Tag: pubmed

J Vector Borne Dis. 2026 Feb 7. doi: 10.4103/jvbd.jvbd_223_25. Online ahead of print.

ABSTRACT

BACKGROUND OBJECTIVES: CD5L (CD5 antigen-like) is a secreted glycoprotein involved in immune regulation, macrophage polarization, and lipid metabolism. While its role in inflammatory and bacterial diseases has been described, its function in viral infections such as dengue virus (DENV) infection remains unclear. This study aimed to evaluate serum CD5L levels in dengue-infected individuals and investigate its association with serological markers and disease severity. A cross-sectional study involving dengue-positive and dengue-negative individuals was conducted to compare serum CD5L concentrations and assess correlations with NS1, IgM, IgG status, and disease severity.

METHODS: Serum samples were collected from confirmed dengue-positive patients and dengue-negative controls. CD5L concentrations were quantified using enzyme-linked immunosorbent assay (ELISA) and analyzed according to serological profiles (NS1, IgM, and IgG). Two-group comparisons were performed using the Mann-Whitney U test, and multiple groups were analyzed using the Kruskal-Wallis test with Dunn’s post hoc test. A P-value < 0.05 was considered statistically significant.

RESULTS: CD5L levels were significantly elevated in dengue-positive individuals compared to dengue-negative controls (P < 0.05), with the highest levels observed in IgG-positive only individuals (P < 0.01). No significant differences were seen in NS1-positive only or IgM-positive only groups, suggesting that CD5L upregulation is associated with IgG seropositivity rather than acute-phase markers. Similarly, CD5L levels did not significantly differ among individuals with combined serological markers (NS1 & IgM-positive, NS1 & IgG-positive, IgM & IgG-positive). Among IgG-positive only individuals, CD5L levels were significantly higher in non-severe dengue cases compared to severe dengue cases (P < 0.05). No significant differences were observed in CD5L levels between severe and non-severe NS1-positive only or IgM-positive only individuals. These findings suggest a potential association between increased CD5L and later stages of dengue virus infection with less severe outcomes.

INTERPRETATION CONCLUSION: This study highlights CD5L’s potential role in dengue pathogenesis, particularly its association with IgG seropositivity and non-severe disease. Further research is needed to clarify its mechanisms and evaluate its potential as a biomarker or therapeutic target in dengue virus infection.

PMID:41706431 | DOI:10.4103/jvbd.jvbd_223_25

J Vector Borne Dis. 2026 Feb 7. doi: 10.4103/jvbd.jvbd_270_25. Online ahead of print.

ABSTRACT

BACKGROUND OBJECTIVES: Dengue fever remains a major global public health threat, responsible for millions of infections annually across tropical and subtropical regions. Despite extensive modeling efforts, most existing studies focus exclusively on mosquito-mediated transmission and overlook additional non-vectorial pathways that may influence outbreak persistence.

METHODS: This study addresses this gap by developing the first fractional-order dengue transmission model that simultaneously integrates human-to-human, mosquito-to-mosquito, human-to-mosquito, and mosquito-to-human transmission routes. The Caputo fractional derivative is applied to capture memory effects and nonlocal temporal behavior inherent in real epidemic processes.

RESULTS: Analytical results demonstrate that the model exhibits backward bifurcation when the mosquito-to-mosquito reproduction number exceeds unity, implying that dengue may persist even when the basic reproduction number falls below one. Numerical simulations reveal that fractional-order dynamics slow epidemic decay, delay infection peaks, and prolong outbreak duration compared with classical integer-order models. These findings indicate that memory effects significantly influence disease persistence and the effectiveness of control measures.

INTERPRETATION CONCLUSION: By bridging an important gap in dengue modeling, this framework highlights the combined epidemiological impact of multi-route transmission and fractional dynamics. The results provide insight into designing integrated and sustainable dengue control strategies that account for vectorial, non-vectorial, and memory-dependent transmission processes.

PMID:41706429 | DOI:10.4103/jvbd.jvbd_270_25

Dig Dis Sci. 2026 Feb 18. doi: 10.1007/s10620-026-09765-1. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is commonly used to treat pancreaticobiliary diseases, but can be technically challenging, leading to occasional unsuccessful attempts. While repeat ERCP is one option in these cases, data on the effectiveness and safety of this practice remain limited. Thus, we conducted a systematic review and meta-analysis to assess outcomes of repeat ERCP after initial unsuccessful attempt.

METHODS: MEDLINE, Embase, and CENTRAL were searched on February 28, 2025. We included randomized trials and observational studies reporting on outcomes of repeat ERCP following an initial unsuccessful attempt, with the primary outcome being technical success of cannulation, and secondary outcomes including adverse events (AEs). Random-effects models were used to pool data, and heterogeneity was assessed through the I² statistic.

RESULTS: A total of 22 studies involving 1514 patients with a median age of 62 years were included. The majority of studies were conducted at a single center (86.4%), where the most common indication for repeat ERCP was choledocholithiasis (41.2%), followed by malignant biliary obstruction (29.0%). The pooled technical success rate of repeat ERCP was 83.6% (95% CI 78.6-88.1%, I² = 76.4%). The pooled AE overall rate was 7.3% (95% CI 5.2-9.6%, I² = 27.5%), with pancreatitis being the most frequent and with this overall AE rate being statistically comparable to that associated with patients’ index ERCPs.

CONCLUSIONS: Our meta-analysis demonstrated encouraging success rates with repeat ERCP after initial failure, with acceptably low AE rates, highlighting its role as a primary option in cases of initial unsuccessful ERCP.

PMID:41706406 | DOI:10.1007/s10620-026-09765-1

Appl Biochem Biotechnol. 2026 Feb 18. doi: 10.1007/s12010-026-05608-x. Online ahead of print.

ABSTRACT

Direct purification of a protein from the culture medium is usually the simplest and most cost-effective method, so maximizing extracellular yield is one of the most important goals in protein supply. Although L-asparaginase is not naturally secreted into the extracellular medium through conventional cellular secretory pathways in Escherichia coli, some proteins were previously shown to be released from periplasm of E. coli into medium depending on culture medium and aeration efficiency. Here, extracellular release of L-asparaginase into the culture medium by the E. coli ATCC 11303 was demonstrated and found to be strongly dependent on medium composition, aeration effectiveness, and their interaction. Employing the RSM-CCD (response surface methodology- central composite design), the impacts of four independent factors (shaking speed, maltose, tryptone, and L-asparagine concentrations) on extracellular L-asparaginase activity were also investigated. Optimization of the culture medium led to a significant increase in extracellular L-asparaginase activity, closely matching the predicted values and confirming the robustness of the model. Although further studies appear necessary, this investigation highlights the practical importance of aeration and culture medium composition in extracellular release of L-asparaginase.

PMID:41706403 | DOI:10.1007/s12010-026-05608-x

Odontology. 2026 Feb 18. doi: 10.1007/s10266-026-01345-z. Online ahead of print.

ABSTRACT

This systematic review aimed to explore the potential effects of mucoadhesive tablets (MATs) on the pain and ulcer size outcomes in patients with recurrent aphthous stomatitis (RAS). A systematic search of EMBASE, PubMed, ScienceDirect, and Web of Science was conducted. Randomized controlled trials (RCTs) comparing MATs with placebo were included. Risk of bias was assessed using the RoB 2 tool, and certainty of evidence was evaluated with GRADE. Outcomes were pooled using random-effects meta-analysis and expressed as mean differences (MD) with 95% confidence intervals (CI). Four RCTs were included in the qualitative review and only three of them were included in the quantitative analysis. For ulcer diameter, MATs demonstrated a statistically significant reduction at day 5 (MD -1.97 mm, 95% CI -3.88 to -0.05; p = 0.044; I² = 78.4%) and day 7 (MD -1.19 mm, 95% CI -1.86 to -0.53; p = 0.0005; I² = 0%). No significant difference was observed at day 3 (MD -1.63 mm, 95% CI -3.99 to 0.74; p = 0.178; I² = 85.9%). For pain intensity, significant short-term reductions were observed at day 2 (MD -1.69, 95% CI -2.46 to -0.93; p < 0.0001), day 3 (MD -2.63, 95% CI -3.93 to -1.32; p < 0.0001), day 4 (MD -2.82, 95% CI -3.83 to -1.81; p < 0.0001), and day 6 (MD -1.22, 95% CI -1.96 to -0.48; p = 0.0012). MATs were associated with short-term improvements in pain and ulcer size in RAS, although results varied across formulations and time points and were influenced by moderate heterogeneity. These findings should therefore be interpreted as preliminary, highlighting the need for larger, longer-term trials with standardized outcome measures.

PMID:41706378 | DOI:10.1007/s10266-026-01345-z

Neurol Ther. 2026 Feb 18. doi: 10.1007/s40120-026-00891-6. Online ahead of print.

ABSTRACT

INTRODUCTION: The spinocerebellar ataxia composite score (SCACOMS) comprises items from the functional Scale for the Assessment and Rating of Ataxia (f-SARA) and the Clinician Global Impression of Change (CGI-C). In the derivation of SCACOMS, weights reflecting 1-year responsiveness were assigned to each item using partial least squares (PLS) regression modeling. The current objective was to incorporate patient-feedback into the SCACOMS item weights, examine corresponding responsiveness of the composite scale, and discuss potential implications for future use.

METHODS: Item weights derived by PLS regression were compared to each item’s relative importance as assigned by 16 patients with SCA during semi-structured interviews. SCACOMS item weights were adjusted using the following combinations: (1) 50/50 weighted combination of PLS and patient weights and (2) reducing the weight of CGI-C to 20% and averaging individual item weights obtained from each perspective. The 1-year mean to standard deviation ratios (MSDRs) for the resulting reweighted scales were compared, with larger MSDRs indicating greatest sensitivity to disease progression.

RESULTS: The PLS-derived SCACOMS had the highest MSDR (0.99). When item weights were averaged across the two sources, the resulting MSDR was 0.91. When the weight of CGI-C was set to 20%, reflecting patient preferences for higher weights on the discrete symptoms, the MSDR was 0.79.

CONCLUSIONS: This study took a novel approach to enhance the face validity of SCACOMS by incorporating patient feedback into the statistically optimized item weights. The result is the merging of objectively derived item weightings (reflecting optimal scale responsiveness) with patient-assigned relevance. While this update may increase the patient centricity of a composite measure, this comes at the expense of reduced sensitivity. This potential trade-off in sensitivity to detect change should be evaluated in the context of the composite measure’s intended use.

PMID:41706362 | DOI:10.1007/s40120-026-00891-6

Sleep Breath. 2026 Feb 18;30(1):55. doi: 10.1007/s11325-026-03591-5.

ABSTRACT

BACKGROUND: Investigation of Restless Legs Syndrome (RLS) in patients with poliomyelitis sequelae (PS) and the effect of RLS on pain, fatigue, sleep and quality of life (QoL).

METHOD: We investigated the presence of RLS in patients with PS who consecutively applied to the neurology outpatient clinic and did not have secondary causes of RLS. Gender, age, side affected by PS, leg muscle strength and length, International RLS Study Group criteria, Pittsburgh Sleep Quality Index questionnaire, Fatigue Severity Scale, SF-36 Form scores were recorded. After receiving a diagnosis of RLS, patients completed the RLS Severity Rating Scale (RLS-SWS) questionnaire.

RESULTS: We identified RLS in 12 (37.5%) of the 32 patients included in the study. There were no differences in demographic characteristics. The leg lengths in the patients with RLS (PwRLS) were significantly shorter (p < 0.001). PwRLS had shorter sleep duration, longer latency, and worse sleep quality and fatigue severity scores (p < 0.001). The pain score was found to be statistically significantly higher in the PwRLS group (p = 0.007). There were no differences in other QoL areas. In the PwRLS study, the RLS-SWS score was positively correlated with sleep latency, sleep quality, and pain and fatigue scores. It was also negatively correlated with sleep duration (p < 0.001).

CONCLUSION: These findings demonstrate that RLS, which has an effective treatment, is a prevalent condition among PS patients that worsens sleep quality and increases pain. Clinicians should screen PS patients who complain of leg pain and/or sleep disturbances for RLS and provide appropriate treatment.

PMID:41706359 | DOI:10.1007/s11325-026-03591-5

J Gambl Stud. 2026 Feb 18. doi: 10.1007/s10899-026-10483-6. Online ahead of print.

NO ABSTRACT

PMID:41706356 | DOI:10.1007/s10899-026-10483-6

Neurosurg Rev. 2026 Feb 18;49(1):232. doi: 10.1007/s10143-026-04139-7.

ABSTRACT

Penetrating traumatic brain injury (pTBI) is a severe subset of cranial trauma associated with high mortality and a substantial burden of intracranial infections. The pTBI infection rates have decreased from approximately 60% in the pre-war era to about 10% today, due to improvements in operative debridement, critical care, and widespread antibiotic availability; however, the independent effect of prophylactic antibiotics remains uncertain, and clinical practice is highly variable. This systematic review and meta-analysis aims to determine whether prophylactic antibiotics truly reduce intracranial infections in pTBI patients. A systematic review and meta-analysis were conducted following PRISMA guidelines. The PubMed, Scopus, and LILACS were rigorously searched. The primary effectiveness outcome analyzed was the risk of central nervous system infection. Secondary outcomes included antibiotic regimens and duration, mortality, and functional outcomes were assessed. Data were analyzed using a random-effects meta-analysis, and statistical heterogeneity was assessed. The study was registered with PROSPERO (CRD420251033854). Eight studies comprising 1372 patients (891 received antibiotic prophylaxis and 481 did not) were included. We found that the administration of prophylactic antibiotics did not significantly reduce the risk of suffering an intracranial infection OR 1.10 (95% CI 0.29-4.22 I² = 48.8%). Furthermore, there was no statistically significant difference between monotherapy and multiple antibiotics, or shorter versus longer courses. Moreover, only one study employed a standardized antibiotic regimen. Prophylactic antibiotic administration in patients with penetrating traumatic brain injury was not associated with a statistically significant reduction in the risk of intracranial infections, as evidenced by substantial heterogeneity in the available literature. However, if prophylaxis is administered, it should be a short-course, monotherapy regimen. These findings highlight the urgent need for high-quality, standardized clinical trials to establish evidence-based guidelines for the use of prophylactic antibiotics in this high-risk population.

PMID:41706320 | DOI:10.1007/s10143-026-04139-7

Child Psychiatry Hum Dev. 2026 Feb 18. doi: 10.1007/s10578-026-01979-8. Online ahead of print.

ABSTRACT

Children and young people living in the Occupied Palestinian Territory (OTP) are repeatedly exposed to potentially traumatic events that can challenge their mental health and school functioning. This study aimed to develop a practical checklist of conflict-related potentially traumatic events of relevance in the school context throughout the OPT. Post-traumatic stress reactions (PTSR) and school functioning assessed the predictive validity of the checklist. Furthermore, we sought to explore the frequency of exposure, PTSR and school functioning between the areas in the OTP and explore how frequency and severity of exposure was associated to PTSR and school functioning. The study was conducted using a mixed method approach between January-June 2019. A qualitative approach with focus group workshops in Gaza city and Ramallah in the West Bank defined the checklist. Quantitative data and statistical analysis validated the checklist and explored the further objectives. The checklist was administered to pupils aged 12-16 (N = 789) recruited from 17 schools in East-Jerusalem, the West Bank and the Gaza Strip, which reported a mean of 5.06 (SD = 2.48) conflict-related potentially traumatic events within the past three months, regardless of where they came from. The predictive validity of the checklist was found to be significant (p < .01), and exposure predicted PTSR and school functioning. Since the checklist consists of only 12 items, it is practical to use for screening and monitoring in a school context. The extent to which the checklist can serve as a multipurpose checklist remains to be tested through practical use, followed by evaluations and further research.

PMID:41706280 | DOI:10.1007/s10578-026-01979-8