Infections as a risk factor for stroke remain an underrecognized issue within the medical community although this link was identified for more than 60 years. Preceding infections acting as triggers or even causal factors for ischemic and hemorrhagic stroke were assessed notably for tropical infections.

Since the COVID 19 pandemic, the interest for all kind of infectious agents (bacteria, viruses, fungi, parasitosis) is becoming an emerging concern worldwide. Surprisingly, this risk is addressed only in classification of causes concerning young adults and children. In addition, the seasonality of meteorological conditions (temperature, humidity, rain patterns) probably obscured the underlying causes such as epidemic infections and air pollution peaks (which can act in synergy, notably for respiratory infections). Greater recognition of infection-related stroke risk is essential, especially given the potential for increased incidence driven by global warming, the availability of biomarkers for risk assessment, and the opportunities improving preventive and therapeutic strategies.

Telerehabilitation has become an important tool for the recovery of coronavirus disease (COVID-19) patients, allowing treatment to be continued remotely for this and other pathologies. Self-efficacy plays a key role in motivating and ensuring adherence to these programs. The aim of this study was to evaluate the effects on self-efficacy (GSES) and sport motivation (BRSQ-36) and analyze the correlation between self-efficacy and physical condition after a program composed of therapeutic exercises and education.

This pilot randomized controlled trial included 35 post-discharge COVID-19, with two groups: an asynchronous telerehabilitation and a booklet-based rehabilitation groups who undertook a 12-week intervention of therapeutic exercise and education..

The telerehabilitation group showed better results in all variables analyzed, with moderate and large clinical changes in overall motivation d = 0.8, but no significant changes. At the 3- and 6-month follow-up, statistically significant differences in self-efficacy were found in favor of the telerehabilitation group (3-m, p = 0.025, d = 0.76); 6-m, p = 0.007, d = 0.79). The telerehabilitation group showed better results in 'Extrinsic Motivation' (3-m, p = 0.037, d = 0.75; 6-m, p = 0.010, d = 0.94) and 'Identified Regulation' (3-m, p < 0.001, d = 1.09; 6-m, p = 0.005, d = 0.49) after 3- and 6-month follow-up. . In all patients, a direct correlation was found between self-efficacy and meters walked in the six minutes' walk test (6 MWT) (p = 0.022; R² = 0.149), '30 STST and 30' ACT (p = 0.002; R² = 0.261; p = 0.017; R² = 0.160), respectively; an inverse correlation was found after three months with the fatigue variable (p < 0.001; R² = 0.2858) and after six months (p < 0.001; R² = 0.2889).

The findings highlight the potential of asynchronous telerehabilitation to improve self-efficacy and extrinsic motivation in a short period of time, which could facilitate better adherence to rehabilitation programs and improve physical condition. However, the results seem to be limited in the long term.

In 2020, the new pathogen SARS-CoV-2 spread fast, causing a pandemic. Health care workers on the frontline were of course highly exposed. This study aims to analyze the risk factors of SARS-CoV-2 infection in HCWs who have been in contact with positive patients in Niger.

A prospective cohort was conducted among HCWs from March 2020 to June 2020 in health facilities in Niamey. A questionnaire was administered at inclusion; RT-PCR testing was performed if clinical signs were present. Serological testing was performed at baseline, Days 15 and 30. Univariate analysis and Cox regression were used.

Regarding inclusion criteria, 129 health care workers were included. The sex ratio (male/female) was 0.82. The participants were mainly physicians (45.7%) and nurses (34.1%). At inclusion, the prevalence of COVID-19 was 34.9%. Only seronegative (n = 84) were followed up; the attack incidence rate for the first month was 440 per 1000 person*month. Regarding the Cox model, the use of alcohol-based hand washing was a protective factor (RR = 0.28, p = 0.01). Furthermore, females were more at risk than males (RR = 2, p-value = 0.049).

HCWs in Niger were faced with high infection risk; this should lead decision-makers to (i) enhance training on preventive measures and (ii) boost access to personal protective equipment in emergency and infectious disease wards.

Video-based cognitive testing is becoming more common. The 'VCog' study aims to evaluate the validity, feasibility, and acceptability of a standardized video-administered cognitive research battery.

Twelve Alzheimer's Disease Research Centers (ADRCs) administered, in randomized order, an in-person and video-adapted Uniform Data Set Version 3 (UDSv3) cognitive assessment battery to participants with normal cognition (n = 156), mild cognitive impairment (MCI; n = 230), and dementia (n = 77). Acceptability of technology and participant experience completing video testing was assessed.

Of 463 participants (mean age 75.1 years, 52.5% female, and 25.5% non-White individuals), most rated video testing as easy (90.0%), convenient (95.3%) and would accept it in future visits (75.5%). Greater cognitive impairment was associated with more difficulty with setup and use of video. Staff rated most administrations as producing valid data (94.8%).

Video-based research cognitive testing with an adapted UDSv3 battery is feasible and well-accepted among older adults with and without cognitive impairment.

The COVID-19 pandemic increased the need for video-administered cognitive assessments in Alzheimer's Disease Research Centers (ADRCs) . Feasibility, acceptability, and validity of video cognitive testing were evaluated. Participant experience and examiner evaluations of data validity were positive. Video assessment may extend the ADRCs reach to otherwise unreachable participants.

This study investigates the moderating role of social support in the relationship between health empowerment and quality of life among elderly pulmonary tuberculosis patients in mainland China, utilizing the Johnson-Neyman (J-N) technique to identify the specific conditions under which this moderation occurs. A convenience sampling approach was employed to recruit 451 elderly pulmonary tuberculosis patients from the Department of Tuberculosis at Anhui Chest Hospital. Data collection took place between June 2023 and December 2023. Key variables were measured using established instruments: the health empowerment scale, the perceived social support scale, and the SF-36 quality of life scale. Statistical analysis included Pearson correlation to assess relationships between variables and J-N moderation analysis to explore the moderating effect of social support. Positive correlations were found between both health empowerment and social support with patients' total quality of life, physical component scores, and mental component scores. The J-N moderation analysis revealed a significant, non-linear moderating effect of social support on the relationship between health empowerment and quality of life. Specifically, at lower levels of social support, health empowerment demonstrated a positive association with quality of life. However, as social support levels increased, this positive relationship weakened. Furthermore, at high levels of social support, the relationship between health empowerment and quality of life turned negative, suggesting that excessive social support might mitigate the beneficial impact of health empowerment. Social support plays a complex and crucial non-linear moderating role in the relationship between health empowerment and quality of life among elderly pulmonary tuberculosis patients. While beneficial at moderate levels, excessive social support can paradoxically diminish the positive effects of health empowerment on quality of life. These results highlight the necessity of designing personalized and balanced intervention strategies that not only foster patient empowerment but also provide an optimal, rather than overwhelming, level of social support to maximize the quality of life for elderly pulmonary tuberculosis patients.

This study analyzes the risk factors for mycoplasma pneumoniae infection in children and the expression of interleukin-6 (IL-6)/signaling and transcriptional activating factor 3 (STAT3) pathway. Seventy-three children diagnosed with mycoplasma pneumoniae infection were admitted to Jinzhou Medical University Hospital between April 2021 and April 2023, forming the study group. Additionally, 730 healthy children who underwent physical examinations during the same period were selected as the control group. A comparison of clinical data between the 2 groups was conducted to analyze the risk factors associated with mycoplasma pneumoniae infection in children. Furthermore, the diagnostic value of IL-6, STAT3, white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT) in children with mycoplasma pneumoniae infection was assessed using receiver operating characteristic (ROC) curve analysis. A history of recurrent upper respiratory tract infections and living in close quarters are identified as risk factors for mycoplasma pneumoniae infection in children (OR = 1.988, 2.123, P < .05). The study group exhibited elevated levels of IL-6, STAT3 mRNA, WBC, CRP, and PCT compared to the control group (P < .05). Analysis of the ROC curve revealed that using IL-6, STAT3, WBC, CRP, and PCT levels individually or in combination yielded area under the curve values of 0.829, 0.813, 0.852, 0.759, 0.849, and 0.953, respectively. The combined detection method demonstrated a sensitivity of 86.30% and specificity of 90.40%. The IL-6/STAT3 pathway is known to be activated in children with mycoplasma pneumoniae infection, leading to an upregulation in the expression of white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT). Utilizing a combination of IL-6, STAT3, WBC, CRP, and PCT levels can aid in the diagnosis of mycoplasma pneumoniae infection in children. Additionally, a history of recurrent upper respiratory tract infections and living in close quarters with others can increase the risk of mycoplasma pneumoniae infection in children.

Asthma is a common chronic lung disease that causes significant morbidity and potential mortality all around the world. Since family medicine and internal medicine physicians, most frequently encounter asthmatic patients, updating their knowledge about the latest. Global Initiative for Asthma (GINA ) guidelines is important for proper asthma management. This study aims to assess the level of knowledge of family medicine and internal medicine physicians in Jordan about the latest GINA guidelines, and possibly to lay out future research and practice recommendations that need to be done for better management outcomes of this condition. A cross-sectional study using an online survey was conducted to investigate the degree to which the current clinical practice for asthma management in Jordan is based on the latest GINA guidelines. A total of 177 responses to the online questionnaire were included in our study, and the Maintenance and Reliever Therapy (MART) dosing approach was examined. Although awareness of the MART strategy was high (72.9%, 129/177), its implementation as first-line therapy for mild asthma (the cornerstone of the GINA 2023 guidelines) was low. Only 20.9% (37/177) of all physicians prescribe MART for mild asthma, which was the adherence group. While 39.0% (69/177) still prescribe short-acting beta agonists (SABA)-only for mild or moderate asthma. Furthermore, a significant proportion (58.2%, 103/177) of physicians who used MART often or always co-prescribed a SABA as a reliever, contrary to guidelines. There was no statistically significant difference between family medicine and internal medicine in terms of the adherence (P-value = .167). The adherence to guidelines group was significantly associated with more follow-up with patients' adherence to their maintenance treatments compared with the nonadherence group (P-value < .001). The primary source of knowledge on MART was the GINA guidelines themselves (71.3%, 92/129). Despite good awareness of GINA guidelines among Jordanian physicians, a significant gap exists between knowledge and implementation, particularly concerning the persistent use of SABA in mild asthma. This practice misalignment shows that guidelines dissemination alone is insufficient. Bridging this gap needs multiple strategies that address systemic barriers, practical education, and changes in policy. These steps will help turn guidelines into real practice and improve patient outcomes.

Chronic obstructive pulmonary disease (COPD) and asthma are common and serious respiratory diseases worldwide. Their clinical overlap and lack of specificity in current biomarkers pose a great diagnostic challenge for early diagnosis. To address this gap, this study aimed to identify common transcriptomic features and potential diagnostic biomarkers for the diseases using an integrated bioinformatics approach. This study analyzed COPD chip data using weighted gene co-expression network analysis, identifying 375 key differential genes. Functional enrichment analysis was performed to assess the biological roles of these genes. Machine learning methods, including least absolute shrinkage and selection operator and random forest, were employed to identify 5 key biomarkers: MYO16, CHML, POLR3B, ZNF101, and ZNF143. The findings revealed that the identified genes were primarily associated with immune response and T cell-related inflammatory pathways. Among the biomarkers, ZNF143 was significantly upregulated in both COPD and asthma, with expression levels notably higher in COPD patients compared to asthma patients. Expression analysis and receiver operating characteristic curve assessment validated ZNF143 as a potential diagnostic biomarker. Additionally, the CIBERSORT algorithm was used to evaluate immune cell infiltration, revealing a positive correlation between ZNF143 and CD8 T cells, M2 macrophages, and γ-δ T cells, and a negative correlation with memory-activated CD4 T cells, plasma cells, and neutrophils. These findings suggest a potential role for ZNF143 in both COPD and asthma, supporting its candidacy as an early diagnostic biomarker. This research offers preliminary insights into the molecular mechanisms underlying these respiratory diseases and may inform future directions for diagnostic and therapeutic exploration.

Overall, 5% to 10% of all atrial septal defects (ASDs) are of the sinus venosus type, a rare congenital disease. This defect must be identified and treated immediately since it might cause significant left atrial dilatation and dyspnea.

A 15-year-old male presented with previously undetected sinus venosus type ASD. The patient arrived with a high-grade heart murmur and a history of recurring respiratory illnesses.

A clinical examination identified a 3/6 systolic ejection murmur in the second left intercostal gap and a fixed split second heart sound. Electrocardiography revealed sinus rhythm with partial right bundle branch block, while echocardiography indicated considerable enlargement of the right atrium and right ventricle, accompanied by a D-shaped left ventricle. A sinus venosus type ASD with an inferior vena cava-right atrial shunt was verified.

The patient had surgical closure of the defect via midline sternotomy, thereafter gaining access to the right atrium and performing pericardial patch repair.

Two months postoperatively, the patient's right ventricular diameters and pulmonary artery pressures were significantly diminished (25-30 mm Hg), and his overall status was excellent.

Sinus venosus type ASD is an infrequent etiology of persistent respiratory problems in adolescents. Early detection by thorough clinical and echocardiographic assessment, followed by timely surgical intervention, may lead to superior functional recovery and improved long-term quality of life.

Inflammation is a crucial factor in the development of chronic obstructive pulmonary disease (COPD). Dietary interventions that reduce inflammation are effective in managing COPD. However, little is known about the association between the DII and COPD in the general adult population in the United States. This study aimed to investigate the association between the inflammatory potential of diet and COPD in an adult population in the U.S. Data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were used, with COPD as the dependent variable and DII as the independent variable. Multifactor logistic regression, curve fitting, and threshold effect analyses were performed to examine this relationship. A total of 39,195 participants were included in this study, and DII was positively associated with COPD in a model adjusted for all confounders (odds ratio [OR] = 1.05; 95% confidence interval [CI], 1.02-1.09). Delineation of DII into tertiles revealed that those with the highest DII scores (T3; 2.59 to 5.48) were 23% more likely to have COPD than those in the lowest tertile (T1; -5.28 to 0.84). There was a J-shaped association between the DII and COPD (P = .003), with a turnaround point of 2.71. After the turnaround (≥2.71), a significant positive association emerged (OR = 1.268; 95% CI: 1.081-1.487). Subgroup analyses suggested no significant interactions (P values for interactions were all >.05). Our study demonstrated a J-shaped association between the DII and COPD in a nationally representative sample of U.S. adults.