Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 16 appraisals
Emergency medicine journal : EMJ
Are rapid diagnostic tests reliable for the detection of malaria in the emergency department?
A short systematic review assessed the diagnostic accuracy of malaria rapid diagnostic tests in febrile adults from malaria-endemic regions. A database search of MEDLINE, EMBASE, Cochrane and Google Scholar returned 138 papers. Six papers met the inclusion criteria and were included in our analysis.
23 July 2026
Read appraisal →International journal of biometeorology
Scorpion sting stratification in Iran: A systematic review of epidemiological patterns, determinants, and climate change impacts
This systematic review provides a comprehensive synthesis of the epidemiology of scorpion sting stratification across Iran's geography, a critical public health concern in its arid and semi-arid regions. Conducted in accordance with PRISMA 2020 guidelines, the review analyzes the spatial and temporal patterns of envenomations, identifies key ecological, climatic, and anthropogenic determinants, and evaluates the growing evidence for climate change as a driver of increased risk. The study confirms hyperendemic levels of scorpion stings in the southwestern and western provinces, with species from the genera Hemiscorpius and Androctonus presenting the most severe medical threat. A meta-analysis of national data yields a pooled incidence rate of 92.7 per 100,000 population per year (95% CI: 68.4-117.0), with extreme heterogeneity (I² = 98.9%) reflecting stark regional disparities. The primary determinants of scorpion distribution and human-scorpion conflicts include climatic variables (temperature, precipitation, and humidity), land-use practices, unplanned urbanization, and occupational exposure. Recent evidence from species distribution modeling strongly suggests that climate change is expanding suitable habitats for scorpions, prolonging their active seasons, and increasing human-scorpion conflicts. This review highlights the critical need for improved surveillance, predictive spatial risk models, and climate-adaptive public health strategies to address this growing threat.
11 July 2026
Read appraisal →Transactions of the Royal Society of Tropical Medicine and Hygiene
Atomic clarity: how structural biology is shaping blood-stage malaria vaccines
Developing an effective malaria vaccine is challenging because Plasmodium parasites use complex strategies to invade host cells. The blood stage, where parasites replicate inside red blood cells, causes disease symptoms and relies on large multiprotein surface complexes that are difficult to target. Understanding their structure is essential for rational vaccine design. Cryogenic electron microscopy (cryoEM) enables atomic-level analysis of dynamic and membrane-associated complexes without crystallization, revealing key processes such as protein trafficking, nutrient uptake, and host cell remodeling. Recent advances in artificial intelligence and deep learning have improved cryoEM data analysis and structural modeling. Together with genomic data, this integrated approach is accelerating progress toward broadly protective malaria vaccines.
9 July 2026
Read appraisal →Human vaccines & immunotherapeutics
Immunogenicity and safety of AS03-adjuvanted A/Astrakhan/3212/2020 (H5N8)-like influenza vaccine in adults: Phase 1/2, observer-blinded, randomized trial
Influenza pandemics arise from novel influenza A viruses. Recent emergence of a new clade (2.3.4.4.b) of the highly pathogenic H5N1 in animals and humans highlighted its pandemic potential. We evaluated the immunogenicity and safety of GSK's AS03-adjuvanted H5N8 vaccine in adults. In this phase 1/2, observer-blinded, age-stratified, randomized trial, healthy US adults (age, ≥18 y) received two intramuscular doses of hemagglutinin antigen (3.75 or 7.50 μg) with AS03A or AS03B, administered 21 d apart. Immunogenicity - seroprotection rates (SPRs), seropositivity, geometric mean titers (GMTs), geometric mean fold rise (GMFR), and seroconversion rates (SCRs) - was evaluated on day 43 using hemagglutination inhibition (HI) and microneutralization (MN) assays. Safety was monitored throughout the study. Of 520 enrolled participants, 518 were vaccinated. On day 43, the US Food and Drug Administration's (FDA) Center for Biologics Evaluation and Research criteria for influenza vaccines were met. HI SPRs, seropositivity rates, SCRs, GMTs, and GMFR appeared to be higher in the AS03A vs AS03B group. Immune responses were generally higher in younger (aged 18-64 y) vs older (aged ≥65 y) adults. Immune responses were also detected in MN assays, with a correlation between HI and MN responses on day 43 across age groups and vaccine formulations. Safety was acceptable, with no increase in adverse events post-dose 2. Reactogenicity appeared more common in younger adults. The antigen-sparing potential of AS03 was demonstrated, with an acceptable safety profile. The benefit/risk profile was favorable for all formulations tested, including 3.75 µg AS03A (licensed in the US).ClinicalTrials.gov registration: NCT05975840. Influenza pandemics occur when new influenza viruses emerge, causing widespread illness. A recent study investigated a new vaccine, GSK’s AS03-adjuvanted H5N8 influenza vaccine, for its ability to trigger an immune response and its safety in adults aged 18–64 y and older adults aged ≥65 y. Overall, 518 participants received at least one dose of the vaccine, with different amounts of hemagglutinin antigen (3.75 or 7.50 µg) combined with different concentrations of AS03 adjuvant. Immune responses were assessed at multiple time points, with the primary endpoint measured on day 43 post-vaccination. The vaccine produced a strong immune response in both age groups, with younger adults showing slightly better responses than older adults. The vaccine met the required standards for an immune response set by the US Food and Drug Administration (FDA). AS03A typically induced greater immune response than AS03B. Safety monitoring showed that the vaccine was generally well tolerated, with the most common side effects being mild, such as injection-site pain and muscle ache. This study confirmed that the AS03-adjuvanted H5N8 vaccine has the potential to provide protection against influenza with an acceptable safety profile, making it a valuable candidate for pandemic preparedness.
14 June 2026
Read appraisal →Vaccine
Can a DNA vaccine protect against Chagas disease? A systematic review of preclinical studies.
Chagas disease, caused by Trypanosoma cruzi, remains a major neglected tropical disease with limited treatment options. DNA-based vaccination has been explored as a preventive strategy, but its overall efficacy and translational value remain uncertain. Despite encouraging preclinical findings, the evidence on DNA-based vaccines against T. cruzi remains heterogeneous and has not been systematically integrated across outcomes. A comprehensive review is therefore needed to contextualize the current knowledge and define the translational relevance of this platform. To systematically review preclinical in vivo evidence on the efficacy of DNA-based vaccination against T. cruzi, focusing on parasitological, immunological, histopathological, and cardiac outcomes. PubMed/MEDLINE, Scopus, Embase, and Web of Science were searched without date restrictions. Eligible studies were controlled in vivo experiments evaluating DNA vaccines against T. cruzi in animal models. Two reviewers performed study selection, data extraction, risk-of-bias (SYRCLE) and certainty of evidence (GRADE) assessment independently. Thirty preclinical studies were included. Murine models predominated, especially BALB/c, C57BL/6, and C3H/He mice, although canine studies added translational relevance. Naked plasmid DNA, Salmonella-delivered constructs, and adjuvanted DNA vaccines were the most common platforms. The principal antigens belonged to the trans-sialidase family and amastigote surface proteins. Overall, vaccination was associated with reduced parasitemia, improved survival in several murine models, Th1 immune responses characterized by increased IFN-γ, IgG2a, and CD8+ T-cell activation, as well as attenuation of inflammatory, histopathological, and cardiac damage. In canine models, vaccination also reduced parasite burden and myocardial inflammation, although protection remained incomplete. Confidence in the evidence was limited by substantial heterogeneity in animal background, antigen selection, parasite strain, inoculation route, dosing regimens, and follow-up duration. Frequent unclear risk of bias and incomplete reporting prevented meta-analysis and constrain causal inference. DNA-based vaccination against T. cruzi can induce Th1 immunity and reduce parasitological and tissue injury outcomes, but protection is often partial and rarely sterilizing.
11 June 2026
Read appraisal →Renal failure
Prognostic factors in malaria patients with acute kidney injury: a systematic review and meta analysis
This systematic review and meta-analysis aims to evaluate the predictors of mortality in malaria patients with AKI. Studies were searched in PubMed, Scopus, Ebsco, and ScienceDirect. We included observational studies that showed the association between clinical or laboratory abnormalities and mortality, reported in odds ratio. The quality of each study was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using R. Sixteen studies with 1,104 patients were analyzed. Factors significantly associated with mortality were respiratory distress syndrome (OR: 18.50, p < 0.001), neurological involvement (OR: 12.83, p < 0.001), disseminated intravascular coagulation (OR: 12.00, p < 0.001), hypotension (OR: 18.23, p < 0.001), oliguria (OR: 3.41, p = 0.002), ventilator requirement (OR: 30.35, p < 0.001), leukocytosis (OR: 4.87, p = 0.003), hyponatremia (OR: 3.67, p = 0.048), acidosis (OR: 4.88, p < 0.001), hyperkalemia (OR: 3.99, p < 0.001), and jaundice (OR: 5.03, p = 0.001). ARDS, neurological involvement, DIC, hypotension, oliguria, ventilator requirement, leukocytosis, hyponatremia, acidosis, hyperkalemia, and jaundice were associated with mortality in malaria patients with AKI. The findings underscored the importance of heightened awareness and vigilance in managing patients with these conditions.
26 May 2026
Read appraisal →Vaccine
Factors influencing rabies vaccines immunogenicity during post-exposure prophylaxis: a systematic literature search and meta-analysis
BACKGROUND: Rabies post-exposure prophylaxis (PEP) requires timely appropriate wound management and vaccination (including concomitant rabies immunoglobulin [RIG], depending on vaccination history and wound severity) to ensure rapid increases in rabies virus neutralizing antibody (RVNA) titers, a surrogate marker of protection. In this systematic review and meta-analysis, we assessed factors influencing the immunogenicity of rabies vaccines administered as PEP. METHODS: PubMed, Embase, and The Cochrane Library were systematically searched for randomized controlled trials published in English, French, Spanish, or Portuguese from January 1, 1983 to March 28, 2022 reporting the immunogenicity of rabies vaccines, specifically rabies human diploid cell vaccine (Imovax Rabies), purified Vero cell rabies vaccine (Verorab), and purified chick embryo cell rabies vaccine (RabAvert/Rabipur), as part of PEP in healthy individuals. Pooled RVNA geometric mean titers (GMTs) and seroconversion rates at Day 14 (D14) post-vaccination, determined by rapid fluorescent focus inhibition test, were estimated using random effects meta-analyses. RESULTS: We identified 1040 studies, of which 67 (9689 participants across 140 intervention groups) were included. The pooled RVNA GMT across all vaccines at D14 post-vaccination was 8.19 (95% CI: 6.73-9.98) and did not differ significantly by vaccine, administration route, or RIG use; however, there were significant interlaboratory differences. Meta-regression analysis, including titration year, demonstrated a negative association with log-transformed RVNA GMTs, equating to a 4.18% reduction (95% CI: -5.89 to -2.44) in log-transformed GMTs per year during the period assessed. Across all vaccines assessed, the pooled seroconversion rate by D14 post-vaccination was 98% (95% CI: 97-98; n = 7023; I2 = 64%) and was not impacted by vaccine, administration route, RIG use, test laboratory, or titration year. CONCLUSIONS: Although RVNA GMTs appear to have decreased by titration year, there was no clinically meaningful impact on immunogenicity, and the three licensed rabies vaccines assessed are expected to provide similar protection.
13 May 2026
Read appraisal →Vaccine
Effects of candidate vaccines against Zika virus infection: A systematic review of the clinical trials
INTRODUCTION: The 2015-2016 Zika virus (ZIKV) pandemic revealed a pathogenic potential, including Guillain-Barré syndrome and Congenital Zika Syndrome (CZS). Despite the decline in incidence, the potential for future circulation and the absence of specific antivirals underscore continued scientific interest in prophylactic vaccine development. OBJECTIVE: To synthesize evidence from clinical trials regarding the safety and preliminary immunogenicity of current ZIKV vaccine candidates. METHODS: This systematic review followed PRISMA guidelines (CRD420251056463). Searches were performed in MEDLINE, Embase, Web of Science, SciELO, and LILACS for clinical trials published between 2015 and 2025. Risk of bias was assessed using the Cochrane RoB 2 tool. RESULTS: Ten Phase 1 clinical trials were included, evaluating four platforms: inactivated virus (ZPIV, TAK-426, VLA1601), DNA (GLS-5700, VRC5283), mRNA (mRNA-1325, mRNA-1893), and viral vector (Ad26.ZIKV.001). All candidates demonstrated acceptable safety profiles, with predominantly mild-to-moderate and transient adverse events (e.g., injection site pain, fatigue, and headache); no vaccine-related serious adverse events were reported. Most platforms induced robust neutralizing antibody responses. Specifically, TAK-426 showed immune persistence for up to two years, while mRNA-1893 maintained responses for 13 months. The viral vector vaccine (Ad26.ZIKV.001) achieved 100% seroconversion with a single dose. Previous orthoflavivirus exposure did not significantly hinder vaccine-induced immunogenicity. Most studies presented a low risk of bias. CONCLUSIONS: ZIKV vaccine candidates across diverse technological platforms are safe and highly immunogenic. The evidence of long-term durability and the success of single-dose or mRNA regimens support the progression of the most promising candidates to Phase 2/3 trials.
12 May 2026
Read appraisal →International health
Global trends in travel-related antimicrobial resistance: a systematic review, 2020-2024
Antimicrobial resistance (AMR) is a growing global health threat, with international travel playing a key role in the spread of resistant bacteria. This systematic review examines trends in travel-associated AMR from 2020 to 2024. A search of PubMed, Scopus and Web of Science identified 10 studies involving 359 AMR isolates. Using the Newcastle-Ottawa scale, the study quality was assessed and findings were synthesised to identify patterns in prevalence, diversity and geographic spread. Results revealed a consistent rise in travel-associated AMR, particularly from regions such as Southeast Asia and Africa, which acted as major sources of diverse resistant pathogens. These include extended spectrum beta-lactamase-producing Escherichia coli, multidrug-resistant (MDR) Corynebacterium diphtheriae and colistin-resistant Enterobacterales. The number of MDR strains increased over time, making up 15.3% of cases by 2024. Healthcare exposure during travel emerged as a significant risk factor. Overall, the prevalence and diversity of AMR bacteria linked to travel have risen steadily, highlighting the urgent need for global cooperation. Enhanced surveillance, antimicrobial stewardship, infection control measures and international collaboration are essential to curb the spread of these dangerous pathogens.
11 May 2026
Read appraisal →ChemMedChem
A Novel Triose Phosphate Isomerase Inhibitor With Dual Trypanosomicidal Activity was Identified Using Artificial Intelligence-Based Virtual Screening
Chagas disease and leishmaniasis are neglected protozoan diseases recognized by the World Health Organization as major public health problems. These diseases affect millions of people worldwide, yet effective treatments remain unavailable. Triosephosphate isomerase (TIM), a glycolytic enzyme that exhibits high catalytic efficiency for the isomerization of glyceraldehyde-3-phosphate and dihydroxyacetone-phosphate exclusively in its dimeric form, was subjected to virtual screening. Using a deep neural network for structure-based drug design that predicts binding affinity between small molecules and proteins of known structure, 12.5 million commercially available compounds were screened. From this, 82 compounds were selected for in vitro evaluation. Six compounds inhibited TIM from Trypanosoma cruzi, three of which exhibited anti-T. cruzi activity. Eight compounds demonstrated activity against the parasites T. cruzi and Leishmania infantum. Two compounds showed similar potency against both parasites: 3-(1-acetyl-5-(4-bromophenyl)-4,5-dihydro-1H-pyrazol-3-yl)-4-hydroxy-6-methyl-2H-pyran-2-one (IC50 = 16 ± 3 μM) and 3-[(4-bromophenyl)sulfanyl]-1-(3-nitrophenyl)propan-1-one (IC50 = 12 ± 1 μM). These compounds exhibit favorable selectivity and toxicological profiles, as well as in vivo activity, indicating their potential for future drug development.
2 May 2026
Read appraisal →Lancet (London, England)
Safety and efficacy of the monoclonal antibody L9LS for malaria prevention in children exposed to perennial malaria transmission in Kenya: a randomised, double-blind, placebo-controlled, phase 2 trial
BACKGROUND: Malaria remains a major cause of mortality globally, especially among young children in sub-Saharan Africa. The long-acting monoclonal antibody L9LS has shown high efficacy in preventing malaria in children aged 6-10 years exposed to seasonal transmission but remains untested in perennial transmission settings and younger children. We assessed the safety, tolerability, and efficacy of L9LS in infants and children in a high perennial malaria transmission setting. METHODS: This double-blind, two-part, randomised, placebo-controlled, phase 2 trial was done in Siaya county in western Kenya. In parts 1a and 1b, we tested the safety and tolerability of L9LS using an age de-escalation and dose escalation approach and randomly assigned (3:1) cohorts of healthy children (three cohorts aged 5-10 years, three cohorts aged 5-59 months, and two cohorts aged 5-71 months) to L9LS at doses of 5, 10, 20, 30, or 40 mg/kg subcutaneously or to placebo (normal saline). In part 2, healthy children aged 5-59 months were randomly assigned (1:1:1) by use of centralised computer-generated lists to receive two doses of L9LS at 10-20 mg/kg at baseline and month 6, one dose of L9LS at baseline and placebo at month 6, or placebo at both timepoints. Children were followed up for 12 months with monthly clinic visits and blood smear collections. Primary safety outcomes were incidence and severity of local and systemic solicited adverse events within 7 days of dosing and serious adverse events throughout follow-up. The primary efficacy endpoint was Plasmodium falciparum infection detected by blood smear over 12 months. Primary analyses were done in the modified intention-to-treat population, consisting of all randomly assigned participants who received the study intervention. This trial is registered with ClinicalTrials.gov (NCT05400655) and is complete. FINDINGS: In parts 1a and 1b, 96 children were enrolled and randomly assigned between Oct 1, 2022, and Jan 16, 2024; 72 participants were assigned to L9LS and 24 were assigned to placebo. In part 2, 324 children aged 5-59 months were enrolled and randomly assigned between Jan 26 and June 2, 2023; 108 children were assigned to one-dose L9LS, 106 to two-dose L9LS, and 110 to placebo. Across all study parts, grade 3 or worse treatment-related adverse events occurred after four (1%) of 384 L9LS injections and two (1%) of 338 placebo injections; these events all resolved by study end. The proportion of solicited and unsolicited adverse events was similar across all L9LS dose groups. There were no serious adverse events related to the trial. In part 2, 70 (66%) of 106 children in the two-dose L9LS group had at least one P falciparum infection during the 12-month follow-up versus 91 (83%) of 110 children in the placebo group (protective efficacy 42·7%, 95% CI 22·5-57·7; p=0·0003). INTERPRETATION: L9LS was protective against malaria in young children in western Kenya without evident safety concerns over 6-12 months. A higher dose of L9LS might be needed to achieve high-level efficacy against malaria in young children exposed to intense perennial P falciparum transmission. FUNDING: Gates Foundation.
2 May 2026
Read appraisal →Journal of chemical information and modeling
Multiscale-Aware Graph Embedding Approach Uncovers LC-61, a Potent Anti-Leishmania infantum Compound
Visceral leishmaniasis caused by Leishmania infantum remains a lethal disease with few therapeutic options, necessitating innovative computational methods and approaches to accelerate drug discovery. Here, we present a graph neural network (GNN) framework incorporating well-established multiscale mechanisms to improve the identification of novel antileishmanial compounds. Across two classificatory antileishmanial data sets, our GNNs demonstrated significant improvements in predictive performance, with area under the receiver operating characteristic curve (AUC) increases of 2.2-29.2% on the imbalanced data set (activity cutoff: 1 μM) and 3.4-22.5% on the balanced data set (activity cutoff: 10 μM) compared to default GNNs. Subsequently, the framework was applied to screen a library of approximately 1.3 million compounds, pinpointing LC-61 as a potent antileishmanial agent with nanomolar activity against intracellular L. infantum (IC50 = 0.076 μM) and minimal cytotoxicity to macrophages (THP-1 CC50 = 157 μM). A comprehensive in vitro ADME profiling revealed that LC-61 combines high solubility at both acidic and physiological pH (>28 μg/mL), balanced lipophilicity (eLogD = 4.07), and favorable passive permeability (PAMPA = 4.86 × 10-6 cm/s), while exhibiting lower microsomal stability. Overall, our GNN framework effectively accelerated the discovery of LC-61, a novel and biologically validated hit suitable for hit-to-lead optimization.
14 Apr 2026
Read appraisal →PloS one
Prevalence and risk factors for AMS: A systematic review and meta-analysis
BACKGROUND: Acute Mountain Sickness (AMS) is a high-altitude-specific condition with variable prevalence and poorly defined risk factors. Despite growing global exposure to high-altitude environments, no systematic review has comprehensively synthesized AMS epidemiology. OBJECTIVES: To assess the prevalence of AMS and critically evaluate evidence on risk factors associated with increased susceptibility. DESIGN: A systematic review and meta-analysis following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. DATA SOURCES: PubMed, Cochrane Library, Web of Science, CINAHL Plus, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and Weipu Database (VIP) were comprehensively searched for observational studies investigating the prevalence and risk factors of AMS from January 1, 2004 to December 31, 2024. REVIEW METHODS: Original journal articles were included which met the inclusion criteria. The quality of the included studies was evaluated independently by two investigators. Meta-analysis was conducted using R software (v4.2.2), with estimates of AMS from pooled using a random-effects model. RESULTS: Fifty-eight studies (n = 2,705) were included. The pooled AMS prevalence was 48.25% (95% CI: 42.58-53.96%), with substantial heterogeneity (I² = 82.3%). Significant risk factors included extreme altitude (>5500 m; RR = 1.89), rapid ascent (<6 h; RR = 1.60), marked heart rate increase (>20 bpm; RR = 2.35), and oxygen saturation decline (>10%; RR = 2.02). Prior AMS history (RR = 1.36) and male sex (RR = 1.15) were also associated with higher risk, while older age (>50 years) was protective (RR = 0.78). CONCLUSION: AMS affects nearly half of high-altitude visitors. Altitude, ascent rate, cardiopulmonary response, and prior AMS history are key risk determinants. These findings support pre-exposure risk stratification, staged ascent protocols, and real-time physiological monitoring. PROSPERO CRD42024595365.
11 Apr 2026
Read appraisal →The New England journal of medicine
Immunogenicity and Safety of vYF, a Yellow Fever Vaccine - A Phase 2 Trial
BACKGROUND: A next-generation, live-attenuated yellow fever vaccine, vYF, was developed in Vero cells to improve vaccine supply and availability. The safety of and immune response to vYF as compared with those of the licensed yellow fever vaccine, YF-VAX, are unclear. METHODS: In this year 1 interim analysis of a phase 2, observer-blinded, randomized, active-controlled trial, we randomly assigned healthy adults 18 to 60 years of age in a 2:1 ratio to receive vYF or YF-VAX as a single vaccine injection on day 1. Neutralizing antibody titers were measured on day 29, month 6, and year 1. The primary analysis focused on the per-protocol population, which included participants with no history of yellow fever infection or vaccination and with no protocol deviations. Noninferiority would be shown if the lower limit of the two-sided 95% confidence interval of the between-group difference in the percentage of participants with seroconversion was greater than -5 percentage points on day 29. RESULTS: A total of 568 participants were enrolled: 382 in the vYF group and 186 in the YF-VAX group; 329 and 156 participants, respectively, were included in the per-protocol population for the noninferiority analysis. Seroconversion by day 29 occurred in 99.7% of participants receiving vYF and 99.4% of those receiving YF-VAX (difference, 0.3 percentage points; 95% confidence interval, -1.2 to 3.2, which met the criterion for noninferiority). Neutralizing antibody geometric mean titers were similar in the two vaccine groups, peaking on day 29 (in the vYF group, 1:2654 among participants with no history of yellow fever infection or vaccination and 1:1312 among participants with a history of yellow fever infection or vaccination; in the YF-VAX group, 1:3147 and 1:1079, respectively), then decreasing through 1 year after vaccination (in the vYF group, 1:401 among participants with no history of yellow fever infection or vaccination and 1:490 among participants with a history of yellow fever infection or vaccination; in the YF-VAX group, 1:548 and 1:646, respectively). No major safety concerns were identified. The safety profiles were similar in the two vaccine groups: solicited adverse events were reported by 208 of 367 participants (56.7%) in the vYF group and 113 of 185 participants (61.1%) in the YF-VAX group, and unsolicited adverse events were reported by 99 of 379 participants (26.1%) and 39 of 186 participants (21.0%), respectively. CONCLUSIONS: In this trial, vYF had immunogenicity and safety profiles similar to those of YF-VAX. (Funded by Sanofi; ClinicalTrials.gov number, NCT04942210.).
9 Apr 2026
Read appraisal →Advanced science (Weinheim, Baden-Wurttemberg, Germany)
A Wearable Brain-Computer Interface for Mitigating Car Sickness via Attention Shifting
Car sickness, an enormous vehicular travel challenge, affects a significant proportion of the population. Pharmacological interventions are limited by adverse side effects, and effective nonpharmacological alternatives remain to be identified. Here, we introduce a novel attention-shifting method based on a closed-loop, artificial intelligence (AI)-driven, wearable mindfulness brain-computer interface (BCI) to alleviate car sickness. As the user performs an attentional task, i.e., focusing on breathing as in mindfulness, with a wearable headband, the BCI collects and analyzes electroencephalography (EEG) data via a convolutional neural network to assess the user's mindfulness state and provide real-time audiovisual feedback. This approach might sustainedly shift the user's attention from physiological discomfort toward the BCI-based mindfulness practices, thereby mitigating car sickness symptoms. The efficacy of the proposed method was rigorously evaluated in two real-world experiments, namely, short and long car rides, with a large cohort of more than 100 participants susceptible to car sickness. Remarkably, over 83% of the participants rated the BCI-based attention shifting as effective, with significant reductions in car sickness severity, particularly in individuals with severe symptoms. Furthermore, EEG data analysis revealed a neurobiological signature of car sickness, which provided mechanistic insights into the efficacy of the BCI-based attention shifting for alleviating car sickness. This study proposes a wearable, nonpharmacological intervention for car sickness, validated in a relatively large-scale study involving over 100 participants in real-world car riding. These findings, derived from a between-cohort comparison, support the potential of this approach to improve the travel experience for car sickness sufferers and represent a novel practical application of BCI technology.
4 Apr 2026
Read appraisal →Clin Dermatol
Chancroid.
Chancroid, caused by Haemophilus ducreyi, is a sexually transmitted genital ulcerative condition associated with inguinal bubo formation. The relative prevalence of chancroid has dramatically declined based on surveillance findings in those few endemic settings where the appropriate diagnostic tools exist; however, laboratory-based diagnostics are lacking to assist clinical management and support etiological surveillance in most parts of the world. Recent yaws surveys within the Western Pacific region indicate that H ducreyi has re-emerged as a frequent cause of chronic skin ulceration. Although there have been no antimicrobial susceptibility studies for three decades, it is assumed that a cure remains possible with extended-spectrum cephalosporins, macrolides, or fluoroquinolones. HIV-1-infected patients require careful followups due to reports of treatment failure with single-dose regimens. Buboes may need additional treatment with either aspiration or excision and drainage.
1 Jan 2026
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