Search Results (1,843)

Rift Valley fever (RVF) is a re-emerging vector-borne zoonotic disease that causes outbreaks in humans and animals across Africa. To better understand RVF at human–animal interfaces, a prospective longitudinal survey of people, livestock, and mosquitoes was conducted from 2016 to 2018, in two regions of Tanzania, with distinct climatic zones (Iringa and Morogoro). Molecular and serological tools for testing (RT-qPCR and IgM/IgG ELISA) for RVF virus (RVFV) were used to assess infection and exposure in people and animals. Mosquitoes were collected quarterly from 10 sentinel locations. In total, 1385 acutely febrile humans, 4449 livestock, and 3463 mosquito pools were tested. In humans, IgM seroprevalence was 3.75% (n = 52/1385), and overall seroprevalence (IgM and/or IgG positive) was 8.30% (n = 115/1385). People from Iringa had a higher exposure risk than those from Morogoro (aOR 2.63), and livestock owners had an increased risk compared to non-owners (aOR 2.51). In livestock, IgM seroprevalence was 1.09%, while overall seroprevalence was 10.11%. A total of 68.4% of herds had at least one seropositive animal. Sentinel animal follow-up revealed that the probability of seroconversion was significantly higher in Morogoro. Low-level RVFV RNA was detected in 8 human and 22 mosquito pools. These findings indicate active transmission among vectors, livestock, and people during the study period, highlighting the need for One Health surveillance approaches for RVFV and other arboviruses. Full article

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder marked by insulin resistance, hyperglycemia, systemic inflammation, and immune imbalance. This randomized, double-blind, placebo-controlled, crossover trial investigated the effects of Bifidobacterium animalis subsp. lactis TISTR 2591 (BA-2591), a probiotic strain isolated in Thailand, on metabolic, immunologic, and safety parameters. Methods: A total of 44 Thai adults (aged 35–65) with T2DM receiving metformin monotherapy were administered BA-2591 (1 × 10⁹ CFU/g/day) or placebo for 6 weeks, followed by a 4-week washout and crossover. Results: Compared to placebo, BA-2591 significantly attenuated fasting blood glucose elevation (Δ = +1.143 mg/dL vs. +12.570 mg/dL; p < 0.001), minimized the increase in insulin resistance (HOMA-IR: Δ = +0.567 vs. +0.980; p = 0.006), and enhanced β-cell function (HOMA-β: Δ = +6.791% vs. −8.313%; p < 0.001). It also elevated immunoglobulin levels (IgM: +150.300 mg/dL; IgG: +261.500 mg/dL; p < 0.001), reduced LDL-C (p = 0.009), and decreased cathepsin D activity (p = 0.005), with no significant changes in IL-6, adiponectin, MDA, hs-CRP, or body composition. No severe adverse effects were reported. Conclusions: BA-2591 was safe and demonstrated modest, adjunctive benefits for fasting glycemia and immunologic profiles over 6 weeks, without changes in body weight or fat mass. These findings support BA-2591 as a potential adjunct to standard care in early T2DM; larger and longer-duration trials are needed to define its effects on longer-term outcomes. Full article

Background: Allergen immunotherapy (AIT) is generally considered a safe treatment modality, with systemic reactions (SRs) representing its most significant adverse events, despite their low incidence. This study aimed to evaluate the frequency and characteristics of SRs associated with subcutaneous allergen immunotherapy (SCIT) and to identify potential risk factors. Methods: We conducted a retrospective analysis of 47,982 SCIT injections administered to 317 patients over 468 SCIT courses between January 2019 and January 2024. The study population consisted of 26 patients diagnosed with allergic rhinitis sensitized to pollen and/or house dust mites (HDMs), as well as individuals with venom allergies who experienced SRs to SCIT during the study period. Data collected included demographic characteristics, presence of asthma, allergen sensitivities, immunoglobulin E (IgE)-related immunologic biomarkers, and adverse reactions. SRs were classified according to the World Allergy Organization (WAO) SCIT SR Grading System. Results: A total of 26 SCIT-related SRs were documented in 26 patients (57.7% female; mean age 37.3 ± 10.04 years), corresponding to an incidence rate of 0.05% per injection, and 8.2% per patient. Asthma was present in 42.3% of patients. Prior adverse reactions to SCIT were noted in eight patients (30.8%). SRs occurred during the build-up phase in 61.5% of cases, compared with the maintenance phase. In 46.2% of patients, a single allergen was administered, while 53.8% received multiple allergens. Based on the WAO grading system, 30.8% of SRs were classified as grade 1, 42.3% as grade 2, 15.4% as grade 3, and 11.5% as grade 4. No fatalities were reported. The majority of SRs were early onset (88.5%), and epinephrine was administered in 76.9% of the cases. A higher serum specific IgE to total IgE (sIgE/tIgE) ratio was significantly associated with more severe SRs. Conversely, a history of prior allergic reactions to SCIT appeared to correlate with milder SRs. Conclusions: Our findings confirm that SRs to SCIT are rare, and severe reactions are infrequent. A higher serum sIgE/tIgE ratio can be risk factor for severe SRs. Nonetheless, a thorough risk–benefit assessment is essential prior to initiating SCIT, particularly in patients with identified risk factors. Full article

A shift in the public health goal for onchocerciasis from control to elimination implies that the treatment of onchocerciasis must be extended to communities that are hypoendemic for the disease. However, in such communities, the majority of the population may not manifest the symptoms of onchocerciasis. As a result, they may be reluctant to take part in epidemiological surveys aimed at monitoring parasite transmission, particularly due to the invasive nature of the currently approved diagnostic tests. This reluctance is compounded by the absence of visible, severe manifestations of the disease in these areas. On the other hand, diagnostic methods that utilize samples collected by a non-invasive procedure, such as urine, are generally painless and not risky. In this context, we evaluated the diagnostic performances of OvMANE1 and OvMCBL02 multiepitope antigens using urine samples. The evaluation of total IgG and IgG subclass responses revealed IgG3 as the most effective IgG for the OvMANE1 test (sensitivity = 87.5%, specificity = 100.0%), total IgG for the OvMCBL02 test (sensitivity = 92.5%, specificity = 100.0%), and IgG3 for the OvMANE1_OvMCBL02 cocktail test (sensitivity = 92.5%, specificity = 100.0%). These tests have the potential to meet the criteria of a diagnostic test’s target product profile to map onchocerciasis in low-prevalence areas, where a sensitivity of ≥60.0% and specificity of ≥99.8% are recommended. Furthermore, the OvMCBL02 and OvMANE1_OvMCBL02 cocktail tests may have the features of a diagnostic test’s target product profile to determine treatment endpoints (recommended sensitivity ≥ 89.0%, specificity ≥ 99.8%) as reported by the Diagnostics Technical Advisory Group for Neglected Tropical Diseases of the World Health Organization. Consequently, further characterization of these multiepitope antigens may enable urine, which can be collected non-invasively, to be used in the OvMANE1 and OvMCBL02 tests for the field evaluation of onchocerciasis. Full article

Background: To reduce work-related illnesses among teachers, various types of programs were implemented. Objectives: The aim of this study was to evaluate the effects of a 12-week multicomponent program on mental disorders, biochemical parameters, and immunological markers in female teachers with overweight. Methods: A total of 33 women who were basic education teachers with a body mass index (BMI) ≥ 25 kg/m² participated in this study. Participants were randomly assigned to either a control group (n = 16), which did not participate in the program, or an intervention group (n = 17), which underwent the multicomponent intervention. The program included physical exercise (three sessions per week), cognitive–behavioral therapy delivered monthly across three modules, and nutritional education consisting of both general and specific guidance. Assessments were conducted at baseline and after 12 weeks and included measurements of symptoms of depression, anxiety, and stress; fasting glucose; total cholesterol; LDL cholesterol; HDL cholesterol; VLDL cholesterol; triglycerides; and concentrations of immunoglobulins IgA, IgG, and IgM. Results: After 12 weeks, the intervention group showed a significant reduction in symptoms of depression, anxiety, and stress (p < 0.05), as well as in fasting glucose, triglycerides, and VLDL cholesterol levels compared to the control group (p < 0.05). No significant changes were observed in the levels of immunoglobulins IgA, IgG, or IgM (p > 0.05). Conclusions: The multicomponent program improved mental health and reduced the risk of developing metabolic and cardiovascular diseases in female teachers with overweight. Full article

Introduction (Objectives): This study aimed to evaluate the serological response to a fourth dose of mRNA COVID-19 vaccine in patients with conditions that confer a high risk of severe disease, particularly those with high-level immunosuppression. Methods: An observational study was conducted at the Ramón y Cajal University Hospital between February and August 2022. Adults (≥18 years) with high-risk conditions who had received four doses of either BNT162b2 or mRNA-1273 were included. Anti-spike IgG levels were measured ≥14 days post-vaccination. An adequate response was defined as an antibody concentration ≥260 BAU/mL. Results: A total of 943 patients were analyzed; 846 (89.7%) achieved an adequate response. In the bivariate analysis, patients aged 60–74 years had a higher risk of inadequate response compared to those aged 18–39 years (OR 1.824 vs. OR 0.257). Female sex was associated with a higher risk of inadequate response (OR 1.522; 95% CI: 0.974–2.371). In multivariable logistic regression, patients with high immunosuppression had a higher, though not statistically significant, risk of inadequate response compared with those without. Discussion: Our findings are consistent with international evidence suggesting that age and certain clinical factors reduce vaccine immunogenicity. The observed paradoxical effect of sex could reflect the higher prevalence of aggressive immunosuppressive therapies among women in the study cohort. Conclusions: Most immunosuppressed patients achieved seroconversion after the fourth dose. These results underscore the need for tailored vaccination strategies and additional measures in highly immunosuppressed subgroups. Full article

A practical methodology for estimating regionally optimized Klobuchar coefficients using only International GNSS Service (IGS) Global Ionosphere Map (GIM) data is proposed. The method preserves computational simplicity, enabling near-real-time corrections suitable for accurate GNSS positioning. Utilizing both slant and vertical total electron content (STEC and VTEC) values extracted from GIM as inputs to estimate eight Klobuchar coefficients, robust parameter sets were obtained. Root mean square error (RMSE) analysis was used to compare these models to the standard Klobuchar model. Comprehensive performance evaluations using STEC-derived parameters, encompassing both seasonal and spatial analyses across South Korea, demonstrated significant reductions in ionospheric delay errors, with improvements reaching up to 57% compared to the conventional Klobuchar model. The far less computationally intensive VTEC-based model was applied over a wider region with 120 grid points. Continuous testing of this model over an entire year confirmed consistent enhancements in correction accuracy every day, demonstrating stable performance throughout the period. The developed regional Klobuchar models were further validated indirectly through satellite positioning performance, demonstrating daily RMSE improvements over the standard Klobuchar model ranging from 17.3% to 44.6%. Full article

Background: Early-life sensitization to house dust mites (HDMs) is a recognized risk factor for adverse respiratory allergic outcomes. Methods: We investigated the clinical characteristics of infants under two years of age who visited our allergy clinic for evaluation with detectable HDM-specific IgE (sIgE) and compared them to HDM-sIgE–negative infants. Results: Among 1793 infants tested for HDM sIgE, 96 (5.4%) demonstrated sensitization. In the HDM-positive cohort, the prevalence of atopic dermatitis was 74.0% (90.9% among those <12 months), food allergy was 57.3% (100% among those <12 months), egg white sensitization was 71.9% (90.9% among those <12 months), and cow’s milk sensitization was 56.3% (81.8% among those <12 months). Atopic dermatitis, food allergy, ≥4 wheezing episodes, physician-diagnosed asthma, allergic rhinitis, egg white sensitization, cow’s milk sensitization, and sensitization to three or more food allergens were significantly more common in the HDM-positive group compared with the HDM-negative group. Significant correlations were observed between HDM sIgE and total IgE levels, as well as between HDM sIgE and egg white sIgE levels. Overall, HDM sensitization in infants was most frequently accompanied by atopic dermatitis and egg white sensitization. Conclusions: These findings suggest that early HDM sensitization should be closely monitored, particularly in infants with atopic dermatitis and food allergies who exhibit elevated total IgE and egg white sIgE levels. Full article

Background: Total hip (THR) and knee replacement (TKR) effectively treat end-stage osteoarthritis, but many patients continue to experience functional limitations and reduced quality of life (QoL) after rehabilitation. The aim of this pilot study was to assess the changes in terms of QoL in people with THR and TKR after a specifically designed PA intervention. The secondary aim was to evaluate changes in physical function through strength and mobility tests. Methods: Eighteen participants (mean age 65.8 ± 7.1 years) were enrolled at the Rizzoli Orthopedic Institute and were randomly assigned to an intervention group (IG), which completed a six-month supervised PA program (6 months after surgery), or a control group (CG), which received standard care. Assessments were conducted at four time points: before surgery, after rehabilitation, and at 9- and 12-month post-surgery. Repeated measures ANOVA was used to assess within- and between-group differences over time, with post hoc pairwise comparisons conducted using independent t-tests with Sidak correction. The level of statistical significance was set at p < 0.05 for all analyses. Results: Both groups showed significant improvements in QoL over time, with greater gains in physical functioning observed in the IG. Lower limb strength increased more in the IG; however, the differences between groups were not statistically significant. The Timed Up and Go and 30-Second Chair Stand Test improved in both groups. No adverse events were reported. Conclusions: These findings support the feasibility and potential benefits of adapted PA programs after rehabilitation. Although no significant differences emerged between groups, clinically relevant improvements were observed in the IG. Larger studies are warranted to confirm these results and explore long-term outcomes across multiple domains. Full article

Objectives: Gla-rich protein (GRP), a vitamin K-dependent protein, has been increasingly recognized for its dual role in modulating inflammation and inhibiting pathological calcification. Despite its emerging importance in chronic conditions, limited evidence exists regarding its behavior during acute critical illness. This study aimed to investigate the association between GRP, systemic inflammatory markers, oxidative stress (via total thiol oxidation-reduction ratio, TORR), and calcium metabolism in critically ill patients. Materials and Methods: This cross-sectional observational study included 93 critically ill patients admitted to the intensive care unit (ICU) and 60 age- and sex-matched non-critically ill volunteers. Serum GRP levels were measured using ELISA. Other biomarkers including TORR, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), immature granulocytes (IGs), and serum calcium were also analyzed. Pearson’s correlation, multivariate linear regression, and ROC analysis were performed to assess the relationships among GRP and biochemical markers, as well as their capacity to differentiate ICU patients from controls. Results: GRP, TORR, CRP, PCT, WBC, IGs, and ferritin levels were significantly elevated in ICU patients compared to the control group, whereas serum calcium levels were markedly reduced (all p < 0.05). GRP levels demonstrated moderate positive correlations with WBC (r = 0.47), neutrophils (r = 0.51), TORR (r = 0.42), CRP (r = 0.30), and IGs (r = 0.46), and a strong negative correlation with calcium (r = −0.63). In multivariate regression, TORR, CRP, WBC, IGs, PCT, and calcium levels showed significant correlations with GRP levels in univariate analysis. ROC analysis revealed that CRP had the highest discriminatory power (AUC = 0.88; 95% CI: 0.82–0.94), followed by TORR (AUC = 0.79; 95% CI: 0.71–0.86), GRP (AUC = 0.76; 95% CI: 0.68–0.84), and IGs (AUC = 0.77; 95% CI: 0.69–0.85), for distinguishing ICU patients from non-critically ill individuals. Conclusions: Our findings demonstrated that GRP is significantly associated with systemic inflammation, oxidative stress, and calcium metabolism disturbances in critically ill patients. The combined evaluation of GRP and TORR may enhance the understanding of inflammatory and oxidative mechanisms in acute critical illness. Although this study did not assess patient outcomes, these biomarkers could serve as promising candidates for future prognostic research in ICU settings. Full article

Due to possible congenital infections, cytomegalovirus (CMV) remains a significant public health concern in childbearing-aged and pregnant women. We analyzed the spatial, temporal, and age-related trends in CMV seroepidemiology in Croatia over 10 years. A total of 2838 childbearing-aged and pregnant women, aged 16–45 years, tested between 2015 and 2024 were included in the study. CMV IgM/IgG antibodies were detected using a commercial ELISA. IgM/IgG-positive samples were tested for IgG avidity. CMV IgG antibodies were detected in 2006 (70.6%) of participants. No significant differences were observed between 2015–2019 and 2020–2024 (72.0% vs. 69.8%), while yearly differences were of borderline significance, ranging from 62.4 to 77.3%. The overall seropositivity increased progressively with age from 49.6% in the 16–20 age group to 77.5% in the 36–40 age group. Significant regional differences in IgG seroprevalence were observed: 68.6% in the City of Zagreb/Northern Croatia, 78.5% in Pannonian Croatia, and 71.9% in Adriatic Croatia, while differences between settlement types were not significant. IgG seroprevalence was higher in women with an unfavorable obstetric history (85.3%) than in non-pregnant women and those with a normal pregnancy (70.6% and 66.5%, respectively). IgM antibodies were detected in 278 (9.8%) of participants. Acute infections were more common in younger participants, with rates decreasing from 13.6% in the youngest age group to 6.7% in the oldest. Logistic regression showed that age was a significant predictor of both IgG and IgM positivity. Region and obstetric history were significant predictors of IgG seropositivity, while settlement was a significant predictor of IgM seropositivity. Full article

Background: Zoonotic risks in exposed students are poorly documented in Belgium. According to the literature, even though human tick-borne encephalitis (TBE) infection risk has increased significantly in southern Belgium, no previous human serological survey has demonstrated specific antibodies directed at TBE virus. Methods and principal findings: The aim of this paper was to perform a representative serological survey on sera involving students at the University of Liege, in the southern part of Belgium, to discover possible exposure to TBEV. A total of 207 sera samples were randomly chosen and analyzed using ELISA IgM (with 1 positive student out of 207) and ELISA IgG (with 10 positive students out of 207), subsequent serial immunofluorescence antibody testing (IFAT) IgG (with 8 positive students out of 10 positive in ELISA IgG) and serial IFAT IgM (with 1 negative student out of 1 positive in ELISA IgM), and confirmatory tests, i.e., 50% and 90% plaque reduction neutralization tests (PRNTs) (1 strongly positive student out of 8 positive in IFAT). Conclusions and significance: The exposure of students from the southern part of Belgium (area with increasing risk) to TBEV was assessed for the first time. Antibodies against TBEV could only be demonstrated in 1 out of 207 students. This finding contributes to better decision-making in public health and prevention and management of tick-borne diseases in the context of climate change. Awareness among all students should be prioritized, with prevention measures against tick bites, particularly during forest and recreational activities contributing to risk, to maintain the current low seroprevalence levels. Full article

Background/Objectives: Bullous pemphigoid (BP) is a manageable condition, and the primary goal of treatment is to control the disease while minimizing the use of corticosteroids due to their potential side effects with long-term use. The primary aim of this study was to assess the effectiveness of omalizumab (OMZ) treatment in bullous pemphigoid patients using both objective and subjective indicators, including bullous pemphigoid disease area index (BPDAI) score, peripheral eosinophil count, serum total IgE level, systemic corticosteroid dosage, and pruritus severity (VAS pruritus). The secondary aim was to explore potential predictors of treatment response, such as baseline BPDAI, age, gender, lesion distribution, serum total IgE, peripheral eosinophil count, maximum and minimum corticosteroid dose, and comorbidities, as well as to evaluate the time to clinical response and corticosteroid tapering. Methods: This retrospective analysis included 25 BP patients treated with OMZ as add-on therapy to systemic corticosteroids between January 2023 and December 2024 at Health Sciences University, Başakşehir Çam and Sakura Training and Research Hospital, Dermatology and Venerology Clinic. No other systemic immunosuppressants were permitted. All patients were already receiving systemic corticosteroids at enrolment. This retrospective analysis included 25 BP patients receiving omalizumab (300 mg/4 weeks) as an add-on to systemic corticosteroids, initiated primarily for steroid-refractory disease and/or persistent, sleep-disrupting pruritus. Baseline was defined immediately before the first OMZ dose; assessments were performed at baseline and week 12. Clinical (BPDAI, VAS pruritus) and laboratory (eosinophil count, total IgE levels) parameters were assessed at baseline and week 12. Results: OMZ treatment significantly reduced disease severity, as evidenced by a mean decrease in the BPDAI score of 105.0 ± 48.9 (95% CI 84.8–125.2) compared to baseline (p < 0.001). Peripheral eosinophil count also decreased by 0.6 ± 0.3 (95% CI 0.4–0.7) after treatment (p < 0.001). Total serum IgE levels declined significantly in 92% of patients (95% CI 244.5–2171.3) compared to pretreatment (p < 0.001), although two patients (8%) showed an increase (202.0 ± 258.8) after OMZ treatment. OMZ treatment led to a mean systemic corticosteroid dose reduction of 37.0 ± 14.1 mg (95% CI 31.1–42.8 mg), with a median corticosteroid tapering time of 4 weeks (3.0–4.0). Additionally, pruritus severity, measured by pruritus VAS, decreased by 6.2 ± 1.4 (95% CI 5.6–6.7) following treatment (p < 0.001). OMZ was well tolerated, with no serious adverse events. Conclusions: Within a 12-week observation window, we observed improvements in disease activity and pruritus alongside reduced corticosteroid exposure. Given the retrospective, uncontrolled add-on design, these findings do not establish causality but support further prospective controlled evaluation of omalizumab as a steroid-sparing option. Importantly, OMZ treatment significantly reduced the mean corticosteroid dose, pruritus VAS score, total IgE levels, and eosinophil count, indicating therapeutic activity and supporting its use as an effective steroid-sparing option in the management of bullous pemphigoid. Full article

This study aims to investigate the effects of dietary supplementation with different concentrations of oligofructose (FOS) on growth performance, antioxidant capacity, immunity, and intestinal microbial composition in growing rabbits. One hundred female Dehua black rabbits (34 d of age) were randomly assigned to four groups (CON, FOS-1, FOS-2, and FOS-3), with twenty-five rabbits in each group. The CON group received only a basal diet, while the FOS-1/FOS-2/FOS-3 group received the diet supplemented with 0.3%/0.6%/0.9% FOS, respectively. The trial period lasted for 72 days. Our results revealed that FOS supplementation could improve the growing performance of rabbits and decrease the feed/gain ratio. FOS significantly enhanced serum antioxidant enzyme (SOD) and total antioxidant capacity (T-AOC) while reducing malondialdehyde (MDA). The levels of plasmic immunoglobulin (IgG, IgA, and IgM) and intestinal immune factors (IL-1α, IL-2, and sIgA) were significantly improved with the FOS supplement. Additionally, FOS can improve intestinal morphology and enhance the activity of intestinal enzymes, including cellulase, lipase, and protease. Furthermore, FOS supplementation influenced the composition of intestinal microflora by increasing the abundance of Lachnospiraceae_NK4A136_group (barrier-enhancing) and Monoglobus (fiber-degrading). In conclusion, the addition of FOS has a positive impact on the growth performance, antioxidant capacity, immunity, and intestinal health of growing rabbits. The optimal dietary addition for rabbits was identified as 0.6% oligofructose. Full article

Primary or recurrent infection of cytomegalovirus (CMV) in pregnant women may cause transplacental transmission to fetuses. We aimed to investigate the rate of transplacental CMV transmission in women with positive anti-CMV IgG and negative anti-CMV IgM and its impact on newborns. Pregnant women with positive anti-CMV IgG and negative anti-CMV IgM during the first or second trimester who delivered by Cesarean section were included. Amniotic fluid collected during the Cesarean section was tested for CMV DNA with quantitative real-time polymerase chain reaction. CMV IgG and IgM were measured with enzyme-linked immunosorbent assay. A total of 695 pregnant women were enrolled between April 2019 and February 2023. Of them, 567 (81.6%) were single pregnancies and 128 (18.4%) were twin pregnancies, and 594 (85.5%) were full-term pregnancies and 101 (14.5%) were premature pregnancies. Of the 823 newborns, 7 (0.9%) were CMV DNA positive in amniotic fluid, demonstrating the transplacental CMV transmission. One of these seven neonates was diagnosed with intrauterine growth restriction at gestation week 25⁺¹ and at birth at a gestational age of 30⁺² weeks. However, all seven children had normal hearing, vision, and neurodevelopment at the age of 18–56 months. Transplacental CMV transmission may occur in offspring of pregnant women with positive anti-CMV IgG and negative anti-CMV IgM, but the long-term sequelae appear to be minimal. Full article