, and vasomotor symptoms (all p < 0.05). Hives was also associated with pain (OR 3.47, 95% CI 1.54-7.77, p = 0.002) and tingling (OR 5.73, CI 2.15-15.26, p < 0.001), but not orthostatic symptoms. These associations persisted after multivariable adjustment.

Conclusion: Hives are common in orthostatic intolerance syndromes and are associated with increased symptom burden. Future studies are needed to clarify the role of mast cell activation and evaluate mast cell-targeted therapies.

Background: Body shape concerns (BSC) and body dissatisfaction represent emerging public health issues, yet evidence from Middle Eastern contexts, including Jordan, remains limited. These concerns adversely affect psychological health and are shaped by sociocultural pressures and digital media exposure.

Methods: A cross-sectional study was conducted among 418 undergraduate university students in Northern Jordan. Participants completed the Body Shape Questionnaire-8D (BSQ-8D) to assess BSC. Demographic, behavioral, and media use variables were analyzed to identify correlations.

Results: Among 418 respondents (96% aged 17-24; 53% female), 73% reported no BSC. Higher levels of BSC were significantly associated with increased body mass index (BMI) (p < 0.001). Compared to normal-weight peers, overweight students had higher odds of reporting mild [adjusted odds ratio (AOR: 3.7)]and moderate to marked (AOR: 2.56) BSC. Parental education and social media use were also significant factors. Students who did not use Snapchat (AOR = 2.05), did not use TikTok (AOR = 2.15), and cigarette smokers (AOR = 2.75) had higher odds of reporting elevated BSC levels.

Conclusions: BSC among Jordanian university students is shaped by multiple psychosocial and behavioral factors, with BMI emerging as the strongest predictor. Findings underscore the need for culturally informed strategies addressing weight stigma, smoking, parental influences, and media engagement. Integrating BSC screening into routine healthcare may support early detection of at-risk groups.

The modulator pocket is a cryptic site discovered in the TREK1 (K_2P2.1) K2P channel. This pocket, located close to the selectivity filter, accommodates agonists that enhance the channel's activity. Since its discovery, equivalent sites in other K2P channels have been shown to bind various ligands, both endogenous and exogenous. In this review, we attempt to elucidate how the modulator pocket contributes to K2P channel activation. To this end, we first describe the gating mechanisms reported in the literature and rationalize their modes of action. We then highlight previous experimental and computational evidence for agonists that bind to the modulator pocket, together with mutations at this site that affect gating. Finally, we elaborate how the activation signal arising from the modulator pocket is transduced to the gates in K2P channels. In doing so, we outline a potential common modulator pocket architecture across K2P channels: a largely amphipathic structure - consistent with the expected properties of a pocket exposed at the interface between a hydrophobic membrane and the aqueous solvent - but still with some important channel-sequence-variations. This architecture and its key differences can be leveraged for the design of new selective and potent modulators.

Hutchinson Gilford Progeria Syndrome (HGPS) is an ultra-rare pediatric premature aging disorder. It is caused by a point mutation in the LMNA gene leading to the production of the dominant-negative progerin isoform of the nuclear envelope protein lamin A. Most of the mechanistic insights into the disease have come from studies using cellular or mouse models of HGPS. To probe the clinical relevance of previously implicated cellular pathways and to address the extent of gene expression heterogeneity between patients, we performed transcriptomic analysis of a comprehensive set of HGPS patients. We find misexpression of several cellular pathways, including multiple signaling pathways, the Unfolded Protein Response (UPR) and mesodermal cell fate specification. Variability amongst individual patients was limited, with misregulation of the major pathways observed in most patients. Comparing the transcriptome of patients with an inducible HGPS cell model, we also identified the primary target pathways of the disease-causing progerin protein.