Previous
Background:
Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) frequently coexist, showing a bidirectional relationship. MAFLD increases the risk of T2DM, while T2DM independently raises the likelihood of MAFLD.
Methods:
A comprehensive review was carried out on recent systematic reviews and meta-analyses by searching databases including PubMed, Embase, Web of Science, and the Cochrane database of systematic reviews, covering studies from inception to February 2025. Additionally, manual searches of reference lists were conducted. Inclusion criteria involved systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating treatment effects on health outcomes in individuals with T2DM and MAFLD.
Results:
The search yielded 19 meta-analyses and 112 health outcomes from 622 unique articles. Most analyses focused on treatment effects on endocrine metabolic outcomes (n = 28), lipid metabolic indicators (n = 26), liver health indicators (n = 34), and body composition indicators (n = 24). High-quality evidence indicates that high-intensity interval training improves insulin resistance and low-density lipoprotein cholesterol levels. High-quality evidence also indicates sodium-glucose cotransporter-2 (SGLT-2) inhibitors improved liver proton density fat fraction and fatty liver index, while glucagon-like peptide-1 receptor agonists (GLP-1RAs), particularly liraglutide, enhanced subcutaneous adipose tissue (SAT). Moderate-quality evidence shows that dipeptidyl peptidase-4 (DPP-4) inhibitors enhanced insulin resistance and GLP-1RAs benefited triglycerides, aspartate transaminase, liver fat, and visceral adipose tissue. SGLT-2 inhibitors improved controlled attenuation parameter, body mass index (BMI), SAT, visceral fat mass, and moderate-intensity continuous training improved triglycerides and high-density lipoprotein cholesterol. Fifty-six outcomes were rated as low-quality evidence, and five as very low-quality.
Discussion:
GLP-1RAs, SGLT-2 inhibitors, DPP-4 inhibitors, exercise, and Chinese Herbal Medicines benefited liver health, glycemic control in T2DM with MAFLD, and impacted body composition and lipid metabolism.
Background:
Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) frequently coexist, showing a bidirectional relationship. MAFLD increases the risk of T2DM, while T2DM independently raises the likelihood of MAFLD.
Methods:
A comprehensive review was carried out on recent systematic reviews and meta-analyses by searching databases including PubMed, Embase, Web of Science, and the Cochrane database of systematic reviews, covering studies from inception to February 2025. Additionally, manual searches of reference lists were conducted. Inclusion criteria involved systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating treatment effects on health outcomes in individuals with T2DM and MAFLD.
Results:
The search yielded 19 meta-analyses and 112 health outcomes from 622 unique articles. Most analyses focused on treatment effects on endocrine metabolic outcomes (n = 28), lipid metabolic indicators (n = 26), liver health indicators (n = 34), and body composition indicators (n = 24). High-quality evidence indicates that high-intensity interval training improves insulin resistance and low-density lipoprotein cholesterol levels. High-quality evidence also indicates sodium-glucose cotransporter-2 (SGLT-2) inhibitors improved liver proton density fat fraction and fatty liver index, while glucagon-like peptide-1 receptor agonists (GLP-1RAs), particularly liraglutide, enhanced subcutaneous adipose tissue (SAT). Moderate-quality evidence shows that dipeptidyl peptidase-4 (DPP-4) inhibitors enhanced insulin resistance and GLP-1RAs benefited triglycerides, aspartate transaminase, liver fat, and visceral adipose tissue. SGLT-2 inhibitors improved controlled attenuation parameter, body mass index (BMI), SAT, visceral fat mass, and moderate-intensity continuous training improved triglycerides and high-density lipoprotein cholesterol. Fifty-six outcomes were rated as low-quality evidence, and five as very low-quality.
Discussion:
GLP-1RAs, SGLT-2 inhibitors, DPP-4 inhibitors, exercise, and Chinese Herbal Medicines benefited liver health, glycemic control in T2DM with MAFLD, and impacted body composition and lipid metabolism.
DOI: https://doi.org/10.37349/eemd.2025.101443
This article belongs to the special issue Innovative Strategies for Diabetes and Metabolic Disorders: Current and Future Directions
Background:
Cardiac computed tomography (CT) has evolved from an anatomic test to a platform that quantifies functional, inflammatory, and tissue-characterization biomarkers. We synthesized evidence on the diagnostic and prognostic value of CT-based biomarkers.
Methods:
Systematic review of 29 human studies (2015–2025) appraising low-attenuation plaque (LAP), perivascular fat attenuation index (FAI/PCAT), total/non-calcified plaque burden, epicardial adipose tissue, CT-derived fractional flow reserve (FFR-CT), and CT myocardial perfusion. Study quality was assessed with risk of bias (RoB) 2.0, Newcastle-Ottawa Scale (NOS), and AMSTAR 2.
Results:
CT biomarkers extended risk assessment beyond stenosis severity. LAP burden > 4% predicted myocardial infarction (MI) [hazard ratio (HR) 4.65; 95% CI 2.06–10.5] and per-doubling LAP predicted MI (HR 1.60; 95% CI 1.10–2.34). Perivascular FAI/PCAT showed independent prognostic value: high FAI was associated with ~2-fold higher cardiac mortality (derivation HR 2.15, validation HR 2.06), and RCA PCAT ≥ −70.5 Hounsfield unit (HU) predicted MI (HR 2.45) with additive risk when combined with high-risk plaque (HRP) features (reported up to ~6-fold vs. reference). FFR-CT achieved up to 81% diagnostic accuracy (sensitivity ~86%, specificity ~79%) vs. invasive FFR, improving specificity over CTA alone. Emerging metrics (e.g., total plaque volume, CT perfusion) demonstrated incremental discrimination in selected cohorts, though standardization remains variable.
Discussion:
CT-based biomarkers provide measurable diagnostic and prognostic information on coronary anatomy, function, inflammation, and tissue health. Priorities include standardized acquisition/analysis, multicenter validation, and integration into decision pathways to optimize individualized risk stratification and therapy.
Background:
Cardiac computed tomography (CT) has evolved from an anatomic test to a platform that quantifies functional, inflammatory, and tissue-characterization biomarkers. We synthesized evidence on the diagnostic and prognostic value of CT-based biomarkers.
Methods:
Systematic review of 29 human studies (2015–2025) appraising low-attenuation plaque (LAP), perivascular fat attenuation index (FAI/PCAT), total/non-calcified plaque burden, epicardial adipose tissue, CT-derived fractional flow reserve (FFR-CT), and CT myocardial perfusion. Study quality was assessed with risk of bias (RoB) 2.0, Newcastle-Ottawa Scale (NOS), and AMSTAR 2.
Results:
CT biomarkers extended risk assessment beyond stenosis severity. LAP burden > 4% predicted myocardial infarction (MI) [hazard ratio (HR) 4.65; 95% CI 2.06–10.5] and per-doubling LAP predicted MI (HR 1.60; 95% CI 1.10–2.34). Perivascular FAI/PCAT showed independent prognostic value: high FAI was associated with ~2-fold higher cardiac mortality (derivation HR 2.15, validation HR 2.06), and RCA PCAT ≥ −70.5 Hounsfield unit (HU) predicted MI (HR 2.45) with additive risk when combined with high-risk plaque (HRP) features (reported up to ~6-fold vs. reference). FFR-CT achieved up to 81% diagnostic accuracy (sensitivity ~86%, specificity ~79%) vs. invasive FFR, improving specificity over CTA alone. Emerging metrics (e.g., total plaque volume, CT perfusion) demonstrated incremental discrimination in selected cohorts, though standardization remains variable.
Discussion:
CT-based biomarkers provide measurable diagnostic and prognostic information on coronary anatomy, function, inflammation, and tissue health. Priorities include standardized acquisition/analysis, multicenter validation, and integration into decision pathways to optimize individualized risk stratification and therapy.
DOI: https://doi.org/10.37349/ec.2025.101278
The diagnosis of acute myocarditis requires the exclusion of coronary artery disease (CAD). Coronary CTA (computed tomography angiography) is usually used to evaluate the coronary arteries in young patients. However, the use of coronary CTA for the diagnosis of myocarditis has been rarely reported. Here we present a Han male clinical myocarditis patient who was 18 years old, had a focus of enhancement in the subcardia, and predominantly involving the lateral wall of the left ventricle with iodinated contrast in coronary CTA. The patient was diagnosed with myocarditis. Immunoglobulin, vitamin C antioxidant, and myocardial nutrition were given to the patient for treatment. During follow-up, the patient’s myocardial enzymes gradually decreased to normal, and the original symptoms disappeared. As a non-invasive rapid examination method that can evaluate coronary artery and myocardial lesions at the same time, the utility of myocardial delayed enhancement on CTA may warrant further investigation.
The diagnosis of acute myocarditis requires the exclusion of coronary artery disease (CAD). Coronary CTA (computed tomography angiography) is usually used to evaluate the coronary arteries in young patients. However, the use of coronary CTA for the diagnosis of myocarditis has been rarely reported. Here we present a Han male clinical myocarditis patient who was 18 years old, had a focus of enhancement in the subcardia, and predominantly involving the lateral wall of the left ventricle with iodinated contrast in coronary CTA. The patient was diagnosed with myocarditis. Immunoglobulin, vitamin C antioxidant, and myocardial nutrition were given to the patient for treatment. During follow-up, the patient’s myocardial enzymes gradually decreased to normal, and the original symptoms disappeared. As a non-invasive rapid examination method that can evaluate coronary artery and myocardial lesions at the same time, the utility of myocardial delayed enhancement on CTA may warrant further investigation.
DOI: https://doi.org/10.37349/ec.2025.101277
Graphene-based nanomaterials are promising candidates for neuromuscular regeneration due to their electrical conductivity, mechanical strength, and functionalizability. In this perspective, reduced graphene oxide (rGO) nanocomposites decorated with gold nanoparticles (AuNPs) or silver nanoparticles (AgNPs) were synthesized via a one-step green process using Camellia sinensis (tea) extracts. The extracts acted as reducing and stabilizing agents and left bioactive catechins and polyphenols adsorbed on the graphene surface. The resulting nanocomposites combined structural support, electrical conductivity, and bioactive molecular modulation. rGO can provide scaffolding for cell growth, while the retained plant metabolites contributed antioxidant and anti-inflammatory effects. Incorporation of metallic nanoparticles enhanced mechanical strength, surface reactivity, and antimicrobial properties. These multifunctional graphene-metal nanocomposites offer a sustainable and biocompatible platform for guiding neuromuscular regeneration and represent a promising basis for future clinical translation.
Graphene-based nanomaterials are promising candidates for neuromuscular regeneration due to their electrical conductivity, mechanical strength, and functionalizability. In this perspective, reduced graphene oxide (rGO) nanocomposites decorated with gold nanoparticles (AuNPs) or silver nanoparticles (AgNPs) were synthesized via a one-step green process using Camellia sinensis (tea) extracts. The extracts acted as reducing and stabilizing agents and left bioactive catechins and polyphenols adsorbed on the graphene surface. The resulting nanocomposites combined structural support, electrical conductivity, and bioactive molecular modulation. rGO can provide scaffolding for cell growth, while the retained plant metabolites contributed antioxidant and anti-inflammatory effects. Incorporation of metallic nanoparticles enhanced mechanical strength, surface reactivity, and antimicrobial properties. These multifunctional graphene-metal nanocomposites offer a sustainable and biocompatible platform for guiding neuromuscular regeneration and represent a promising basis for future clinical translation.
DOI: https://doi.org/10.37349/ebmx.2025.101349
This article belongs to the special issue Green Nanoparticles for Biomedical Applications
Immune checkpoint inhibitors (ICIs) have transformed cancer care, but their use is frequently complicated by immune-related adverse events (irAEs), including rheumatic manifestations such as arthritis. Distinguishing between inflammatory and non-inflammatory musculoskeletal symptoms is challenging, yet critical for appropriate management. Musculoskeletal ultrasound (MSKUS) provides unique advantages in this context by enabling the detection of subclinical synovitis, periarticular pathology, and crystal deposition, while also facilitating treatment decisions, including targeted corticosteroid injections. We present four cases that highlight the utility of MSKUS as a frontline tool in the evaluation of musculoskeletal irAEs.
Immune checkpoint inhibitors (ICIs) have transformed cancer care, but their use is frequently complicated by immune-related adverse events (irAEs), including rheumatic manifestations such as arthritis. Distinguishing between inflammatory and non-inflammatory musculoskeletal symptoms is challenging, yet critical for appropriate management. Musculoskeletal ultrasound (MSKUS) provides unique advantages in this context by enabling the detection of subclinical synovitis, periarticular pathology, and crystal deposition, while also facilitating treatment decisions, including targeted corticosteroid injections. We present four cases that highlight the utility of MSKUS as a frontline tool in the evaluation of musculoskeletal irAEs.
DOI: https://doi.org/10.37349/emd.2025.1007106
This article belongs to the special issue Multifaceted Imaging in Rheumatic and Musculoskeletal Diseases
Cyclic vomiting syndrome (CVS) is a rare disorder in which stereotypical periods of intermittent nausea and vomiting last between hours and over a week. The disorder overlaps with migraine, and the current treatment recommendations follow those of migraine management. The current patient had experienced vomiting periods lasting up to a week since the age of two. Prophylactic amitriptyline had led to probably slightly longer intervals between CVS periods, while several medications had proven ineffective. At the age of 17, there was an excellent response to peroral olanzapine, which eventually proved sufficient to abort the vomiting periods in a single dose when taken at the beginning of one. In light of these and previously reported cases, early administration of olanzapine is suggested to treat CVS periods.
Cyclic vomiting syndrome (CVS) is a rare disorder in which stereotypical periods of intermittent nausea and vomiting last between hours and over a week. The disorder overlaps with migraine, and the current treatment recommendations follow those of migraine management. The current patient had experienced vomiting periods lasting up to a week since the age of two. Prophylactic amitriptyline had led to probably slightly longer intervals between CVS periods, while several medications had proven ineffective. At the age of 17, there was an excellent response to peroral olanzapine, which eventually proved sufficient to abort the vomiting periods in a single dose when taken at the beginning of one. In light of these and previously reported cases, early administration of olanzapine is suggested to treat CVS periods.
DOI: https://doi.org/10.37349/en.2025.1006113
This review explores recent advancements in the management of Helicobacter pylori infection, a widespread bacterial pathogen associated with various gastrointestinal disorders. The paper discusses improved diagnostic techniques, including molecular methods and non-invasive tests, which have enhanced detection accuracy and antibiotic resistance profiling. New treatment strategies, such as individualized therapy based on antimicrobial susceptibility testing (AST) and the use of probiotics as adjunctive therapy, are examined. The review also addresses the challenges of antibiotic resistance, highlighting the importance of surveillance and monitoring strategies. Novel antibiotic combinations and non-antibiotic therapies, including antibiofilm agents, are presented as potential solutions. The paper concludes by discussing post-treatment follow-up, management of persistent infections, and considerations for special patient populations. Future directions in Helicobacter pylori management, including emerging technologies and global eradication efforts, are briefly outlined.
This review explores recent advancements in the management of Helicobacter pylori infection, a widespread bacterial pathogen associated with various gastrointestinal disorders. The paper discusses improved diagnostic techniques, including molecular methods and non-invasive tests, which have enhanced detection accuracy and antibiotic resistance profiling. New treatment strategies, such as individualized therapy based on antimicrobial susceptibility testing (AST) and the use of probiotics as adjunctive therapy, are examined. The review also addresses the challenges of antibiotic resistance, highlighting the importance of surveillance and monitoring strategies. Novel antibiotic combinations and non-antibiotic therapies, including antibiofilm agents, are presented as potential solutions. The paper concludes by discussing post-treatment follow-up, management of persistent infections, and considerations for special patient populations. Future directions in Helicobacter pylori management, including emerging technologies and global eradication efforts, are briefly outlined.
DOI: https://doi.org/10.37349/edd.2025.100598
This article belongs to the special issue Helicobacter Pylori and Infection: Genomics, Diagnosis, Pathogenesis, Antibiotic Resistance, Microbiota, Cancer, Prevention and Therapeutics
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
