by Muhammad Syafiq Kunyahamu, Aziah Daud, Ijlal Syamim Mohd Basri, Tengku Alina Tengku Ismail, Mohd Faiz Md Tahir
IntroductionMental health problems among health workers are a growing concern globally, including in Malaysia. Despite the availability of mental health services, some health workers do not seek professional help. This study aims to determine the level of health workers’ intention to seek professional help, examine the barriers they perceive, and identify predictors of mental health help-seeking intention.
MethodsThis cross-sectional study involved 470 health workers in the East Coast region of Peninsular Malaysia. Data was collected using a self-administered questionnaire. Linear regression analysis was employed to identify the predictors of professional help-seeking intention.
ResultsThe mean score for mental health help-seeking intention was 4.90 (SD = 1.03). Perceived need for help positively predicted help-seeking intention (B = 0.532, p Conclusions
This study highlights the roles of the perceived need for help and perceived stigma barriers in predicting health workers’ help-seeking intentions, offering a basis for targeted interventions and policies to enhance mental health support within Malaysian healthcare settings.
Global ageing populations require accessible, non-invasive tools for early detection and monitoring of neurological chronic and neurodegenerative diseases. Current diagnostic methods face limitations including invasiveness, high costs and infrequent clinical assessments. The human voice has emerged as a promising digital biomarker, with vocal characteristics reflecting physiological and cognitive changes associated with conditions like dementia and Parkinson’s disease. While artificial intelligence (AI) and machine learning have enabled sophisticated vocal analysis, the literature remains fragmented without comprehensive synthesis. This scoping review protocol delineates a systematic approach to collate and synthesise existing research on the application of AI-driven audio biomarkers for the detection and management of neurological diseases (eg, cognitive decline, Parkinson’s disease, Alzheimer’s, dementia and depression) in older adults aged 65 years and above.
This scoping review will be conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines and the methodological framework proposed by Arksey and O’Malley, incorporating recent methodological advancements. The eligibility criteria for study selection will be formulated using the PCC (Population, Concept, Context) framework. A comprehensive literature search will be performed across several electronic databases, including PubMed/MEDLINE, Scopus, Web of Science, IEEE Xplore, Embase, Compendex, CINAHL, Scientific Information Database (SID), Magiran, IranMedex and Barakat Knowledge Network System (BKNS). The search will encompass peer-reviewed articles published in Persian and English from 1 January 2012 to 31 March 2026. Two independent reviewers will screen titles, abstracts and full texts and extract data according to the predefined PCC-based eligibility criteria. Discrepancies will be resolved through discussion or, if necessary, by consultation with a third reviewer. The results will be synthesised and presented narratively, accompanied by summary tables, charts and figures to address each research question.
The Research Ethics Committee of Tabriz University of Medical Sciences approved the protocol for this scoping review (approval number: IR.TBZMED.VCR.REC.1404.223). They concluded that since the review involves only analysis of existing literature without direct patient involvement or clinical procedures, it meets the relevant ethical standards. Results from the review will be shared through peer-reviewed journals and conference presentations to provide valuable insights for researchers, clinicians and policymakers on the use of audio-based biomarkers in older adults.
Not registered.
by Chanseo Lee, Jaihyoung Lee, Kimon-Aristotelis Vogt, Muhammad Munshi
BackgroundAccurate intraoperative detection of nociceptive events is essential for optimizing analgesic administration and improving postoperative outcomes. Although deep learning approaches promise improved modeling of complex physiologic dynamics, their added computational and operational complexity may not translate into clinically meaningful benefit, particularly in small, high-resolution perioperative datasets.
MethodsWe performed a head-to-head evaluation of classical supervised models (L1-regularized logistic regression and 50-, 200-tree Random Forests, with and without drug dosing features) against a Temporal Convolutional Network (TCN) transfer-learning framework for intraoperative nociception detection. Using 101 adult surgical cases with 30 physiologic and 18 drug dosing features sampled in 5-second windows, models were assessed under leave-one-surgery-out cross-validation using AUROC and AUPRC. We further examined probability calibration, multiple ensemble strategies, permutation importance features, and computational cost in terms of inference operations and memory footprint.
ResultsDrug-aware Random Forests of various trees (50 trees vs. 200 trees) achieved the highest discrimination (AUROC 0.716; AUPRC 0.399), outperforming the TCN transfer-learning model (AUROC 0.649; AUPRC 0.311). However, increasing personalization windows in the TCN yielded inconsistent and modest gains (p > 0.05). Isotonic calibration substantially improved probability calibration but did not affect discrimination. No ensemble method surpassed the standalone Random Forest; the gated network consistently assigned >84% weight to the classical model. Computational analysis revealed that while the TCN was more compact in total memory footprint, the smaller, 50-tree Random Forest inference required two orders of magnitude fewer operations, with faster training and lower operational complexity.
ConclusionsIn this clinically realistic benchmark, interpretable classical models operating on well-engineered features without personalization matched or exceeded the performance of a personalized deep learning approach while remaining computationally cheaper and simpler to deploy. These findings underscore the importance of rigorously justifying model complexity in perioperative machine learning and suggest that, for intraoperative nociception monitoring, classical approaches may offer a more favorable balance of accuracy, interpretability, and operational efficiency.
Childbirth readiness can reflect women’s childbirth readiness in terms of knowledge, psychological aspects and planning. The purpose of this study was to evaluate childbirth readiness, its related factors and consequences in Iranian pregnant women.
This longitudinal study was the first stage (quantitative stage) of a sequential explanatory mixed-method study. It followed women during late pregnancy (from 37 weeks of gestation) and the postpartum period (4–6 weeks after childbirth) from March to September 2023.
Health centres of Tabriz, Iran.
This study involved 360 pregnant women with a gestational age of 37 weeks and above, selected via cluster sampling. Participants were excluded for high-risk pregnancies, unfavourable incidents in the last 3 months, mental-psychological diseases or a prior caesarean section.
Childbirth readiness and its related factors were assessed using several instruments completed from the 37th week of pregnancy onward, including the Childbirth Readiness Scale, a sociodemographic questionnaire, the Pregnancy Experience Scale and the Wijma Delivery Expectancy/Experience Questionnaire Version A. The consequences of childbirth readiness were then evaluated 4–6 weeks post partum using the Childbirth Experience Questionnaire, the Edinburgh Postnatal Depression Scale and the Postpartum-Specific Anxiety Scale.
The mean (SD) childbirth readiness score was 67.83 (9.41) out of 90. In the adjusted general linear model (GLM), several factors were significantly associated with lower readiness. These included a higher fear of childbirth score (β –0.12, 95% CI –0.16 to –0.08, p
Key factors associated with readiness included fear of childbirth, obstetric history (gravidity, parity, history of abortion and participation in childbirth readiness classes), maternal education, home ownership, husband’s occupation—though several associations showed small effect sizes. After adjustment, readiness did not independently predict childbirth experience or postpartum mental health. The low participation rate in readiness courses highlights a major service gap. Integrating readiness assessment into prenatal care and expanding access to targeted education are recommended to improve outcomes such as birth satisfaction and caesarean rates.
by Md. Masud Reza, Hasibul Hasan Shanto, Samira Dishti Irfan, A. K. M. Masud Rana, Mohammad Niaz Morshed Khan, Golam Sarwar, Mohammad Sha Al Imran, Mahbubur Rahman, Md. Safiullah Sarker, Muntasir Alam, Md. Abu Hena Chowdhury, Mustafizur Rahman, Sharful Islam Khan
BackgroundUnintended pregnancy among female sex workers (FSW) is a pressing reproductive health concern attributable to risky sexual behaviors, healthcare inequities and poor negotiation powers with male sex partners. However, evidence is scarce on the prevalence and determinants of unintended pregnancies among FSW, which is crucial for enhancing reproductive healthcare. This analysis aims to measure the prevalence of lifetime unintended pregnancies and their associated factors.
MethodsA cross-sectional study was conducted on 327 FSW in Jashore (a border belt district of Bangladesh) from September 2022 to March 2023. Participants were recruited through take-all sampling. Data were collected on the lifetime history of unintended pregnancies and other relevant variables through face-to-face interviews. Chi-square statistic was used to compare the characteristics of FSW reporting unintended pregnancies. To assess the net association of factors associated with unintended pregnancy, multiple logistic regression was applied.
ResultThe lifetime prevalence of unintended pregnancies was reported at 75.8% (95%CI: 71.0–80.1). Among those who reported unintended pregnancies, 37.1% (95%CI: 30.8–43.8) had no education, 39.9% (95%CI: 32.8–47.5) were 25–34 years old, 49.6% (95%CI: 39.3–59.9) were currently married and 62.9% (95%CI: 49.7–74.4) earned ≤10,000 BDT per month compared to those who did not report lifetime unintended pregnancies. The likelihood of unintended pregnancies was significantly higher among those who reported having sex with non-transactional male sex partners (AOR: 2.4, 95%CI: 1.1–5.3, p = 0.036) than those who never had sex with any non-transactional male sex partner. The likelihood was also higher among those who reported rape in their lifetime (AOR: 2.0, 95%CI: 1.0–3.8, p = 0.037) and who self-reported mental health problems (AOR: 2.1, 95%CI: 1.0–4.2, p = 0.045) within the past year, compared to their counterparts.
ConclusionThis study highlights the considerable prevalence and associated determinants of unintended pregnancies among FSW in Jashore. These determinants need to be considered to strengthen reproductive healthcare interventions and policies for FSW. Reproductive health of FSW cannot be improved unless these factors are addressed in the ongoing interventions.
by Fahad Saleem, Fazal ur Rehman Khilji, Sajjad Haider, Qaiser Iqbal, Baharudin Ibrahim, Fatiha Hana Shabaruddin, Mohammad Bashaar
Terrorism-related disasters (TRDs) continue to exert profound and recurring pressures on healthcare systems, particularly in vulnerable regions like Pakistan. Although pharmacists are increasingly recognized as an essential component of disaster management, there is a clear gap in the literature regarding their preparedness, experience, and specific roles in responding to TRDs particularly in low and middle-income countries. This study aimed to explore the preparedness, experiences, and response strategies of pharmacists managing TRDs at the Trauma Centre of Sandeman Provincial Hospital, Quetta, Pakistan. A qualitative design was adopted, guided by the Consolidated Criteria for Reporting Qualitative Research. Semi-structured, face-to-face interviews were conducted with pharmacists (n = 10) providing services at the Trauma Centre. Data were audio-recorded, transcribed verbatim, validated by participants, and analyzed using thematic content analysis. Analysis revealed five overarching themes: (1) pharmacists’ experiences with terrorism-related incidents and existing response mechanisms; (2) professional and personal responses to emergencies, reflecting both commitment and psychological burden; (3) preparedness challenges, including lack of disaster management training, limited awareness of policies and protocols, and inadequate understanding of triage and coordination; (4) barriers such as security risks, pharmacy curriculum deficiencies, insufficient experiential learning, and minimal involvement in planning and management activities; and (5) recommendations for strengthening capacity, including revising curricula, implementing structured training programs, conducting regular disaster drills, and expanding pharmacists’ roles in preparedness and response. Findings revealed a pronounced lack of formal training in disaster management, limited awareness of protocols and triage systems, and minimal involvement of pharmacists in planning and coordination activities. Despite strong professional commitment and frontline engagement, pharmacists’ contribution remain constrained by educational, structural, and policy-level shortcomings. The study highlights the urgent need for integrating disaster management into pharmacy curricula, implementing structured training programs and regular disaster drills, and expanding pharmacists’ roles within institutional and national disaster preparedness frameworks.by Nurdiana Mohammad Hussin, Nik Ruzyanei Nik Jaafar, Idayu Badilla Idris, Azmawati Mohammed Nawi
Individuals with breast cancer (BC) experience significant psychological distress, yet their utilization of mental health services remains low. This study identified key factors influencing help-seeking behavior through integrated Theory of Planned Behavior (TPB) and Health Belief Model (HBM) frameworks. We conducted in-depth interviews (IDIs) with eight BC patients and nominal group technique (NGT) with six health professionals, followed by Fuzzy Delphi Method (FDM) to assess expert consensus. The IDIs revealed that the individuals with BC recognized the value of professional psychological support but were reluctant to engage with these services personally. The participants identified emotional thresholds for help-seeking, expressed preference for informal support networks, and demonstrated varied understanding of mental health professional roles. The FDM evaluation demonstrated strong expert consensus across all assessed elements, particularly those related to emotional support mechanisms. Three barrier categories emerged: individual factors (mental health literacy, autonomy preferences), social factors (family support, cultural stigma), and systemic factors (healthcare integration gaps). Expert consensus exceeded 80% agreement across all domains.This study identified a complex interplay between individual psychological barriers and systemic factors affecting mental health help-seeking among individuals with BC. Effective interventions must address psychological barriers and healthcare delivery factors while respecting individual autonomy in coping choices. A multi-level approach targeting individual education, family support systems, and healthcare integration is recommended to improve mental health service utilization among individuals with BC.Burn injuries are a significant cause of morbidity and mortality globally; however, limited data are available from low- and middle-income countries such as Jordan. This study aimed to describe burn patient presentation, initial management and factors associated with in-hospital mortality. A retrospective descriptive study was conducted using records of 493 patients admitted to a national referral centre in Jordan between 2018 and 2022. The sample was predominantly male (61.5%) with a mean age of 19.6 years (SD = 21); children under 18 years comprised 58.4%. The mean total body surface area (TBSA) burned was 18%. Flame (50.1%) and scald (44.6%) injuries were most common. Inhalation injury occurred in 25.8% and 21.3% required mechanical ventilation. The hospital mortality rate was 15.6%, significantly associated with TBSA, age, inhalation injury and low serum total protein. Baux and revised Baux scores showed high predictive accuracy (AUC = 0.902 and 0.918). Logistic regression identified TBSA, age, inhalation injury and total protein level as independent predictors of mortality. Burn injuries in Jordan disproportionately affect children and are associated with substantial mortality. Early identification of high-risk patients using validated scores and prompt nutritional and respiratory interventions are essential. Multicentre studies and a national burn registry are recommended to guide future policy and care improvements.
by Afsana Anwar, Mahmood Parvez, Farhan Azim, Uday Narayan Yadav, Saruna Ghimire, Ateeb Ahmad Parray, Shovon Bhattacharjee, ARM Mehrab Ali, Rashidul Alam Mahumud, Md Irteja Islam, Md Nazmul Huda, Mohammad Enamul Hoque, Probal Kumar Mondal, Abu Ansar Md Rizwan, Suvasish Das Shuvo, Sabuj Kanti Mistry
BackgroundFrailty and disability often emerge with ageing and affect quality of life. Older adults residing in Rohingya refugee camp in Bangladesh are particularly susceptible to frailty and disability due to adverse physical and social environment along with limited health and social care services available in the camp. This study aimed to investigate the prevalence and factors associated with frailty and disability among Rohingya older adults living in Bangladesh.
MethodsThis cross-sectional study was conducted among older adults aged ≥60 years residing in the Rohingya refugee settlement in Bangladesh. The primary outcomes were frailty and disability, explored using the ‘Frail Non-Disabled (FiND) questionnaire. Data were collected face-to-face during November-December 2021, using a semi-structured questionnaire. A multinomial logistic regression model was used to identify the factors associated with frailty and disability.
ResultsThe majority of participants (n = 864) were aged 60–69 years (72.34%), male (56.25%), married (79.05%), and without formal education (89.0%). The study revealed a high prevalence of frailty (36.92%) and disability (55.21%) among the participants. The multinomial regression analysis showed that the likelihood of experiencing disability was significantly higher among participants who were aged 70–79 years (RRR = 2.65, 95% CI: 1.25, 5.66) and ≥80 years (RRR = 8.06, 95% CI: 1.05, 61.80), were female (RRR = 3.93, 95% CI: 1.88, 8.1.9), had no formal education (RRR = 4.34, 95% CI: 2.19, 8.63), were living in a large family (RRR = 1.82, 95% CI: 1.05, 3.18) and were suffering from non-communicable diseases (RRR = 2.36, 95% CI: 1.32, 4.22) compared to their respective counterparts. The regression analysis also revealed that frailty was significantly higher among participants who were female (RRR = 2.82, 95% CI: 1.34, 5.94), were suffering from non-communicable diseases (RRR = 2.28, 95% CI: 1.27, 4.09), and had feeling of loneliness (RRR = 2.16, 95% CI: 1.11, 4.22).
ConclusionsThe findings underscore the need for long-term care and health promotion activities to alleviate the burden of frailty and disability among older adults in humanitarian settings. Efforts should particularly target the most vulnerable groups- older individuals (≥80 years), women, those without formal education, those living in large families, and those with non-communicable diseases.
by Yeahyea Ahmed, Md Abdullah Saeed Khan, Laila Afroz, Mohammad Nurunnabi, Md Golam Abbas
BackgroundStreet adolescents often engage in early sexual activity, have multiple partners, and are at high risk of sexual abuse and exploitation. Despite the significance of this issue, there is a critical gap in understanding the sexual and reproductive health (SRH) needs, practices, and challenges of this marginalized population in Bangladesh, which this study aimed to explore.
MethodsA cross-sectional study was conducted from August to December 2023, involving 311 street adolescents aged 16–19 years in Sylhet City Corporation, Bangladesh. Data were collected through face-to-face interviews using a semi-structured questionnaire. The questionnaire covered sociodemographic characteristics, pubertal changes, SRH status, and SRH-seeking behaviors.
ResultsOf all participants, 62.8% were males and 37.2% were females, with a mean age of approximately 17.3 years for both sexes. Sexual intercourse was reported by 32.56% of participants, with a significant gender disparity (76.79% females vs. 6.35% males, p Conclusion
Street adolescents in Sylhet City face severe SRH challenges, including high rates of sexual abuse, low contraceptive use, and limited STD knowledge, with significant gender disparities, which should be addressed through appropriate and urgent interventions.
by Aniket Pramanick, Yufang Hou, Saif M. Mohammad, Iryna Gurevych
Large Language Models (LLMs) have ushered in a transformative era in Natural Language Processing (NLP), reshaping research and extending NLP’s influence to other fields of study. However, there is little to no work examining the degree to which LLMs influence other research fields. This work empirically and systematically examines the influence and use of LLMs in fields beyond NLP. We curate 106 LLMs and analyze ∼148k papers citing LLMs to quantify their influence and reveal trends in their usage patterns. Our analysis reveals not only the increasing prevalence of LLMs in non-CS fields but also the disparities in their usage, with some fields utilizing them more frequently than others since 2018, notably Linguistics and Engineering together accounting for ∼45% of LLM citations. Our findings further indicate that most of these fields predominantly employ task-agnostic LLMs, proficient in zero or few-shot learning without requiring further fine-tuning, to address their domain-specific problems. This study sheds light on the cross-disciplinary impact of NLP through LLMs, providing a better understanding of the opportunities and challenges.To examine the associations between food-related behaviours and nutrient intake on nutritional status among clients undergoing Community-Based Treatment and Rehabilitation (CBTaR) in Kelantan, Malaysia.
Cross-sectional analytical study.
Seven CBTaR centres (n=7) across the state of Kelantan, Malaysia.
A total of 393 adult clients (aged 18 years and above) enrolled in CBTaR programmes between June and December 2022 were selected through stratified random sampling.
The primary outcome was nutritional status, assessed using body mass index. Secondary outcomes included nutrient intake (macronutrients and micronutrients) and food-related behaviours (emotional eating, external eating, restrained eating and food addiction), measured through Bahasa Malaysia validated questionnaires and 24-hour dietary recalls. All variables were introduced into the structural equation modelling to examine the associations among these variables and their association with nutritional status.
The results revealed that food-related behaviour was significantly associated with the nutrient intake (β=–0.524, p≤0.001). Additionally, the drug use profile significantly determined the food-related behaviour (β=–0.129, p=0.006) and nutritional status (β=–0.134, p=0.007). Nutrient intake was found to be a significant predictor of nutritional status (β=–0.213, p≤0.001). Sociodemographic and drug use profiles were significantly correlated with nutritional outcomes through behavioural and dietary associations. Importance-performance map analysis identified nutrient intake as the most impactful variable, highlighting the need for urgent intervention (R2=0.272).
This study highlights that nutrient intake is a significant predictor associated with food-related behaviours on nutritional status among individuals with substance use disorder. Integrating nutrition counselling and behavioural interventions into CBTaR services may improve recovery and long-term health outcomes.
Systemic sclerosis (SSc) is an autoimmune disorder causing progressive fibrosis of internal organs and skin, leading to increased thickness and rigidity. It frequently results in malnutrition, which can decrease survival rates and physical performance, while also imposing financial burdens on healthcare systems and society. Multimodal nutritional interventions may encompass various approaches, including nutritional counselling, consumption of oral nutritional supplements and disease-specific dietary regimens based on nutritional needs. The present clinical trial is designed to examine the effectiveness of multimodal nutritional intervention on nutritional status, quality of life, food intake, body composition and fatigue in patients with SSc.
This is a parallel, randomised, placebo-controlled clinical trial that will investigate the impacts of multimodal nutritional interventions in SSc patients. 46 qualified SSc participants will be chosen at random and given multimodal nutritional intervention or dietary recommendations for a period of 8 weeks. The primary outcomes of this study are changes in nutritional status and quality of life. The secondary outcomes include changes in body composition, fatigue, body weight, body mass index and calf circumference. Statistical analysis will be conducted using the SPSS software (Version 24).
The current trial received approval from the Medical Ethics Committee of Tehran University of Medical Sciences, Tehran, Iran (IR.TUMS.MEDICINE.REC.1403.345). The findings will be submitted to international, peer-reviewed publications and presented at national and international conferences.
IRCT20220208053971N4.
by Thea Lynne Hedemann, Yun Lu, Sofia Campitelli, Lisa D. Hawke, Nelson Shen, Sarah Saperia, Brett D. M. Jones, Gillian Strudwick, Chelsey R. Wilks, Wei Wang, Marco Solmi, Michael Grossman, Muhammad Ishrat Husain, Nicole Kozloff, George Foussias, Muhammad Omair Husain
BackgroundYouth at clinical high risk (CHR) for psychosis often experience emotional dysregulation, psychiatric symptoms, substance use, suicidality, and functional impairment. Dialectical behaviour therapy (DBT) is an evidence-based intervention that improves emotion regulation, clinical outcomes, and functioning across psychiatric populations. Digital adaptations (d-DBT) may enhance accessibility and engagement for CHR youth, but acceptability and potential benefits in this group are unknown.
ObjectiveTo adapt d-DBT for CHR youth and evaluate the acceptability of delivering it to this population, as well as the feasibility of a larger-scale clinical trial.
MethodsThis mixed-methods clinical trial has two phases. In Phase 1, d-DBT will be adapted for CHR youth in collaboration with a lived-experience youth advisory group. In Phase 2, an assessor-masked randomized controlled trial will compare d-DBT (n = 30) with treatment as usual (n = 30). The intervention consists of eight weekly modules, with primary outcomes assessing acceptability, usability, and trial feasibility. Secondary outcomes include changes in emotional dysregulation, psychiatric symptoms, substance use, suicidality, and functioning.
ConclusionsWe anticipate that d-DBT will be acceptable to CHR youth and that conducting a larger trial will be feasible. Preliminary findings may demonstrate improvements in emotion regulation, psychiatric symptoms, suicidality, and functioning. Results will guide further refinement of the intervention and inform the design of a confirmatory clinical trial.
Trial registrationClinicalTrials.gov #NCT06928935
by Maha Rabayaa, Mustafa Ghanim, Malik Alqub, Mohammad Abuawad, Majdi Dwikat, Samar Alkhaldi, Haneen Badawi, Johnny Amer
IntroductionAllergy is a form of chronic illness with an increasing prevalence globally. Adequate knowledge among the community about the causes, symptoms, and treatment of allergy is crucial in preventing the associated life-threatening complications. Limited research has been conducted in Palestine regarding this health priority. The current study aimed to assess the Palestinian community’s level of knowledge regarding allergy.
MethodsAn observational cross-sectional study was conducted using an online questionnaire targeting Palestinians aged 18 years and older between 1 June 2024 and 26 January 2025. The questionnaire gathered demographic information about the participants and assessed their knowledge level concerning allergy.
ResultsA total of 1002 participants were included in the study. The mean age of the participants was 30.33 years. 66.1% of the participants were females, 60.2% were unmarried, 60.1% had possessed a bachelor’s degree, 63.1% had a personal history of allergy, and 82% reported knowing of someone with allergies. The mean knowledge score about allergies was 5.4 out of 10, with over half of the participants having an average level of knowledge (4–6). The knowledge score about allergies was significantly different based on the participants’ sex, marital status, place of residence, educational level, and occupation (p-value Conclusion
The Palestinians’ knowledge of allergy is considered good regarding its common causes and symptoms. However, there is still inadequate knowledge about the treatment of allergy and its less common causes. The community awareness of allergy should be improved through targeted campaigns and brochures aimed at achieving earlier diagnosis and proper management to prevent the development of life-threatening complications.
This study aims to review case reports/series on West Nile virus (WNV) infection-associated cranial nerve (CN) neuropathy to explore the associated patterns and characteristics.
A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria.
We reviewed the literature in PubMed/Medline, Google Scholar and ScienceDirect databases to retrieve relevant case reports.
Case reports published in the past 25 years on CN neuropathy in WNV-infected patients, with no language or geographic restrictions.
Retrieved data included patient demographics, disease presentation and treatment outcomes. Descriptive statistical analyses were performed to describe frequency and characteristics of CN neuropathies. Cross tabulation was performed to calculate statistical significance of association between patient characteristics, disease factors and treatment outcomes. Risk of bias was assessed using the JBI Critical Appraisal Tool for case reports.
A total of 30 case reports satisfied inclusion criteria. These studies described 42 cases that developed CN neuropathies as an outcome of WNV infection. Patients were in the main males (54.8%) and had a mean age of 52.5±15.5 years. The most frequently affected CNs were, in descending order, optic (n=21, 50.0%), facial (n=14, 33.3%) and abducent nerves (n=8, 19.0%). Age was significantly associated with optic nerve neuropathy (≥51 years) and facial palsy (
CN neuropathy represents an important subset of neuroinvasive disease caused by WNV. There is a slight male preponderance among the patient population who are mostly middle aged. Optic and facial nerves are mostly affected. Most patients show complete recovery, particularly in the absence of chronic diseases. The role of systemic antivirals in improving disease outcomes should be further investigated. Early detection of CN neuropathies is recommended by routine CN screening and use of specific tools such as MRI and neurophysiological tests.
by Cindy Xinyu Ji, Majid Sorouri, Mohammad Abdollahi, Omalbanin Paknejad, Ali R. Mani
Network physiology is a multidisciplinary field that offers a comprehensive view of the complex interactions within the human body, emphasising the critical role of organ system connectivity in health and disease. This approach has the potential to provide pathophysiological insights into complex and emerging diseases. This study aims to evaluate the effectiveness of physiological network mapping in predicting outcomes for COVID-19 patients, using data from the first wave of the pandemic. Routine clinical and laboratory data from 202 patients with COVID-19 were retrospectively analysed. Twenty-one physiological variables representing various organ systems were used to construct organ network connectivity through correlation analysis. Parenclitic network analysis was also employed to measure deviations in individual patients’ organ system correlations from the reference physiological interactions observed in survivors. We observed distinct features in the correlation network maps of non-survivors compared to survivors. In non-survivors, there was a significant correlation between the level of consciousness and the liver enzyme cluster, a relationship not present in the survivor group. This relationship remained significant even after adjusting for age and degree of hypoxia. Additionally, a strong correlation along the BUN–potassium axis was identified in non-survivors, suggesting varying degrees of kidney damage and impaired potassium homeostasis in non-survivors. These findings highlight the potential of network physiology as a valuable tool for uncovering complex inter-organ interactions in emerging diseases, with applications that could support clinicians, researchers, and policymakers in future epidemics.