Previous
The World Health Organization (WHO) estimates that unsafe food is responsible for 600 million cases and over 400,000 deaths annually. Traditional outbreak investigations are often time-consuming, inefficient, and limited by the quality and timeliness of available data. The integration of artificial intelligence (AI), such as machine learning, offers innovative approaches to improve the accuracy, speed, and efficiency of foodborne disease surveillance and outbreak detection. We conducted a mini review of the published literature and explored the potential applications of AI in foodborne disease prevention and control. Key areas explored included predictive analytics, food supply chain monitoring, public health surveillance, and laboratory-based investigations. AI-based predictive models support improved monitoring of environmental risk factors, better management of food supply chains, and more timely detection and prevention of contamination and outbreaks. We also described several challenges related to the integration of AI in food safety systems, including data quality, regulatory frameworks, and ethical considerations. By integrating advanced AI-driven methods, the future of food safety promises greater efficacy and equity in public health.
The World Health Organization (WHO) estimates that unsafe food is responsible for 600 million cases and over 400,000 deaths annually. Traditional outbreak investigations are often time-consuming, inefficient, and limited by the quality and timeliness of available data. The integration of artificial intelligence (AI), such as machine learning, offers innovative approaches to improve the accuracy, speed, and efficiency of foodborne disease surveillance and outbreak detection. We conducted a mini review of the published literature and explored the potential applications of AI in foodborne disease prevention and control. Key areas explored included predictive analytics, food supply chain monitoring, public health surveillance, and laboratory-based investigations. AI-based predictive models support improved monitoring of environmental risk factors, better management of food supply chains, and more timely detection and prevention of contamination and outbreaks. We also described several challenges related to the integration of AI in food safety systems, including data quality, regulatory frameworks, and ethical considerations. By integrating advanced AI-driven methods, the future of food safety promises greater efficacy and equity in public health.
DOI: https://doi.org/10.37349/edht.2025.101167
Aim:
The current study uses the depicted approach to synthesize curcumin-piperine loaded Poloxamer F-68 coated magnetic nanoparticles (CUR-PIP-F68-Fe3O4 NPs) to achieve a synergistic anti-cancer impact on an in vitro HCT-116 colon cancer cell. Integrating magnetic nanoparticle technology with phytoconstituents enhances the potential for targeted drug delivery with minimal systemic toxicity and facilitates therapeutic outcomes.
Methods:
A Box-Behnken design was employed to optimize the CUR-PIP-F68-Fe3O4 NPs prepared by the co-precipitation method. Optimized formulation was evaluated for morphological characteristics, elemental composition, and magnetic properties. An in vitro cytotoxicity assay was conducted to observe the % viability of cells and to further calculate the IC50. Cellular uptake studies were investigated using confocal microscopy.
Results:
Results showed that the optimised nanoparticles possessed a particle size of 158.7 ± 0.057 nm, zeta potential of –30.3 ± 0.1 mV, and encapsulation efficiency of 98.85 ± 0.066%. Analysis by vibrational sample magnetometer revealed that magnetic saturation was 75.6 emu/g and 50.7 emu/g for bare Fe3O4 nanoparticles and drug-loaded magnetic nanoparticles, respectively. Scanning electron microscopy (SEM) depicted the morphological characteristics; elemental composition of synthesized magnetic nanoparticles was confirmed by energy dispersive X-ray (EDX) analysis by illustrating the presence of C (13.50 ± 0.30%), Fe (78.81 ± 1.23%), and O (7.69 ± 0.29%). The MTT assay and cellular uptake studies unveiled that CUR-PIP-loaded magnetic nanoparticles possess a synergistic cytotoxic effect and the highest drug uptake against the HCT-116 colon cell line.
Conclusions:
The combination approach of curcumin-piperine magnetic nanoparticles to HCT-116 cells enhanced the anticancer efficacy of the curcumin and further demonstrated the potential of this approach to conduct in vivo studies.
Aim:
The current study uses the depicted approach to synthesize curcumin-piperine loaded Poloxamer F-68 coated magnetic nanoparticles (CUR-PIP-F68-Fe3O4 NPs) to achieve a synergistic anti-cancer impact on an in vitro HCT-116 colon cancer cell. Integrating magnetic nanoparticle technology with phytoconstituents enhances the potential for targeted drug delivery with minimal systemic toxicity and facilitates therapeutic outcomes.
Methods:
A Box-Behnken design was employed to optimize the CUR-PIP-F68-Fe3O4 NPs prepared by the co-precipitation method. Optimized formulation was evaluated for morphological characteristics, elemental composition, and magnetic properties. An in vitro cytotoxicity assay was conducted to observe the % viability of cells and to further calculate the IC50. Cellular uptake studies were investigated using confocal microscopy.
Results:
Results showed that the optimised nanoparticles possessed a particle size of 158.7 ± 0.057 nm, zeta potential of –30.3 ± 0.1 mV, and encapsulation efficiency of 98.85 ± 0.066%. Analysis by vibrational sample magnetometer revealed that magnetic saturation was 75.6 emu/g and 50.7 emu/g for bare Fe3O4 nanoparticles and drug-loaded magnetic nanoparticles, respectively. Scanning electron microscopy (SEM) depicted the morphological characteristics; elemental composition of synthesized magnetic nanoparticles was confirmed by energy dispersive X-ray (EDX) analysis by illustrating the presence of C (13.50 ± 0.30%), Fe (78.81 ± 1.23%), and O (7.69 ± 0.29%). The MTT assay and cellular uptake studies unveiled that CUR-PIP-loaded magnetic nanoparticles possess a synergistic cytotoxic effect and the highest drug uptake against the HCT-116 colon cell line.
Conclusions:
The combination approach of curcumin-piperine magnetic nanoparticles to HCT-116 cells enhanced the anticancer efficacy of the curcumin and further demonstrated the potential of this approach to conduct in vivo studies.
DOI: https://doi.org/10.37349/etat.2025.1002340
This article belongs to the special issue Potential Clinical Applications of Inorganic Nanomaterials in Cancer
Aim:
Allergic conjunctivitis (AC) is an inflammatory response of the conjunctiva triggered by exposure to common allergens, including pollen, dust mites, and animal dander. This study aimed to identify probable allergens in Iranian patients with AC.
Methods:
This cross-sectional study included individuals with AC from Southwestern Iran in 2024. Skin prick tests (SPTs) were performed using commercial extracts of various allergens, including tree mix, weed mix, grass mix, dust mite mix, fungi mix, as well as cat and cockroach allergens.
Results:
Among 92 patients with conjunctivitis, with a mean age of 23.66 ± 14.70 years, 80 patients (86.96%) had a positive SPT to at least one of the applied extracts. Sensitization rates detected by SPTs were as follows: weed mix 68.48%, tree mix 58.70%, grass mix 53.26%, dust mite mix 45.65%, cockroach 29.35%, fungi mix 22.83% and cat allergen 17.39%. A significant difference in dust mite sensitization was observed between patients with seasonal and perennial AC (p = 0.023).
Conclusions:
This study highlights the allergic sensitization of patients with conjunctivitis and its connections to other allergic conditions. Allergists can play a crucial role in managing conjunctivitis through comprehensive testing and holistic treatment approaches.
Aim:
Allergic conjunctivitis (AC) is an inflammatory response of the conjunctiva triggered by exposure to common allergens, including pollen, dust mites, and animal dander. This study aimed to identify probable allergens in Iranian patients with AC.
Methods:
This cross-sectional study included individuals with AC from Southwestern Iran in 2024. Skin prick tests (SPTs) were performed using commercial extracts of various allergens, including tree mix, weed mix, grass mix, dust mite mix, fungi mix, as well as cat and cockroach allergens.
Results:
Among 92 patients with conjunctivitis, with a mean age of 23.66 ± 14.70 years, 80 patients (86.96%) had a positive SPT to at least one of the applied extracts. Sensitization rates detected by SPTs were as follows: weed mix 68.48%, tree mix 58.70%, grass mix 53.26%, dust mite mix 45.65%, cockroach 29.35%, fungi mix 22.83% and cat allergen 17.39%. A significant difference in dust mite sensitization was observed between patients with seasonal and perennial AC (p = 0.023).
Conclusions:
This study highlights the allergic sensitization of patients with conjunctivitis and its connections to other allergic conditions. Allergists can play a crucial role in managing conjunctivitis through comprehensive testing and holistic treatment approaches.
DOI: https://doi.org/10.37349/eaa.2025.100995
Background:
Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, poses a significant and growing public health challenge in India. With India housing the world’s largest diabetes population, the rising prevalence of GDM has profound implications for maternal and neonatal health, contributing to complications including preeclampsia, macrosomia, neonatal hypoglycaemia, and increased lifelong risk of type 2 diabetes mellitus (T2DM) for both mother and child.
Methods:
We conducted a systematic literature search of PubMed, Embase, Google Scholar, and Cochrane Library for studies published between January 2019 and December 2024, with seminal works from 2015–2018. Search terms included “gestational diabetes mellitus”, “India”, “screening”, “prevalence”, “management”, and “health systems”. Eligible studies included peer-reviewed articles, government reports, and systematic reviews focusing on Indian populations. Two reviewers independently screened and extracted data. The PRISMA 2020 framework guided reporting.
Results:
From 2,847 initial records, 156 studies met the inclusion criteria. GDM prevalence in India ranges from 7.2% to 21.4%, with substantial regional variations. Southern states consistently report higher prevalence (15–22%) compared to northern (10–17%) and eastern regions (8–15%). Key challenges identified include low awareness among pregnant women (32% rural, 58% urban) and healthcare providers, inconsistent adoption of evidence-based guidelines (41% of facilities following standardized protocols), severe resource and infrastructural constraints, and significant socioeconomic barriers. Laboratory facilities for oral glucose tolerance test (OGTT) are available in only 34% of community health centers and 12% of primary health centers. Digital health interventions show promise but face implementation barriers, including limited smartphone penetration (45% in rural areas) and inadequate Accredited Social Health Activist (ASHA) workforce training (34% completion rate).
Discussion:
Despite the escalating burden of GDM in India, numerous unmet needs persist across the care continuum. This review proposes actionable recommendations, including simplified, cost-effective screening strategies, capacity building, integration into existing maternal health programs, and robust postpartum follow-up systems. Success requires sustained commitment to collaborative research, policy initiatives, and integrated, equitable, and sustainable GDM care approaches.
Background:
Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, poses a significant and growing public health challenge in India. With India housing the world’s largest diabetes population, the rising prevalence of GDM has profound implications for maternal and neonatal health, contributing to complications including preeclampsia, macrosomia, neonatal hypoglycaemia, and increased lifelong risk of type 2 diabetes mellitus (T2DM) for both mother and child.
Methods:
We conducted a systematic literature search of PubMed, Embase, Google Scholar, and Cochrane Library for studies published between January 2019 and December 2024, with seminal works from 2015–2018. Search terms included “gestational diabetes mellitus”, “India”, “screening”, “prevalence”, “management”, and “health systems”. Eligible studies included peer-reviewed articles, government reports, and systematic reviews focusing on Indian populations. Two reviewers independently screened and extracted data. The PRISMA 2020 framework guided reporting.
Results:
From 2,847 initial records, 156 studies met the inclusion criteria. GDM prevalence in India ranges from 7.2% to 21.4%, with substantial regional variations. Southern states consistently report higher prevalence (15–22%) compared to northern (10–17%) and eastern regions (8–15%). Key challenges identified include low awareness among pregnant women (32% rural, 58% urban) and healthcare providers, inconsistent adoption of evidence-based guidelines (41% of facilities following standardized protocols), severe resource and infrastructural constraints, and significant socioeconomic barriers. Laboratory facilities for oral glucose tolerance test (OGTT) are available in only 34% of community health centers and 12% of primary health centers. Digital health interventions show promise but face implementation barriers, including limited smartphone penetration (45% in rural areas) and inadequate Accredited Social Health Activist (ASHA) workforce training (34% completion rate).
Discussion:
Despite the escalating burden of GDM in India, numerous unmet needs persist across the care continuum. This review proposes actionable recommendations, including simplified, cost-effective screening strategies, capacity building, integration into existing maternal health programs, and robust postpartum follow-up systems. Success requires sustained commitment to collaborative research, policy initiatives, and integrated, equitable, and sustainable GDM care approaches.
DOI: https://doi.org/10.37349/eemd.2025.101442
The transition from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) reflects a paradigm shift in hepatology and highlights the need for a more pathophysiologically based classification. The aim of this review is to critically examine the conceptual evolution from NAFLD to MASLD, highlighting the implications for pathogenesis, diagnosis, risk stratification, and therapeutic strategies within the broader context of systemic metabolic dysfunction. Unlike the exclusion-based NAFLD definition, MASLD is grounded in positive diagnostic criteria and recognizes hepatic steatosis as a manifestation of metabolic disease. This reclassification improves clinical risk assessment and aligns hepatic care with cardiometabolic management. MASLD is closely linked to insulin resistance, lipotoxicity, chronic inflammation, and gut dysbiosis, which contribute to cardiovascular disease, chronic kidney disease, type 2 diabetes, and hepatocellular carcinoma. Non-invasive tools (e.g., FIB-4, elastography, ELF score) and emerging biomarkers (e.g., miR-122, CK-18, FGF21) support early diagnosis and personalized approaches. Therapeutically, MASLD management includes lifestyle modification, antidiabetic agents (GLP-1 receptor agonists, SGLT2 inhibitors), PPAR agonists, and novel drugs such as resmetirom. This evolving framework demands integrated, multidisciplinary strategies to address the systemic burden and clinical heterogeneity of MASLD.
The transition from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) reflects a paradigm shift in hepatology and highlights the need for a more pathophysiologically based classification. The aim of this review is to critically examine the conceptual evolution from NAFLD to MASLD, highlighting the implications for pathogenesis, diagnosis, risk stratification, and therapeutic strategies within the broader context of systemic metabolic dysfunction. Unlike the exclusion-based NAFLD definition, MASLD is grounded in positive diagnostic criteria and recognizes hepatic steatosis as a manifestation of metabolic disease. This reclassification improves clinical risk assessment and aligns hepatic care with cardiometabolic management. MASLD is closely linked to insulin resistance, lipotoxicity, chronic inflammation, and gut dysbiosis, which contribute to cardiovascular disease, chronic kidney disease, type 2 diabetes, and hepatocellular carcinoma. Non-invasive tools (e.g., FIB-4, elastography, ELF score) and emerging biomarkers (e.g., miR-122, CK-18, FGF21) support early diagnosis and personalized approaches. Therapeutically, MASLD management includes lifestyle modification, antidiabetic agents (GLP-1 receptor agonists, SGLT2 inhibitors), PPAR agonists, and novel drugs such as resmetirom. This evolving framework demands integrated, multidisciplinary strategies to address the systemic burden and clinical heterogeneity of MASLD.
DOI: https://doi.org/10.37349/emed.2025.1001365
Aim:
This manuscript summarizes the key scientific and practical outcomes of the #DHPSP2024 digital networking event, focusing on emerging trends in digital health technologies, innovations in patient safety, and their implications for improving healthcare delivery.
Methods:
The #DHPSP2024 event was held from June 18 to 20, 2024, on X (formerly Twitter) and LinkedIn, connecting professionals and stakeholders in digital health and patient safety from different sectors. Data from posts on X and LinkedIn were analyzed for geographical distribution, engagement metrics (impressions, likes, shares), top hashtags, and frequently used terms. A qualitative analysis of the central themes and key online messaging discussions of the network event was also conducted.
Results:
On X, 2,329 posts by 179 participants from 38 countries generated over 231,000 impressions, with the most activity in Austria, China, and India. LinkedIn engagement included 3,475 likes, 217 comments, and 2,030 shares. Both platforms highlighted core themes such as digital health, patient safety, treatment quality, research on natural compounds, and interdisciplinary collaboration. Online messaging discussions emphasized technologies like telemedicine and artificial intelligence as critical tools for enhancing care delivery and patient safety. Participants also promoted special issues of scientific journals and explored collaborative research opportunities.
Conclusions:
The #DHPSP2024 event underscored the pivotal role of digital technologies in transforming healthcare, particularly in improving the quality and safety of interventions. The findings demonstrate how digital networking events, grounded in open innovation, foster global research communities, accelerate knowledge exchange, and support the integration of clinically relevant digital solutions. The strong engagement reflects growing interest in leveraging digital platforms to advance health outcomes and professional development. Overall, the event contributed to greater visibility of ongoing research, encouraged interdisciplinary cooperation, and may positively influence both the adoption of innovations in healthcare practice and the dissemination of scientific knowledge.
Aim:
This manuscript summarizes the key scientific and practical outcomes of the #DHPSP2024 digital networking event, focusing on emerging trends in digital health technologies, innovations in patient safety, and their implications for improving healthcare delivery.
Methods:
The #DHPSP2024 event was held from June 18 to 20, 2024, on X (formerly Twitter) and LinkedIn, connecting professionals and stakeholders in digital health and patient safety from different sectors. Data from posts on X and LinkedIn were analyzed for geographical distribution, engagement metrics (impressions, likes, shares), top hashtags, and frequently used terms. A qualitative analysis of the central themes and key online messaging discussions of the network event was also conducted.
Results:
On X, 2,329 posts by 179 participants from 38 countries generated over 231,000 impressions, with the most activity in Austria, China, and India. LinkedIn engagement included 3,475 likes, 217 comments, and 2,030 shares. Both platforms highlighted core themes such as digital health, patient safety, treatment quality, research on natural compounds, and interdisciplinary collaboration. Online messaging discussions emphasized technologies like telemedicine and artificial intelligence as critical tools for enhancing care delivery and patient safety. Participants also promoted special issues of scientific journals and explored collaborative research opportunities.
Conclusions:
The #DHPSP2024 event underscored the pivotal role of digital technologies in transforming healthcare, particularly in improving the quality and safety of interventions. The findings demonstrate how digital networking events, grounded in open innovation, foster global research communities, accelerate knowledge exchange, and support the integration of clinically relevant digital solutions. The strong engagement reflects growing interest in leveraging digital platforms to advance health outcomes and professional development. Overall, the event contributed to greater visibility of ongoing research, encouraged interdisciplinary cooperation, and may positively influence both the adoption of innovations in healthcare practice and the dissemination of scientific knowledge.
DOI: https://doi.org/10.37349/edht.2025.101166
Cedarwood essential oil (CWO), obtained from Cedrus and related species, has a long history in traditional medicine but remains relatively underexplored in modern pharmacology. This review consolidates current evidence on its phytochemical composition and pharmacological activities. Literature was retrieved from PubMed, Web of Science, and Scopus up to July 2025, including in vitro, in vivo, and limited clinical studies. Findings suggest antimicrobial, anti-inflammatory, sedative, and dermatological properties, primarily attributed to sesquiterpenes such as cedrol and α-cedrene. However, most data derive from small-scale or preclinical studies, with limited standardization of dosage and formulations. Safety aspects and toxicological gaps are also highlighted as essential considerations for future clinical translation. We conclude that CWO shows therapeutic potential, but rigorous clinical trials, standardized protocols, and comprehensive toxicological evaluations are essential before its safe and effective integration into evidence-based practice.
Cedarwood essential oil (CWO), obtained from Cedrus and related species, has a long history in traditional medicine but remains relatively underexplored in modern pharmacology. This review consolidates current evidence on its phytochemical composition and pharmacological activities. Literature was retrieved from PubMed, Web of Science, and Scopus up to July 2025, including in vitro, in vivo, and limited clinical studies. Findings suggest antimicrobial, anti-inflammatory, sedative, and dermatological properties, primarily attributed to sesquiterpenes such as cedrol and α-cedrene. However, most data derive from small-scale or preclinical studies, with limited standardization of dosage and formulations. Safety aspects and toxicological gaps are also highlighted as essential considerations for future clinical translation. We conclude that CWO shows therapeutic potential, but rigorous clinical trials, standardized protocols, and comprehensive toxicological evaluations are essential before its safe and effective integration into evidence-based practice.
DOI: https://doi.org/10.37349/eds.2025.1008131
This article belongs to the special issue Essential Oils: Insights into Pharmacology, In Vivo, In Vitro and In Silico Studies
Tau phosphorylated at threonine 217 (p-tau217) has moved from research novelty to clinical reality, but its greatest value lies in dynamic monitoring, not static stratification. The pace of adoption of the plasma measurement of p-tau217 now demands clear guidance on optimal use. Two complementary evidence strands inform this perspective. First, a multi-cohort evaluation of a commercial assay shows high concordance with amyloid and tau reference standards and supports a pragmatic three-zone interpretation, rule-out, indeterminate, and rule-in, that can streamline diagnostic pathways while preserving accuracy. Second, longitudinal analyses in amyloid-positive individuals reveal that the most informative property of p-tau217 is dynamic: steeper rises occur in those who decline faster, whereas baseline values substantially overlap across outcome groups. These findings show that plasma p-tau217 levels can be a complementary tool for triage, enrichment, and longitudinal monitoring, but not as a time-stable baseline stratifier for defining trial cohorts or assessing therapeutic efficacy. Stratification should instead anchor to independent, stable measures such as tau burden measured by positron emission tomography (PET), structural magnetic resonance imaging (MRI), and cognitive history, reducing misclassification and avoiding circular validation. Comparable scrutiny should be applied to other p-tau biomarkers and to composite measures, such as the p-tau217/Aβ1–42 ratio, to rigorously define their risk-benefit profile, guide therapeutic evaluation, and maximize translational impact.
Tau phosphorylated at threonine 217 (p-tau217) has moved from research novelty to clinical reality, but its greatest value lies in dynamic monitoring, not static stratification. The pace of adoption of the plasma measurement of p-tau217 now demands clear guidance on optimal use. Two complementary evidence strands inform this perspective. First, a multi-cohort evaluation of a commercial assay shows high concordance with amyloid and tau reference standards and supports a pragmatic three-zone interpretation, rule-out, indeterminate, and rule-in, that can streamline diagnostic pathways while preserving accuracy. Second, longitudinal analyses in amyloid-positive individuals reveal that the most informative property of p-tau217 is dynamic: steeper rises occur in those who decline faster, whereas baseline values substantially overlap across outcome groups. These findings show that plasma p-tau217 levels can be a complementary tool for triage, enrichment, and longitudinal monitoring, but not as a time-stable baseline stratifier for defining trial cohorts or assessing therapeutic efficacy. Stratification should instead anchor to independent, stable measures such as tau burden measured by positron emission tomography (PET), structural magnetic resonance imaging (MRI), and cognitive history, reducing misclassification and avoiding circular validation. Comparable scrutiny should be applied to other p-tau biomarkers and to composite measures, such as the p-tau217/Aβ1–42 ratio, to rigorously define their risk-benefit profile, guide therapeutic evaluation, and maximize translational impact.
DOI: https://doi.org/10.37349/ent.2025.1004118
Healthcare professionals, especially those in rehabilitation, are increasingly vulnerable to occupational burnout, particularly in the post-pandemic landscape. This review synthesizes existing literature on the prevalence of burnout, possible contributing factors, resilience mechanisms, and interventions tailored to physiotherapists and related disciplines. A narrative review was carried out by combing through databases including PubMed, Scopus, and Web of Science for literature published between 2020 and 2025. The studies focused on burnout, mental health, and resilience among rehabilitation professionals were included in the review. Burnout remains prevalent, with emotional exhaustion and reduced personal growth commonly reported. Risk factors include lack of support, excessive workload, and exposure to workplace bullying. Protective mechanisms entail individual resilience behaviors, social support, and institutional strategies such as regulated supervision and workload management. Addressing burnout in rehabilitation settings requires a dual approach—strengthening individual factors and directing systemic organizational reforms. Embedding resilience education into the training core curriculum and workplace code of conduct may boost mental well-being.
Healthcare professionals, especially those in rehabilitation, are increasingly vulnerable to occupational burnout, particularly in the post-pandemic landscape. This review synthesizes existing literature on the prevalence of burnout, possible contributing factors, resilience mechanisms, and interventions tailored to physiotherapists and related disciplines. A narrative review was carried out by combing through databases including PubMed, Scopus, and Web of Science for literature published between 2020 and 2025. The studies focused on burnout, mental health, and resilience among rehabilitation professionals were included in the review. Burnout remains prevalent, with emotional exhaustion and reduced personal growth commonly reported. Risk factors include lack of support, excessive workload, and exposure to workplace bullying. Protective mechanisms entail individual resilience behaviors, social support, and institutional strategies such as regulated supervision and workload management. Addressing burnout in rehabilitation settings requires a dual approach—strengthening individual factors and directing systemic organizational reforms. Embedding resilience education into the training core curriculum and workplace code of conduct may boost mental well-being.
DOI: https://doi.org/10.37349/ent.2025.1004117
HIV/AIDS has changed from a deadly disease in the early 1990s to a chronic treatment following huge research efforts. HIV had a great impact due to the long period until its fatal consequences in the form of AIDS appeared. As a consequence, the spread of the disease was global. However, even now, after many years of extensive research, there is still no functional cure or eradication possible. This review provides an overview on HIV/AIDS covering a description of the disease, the mechanism of infection, HIV/AIDS symptoms, the current treatment options, the formation of latent reservoirs, and the efforts to provide a cure of HIV including CCR5Δ32/Δ32 donor stem cell transplantation, gene therapy, broadly neutralizing antibodies, HIV vaccination, chimeric antigen receptor cells, latency-addressing agents, and combination approaches.
HIV/AIDS has changed from a deadly disease in the early 1990s to a chronic treatment following huge research efforts. HIV had a great impact due to the long period until its fatal consequences in the form of AIDS appeared. As a consequence, the spread of the disease was global. However, even now, after many years of extensive research, there is still no functional cure or eradication possible. This review provides an overview on HIV/AIDS covering a description of the disease, the mechanism of infection, HIV/AIDS symptoms, the current treatment options, the formation of latent reservoirs, and the efforts to provide a cure of HIV including CCR5Δ32/Δ32 donor stem cell transplantation, gene therapy, broadly neutralizing antibodies, HIV vaccination, chimeric antigen receptor cells, latency-addressing agents, and combination approaches.
DOI: https://doi.org/10.37349/emed.2025.1001364
This article belongs to the special issue Global Perspectives on the Clinical Diagnosis, Treatment, and Functional Cure of HIV Infection in the Post-ART Era
A left ventricular pseudoaneurysm typically occurs as a result of myocardial infarction, blunt chest trauma, or cardiac surgery (typically coronary artery bypass grafting or mitral valve replacement). Pseudoaneurysms form due to left ventricular free wall rupture that is contained by the pericardium, not the myocardial wall, as is the case with a true aneurysm. Pseudoaneurysms have the tendency to expand rapidly as opposed to true aneurysms due to the weakness of the pericardium or fibrous tissue in comparison to myocardial tissue. This case presents a 63-year-old male found to have a very large left ventricular pseudoaneurysm measuring 8 × 7 × 5 cm. The vast majority of left ventricular pseudoaneurysms enlarge with worsening symptomatology and eventual rupture if not surgically repaired. Rarely, large pseudoaneurysms treated conservatively can lead to the gradual resolution of a patient’s symptoms and normalization of right ventricular function. The purpose of this case report is to describe the clinical course and outcomes of a patient with a large left ventricular pseudoaneurysm managed conservatively, thereby contributing to the limited medical data regarding the prognosis and long-term outcomes in this high-risk population.
A left ventricular pseudoaneurysm typically occurs as a result of myocardial infarction, blunt chest trauma, or cardiac surgery (typically coronary artery bypass grafting or mitral valve replacement). Pseudoaneurysms form due to left ventricular free wall rupture that is contained by the pericardium, not the myocardial wall, as is the case with a true aneurysm. Pseudoaneurysms have the tendency to expand rapidly as opposed to true aneurysms due to the weakness of the pericardium or fibrous tissue in comparison to myocardial tissue. This case presents a 63-year-old male found to have a very large left ventricular pseudoaneurysm measuring 8 × 7 × 5 cm. The vast majority of left ventricular pseudoaneurysms enlarge with worsening symptomatology and eventual rupture if not surgically repaired. Rarely, large pseudoaneurysms treated conservatively can lead to the gradual resolution of a patient’s symptoms and normalization of right ventricular function. The purpose of this case report is to describe the clinical course and outcomes of a patient with a large left ventricular pseudoaneurysm managed conservatively, thereby contributing to the limited medical data regarding the prognosis and long-term outcomes in this high-risk population.
DOI: https://doi.org/10.37349/ec.2025.101276
Ischemic heart disease (IHD) is a leading cause of morbidity and mortality worldwide, highlighting the necessity for better diagnostic modalities. Artificial intelligence (AI) and machine learning (ML) are increasingly being used with multimodal cardiovascular diagnostic testing to provide standardized and reproducible assessment methodologies that have been shown to detect subtle signals beyond human recognition. This state-of-the-art review will summarize the various applications of AI across key modalities: describing its use in electrocardiography to risk-stratify patients; in coronary computed tomography angiography (CCTA) for quantitative plaque and stenosis measurements as well as measuring fractional flow reserve (FFR) derived from imaging; in cardiac magnetic resonance imaging (MRI) to automatically segment cardiac chambers and characterize tissue; and in intracoronary imaging [specifically intravascular ultrasound (IVUS) and optical coherence tomography (OCT)], where automation is evolving. We will also discuss combining these sources of data through clinical decision support systems (CDSS) that can enhance the comprehensive evaluation of IHD. We anticipate several issues for implementation, including validation, regulation, transparency, and clinical integration. Overall, AI can help reduce the number of time-consuming manual measurements used to augment quantitative features of an assessment and improve physiology-based decision-making. However, there were marked differences in performance based on the task and dataset, and AI was not always better than the human experts. Ultimately, AI must be validated prospectively, must be generalizable, and reported transparently for safe adoption in IHD care globally.
Ischemic heart disease (IHD) is a leading cause of morbidity and mortality worldwide, highlighting the necessity for better diagnostic modalities. Artificial intelligence (AI) and machine learning (ML) are increasingly being used with multimodal cardiovascular diagnostic testing to provide standardized and reproducible assessment methodologies that have been shown to detect subtle signals beyond human recognition. This state-of-the-art review will summarize the various applications of AI across key modalities: describing its use in electrocardiography to risk-stratify patients; in coronary computed tomography angiography (CCTA) for quantitative plaque and stenosis measurements as well as measuring fractional flow reserve (FFR) derived from imaging; in cardiac magnetic resonance imaging (MRI) to automatically segment cardiac chambers and characterize tissue; and in intracoronary imaging [specifically intravascular ultrasound (IVUS) and optical coherence tomography (OCT)], where automation is evolving. We will also discuss combining these sources of data through clinical decision support systems (CDSS) that can enhance the comprehensive evaluation of IHD. We anticipate several issues for implementation, including validation, regulation, transparency, and clinical integration. Overall, AI can help reduce the number of time-consuming manual measurements used to augment quantitative features of an assessment and improve physiology-based decision-making. However, there were marked differences in performance based on the task and dataset, and AI was not always better than the human experts. Ultimately, AI must be validated prospectively, must be generalizable, and reported transparently for safe adoption in IHD care globally.
DOI: https://doi.org/10.37349/ec.2025.101275
This article belongs to the special issue Multimodality Imaging in Ischemic Heart Disease
Aim:
Post-exertional malaise (PEM) has been a challenging construct to measure, particularly with self-report instruments, which have the benefits of being less expensive and less invasive than cardiopulmonary exercise tests. Existing PEM questionnaires have often been used for diagnostic purposes and less frequently as outcome measures. Few self-report PEM measures address comprehensive PEM domains, including types of triggers, duration of symptoms, delayed symptom onset, number of symptoms, frequency and severity of symptoms, as well as whether pacing or other strategies reduce or eliminate PEM. Without characterizing these features, salient aspects of PEM would be overlooked. However, efforts to assess all these domains can be time-consuming and potentially burdensome.
Methods:
The current study offers investigators a brief but comprehensive instrument of critical PEM domains, called the DePaul Symptom Questionnaire (DSQ)-PEM-2, to assess PEM. Validation data were derived from a large sample of individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
Results:
The DSQ-PEM-2 was developed using an existing dataset of individuals with ME, CFS, or both ME and CFS, allowing comprehensive coverage of key PEM domains.
Conclusions:
The DSQ-PEM-2 can be used either for diagnostic purposes or as an outcome measure. The instrument’s time frames for symptom manifestation can be adapted to suit a variety of research or clinical contexts. Future validation studies need to include a healthy control group.
Aim:
Post-exertional malaise (PEM) has been a challenging construct to measure, particularly with self-report instruments, which have the benefits of being less expensive and less invasive than cardiopulmonary exercise tests. Existing PEM questionnaires have often been used for diagnostic purposes and less frequently as outcome measures. Few self-report PEM measures address comprehensive PEM domains, including types of triggers, duration of symptoms, delayed symptom onset, number of symptoms, frequency and severity of symptoms, as well as whether pacing or other strategies reduce or eliminate PEM. Without characterizing these features, salient aspects of PEM would be overlooked. However, efforts to assess all these domains can be time-consuming and potentially burdensome.
Methods:
The current study offers investigators a brief but comprehensive instrument of critical PEM domains, called the DePaul Symptom Questionnaire (DSQ)-PEM-2, to assess PEM. Validation data were derived from a large sample of individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
Results:
The DSQ-PEM-2 was developed using an existing dataset of individuals with ME, CFS, or both ME and CFS, allowing comprehensive coverage of key PEM domains.
Conclusions:
The DSQ-PEM-2 can be used either for diagnostic purposes or as an outcome measure. The instrument’s time frames for symptom manifestation can be adapted to suit a variety of research or clinical contexts. Future validation studies need to include a healthy control group.
DOI: https://doi.org/10.37349/ent.2025.1004116
Aim:
Given the ubiquitous use of social media among young adults, understanding its impact on their psychological well-being is increasingly important. Research has identified negative associations between social media use and internalizing problems, such as depression and anxiety. Building on the previous research, the current study explored the mediating role of self-esteem in the associations between social media rumination (SMR) and symptoms of depression and anxiety in college students. Additionally, the study investigated the moderating role of gender in these associations.
Methods:
The study sample consisted of 551 college students (mean age = 19 years; 36% men, 23.8% White) from a diverse midwestern university. The participants completed measures of depression (PHQ-9), anxiety (GAD-7), self-esteem (RSES), and SMR (Social Media Rumination Scale [SMRS]). An exploratory factor analysis was performed on the SMRS and supported a one-factor structure for the measure. Main analyses were conducted in R using PROCESS Model 4 and examined the associations between SMR and symptoms of depression and anxiety, with self-esteem as a mediator, and gender as a moderator. Additionally, time spent on social media and the number of posts per week were included as covariates in the analyses.
Results:
Results indicated that SMR, above and beyond time spent on social media and type of engagement, was indirectly associated with depression and anxiety through self-esteem, and gender did not moderate these associations.
Conclusions:
The study’s findings contribute to our understanding of the mechanisms linking social media use to internalizing problems, highlighting the crucial role of self-esteem in this process. Moreover, the study offers valuable insights for developing targeted interventions aimed at mitigating the negative effects of social media use on mental health by addressing SMR and bolstering self-esteem in young adults.
Aim:
Given the ubiquitous use of social media among young adults, understanding its impact on their psychological well-being is increasingly important. Research has identified negative associations between social media use and internalizing problems, such as depression and anxiety. Building on the previous research, the current study explored the mediating role of self-esteem in the associations between social media rumination (SMR) and symptoms of depression and anxiety in college students. Additionally, the study investigated the moderating role of gender in these associations.
Methods:
The study sample consisted of 551 college students (mean age = 19 years; 36% men, 23.8% White) from a diverse midwestern university. The participants completed measures of depression (PHQ-9), anxiety (GAD-7), self-esteem (RSES), and SMR (Social Media Rumination Scale [SMRS]). An exploratory factor analysis was performed on the SMRS and supported a one-factor structure for the measure. Main analyses were conducted in R using PROCESS Model 4 and examined the associations between SMR and symptoms of depression and anxiety, with self-esteem as a mediator, and gender as a moderator. Additionally, time spent on social media and the number of posts per week were included as covariates in the analyses.
Results:
Results indicated that SMR, above and beyond time spent on social media and type of engagement, was indirectly associated with depression and anxiety through self-esteem, and gender did not moderate these associations.
Conclusions:
The study’s findings contribute to our understanding of the mechanisms linking social media use to internalizing problems, highlighting the crucial role of self-esteem in this process. Moreover, the study offers valuable insights for developing targeted interventions aimed at mitigating the negative effects of social media use on mental health by addressing SMR and bolstering self-esteem in young adults.
DOI: https://doi.org/10.37349/edht.2025.101164
This article belongs to the special issue Digital Health Innovations in the Battle Against Psychological Problems: Progress, Hurdles, and Prospects
The prevalence of tinnitus in veterans is notably higher than in the general population and can significantly disrupt daily life. Given the impact of tinnitus, along with the lack of effective interventions, exploring new approaches is warranted. Wearable sound technologies offer a non-invasive and easily accessible approach. However, limited research has explored the effectiveness of sound therapy in UK veterans. A prior study supported the feasibility and acceptability of a non-invasive wearable device (i.e., TinniSoothe) in a sample of veterans. However, a waitlist-controlled trial is needed to investigate the effectiveness of the device. This waitlist-controlled trial aims to explore the effectiveness of a wearable device in reducing tinnitus symptoms in a sample of UK veterans. Veterans will be randomly allocated to one of two conditions: (1) the immediate intervention condition, which receives the device post-randomisation, or (2) the waitlist control group, which receives the device one-month post-randomisation. The trial will be conducted in veterans (n = 20) who have experienced tinnitus. Participants will be asked to use the device for one month. The immediate intervention group will be compared to the waitlist control group. The primary outcome is change in tinnitus severity (Tinnitus Functional Index, TFI) and mental health (General Health Questionnaire-12, GHQ-12) from baseline to one-month post-randomisation. Primary and secondary outcomes will be assessed at all timepoints (baseline, one-month post-randomisation, and two-month post-randomisation), while predictor variables will only be assessed at baseline to reduce participant burden. Recruitment will begin in October 2025. The study is expected to take 12 months, with results published in 2027. This study explores whether a wearable device is efficacious in reducing self-reported symptoms of tinnitus in comparison to a waitlist control group. This innovative approach, if successful, could offer a practical option for reducing tinnitus distress. The trial is registered on clinicaltrials.gov, identifier: NCT06905158.
The prevalence of tinnitus in veterans is notably higher than in the general population and can significantly disrupt daily life. Given the impact of tinnitus, along with the lack of effective interventions, exploring new approaches is warranted. Wearable sound technologies offer a non-invasive and easily accessible approach. However, limited research has explored the effectiveness of sound therapy in UK veterans. A prior study supported the feasibility and acceptability of a non-invasive wearable device (i.e., TinniSoothe) in a sample of veterans. However, a waitlist-controlled trial is needed to investigate the effectiveness of the device. This waitlist-controlled trial aims to explore the effectiveness of a wearable device in reducing tinnitus symptoms in a sample of UK veterans. Veterans will be randomly allocated to one of two conditions: (1) the immediate intervention condition, which receives the device post-randomisation, or (2) the waitlist control group, which receives the device one-month post-randomisation. The trial will be conducted in veterans (n = 20) who have experienced tinnitus. Participants will be asked to use the device for one month. The immediate intervention group will be compared to the waitlist control group. The primary outcome is change in tinnitus severity (Tinnitus Functional Index, TFI) and mental health (General Health Questionnaire-12, GHQ-12) from baseline to one-month post-randomisation. Primary and secondary outcomes will be assessed at all timepoints (baseline, one-month post-randomisation, and two-month post-randomisation), while predictor variables will only be assessed at baseline to reduce participant burden. Recruitment will begin in October 2025. The study is expected to take 12 months, with results published in 2027. This study explores whether a wearable device is efficacious in reducing self-reported symptoms of tinnitus in comparison to a waitlist control group. This innovative approach, if successful, could offer a practical option for reducing tinnitus distress. The trial is registered on clinicaltrials.gov, identifier: NCT06905158.
DOI: https://doi.org/10.37349/edht.2025.101165
This article belongs to the special issue Digital Health Innovations in the Battle Against Psychological Problems: Progress, Hurdles, and Prospects
Aim:
Vitamin D deficiency is increasingly recognised as a global health concern and is associated with musculoskeletal pain. Women adhering to cultural clothing practices may be at increased risk due to limited sun exposure. This study aimed to determine the prevalence of vitamin D deficiency and identify its predictors among Northern Muslim women with chronic musculoskeletal pain living in Port Harcourt, Nigeria.
Methods:
A cross-sectional study of 220 Northern Muslim women aged ≥ 18 years with chronic musculoskeletal pain was conducted in Port Harcourt, Nigeria. Sociodemographic and lifestyle data were collected, and serum 25-hydroxyvitamin D levels were measured using ELISA. Participants with conditions affecting vitamin D absorption or metabolism, or those taking interfering medications, were excluded. Group comparisons (deficient vs. non-deficient) were performed using chi-square tests for categorical variables, independent-samples t-tests for continuous variables, and one-way ANOVA for pain scores across vitamin D status categories. Multivariate logistic regression was used to identify predictors of vitamin D deficiency. Analyses were conducted using IBM SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA), with p < 0.05 considered significant.
Results:
The prevalence of vitamin D deficiency was 65.0%, a rate slightly higher yet comparable to reports from other urban populations. Significant predictors included full-body covering (adjusted OR = 3.1; 95.00% CI: 1.8–5.3), low intake of vitamin D-rich foods (OR = 2.4; 95.00% CI: 1.3–4.1), and outdoor activity < 3 hours per week (OR = 2.7; 95.00% CI: 1.6–4.6). Vitamin D-deficient participants reported higher mean pain scores (7.3 ± 1.4) than vitamin D-insufficient participants (5.9 ± 1.3).
Conclusions:
Vitamin D deficiency is highly prevalent among Northern Muslim women with chronic musculoskeletal pain in Port Harcourt, largely influenced by clothing practices, low sun exposure, and inadequate dietary intake. Public health strategies, including targeted education and supplementation programs, are recommended to address this burden.
Aim:
Vitamin D deficiency is increasingly recognised as a global health concern and is associated with musculoskeletal pain. Women adhering to cultural clothing practices may be at increased risk due to limited sun exposure. This study aimed to determine the prevalence of vitamin D deficiency and identify its predictors among Northern Muslim women with chronic musculoskeletal pain living in Port Harcourt, Nigeria.
Methods:
A cross-sectional study of 220 Northern Muslim women aged ≥ 18 years with chronic musculoskeletal pain was conducted in Port Harcourt, Nigeria. Sociodemographic and lifestyle data were collected, and serum 25-hydroxyvitamin D levels were measured using ELISA. Participants with conditions affecting vitamin D absorption or metabolism, or those taking interfering medications, were excluded. Group comparisons (deficient vs. non-deficient) were performed using chi-square tests for categorical variables, independent-samples t-tests for continuous variables, and one-way ANOVA for pain scores across vitamin D status categories. Multivariate logistic regression was used to identify predictors of vitamin D deficiency. Analyses were conducted using IBM SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA), with p < 0.05 considered significant.
Results:
The prevalence of vitamin D deficiency was 65.0%, a rate slightly higher yet comparable to reports from other urban populations. Significant predictors included full-body covering (adjusted OR = 3.1; 95.00% CI: 1.8–5.3), low intake of vitamin D-rich foods (OR = 2.4; 95.00% CI: 1.3–4.1), and outdoor activity < 3 hours per week (OR = 2.7; 95.00% CI: 1.6–4.6). Vitamin D-deficient participants reported higher mean pain scores (7.3 ± 1.4) than vitamin D-insufficient participants (5.9 ± 1.3).
Conclusions:
Vitamin D deficiency is highly prevalent among Northern Muslim women with chronic musculoskeletal pain in Port Harcourt, largely influenced by clothing practices, low sun exposure, and inadequate dietary intake. Public health strategies, including targeted education and supplementation programs, are recommended to address this burden.
DOI: https://doi.org/10.37349/emd.2025.1007105
Allergic fungal rhinosinusitis is typically described as a condition involving nasal polyposis and eosinophilic mucin in which fungal hyphae are entrapped within enlarged sinus cavities, accompanied by an immune hypersensitivity response to fungi. There are rare reports in the pediatric literature. Early diagnosis and management with surgery represent the primary therapeutic approach, complemented by corticosteroid therapy and long-term follow-up to prevent relapse. In addition, novel biologic therapies have been investigated in recent years for the treatment of allergic fungal rhinosinusitis. Here, we report the case of a child with allergic fungal rhinosinusitis and summarize the literature review of data published.
Allergic fungal rhinosinusitis is typically described as a condition involving nasal polyposis and eosinophilic mucin in which fungal hyphae are entrapped within enlarged sinus cavities, accompanied by an immune hypersensitivity response to fungi. There are rare reports in the pediatric literature. Early diagnosis and management with surgery represent the primary therapeutic approach, complemented by corticosteroid therapy and long-term follow-up to prevent relapse. In addition, novel biologic therapies have been investigated in recent years for the treatment of allergic fungal rhinosinusitis. Here, we report the case of a child with allergic fungal rhinosinusitis and summarize the literature review of data published.
DOI: https://doi.org/10.37349/eaa.2025.100994
Hepatic encephalopathy (HE) is a debilitating neuropsychiatric complication of liver dysfunction that spans a continuum from subtle cognitive impairment to deep coma. While historically attributed to hyperammonemia, current insights reveal a multifactorial pathogenesis involving systemic inflammation, astrocyte dysfunction, blood-brain barrier (BBB) disruption, and altered neurotransmission. Central to this complex network is the gut-liver axis—a bidirectional system that links the gut microbiota, intestinal barrier integrity, bile acid metabolism, and hepatic immune responses. In cirrhosis, dysbiosis and increased intestinal permeability facilitate the translocation of microbial products—such as endotoxins and ammonia—that trigger hepatic and systemic immune activation, amplifying neurotoxicity through the gut-liver-brain axis. Experimental and clinical evidence has shown that ammonia and bilirubin synergistically promote neuroinflammation, mitochondrial dysfunction, and glial activation. Multiomics data further support the role of the microbiota as an active modulator of liver-brain homeostasis. Microbiota-targeted therapies—including rifaximin, probiotics, synbiotics, and fecal microbiota transplantation (FMT)—demonstrate efficacy in reducing HE recurrence, improving cognition, and restoring microbial balance. Novel receptor-based strategies targeting the farnesoid X receptor (FXR), Takeda G-protein-coupled receptor 5 (TGR5), and aryl hydrocarbon receptor (AhR) show promise for modulating bile acid pathways and mitigating neuroinflammation. Emerging approaches also focus on dietary interventions, the reinforcement of epithelial barrier function, and artificial intelligence (AI)-driven tools for personalized monitoring. Despite these advances, challenges persist regarding FMT standardization, long-term safety, and the integration of digital diagnostics into routine care.
Hepatic encephalopathy (HE) is a debilitating neuropsychiatric complication of liver dysfunction that spans a continuum from subtle cognitive impairment to deep coma. While historically attributed to hyperammonemia, current insights reveal a multifactorial pathogenesis involving systemic inflammation, astrocyte dysfunction, blood-brain barrier (BBB) disruption, and altered neurotransmission. Central to this complex network is the gut-liver axis—a bidirectional system that links the gut microbiota, intestinal barrier integrity, bile acid metabolism, and hepatic immune responses. In cirrhosis, dysbiosis and increased intestinal permeability facilitate the translocation of microbial products—such as endotoxins and ammonia—that trigger hepatic and systemic immune activation, amplifying neurotoxicity through the gut-liver-brain axis. Experimental and clinical evidence has shown that ammonia and bilirubin synergistically promote neuroinflammation, mitochondrial dysfunction, and glial activation. Multiomics data further support the role of the microbiota as an active modulator of liver-brain homeostasis. Microbiota-targeted therapies—including rifaximin, probiotics, synbiotics, and fecal microbiota transplantation (FMT)—demonstrate efficacy in reducing HE recurrence, improving cognition, and restoring microbial balance. Novel receptor-based strategies targeting the farnesoid X receptor (FXR), Takeda G-protein-coupled receptor 5 (TGR5), and aryl hydrocarbon receptor (AhR) show promise for modulating bile acid pathways and mitigating neuroinflammation. Emerging approaches also focus on dietary interventions, the reinforcement of epithelial barrier function, and artificial intelligence (AI)-driven tools for personalized monitoring. Despite these advances, challenges persist regarding FMT standardization, long-term safety, and the integration of digital diagnostics into routine care.
DOI: https://doi.org/10.37349/edd.2025.100597
T cell-based immunotherapies increasingly include personalized neoantigen vaccines that target tumor-specific mutations. However, despite their promise, current neoantigen vaccines show limited and unpredictable clinical benefit, with T cell responses observed in only a subset of patients. To overcome these limitations, we developed the VERDI (Vaccine Epitopes Ranked by Digital Intelligence) System—a cloud-based computational platform that integrates a patient’s human leukocyte antigen (HLA) class I and II genotype with selected tumor-associated antigens (TAAs), including cancer-testis antigens (CTAs), to identify peptides with high predicted immunogenicity and low risk of immune-related adverse events (irAEs). Using the VERDI System, we designed ten personalized peptide vaccines for a patient with metastatic signet ring cell carcinoma (SRCC), a rare and aggressive gastric cancer with limited treatment options. All ten VERDI vaccines were well tolerated and consistently induced tumor-specific T cell responses following a single administration, without the need for checkpoint inhibitors. The patient survived for 15 months—substantially longer than the reported median survival of 5.6 months in metastatic SRCC—highlighting the potential of this individualized, predictive vaccine platform to improve outcomes in advanced cancer.
T cell-based immunotherapies increasingly include personalized neoantigen vaccines that target tumor-specific mutations. However, despite their promise, current neoantigen vaccines show limited and unpredictable clinical benefit, with T cell responses observed in only a subset of patients. To overcome these limitations, we developed the VERDI (Vaccine Epitopes Ranked by Digital Intelligence) System—a cloud-based computational platform that integrates a patient’s human leukocyte antigen (HLA) class I and II genotype with selected tumor-associated antigens (TAAs), including cancer-testis antigens (CTAs), to identify peptides with high predicted immunogenicity and low risk of immune-related adverse events (irAEs). Using the VERDI System, we designed ten personalized peptide vaccines for a patient with metastatic signet ring cell carcinoma (SRCC), a rare and aggressive gastric cancer with limited treatment options. All ten VERDI vaccines were well tolerated and consistently induced tumor-specific T cell responses following a single administration, without the need for checkpoint inhibitors. The patient survived for 15 months—substantially longer than the reported median survival of 5.6 months in metastatic SRCC—highlighting the potential of this individualized, predictive vaccine platform to improve outcomes in advanced cancer.
DOI: https://doi.org/10.37349/ei.2025.1003221
Aim:
Baicalin and ginsenoside Rb1 show the ability to promote adipocyte browning, but their effects, especially combined treatment, and the related mechanisms under pathological conditions are less known. The study investigated the regulation of browning markers by baicalin and Rb1 under lipid overload and explored the potential implication of a serine/threonine protein kinase G protein-coupled receptor kinase 2 (GRK2).
Methods:
The 3T3-L1 cells under palmitic acid (PA) stimulation and male ICR mice on a high-fat diet (HFD) challenge were used to evaluate the effects of drugs.
Results:
GRK2 silencing and overexpression inversely regulated the protein abundance of PGC-1α and UCP-1 in 3T3-L1 adipocytes. Baicalin, Rb1, and their combination decreased the PA-induced elevation of GRK2 while increasing the thermogenetic markers at the protein and mRNA levels. In vivo, the tested drugs restored the expression of thermogenetic and mitochondrial biogenetic markers in the inguinal white adipose tissue (WAT) of HFD-fed mice. Consistently, the drug-treated mice displayed an improved metabolic profile. The baicalin-Rb1 combination showed a more potent effect in some examinations, and its effect was comparable to that of GRK2 inhibitor paroxetine or AMP-activated protein kinase activator metformin.
Conclusions:
Baicalin and Rb1, alone or in combination, improved the browning of adipocytes during differentiation and prevented the whitening shift of WAT on an HFD, which was associated with the downregulation of GRK2. The study expands the understanding of the anti-obesity effects of baicalin and Rb1 and the potential of Scutellariae Radix-Ginseng Radix et Rhizoma compatibility for treating obesity-associated metabolic diseases.
Aim:
Baicalin and ginsenoside Rb1 show the ability to promote adipocyte browning, but their effects, especially combined treatment, and the related mechanisms under pathological conditions are less known. The study investigated the regulation of browning markers by baicalin and Rb1 under lipid overload and explored the potential implication of a serine/threonine protein kinase G protein-coupled receptor kinase 2 (GRK2).
Methods:
The 3T3-L1 cells under palmitic acid (PA) stimulation and male ICR mice on a high-fat diet (HFD) challenge were used to evaluate the effects of drugs.
Results:
GRK2 silencing and overexpression inversely regulated the protein abundance of PGC-1α and UCP-1 in 3T3-L1 adipocytes. Baicalin, Rb1, and their combination decreased the PA-induced elevation of GRK2 while increasing the thermogenetic markers at the protein and mRNA levels. In vivo, the tested drugs restored the expression of thermogenetic and mitochondrial biogenetic markers in the inguinal white adipose tissue (WAT) of HFD-fed mice. Consistently, the drug-treated mice displayed an improved metabolic profile. The baicalin-Rb1 combination showed a more potent effect in some examinations, and its effect was comparable to that of GRK2 inhibitor paroxetine or AMP-activated protein kinase activator metformin.
Conclusions:
Baicalin and Rb1, alone or in combination, improved the browning of adipocytes during differentiation and prevented the whitening shift of WAT on an HFD, which was associated with the downregulation of GRK2. The study expands the understanding of the anti-obesity effects of baicalin and Rb1 and the potential of Scutellariae Radix-Ginseng Radix et Rhizoma compatibility for treating obesity-associated metabolic diseases.
DOI: https://doi.org/10.37349/eemd.2025.101441
This article belongs to the special issue Regulators of Glucose Homeostasis, Lipid Metabolism and Energy Balance
