Infectious Research Articles

How international guidelines recommend treating children who have severe COVID-19 or risk disease progression.

This study reviewed the current knowledge and guidelines on managing COVID-19 in children and proposed a practical approach to drug treatment. We analysed international guidelines from four prominent scientific bodies on treating COVID-19 in children. These were the UK National Institute for Health and Care Excellence, the American National Institutes of Health, the Infectious Diseases Society of America and the Australian National Clinical Evidence Taskforce COVID-19. Most paediatric patients with COVID-19 only require symptomatic treatment. There was limited evidence on treatment recommendations for children with severe COVID-19 or at risk of disease progression. However, several drugs are available for children and we have summarised the guidelines, in order to provide a concise, practical format for clinicians. All the guidelines agree that nirmatrelvir plus ritonavir or remdesivir can be used as prophylaxis for severe COVID-19 in high-risk patients. Remdesivir can also be used for severe COVID-19 cases. Glucocorticosteroids are recommended, particularly in patients requiring oxygen therapy. Tocilizumab or baricitinib should be reserved for patients with progressive disease and/or signs of systemic inflammation. The guidelines provide useful advice and a degree of consensus on specific drug treatment for children with severe COVID-19 or at risk of progression.

Portable all-in-one microfluidic system for CRISPR-Cas13a-based fully integrated multiplexed nucleic acid detection.

Point-of-care testing of "sample in, answer out" is urgently needed for communicable diseases. Recently, rapid nucleic acid tests for infectious diseases have been developed for use in resource-limited areas, but they require types of equipment in central laboratories and are poorly integrated. In this work, a portable centrifugal microfluidic testing system is developed, integrated with magnetic bead-based nucleic acid extraction, recombinase-assisted amplification and CRISPR-Cas13a detection. The system, with the advantage of its power-supplied active rotating chip and highly programable flow control through integrated addressable active thermally-triggered wax valves, has a rapid turnaround time within 45 min, requiring only one user step. All reagents are preloaded into the chip and can be automatically released. By exploiting a multichannel chip, it is capable of simultaneously detecting 10 infectious viruses with limits of detection of 1 copy per reaction and 5 copies per reaction in plasmid samples and mock plasma samples, respectively. The system was used to analyse clinical plasma samples with good consistency compared to laboratory-based molecular testing. Moreover, the generalizability of our device is reported by successfully testing nasopharyngeal swabs and whole blood samples. The portable device does not require the operation of professional technicians, making it an excellent assay for on-site testing.

Economic burden of infectious diseases and its equity implications in Indian households: Estimates from a nationally representative household survey (2017–18)

Infectious diseases remain one of the major causes of health and economic burden for Indian households. Furthermore, the magnitude of economic losses on account of infectious disease episodes varies widely across rich and poor households. The primary objective of this research is to estimate the equity impact of infectious disease episodes on out-of-pocket expenditure (OOPE) and wage losses among Indian households. We analysed the Social Consumption: Health (SCH) data from the 75th round (2017–18) of India's National Sample Survey (NSSO). The sample included approximately 113,823 households and 555,352 individuals through a multistage stratified sampling process. We report i) the prevalence of infectious disease and healthcare utilisation rate by levels of care; ii) medical and non-medical OOPE per episode; iii) OOPE and wage loss as a share of households' monthly non-medical consumption expenditure (non-medical MPCE) across wealth quintiles. We adopted a microeconomic cost of illness approach to estimate the OOPE on infectious disease episodes for outpatient care and hospitalization. We also estimated potential wage losses due to a reduction in effective labour supply at the household level because of infectious disease using a production function approach. The overall prevalence of infectious diseases and hospitalization rate were 31 and 9 per thousand persons, respectively. Per capita medical OOPE was more in higher wealth quintiles for outpatient care and hospitalization. However, OOPE as a share of non-medical MPCE was higher in the poorest 20% households (outpatient: 14%; hospitalization: 153%) in comparison to the richest 20% households (outpatient: 5.5%; hospitalization: 96%). Similarly, the wage losses as a share of non-medical MPCE were higher among the poorest 20% households (outpatient: 21%; hospitalization:38%) in comparison to the richest 20% households (outpatient: 15%; hospitalization:11%). Furthermore, the proportion of households reporting the sale of assets and borrowing to finance hospitalization was higher in the poorest (24%) compared to the richest (12.5%). To our knowledge, this is the first paper which contributes to developing an understanding of the equity impact of infectious disease on households in India. We recommend improved targeting and coverage of publicly funded health insurance schemes among socially disadvantaged populations.

Rosa × damascena Herrm. From Azaran region, Kashan: rich in saturated and unsaturated fatty acids with inhibitory effect against Proteus mirabilis

BackgroundOne of the most widely used medicinal plants in Iranian traditional medicine, Rosa × damascena Herrm. (mohammadi flower) that the people of Kashan use as a sedative and to treat nervous diseases and constipation. In this research, the yield, chemical composition and antimicrobial activity of the essential oil of this plant were evaluated for the first time from Azaran region, Kashan.MethodsThe essential oil was extracted by means of hydrodistillation (Clevenger), and its chemical compounds were identified and determined by GC/MS. The antimicrobial activity of the essential oil was determined by the diffusion method in agar, the minimum growth inhibitory concentration (MIC) and the minimum concentration capable of killing bacterial/fungal microorganisms (MBC/MFC).ResultsThe results showed that the yield of essential oil was 0.1586 ± 0.0331% (w/w). Based on the results of the chemical composition analysis of R. x damascena essential oil, 19 different compounds (98.96%) were identified. The dominant and main components of the essential oil were oleic acid (48.08%), palmitic acid (15.44%), stearic acid (10.17%), citronellol (7.37%) and nonadecane (3.70%). Based on the results of diffusion in agar, the highest zone of inhibition against Candida albicans (ATCC 10231) was ~ 9.5 mm. The strongest inhibitory activity of R. x damascena essential oil against Gram-negative Proteus mirabilis (ATCC 43071) was with the diameter of the inhibition zone (~ 9 mm), which was equal to the strength of rifampin (~ 9 mm).ConclusionTherefore, this essential oil is a promising natural option rich in fatty acids, which can be a potential for the production of natural antimicrobials against infectious diseases, especially urinary tract infections.

A Critical Review in Infectious Disease and Mathematical Modelling

A Critical Review in Infectious Disease and Mathematical Modelling

Innovative teaching in infection prevention and control and infectious diseases education: testing and investigation of student perceptions.

Many curricula promote frontal teaching approaches, potentially decreasing interaction and motivation - also within infection prevention & control and infectious diseases (IPC/ID). We aimed to investigate the implementation of three innovative teaching methods (ITM) within IPC/ID education: game-based learning (GBL), peer-teaching (PT) and misinformation detection (MID). Multi-phase study involving third-year medical students was conducted. Phase-1 included a cross-sectional survey, assessing previous ITM-experience and interest to participate in phase-2, where the students were divided into teams. Each team prepared a video covering an IPC/ID-topic with deliberately placed misinformation, which had to be identified and corrected by the opposing team, followed by qualitative evaluation (phase-3). Finally, the MID-concept was incorporated into regular curricula in a non-competitive environment (phase-4) and evaluated within a cohort not involved in phases 1-3. 276 students responded to phase-1. 58% expressed interest in participating in phase-2. Roughly 59% [47-71%] CI-95% of respondents without previous PT-experience stated interest in PT, while the interest in GBL and MID was even higher. 19 students participated in phase-2. All topic MID-scores ranged between 6 and 8/10 points, except for emporiatrics (3/10). Post-hoc analysis revealed a positive student-perception of ITM, particularly GBL. Phase-4 received 103 responses with general positive evaluation. Major agreements existed on the usefulness of critical information evaluation for medical practice (82% [75-91%] CI-95%) and of MID during studies (69% [59-79%] CI-95%). our results hint at a relatively high interest in ITM and show MID applicability in regular IPC/ID curricula, which could be of advantage for the learning environment.

Childhood PFAS exposure and immunotoxicity: a systematic review and meta-analysis of human studies

BackgroundExposure to poly- and perfluoroalkyl substances (PFAS) may affect infant and childhood health through immunosuppression. However, the findings of epidemiological literature examining relationships between prenatal/childhood PFAS exposure and vaccine response and infection in humans are still inconclusive. The aim of this review was to examine the effects of PFAS exposure on vaccine antibody response and infection in humans.MethodsThe MEDLINE/Pubmed database was searched for publications until 1 February 2023 to identify human studies on PFAS exposure and human health.Eligible for inclusion studies had to have an epidemiological study design and must have performed logistic regression analyses of gestational or childhood exposure to PFAS against either antibody levels for pediatric vaccines or the occurrence of children’s infectious diseases. Information on baseline exposure to PFAS (in ng/mL), the age of PFAS exposure (gestational or in years), and the outcome was measured, potentially leading to multiple exposure-outcome comparisons within each study was collected. Percentage change and standard errors of antibody titers and occurrence of infectious diseases per doubling of PFAS exposure were calculated, and a quality assessment of each study was performed.ResultsSeventeen articles were identified matching the inclusion criteria and were included in the meta-analysis. In general, a small decrease in antibody response and some associations between PFAS exposure and childhood infections were observed.ConclusionsThis meta-analysis summarizes the findings of PFAS effects on infant and childhood immune health. The immunosuppression findings for infections yielded suggestive evidence related to PFAS exposure, particularly PFOS, PFOA, PFHxS, and PFNA but moderate to no evidence regarding antibody titer reduction.Systematic review registrationThe research protocol of this systematic review is registered and accessible at the Open Science Framework (https://doi.org/10.17605/OSF.IO/5M2VU).

Mendelian randomization analysis reveals higher whole body water mass may increase risk of bacterial infections

Background and purposeThe association of water loading with several infections remains unclear. Observational studies are hard to investigate definitively due to potential confounders. In this study, we employed Mendelian randomization (MR) analysis to assess the association between genetically predicted whole body water mass (BWM) and several infections.MethodsBWM levels were predicted among 331,315 Europeans in UK Biobank using 418 SNPs associated with BWM. For outcomes, we used genome-wide association data from the UK Biobank and FinnGen consortium, including sepsis, pneumonia, intestinal infections, urinary tract infections (UTIs) and skin and soft tissue infections (SSTIs). Inverse-variance weighted MR analyses as well as a series of sensitivity analyses were conducted.ResultsGenetic prediction of BWM is associated with an increased risk of sepsis (OR 1.34; 95% CI 1.19 to 1.51; P = 1.57 × 10− 6), pneumonia (OR: 1.17; 95% CI 1.08 to 1.29; P = 3.53 × 10− 4), UTIs (OR: 1.26; 95% CI 1.16 to 1.37; P = 6.29 × 10− 8), and SSTIs (OR: 1.57; 95% CI 1.25 to 1.96; P = 7.35 × 10− 5). In the sepsis and pneumonia subgroup analyses, the relationship between BWM and infection was observed in bacterial but not in viral infections. Suggestive evidence suggests that BWM has an effect on viral intestinal infections (OR: 0.86; 95% CI 0.75 to 0.99; P = 0.03). There is limited evidence of an association between BWM levels and bacteria intestinal infections, and genitourinary tract infection (GUI) in pregnancy. In addition, MR analyses supported the risk of BWM for several edematous diseases. However, multivariable MR analysis shows that the associations of BWM with sepsis, pneumonia, UTIs and SSTIs remains unaffected when accounting for these traits.ConclusionsIn this study, the causal relationship between BWM and infectious diseases was systematically investigated. Further prospective studies are necessary to validate these findings.

Post-COVID-19: Hematological Factors Changes in Patients at Three-- time Intervals.

Hematological parameters are crucial factors in disease severity and chronic condition pathogenesis. We aimed to evaluate the hematological factors in different severity stages of COVID-19 at different time intervals. Serum samples were collected from 470 patients (235 men and 235 women) with a confirmed RT-qPCR COVID-19 test exhibiting moderate, severe, and critical symptoms based on WHO criteria. Samples were collected at three-time intervals, including the first: the 1st days of infection, 2nd: the one month after, and 3rd: the three months after disease onset. Total WBC, neutrophil, lymphocyte, monocyte, eosinophil, RBC counting, Hb, HCT, MCV, MCH, MCHC, hsCRP levels, G6PD deficiency, and hemoglobinopathies were determined in all patients. Total WBC, neutrophil, lymphocyte, platelet, RBC counting, Hb, HCT, MCV, MCH, and hsCRP levels were significantly changed with different disease severity (p&#60;0.0001). Also, there were significant differences between different time intervals for WBC and RBC parameters (p&#60;0.0001) except for monocytes and eosinophils. At all time intervals, there are significant changes in levels of hematological and hsCRP based on gender. Moreover, a significant correlation was observed between disease severity, age, and BMI (p&#60;0.0001). Significant differences in hematological parameter and inflammatory parameter levels based on disease severity, time intervals, and gender revealed the importance of evaluating these factors in the management of infectious diseases, such as COVID-19, in patients during and post-disease times.</p>.

Imported Loiasis at a Clinical Reference Center in Germany: A Retrospective Case Series.

Loiasis is a rarely imported infectious disease that is often difficult to diagnose and treat. Here we describe clinical features and treatment outcomes of 11 patients with imported loiasis seen at a German reference center between 2013 and 2023. Clinical presentations varied by patient origin, with eye-worm migration and ophthalmological symptoms being more common among patients from endemic areas and Calabar swelling, subcutaneous swelling, and pruritus more prevalent among returning travelers from nonendemic regions. Eosinophil counts were higher in returning travelers. Diethylcarbamazine was most commonly used for treatment either as monotherapy in combination with ivermectin or with albendazole and ivermectin, respectively. In one patient, long-term follow-up indicated treatment failure after the first course of treatment. Another traveler was prescribed chemoprophylaxis with diethylcarbamazine after experiencing repeated infections due to long-term residence in a high-risk region in Cameroon.

Identification of Immunodominant Epitopes of Dengue Virus 2 Envelope and NS1 Proteins: Evaluating the Diagnostic Potential of a Synthetic Peptide.

Dengue is a major infectious disease with potential for outbreaks and epidemics. A specific and sensitive diagnosis is a prerequisite for clinical management of the disease. We designed our study to identify epitopes on theDengue virus (DENV) envelope (E) and non-structural protein 1 (NS1) with potential for diagnosis. Serology and immunoinformatic approaches were employed. We collected DENV-positive, DENV-negative and Japanese encephalitis virus-positive samples from collaborating hospitals in 2019 and 2022-2023. Seropositive peptides in 15-18 mer peptide arrays of E and NS1 proteins of DENV2 were determined by an indirect enzyme-linked immunosorbent assay. B-cell linear and conformational epitopes were predicted using BepiPred2.0 and ElliPro, respectively. A consensus recombinant peptide was designed, synthesised and evaluated for its diagnostic potential using patient sera. Eight peptides of E protein and six peptides of NS1 protein were identified to be the most frequently recognised by Dengue-positive patients. These peptide sequences were compared with B-cell epitope regions and found to be overlapped with predicted B-cell linear and conformational epitopes. EP11 and NSP15 showed a 100% amino acid sequence overlap with B-cell epitopes. EP1 and NSP15 had 14 whereas EP28, EP31, EP60 16, NSP12 and NSP32 had more than 15 interacting interface residues with a neutralising antibody, suggesting a strength of interaction. Interestingly, potential epitopes identified were localised on the surface of proteins as visualised by PyMOL. Validation with a recombined synthetic peptide yielded 92.3% sensitivity and 91.42% specificity. Immunodominant regions identified by serology and computationally predicted epitopes overlapped, thereby showing the robustness of the methodology and the peptide designedfor diagnosis.

Rapid diagnosis of alveolar echinococcosis from lung puncture sample using metagenomic next-generation sequencing: a case report

IntroductionAlveolar echinococcosis (AE), caused by the larval forms of Echinococcus multilocularis, is a zoonotic disease affecting the liver, lungs, lymph nodes, kidneys, brain, bones, thyroid, and other organs. Diagnosing AE in a non-endemic area is usually challenging. With the rapid development and increasing application of sequencing techniques in recent years, metagenomic next-generation sequencing (mNGS) has become a powerful tool for diagnosing rare infectious diseases.Case PresentationA 45-year-old woman was admitted to the hospital for the presence of pulmonary shadows for more than 3 months. The lung computed tomography (CT) at a local hospital revealed scattered solid and quasi-circular nodules in the left upper lobe, left lower lobe, right middle lobe, and right lower lobe. The largest nodule was located in the dorsal part of the right lung, measuring 2.0 × 1.7 × 1.5 cm. Moreover, abdominal CT revealed one space-occupying lesion each in the left and right lobes. The pathological analysis of the lung biopsy specimen revealed infiltration of lymphocytes, plasma cells, and eosinophils in the alveolar wall and interstitial area. No pathogenic bacteria were observed in the sputum smear and culture tests. There were no parasite eggs in the stool. The mNGS of the lung puncture tissue revealed 6156 sequence reads matching E. multilocularis; thus, the condition was diagnosed as AE. Albendazole 400 mg was administered twice daily, and the patient was stable during follow-up.ConclusionThis case emphasizes the role of mNGS in diagnosing AE. As a novel, sensitive, and accurate diagnostic method, mNGS could be an attractive approach for facilitating early diagnosis and prompt treatment of infectious diseases, especially when the infection was caused by rare pathogens.

Incidence and Characteristics of Pediatric Patients with Acute Otitis Hospitalized in a Romanian Infectious Diseases Hospital

Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and 2023, with the aim of quantifying the incidence and impact of acute otitis (AO) according to pediatric age subgroups. Results: A total of 1118 cases diagnosed with AO were eligible and included in the analysis. Acute congestive otitis media was the most common subtype, identified in 53.3% of cases, followed by acute purulent otitis media (APOM) in 26.7% of children. The majority of AO cases (69.9%) were diagnosed in the pre-pandemic period (2018–2019), and infants (10.6%), toddlers (49.4%), and preschoolers (29.2%) were the most affected age groups. A viral infection associated with the AO episode was documented in 49.6% of cases. Influenza viruses were most commonly reported (20.5%), followed by SARS-CoV-2 (5.8%), and adenovirus (4.9%). A total of 38 cases of AO were identified in children with measles. In 15.9% of APOM cases, Streptococcus pneumoniae was isolated by culture from otic secretions. The duration of hospitalization was longer in children with APOM and acute otitis externa compared to the other subtypes of AO (p &lt; 0.001). Conclusions: Our study highlights the importance of ENT (ear, nose, and throat) monitoring in children hospitalized for acute infectious diseases, as the majority of AO cases occur in the context of a viral infection. These findings emphasize the necessity for tailored assessment and intervention in suspected cases of AO, especially in young children under 5 years of age.

Molecular surveillance of zoonotic pathogens from wild rodents in the Republic of Korea.

Rodents are recognized as major reservoirs of numerous zoonotic pathogens and are involved in the transmission and maintenance of infectious diseases. Furthermore, despite their importance, diseases transmitted by rodents have been neglected. To date, there have been limited epidemiological studies on rodents, and information regarding their involvement in infectious diseases in the Republic of Korea (ROK) is still scarce. We investigated rodent-borne pathogens using nested PCR/RT-PCR from 156 rodents including 151 Apodemus agrarius and 5 Rattus norvegicus from 27 regions in eight provinces across the ROK between March 2019 and November 2020. Spleen, kidney, and blood samples were used to detect Anaplasma phagocytophilum, Bartonella spp., Borrelia burgdorferi sensu lato group, Coxiella burnetii, Leptospira interrogans, and severe fever with thrombocytopenia syndrome virus (SFTSV). Of the 156 rodents, 73 (46.8%) were infected with Bartonella spp., 25 (16.0%) with C. burnetii, 24 (15.4%) with L. interrogans, 21 (13.5%) with A. phagocytophilum, 9 (5.8%) with SFTSV, and 5 (3.2%) with Borrelia afzelii. Co-infections with two and three pathogens were detected in 33 (21.1%) and 11 rodents (7.1%), respectively. A. phagocytophilum was detected in all regions, showing a widespread occurrence in the ROK. The infection rates of Bartonella spp. were 83.3% for B. grahamii and 16.7% for B. taylorii. To the best of our knowledge, this is the first report of C. burnetii and SFTSV infections in rodents in the ROK. This study also provides the first description of various rodent-borne pathogens through an extensive epidemiological survey in the ROK. These results suggest that rodents harbor various pathogens that pose a potential threat to public health in the ROK. Our findings provide useful information on the occurrence and distribution of zoonotic pathogens disseminated among rodents and emphasize the urgent need for rapid diagnosis, prevention, and control strategies for these zoonotic diseases.

Impact of COVID-19 Vaccine Persuasion Strategies on Social Endorsement and Public Response on Chinese Social Media

ABSTRACT Persuading the public to get vaccinated against infectious diseases is critical and carries profound implications for preparing for future pandemics. This study examined whether and how persuasion strategies employed in pro-vaccine messages affect social endorsement and audience stance toward the COVID-19 vaccine expressed in comments on Chinese social media. Through manual coding and pre-trained BERT model, we analyzed 1,500 Weibo posts focused on COVID-19 vaccination persuasion and 238,201 associated comments. Results showed that medical experts succeeded in eliciting heightened social endorsement and receiving more pro-vaccine comments. Posts that employed negative emotional appeal were less likely to be liked or receive pro-vaccine comments. Besides, vaccine persuasion messages presented in a narrative format or emphasizing vaccine efficacy garnered significantly more likes but did not significantly receive more pro-vaccine comments. Discussing domestic issues or employing joy appeal received more pro-vaccine comments. These results offer valuable insights for health practitioners and communicators, highlighting more effective persuasion strategies for engaging citizens in vaccine-related discussions on social media. This study underscores the importance of leveraging persuasion tactics on social media to foster vaccination uptake and better prepare us for handling future pandemics.

ChatGPT With GPT-4 Outperforms Emergency Department Physicians in Diagnostic Accuracy: Retrospective Analysis.

OpenAI's ChatGPT is a pioneering artificial intelligence (AI) in the field of natural language processing, and it holds significant potential in medicine for providing treatment advice. Additionally, recent studies have demonstrated promising results using ChatGPT for emergency medicine triage. However, its diagnostic accuracy in the emergency department (ED) has not yet been evaluated. This study compares the diagnostic accuracy of ChatGPT with GPT-3.5 and GPT-4 and primary treating resident physicians in an ED setting. Among 100 adults admitted to our ED in January 2023 with internal medicine issues, the diagnostic accuracy was assessed by comparing the diagnoses made by ED resident physicians and those made by ChatGPT with GPT-3.5 or GPT-4 against the final hospital discharge diagnosis, using a point system for grading accuracy. The study enrolled 100 patients with a median age of 72 (IQR 58.5-82.0) years who were admitted to our internal medicine ED primarily for cardiovascular, endocrine, gastrointestinal, or infectious diseases. GPT-4 outperformed both GPT-3.5 (P<.001) and ED resident physicians (P=.01) in diagnostic accuracy for internal medicine emergencies. Furthermore, across various disease subgroups, GPT-4 consistently outperformed GPT-3.5 and resident physicians. It demonstrated significant superiority in cardiovascular (GPT-4 vs ED physicians: P=.03) and endocrine or gastrointestinal diseases (GPT-4 vs GPT-3.5: P=.01). However, in other categories, the differences were not statistically significant. In this study, which compared the diagnostic accuracy of GPT-3.5, GPT-4, and ED resident physicians against a discharge diagnosis gold standard, GPT-4 outperformed both the resident physicians and its predecessor, GPT-3.5. Despite the retrospective design of the study and its limited sample size, the results underscore the potential of AI as a supportive diagnostic tool in ED settings.

COVID-19 Food Pyramid: A Novel Approach

COVID-19 is an infectious disease that is caused by SARS-CoV-2 which affects the respiratory framework of the body and continues to devastate the world's health as well as economy. This disease is said to adversely affect the nutritional status of the people. Healthy eating habits as well as lifestyle changes are essential to protect us from this virus. Now, there is a gradual increase in researches and nutritional recommendations on immunity boosting diets for COVID-19. However, there is still no such food pyramid has been specifically designed for COVID-19 period. Therefore, this study aimed to develop a COVID-19 specific food pyramid to illustrate the foods to be consumed on daily basis by a person to maintain health during this pandemic. Such visual representation of the nutritional guideline will help common people also to easily understand and adapt it to their day to day healthy eating behavior.

Amoebae as training grounds for microbial pathogens.

Grazing of amoebae on microorganisms represents one of the oldest predator-prey dynamic relationships in nature. It represents a genetic "melting pot" for an ancient and continuous multi-directional inter- and intra-kingdom horizontal gene transfer between amoebae and its preys, intracellular microbial residents, endosymbionts, and giant viruses, which has shaped the evolution, selection, and adaptation of microbes that evade degradation by predatory amoeba. Unicellular phagocytic amoebae are thought to be the ancient ancestors of macrophages with highly conserved eukaryotic processes. Selection and evolution of microbes within amoeba through their evolution to target highly conserved eukaryotic processes have facilitated the expansion of their host range to mammals, causing various infectious diseases. Legionella and environmental Chlamydia harbor an immense number of eukaryotic-like proteins that are involved in ubiquitin-related processes or are tandem repeats-containing proteins involved in protein-protein and protein-chromatin interactions. Some of these eukaryotic-like proteins exhibit novel domain architecture and novel enzymatic functions absent in mammalian cells, such as ubiquitin ligases, likely acquired from amoebae. Mammalian cells and amoebae may respond similarly to microbial factors that target highly conserved eukaryotic processes, but mammalian cells may undergo an accidental response to amoeba-adapted microbial factors. We discuss specific examples of microbes that have evolved to evade amoeba predation, including the bacterial pathogens- Legionella, Chlamydia, Coxiella, Rickettssia, Francisella, Mycobacteria, Salmonella, Bartonella, Rhodococcus, Pseudomonas, Vibrio, Helicobacter, Campylobacter, and Aliarcobacter. We also discuss the fungi Cryptococcus, and Asperigillus, as well as amoebae mimiviruses/giant viruses. We propose that amoeba-microbe interactions will continue to be a major "training ground" for the evolution, selection, adaptation, and emergence of microbial pathogens equipped with unique pathogenic tools to infect mammalian hosts. However, our progress will continue to be highly dependent on additional genomic, biochemical, and cellular data of unicellular eukaryotes.

The therapeutic potential of exosomes in immunotherapy

Exosomes are found in various tissues of the body and carry abundant contents including nucleic acids, proteins, and metabolites, which continuously flow between cells of various tissues and mediate important intercellular communication. In addition, exosomes from different cellular sources possess different physiopathological immunomodulatory effects, which are closely related to the immune regeneration of normal or abnormal organs and tissues. Here, we focus on the mechanistic interactions between exosomes and the human immune system, introduce the immuno-regenerative therapeutic potential of exosomes in common clinical immune-related diseases, such as infectious diseases, autoimmune diseases, and tumors, and reveal the safety and efficacy of exosomes as a novel cell-free immune regenerative therapy.

Integrating socio-psychological factors in the SEIR model optimized by a genetic algorithm for COVID-19 trend analysis.

The global spread of COVID-19 has profoundly affected health and economies, highlighting the need for precise epidemic trend predictions for effective interventions. In this study, we used infectious disease models to simulate and predict the trajectory of COVID-19. An SEIR (susceptible, exposed, infected, removed) model was established using Wuhan data to reflect the pandemic. We then trained a genetic algorithm-based SEIR (GA-SEIR) model using data from a specific U.S. region and focused on individual susceptibility and infection dynamics. By integrating socio-psychological factors, we achieved a significant enhancement to the GA-SEIR model, leading to the development of an optimized version. This refined GA-SEIR model significantly improved our ability to simulate the spread and control of the epidemic and to effectively track trends. Remarkably, it successfully predicted the resurgence of COVID-19 in mainland China in April 2023, demonstrating its robustness and reliability. The refined GA-SEIR model provides crucial insights for public health authorities, enabling them to design and implement proactive strategies for outbreak containment and mitigation. Its substantial contributions to epidemic modelling and public health planning are invaluable, particularly in managing and controlling respiratory infectious diseases such as COVID-19.