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Post-Vaccination Syndromes: The Evidence and a Roadmap for Rigorous Research.

The recent review by Yong et al. (Rev Med Virol. 2025; 35:e70070) proposes the entity of "Long Vax Syndrome" or Post-COVID-19 Vaccination Syndrome (PCVS). While this synthesis of anecdotal and early observational reports is a timely contribution, it necessitates a critical evaluation of the underlying evidence. This letter highlights substantial methodological limitations, including a reliance on data susceptible to significant ascertainment bias and the conflation of correlation with causation, given the non-negligible background prevalence of conditions like POTS and chronic fatigue. We argu

Food-technology innovations in alternative proteins.

The increasing demand for sustainable, nutritious, and ethically produced foods has driven considerable interest in the development of alternative proteins. This chapter reviews the food-technology innovations involved in the formulation, processing and application of alternative protein foods. It contains functional ingredients used in alternative protein systems and their technological roles in developing structure, texture, and stability. The major processing technologies are then examined, with particular emphasis on protein denaturation and thermomechanical processing, especially high-moi

Existing Tools for Improving Day-to-Day Communication With Parents in Neonatology: A Narrative Review.

AIM: Communication is essential, yet rarely taught in paediatrics. The literature describes skills to improve parent communication in neonatal intensive care units. METHODS: A PubMed search from 1 January 2023 to 5 May 2025 retrieved articles on communication in neonatology. Communication related to poor prognosis, end-of-life, antenatal issues, ethics and family integrated care was excluded. Data underwent deductive and inductive thematic analysis. RESULTS: The review included 37 articles, with three themes: basic skills of good communication, means of strengthening communication and learni

Machine Learning for Multi-Omics Characterization of Blood Cancers: A Systematic Review.

Artificial Intelligence and machine learning are increasingly used to interrogate complex biological data. This systematic review evaluates their application to multi-omics for the molecular characterization of hematological malignancies, an area with unmet clinical need. We searched PubMed, Embase, Institute of Electrical and Electronics Engineers Xplore, and Web of Science from January 2015 to December 2024. Two reviewers screened records, extracted data, and used a modified appraisal emphasizing explainability, performance, reproducibility, and ethics. From 2847 records, 89 studies met incl

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… Ethical Considerations and Bias Assessment Studies were considered for their consideration of ethical principles around ethical consent, ethical review, data ownership, data anonymization, and data sharing ( Table 8 ). Eighty-one of the studies mentioned institutional review board approval. …

The process, logistics and governance behind a high-stakes novel intervention: the use of extracorporeal membrane oxygenation (ECMO) in the hyperbaric chamber.

INTRODUCTION: A multi-trauma patient receiving extracorporeal membrane oxygenation (ECMO) developed severe disseminated vaso-invasive fungal disease. In the absence of any remaining treatment escalation options, hyperbaric oxygen treatment (HBOT) was considered as a last effort at gaining disease control. Previously, the use of modern ECMO devices had not been validated for hyperbaric use at our centre or, to the best of our knowledge, at any other centre around the world. We had, however, identified a potentially hyperbaric compatible ECMO device and had commenced a validation process. The ai

Hand acceleration time (HAT) as a diagnostic tool in the assessment of haemodialysis access-induced distal ischaemia (HAIDI): study protocol for a prospective cohort study in the Barcelona south metropolitan area.

INTRODUCTION: Chronic hand ischaemia may affect some haemodialysis patients with an arteriovenous fistula (AVF) or graft (AVG), a condition known as haemodialysis access-induced distal ischaemia (HAIDI). Duplex ultrasonography (DUS) can provide comprehensive insights into anatomical and perfusion properties, and measuring the hand acceleration time (HAT) has been demonstrated to be sensitive within the framework of chronic upper limb ischaemia. METHODS AND ANALYSIS: This single-centre, prospective cohort study will involve adult end-stage renal disease (ESRD) patients requiring either AVF or

Evaluating the efficacy and acceptability of a digital-based management system for diabetes during pregnancy: protocol for an observational cohort study.

INTRODUCTION: Diabetes during pregnancy poses significant health risks for both mothers and their offspring and requires comprehensive management throughout pregnancy and the postpartum period. The increasing global prevalence of diabetes during pregnancy requires effective and efficient management. The current healthcare system can be challenging because of need for frequent hospital visits and limited availability of gestational diabetes (GDM) specialists.This study investigates the impact of a digital-based management system designed to support women with diabetes from pregnancy through the

Protocolized REDUction of Non-Resuscitation Fluids in SEptic Shock Patients. A Protocol for the REDUSE Randomized Clinical Trial.

In septic shock, administration of large fluid volumes is associated with poor outcomes. Recent evidence shows that non-resuscitation fluids … pha of 5% and a power of 90%, we aim to include 1850 patients. The trial is approved by the Swedish Ethical Review Authority. Results of primary and secondary clinical outcomes and the environmental outcome will be submitted for publication in a peer-reviewed journal. Trial Registration: NCT06140147.

Reviewing the Genetic and Molecular Foundations of Congenital Spinal Deformities: Implications for Classification and Diagnosis.

Congenital spinal deformities (CSDs) are rare but severe conditions caused by abnormalities in vertebral development during embryogenesis. These deformities, including scoliosis, kyphosis, and lordosis, significantly impair patients' quality of life and present challenges in diagnosis and treatment. This review integrates genetic, molecular, and developmental insights to provide a comprehensive framework for classifying and understanding CSDs. Traditional classification systems based on morphological criteria, such as failures in vertebral formation, segmentation, or mixed defects, are evaluat

Machine learning methods to discriminate posttraumatic stress disorder: A protocol of systematic review and meta-analysis.

INTRODUCTION: Recent years have witnessed a persistent threat to public mental health, especially during and after the COVID-19 pandemic. Posttraumatic stress disorder (PTSD) has emerged as a pivotal concern amidst this backdrop. Concurrently, machine learning (ML) techniques have progressively applied in the realm of mental health. Therefore, our present undertaking seeks to provide a comprehensive assessment of studies employing ML methods that use diverse data modalities on the classification of people with PTSD. METHODS AND ANALYSIS: In pursuit of pertinent studies, we will search both En

Safety of herbal medicine in the postpartum period of a Korean Medicine hospital and postpartum care centre: protocol of a registry study (SAFEHERE-PC).

INTRODUCTION: Herbal medicines (HMs) are commonly used during the postpartum period in South Korea. However, the safety concerns associated with these medicines remain unresolved. This study aims to establish a registry of patients receiving HM treatment during the postpartum period and collect clinical data on treatments and adverse reactions to build evidence evaluating the safety of HM use. METHODS AND ANALYSIS: This study will use a prospective observational registry, including patients admitted to the obstetrics and gynaecology department of the Woosuk University Korean Medicine Hospital

Delayed-Interval Delivery in Multiple Pregnancy: A Single-Center Experience of Five Cases.

Objectives  To describe the obstetric management and perinatal outcomes in multiple pregnancies with delayed-interval delivery (DID) of the cotwin in a tertiary hospital. Methods  This is a retrospective chart review of all cases of DID between December 2021 and 2022 at The Ottawa Hospital. Five cases of DID were identified and reviewed to obtain information on obstetric management and maternal-neonatal outcomes. We included eligible twins and triplets. No multiples were excluded. We obtained ethics approval for this case series. Results  Four sets of dichorionic diamniotic twins and one trich

tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears.

INTRODUCTION: Triangular fibrocartilage complex (TFCC) tear is often considered to be the cause of ulnar wrist pain. The primary treatment typically involves non-operative methods; however, in cases of persistent symptoms, operative intervention has been proposed as a viable option. Depending on the tear's morphology, treatment may involve debridement (central or radial tear) or repair (peripheral tear). Efficacy of operative treatment has not been studied in a randomised controlled trial. METHODS AND ANALYSIS: This is a prospective, randomised, controlled, blinded multicentre trial, with two

A current era in pulsatile drug delivery system: Drug journey based on chronobiology.

Almost all biological processes in the human body are regulated by circadian rhythm, which results in drastically different biochemical and physiological conditions throughout a 24 h period. Hence, suitable drug delivery systems should be efficiently monitored to attain the required therapeutic plasma concentration and therapeutic drug responses when needed as per chrono pharmacological concepts. "Chronotherapy" is the fast and transient release of a particular quantity of drug substance post a predetermined off-release period, termed as 'lag time'. Due to rhythmic variations, it is typically

Muscle activity and rehabilitation in spinal stenosis (MARSS) after conservative therapy and surgical decompression with or without fusion: Protocol for a partially randomized patient preference trial on rehabilitation timing.

BACKGROUND: Patients affected by lumbar spinal stenosis (LSS) suffer from a multifactorial degeneration of the lumbar spine resulting in narrowing of the neuroforamina and spinal canal, leading to various functional limitations. It remains unclear whether LSS patients after surgery would benefit from early post-operative rehabilitation, or if a delayed rehabilitation would be more advantageous. The purpose of this partially randomized patient preference trial is to evaluate the impact of post-operative rehabilitation timing as well as surgical intervention type on psychometric properties and f

Comparative effectiveness and complications of intravenous ceftriaxone compared with oral doxycycline in Lyme meningitis in children: a multicentre prospective cohort study.

INTRODUCTION: Lyme disease is the most common vectorborne disease in the Northern hemisphere with more than 400 000 new cases in the USA annually. Lyme meningitis is an uncommon but potentially serious clinical manifestation of Lyme disease. Intravenous ceftriaxone had been the first-line treatment for Lyme meningitis, but is associated with a high rate of complications. Although efficacy and effectiveness (or real-world evidence) data for oral doxycycline are limited, practice guidelines were recently expanded to recommend either oral doxycycline or ceftriaxone as first-line treatments for Ly

Perioperative mental health intervention bundle for older surgical patients: protocol for an intervention development and feasibility study.

INTRODUCTION: The perioperative period is high risk for older adults. Depression and anxiety are common perioperative problems, frequently coexisting with cognitive impairment. Older patients with these conditions are more likely than younger patients to experience postoperative delirium, long hospital stays, poor quality of life and rehospitalisation. These experiences can, in turn, exacerbate anxiety and depressive symptoms. Despite these risks, little is known about how to treat perioperative anxiety and depression among older adults. METHODS AND ANALYSIS: We designed a feasibility study o

Perioperative anaesthetic management in cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC): a retrospective analysis in a single tertiary care cancer centre.

OBJECTIVES: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with increased morbidity and mortality. We retrospectively analysed the perioperative anesthetic management in patients undergoing HIPEC surgery. METHODS: After ethics approval, we reviewed the records of patients who underwent CRS/HIPEC from 2015 until 2020. We noted the peritoneal carcinomatosis index (PCI), blood loss, anastomoses done, total amount of fluid given, delta temperature and duration of surgery. These were correlated with the need for postoperative ventilation, length of

Measuring young adult appeal for menthol and non-menthol cigarettes: protocol of a clinical trial using both laboratory and intensive longitudinal methods (PRISM).

INTRODUCTION: Although the Food and Drug Administration banned other characterising flavours in cigarettes, menthol cigarettes are still available to consumers. Young adult new smokers are initiating with menthol cigarettes, such that the prevalence of young adults menthol versus non-menthol smokers is increasing. Experimentation with menthol cigarettes is associated with progression to regular smoking and nicotine dependence. This ongoing clinical trial in young adult smokers measures appeal and the reinforcing value of smoking menthol versus non-menthol cigarettes and the impact of these var

Efficacy and safety of remifentanil dose titration to correct the spontaneous hyperventilation in aneurysmal subarachnoid haemorrhage: protocol and statistical analysis for a prospective physiological study.

INTRODUCTION: Spontaneous hyperventilation (SHV) is common in aneurysmal subarachnoid haemorrhage (aSAH). The reduction in arterial partial pressure of carbon dioxide (PaCO2) may change the brain physiology, such as haemodynamics, oxygenation, metabolism and may lead to secondary brain injury. However, how to correct SHV safely and effectively in patients with aSAH has not been well investigated. The aim of this study is to investigate the efficacy and safety of remifentanil dose titration to correct hyperventilation in aSAH, as well as the effect of changes in PaCO2 on cerebral blood flow (CB