Spinal muscular atrophy with respiratory distress type 1 (SMARD1) is a rare, inherited genetic disease caused by mutations in the immunoglobulin mu binding protein (IGHMBP2) gene that result in spinal muscular atrophy with respiratory distress (SMARD1) or Charcot-Marie-Tooth Type 2S (CMT2S). SMARD1 clinical symptoms include respiratory failure, progressive muscular weakness, feeding deficiencies, and sensory and autonomic defects. In this paper, we examined respiration in the FVB-Ighmbp2nmd/nmd (FVB-nmd) mouse model that has an average lifespan of twenty days. The previously reported B6.BKS Ighmbp2nmd-2J/J (B6-nmd-2 J) mouse model has a variable lifespan ranging from four weeks to seven months with no respiratory distress noted until end stage; therefore, we wanted to determine whether the reduced lifespan of FVB-nmd mice was attributed to respiratory-associated changes. Our findings demonstrate that FVB-nmd mice showed severe respiratory deficiencies in nearly all parameters quantified by plethysmography. Surprisingly, the innervation status of neuromuscular junctions of respiratory and oral muscles were largely unaffected throughout the lifespan of the FVB-nmd mice. Diaphragm muscle fibers were reduced in size and the phrenic nerve demonstrated changes in fiber size and myelination. The hypoglossal nerve innervating the tongue also showed disease pathology. Assessment of lung tissue also revealed significant pathology. The investigation of the FVB-Ighmbp2nmd/nmd mouse model provides insight on how reduced IGHMBP2 protein alters respiratory function and impacts lifespan.

The use of web-based approaches to identify, recruit, enroll, survey, and interview health-related research participants has increased over time, with rapid acceleration since the COVID-19 pandemic. These approaches can make research more accessible to a broader population, but also increase the risk of fraudulent or imposter participants infiltrating research studies. While this threat has been discussed extensively in quantitative survey research, less has been reported in qualitative and mixed methods studies.

This study aims to identify recurring patterns of fraudulent study participation and to offer strategies for identification, remediation, and reporting.

Encounters with fraudulent or imposter individuals during recruitment, enrollment, survey distribution, data collection, and focus group sessions in 2 multisite qualitative and mixed methods research studies are presented. Content from both studies was analyzed to identify common themes and develop strategies for prevention and remediation.

Investigators across 2 multisite studies observed several indicators of suspected fraudulent activity, including large response volumes over a short period, highly repetitive email addresses, higher-than-expected proportions of phone numbers with area codes outside the study area, and unusual email/phone responses using atypical language and phrasing. Several imposter or fraudulent individuals disrupted online focus group sessions. To mitigate these issues, both studies implemented remediation strategies, including enhanced screening procedures at baseline, cross-checking of survey responses, and additional identity verification methods prior to participation. Studies took various actions to address these experiences, including notifying the institutional review board, recruitment platforms, and funders.

This multisite study identified multiple ways that imposter or fraudulent participants can pose a significant and evolving threat to the integrity of qualitative and mixed methods. These types of fraudulent actors can distort data and undermine research credibility. Lessons learned highlight the importance of real-time recruitment and enrollment analysis and the need for transparent reporting. Addressing this issue will require a comprehensive approach to prevent and address fraudulent study participation that includes collaboration with multiple stakeholders and the broader research community to effectively address this issue.

Chronic obstructive pulmonary disease (COPD) is a progressive condition and a leading cause of morbidity and mortality in the UK. Characterised by persistent airflow limitation, breathlessness, cough and frequent exacerbations, it is often linked to smoking and other environmental exposures. This article reviews COPD from a nursing perspective, outlining definition, pathophysiology and evidence-based management. Pharmacological and non-pharmacological strategies are discussed, with emphasis on smoking cessation, inhaler technique, pulmonary rehabilitation and holistic care. The central role of nurses in supporting self-management, co-ordinating multidisciplinary care and addressing comorbidities is highlighted. Aligning practice with National Institute for Health and Care Excellence guidance can improve outcomes and reduce avoidable admissions.

Background and objectives Myocardial infarction (acute coronary artery thrombotic event) in young adults is known to be associated with certain comorbidities and lifestyle factors. The causal relationship between COVID-19 vaccination and thrombotic events has been debated globally, with varying risks being reported across populations and vaccine platforms. Considering reports of myocardial infarction and other thrombotic events in apparently healthy individuals, this study was conducted to determine the association between COVID-19 vaccination, lifestyle, medical risk factors, and thrombotic events among young adults in India. Methods We conducted a multicentric matched case-control study across 25 tertiary hospitals in India between October 2021 and January 2023. Cases were 18-45-yr-old hospitalised patients with new arterial or venous thrombotic events. Hospitalised cases and controls were matched by admission date (±7 days). Data on exposure factors were obtained through hospital records and telephonic interviews. Conditional logistic regression was used to estimate matched odds ratios (mOR) with confounder adjustments guided by a directed acyclic graph. Results We analysed 432 cases (1293 controls) of acute myocardial infarction and 767 cases (2,144 controls) of any thrombotic event. Acute myocardial infarction was associated with previous history of any thrombotic event [Matched Odds Ratio (mOR) 60.0; 95% Confidence interval (CI): 11.4, 315.1], comorbidities [adjusted mOR (amOR) 4.6; 95% CI: 2.0-10.5], ever smoking (amOR 3.5; 95% CI: 2.3-5.3) and family history of thrombotic event (mOR 3.3; 95% CI: 1.7-6.5). Receiving two or more doses of any COVID-19 vaccine (amOR 0.8; 95% CI: 0.3-2.8) was not associated with acute myocardial infarction. Analyses showed an association of any thrombotic event with prior history of thrombotic event, comorbidities, ever smoking, prior COVID-19 hospitalisation and family history of thrombotic event. There was no association between any thrombotic event and two or more doses (amOR 1.0; 95% CI: 0.5-2.0) of any COVID-19 vaccination. Similar associations were seen when analysed separately for CovishieldTM and CovaxinTM. Interpretations and conclusions Among young Indian adults, thrombotic events were driven by traditional risk factors and prior severe COVID-19 illness. No increased risk of thrombotic events, including myocardial infarction, was identified with COVID-19 vaccination given the widespread SARS-CoV2 infection during the study period. We emphasise the importance of addressing modifiable cardiovascular risk factors and monitoring of young adults with comorbidities, prior thrombotic events or severe COVID-19.

The advent of telemedicine has significantly transformed the healthcare landscape, offering enhanced accessibility to specialised wound care. By integrating digital health solutions, complementary to face-to-face care, in a personalised care pathway telemedicine facilitates timely interventions, reduces unnecessary hospital visits and optimises medical resources. Developing recommendations on the effective use of telemedicine in wound care can encourage good practice. The model proposed by the Haute Autorité de Santé (the French National Authority of Health) consists of developing recommendations for good clinical practice through formal consensus. To this end, and following a Delphi process, a panel of wound care experts was convened, including physicians and nurses of various disciplines involved in wound management (wound healing; dermatology; geriatrics; vascular medicine; vascular surgery; physical and rehabilitation medicine; and plastic and reconstructive surgery); and from a range of organisations (public/state, private, collaborative, independent). As a first step, an extensive review of the evidence-based literature was conducted on the use of telemedicine. Questions were developed by the strategic committee (formed of 10 experts) and proposed to a scoring committee composed of 20 experts in wound healing who established a consensus agreement. Levels of consensus were determined through two successive rounds of consultation. The resulting document was proposed to the lecture committee, composed of 50 experts and non-experts, which reviewed and amended the proposed text. This document reflects the importance of e-health technologies which have emerged since the COVID-19 pandemic in complex wounds.

Guillain-Barré syndrome (GBS) is an acute immune-mediated neuropathy triggered by infections, with poorly understood pathophysiological diversity. COVID-19-associated GBS (COVID-GBS) is a rare but severe post-infectious condition, and its immune mechanisms remain unclear. We profiled immune mediators in cerebrospinal fluid (CSF) and serum from COVID-GBS patients, comparing them to non-COVID GBS (Control-GBS), COVID-19 patients without neurological complications (COVID-no-GBS) and non-inflammatory neuropathy controls (Neuropathy-no-GBS). To gain mechanistic insights, we integrated publicly available single-nucleus transcriptomic data from sural nerve biopsies of neuropathy patients. IL-8 was confirmed as a key cytokine in GBS. Analysis of publicly available single-nucleus transcriptomic data from non-GBS sural nerve biopsies suggested myeloid cells as potential sources of IL-8, with evidence of autocrine signaling capacity. LIF and CD8A emerged as novel biomarkers, with this transcriptomic analysis indicating that LIF receptor components are expressed on endothelial and stromal cells, suggesting these as potential cellular targets. COVID-GBS patients exhibited unique CSF alterations and distinct serum profiles marked by altered NK cell activity, cytotoxic T-cell responses, and myeloid differentiation. Moreover, associations between inflammatory, extracellular matrix, and regulatory markers with clinical disability differed between COVID-GBS and Control-GBS, pointing to divergent immune mechanisms. Our findings suggest that GBS involves myeloid-driven cytokine responses and local LIF signaling. Analysis of publicly available transcriptomic data from non-GBS sural nerve biopsies suggests potential cellular sources and targets, though validation in GBS-affected tissue is needed. COVID-GBS features a distinct immune signature involving localized and systemic inflammation. These insights deepen our understanding of GBS pathogenesis and nominate candidate biomarkers for further validation and potential therapeutic targeting.

We report a case of a young female patient with American Society of Anaesthesiologists Physical Status Class I who underwent functional endoscopic sinus surgery under routine general anaesthesia. After patient positioning, a sudden increase in peak airway pressures was noted, and kinking of the endotracheal tube (ETT) was observed. Bougie-assisted ETT exchange was performed. After an otherwise uneventful surgery, the patient was extubated and transferred to the post-anaesthesia care unit before being discharged to the ward. Several hours later she developed tachypnoea and tachycardia with a drop in oxygen saturation and decreased air entry on the right side of her chest. Radiological imaging confirmed a right pneumothorax. An intercostal chest drain was placed, which allowed for gradual re-expansion of the lung and clinical improvement. She was subsequently discharged from the hospital. Pneumothorax was presumed to be secondary to airway trauma during bougie-guided tube exchange.

A woman with multiple comorbidities developed acute respiratory distress within minutes of intravenous iohexol administration for abdominal imaging. She presented with severe hypoxaemia, bilateral pulmonary crackles and diffuse opacities on chest imaging without evidence of cardiac dysfunction. Bedside echocardiography and brain natriuretic peptide levels excluded cardiogenic pulmonary oedema. A diagnosis of contrast-induced non-cardiogenic pulmonary oedema was made. She required non-invasive ventilation and supportive therapy with complete resolution over 1 week. This case highlights a rare, life-threatening but reversible reaction to iodinated contrast and underscores the importance of early recognition, prompt respiratory support and readiness with resuscitation equipment during contrast administration.

The emergence of animal influenza viruses circulating in poultry and human populations poses a significant public health threat, yet current risk assessment tools that connect surveillance data to human transmission risk and disease severity are lacking. To address this, we employed a semi-quantitative approach to analyze virus tropism and replication competence, conducting risk assessments of influenza and coronavirus adaptation to human transmission in an ex vivo model, and evaluating virus-induced impairment of alveolar fluid clearance (AFC) in vitro as a correlation of disease severity. Our results showed that seasonal influenza A H1N1, H3N2, influenza B, MERS-CoV, and SARS-CoV exhibited productive viral replication and tissue infection in bronchial tissues, whereas wild bird surveillance isolates such as H5N3 and H7N1 showed minimal replication when compared to pandemic H1N1 and highly pathogenic avian influenza (HPAI) H5N1. Notably, differential lung viral replication and tissue tropism were detected for H5N6 and H9N2. HPAI H5N1, H7N9, MERS-CoV, and SARS-CoV caused more severe AFC impairment than seasonal H1N1, H3N2, and influenza B viruses, correlating with their clinical severity. Overall, these findings revealed an important association between viral tropism and human transmissibility in ex vivo explants, as well as the impairment of AFC in vitro, which aligns with the clinical manifestations of disease severity across different viral strains.

To describe in detail changes in the incidence of invasive pneumococcal disease in the Czech Republic during and after the COVID-19 pandemic. Another objective is molecular analysis of S. pneumoniae isolates of serotypes 3 and 19A recovered in the Czech Republic between 2018 and 2024.

Data on the incidence of invasive pneumococcal disease and S. pneumoniae serotypes were obtained from the invasive pneumococcal disease surveillance program in the Czech Republic. S. pneumoniae isolates of serotypes 3 (63) and 19A (66) from 2018-2024 were subjected to whole genome sequencing (WGS) to characterize the GPSCs (Global Pneumococcal Sequence Clusters) and STs (sequence types) and place them in a global context.

During the COVID-19 pandemic, a significant decline was observed in the incidence of influenza in the Czech Republic. Following the pandemic, the incidence of influenza rose again to significantly higher levels than before the pandemic. Compared to the 2018-2019 period, the incidence of certain serotypes increased in 2023-2024, including vaccine serotypes 3, 4, 14, and 15B, while the incidence of serotypes 8, 12F, and 15A, among others, decreased. Whole genome sequencing analysis demonstrated the dominance of GPSC12 ST-180 among serotype 3 isolates throughout the study period. Among serotype 19A isolates, GPSC4 prevailed, particularly ST-416.

The COVID-19 pandemic has demonstrated how rapidly the epidemiological situation of invasive pneumococcal disease can change and that continuous, systematic surveillance of invasive pneumococcal disease is necessary. The best prevention against IPD is vaccination, primarily with higher valency pneumococcal conjugate vaccines.