Home Play-based Intervention for Parents and Infants

Conditions: Attention-Deficit/Hyperactivity Disorder (ADHD); Autism Spectrum Disorder; Premature Birth; Global Developmental Delay

Interventions: Behavioral: SPRINT Intervention; Other: Waitlist Protocol

Sponsors: Nanyang Technological University; Agency for Science, Technology and Research (A*STAR); KK Women’s and Children’s Hospital; Institute for Human Development and Potential (IHDP), Singapore

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Early Genomic Indicators of Praziquantel Resistance in Schistosoma mansoni

The warning signs are subtle—genetic variants scattered across a vast parasite genome—but together they sketch a picture that disease‑control and elimination programs can’t afford to ignore. A new study published in Science Advances, Extensive parasite transmission and variation in a functional receptor associated with drug resistance in endemic Schistosoma mansoni,” reveals genomic changes in the parasite that cause schistosomiasis, which may reduce its sensitivity to praziquantel, the only drug currently available to treat the disease.

The international team, led by researchers at the Wellcome Sanger Institute, the Royal Veterinary College, and the Medical College of Wisconsin, analyzed whole‑genome sequence data from 570 Schistosoma mansoni parasites collected across Africa and the Caribbean. As the paper noted, “Mass drug administration (MDA) with praziquantel is the cornerstone of schistosomiasis control and elimination efforts.” Yet after two decades of large‑scale treatment campaigns, the parasite’s genome is beginning to show signs of drug resistance.

The study uncovered extensive long‑distance transmission of S. mansoni and a striking degree of genetic diversity across endemic regions. But the most consequential finding lies in Sm.TRPMpzQ, a transient receptor potential (TRP) melastatin ion channel recently identified as praziquantel’s molecular target. Researchers found four naturally occurring variants in this receptor with reduced praziquantel sensitivity.

In some cases, parasites persisted even after treatment. As the paper reports, “Analyses of parasite infrapopulations collected from people pre‑ and post‑praziquantel treatment further identified instances of treatment failure, supporting the potential for praziquantel resistance.”

For global health programs that rely entirely on praziquantel, these findings represent an early but important signal.

Stephen Doyle, PhD, co‑senior author and group leader and UKRI Future Leaders Fellow at the Wellcome Sanger Institute, emphasized the shift this genomic insight enables: “Whole‑genome sequencing gives us an unprecedented window into how schistosome populations are structured and evolving across Africa, and by characterizing variation in the drug’s molecular target at scale, we can move from reactive surveillance to proactive monitoring.”

Professor Joanne Webster, DPhil, of the Royal Veterinary College and director of the Global Centre for Neglected Tropical Disease Research, underscored the stakes: “While praziquantel remains largely highly effective, our findings provide a sobering warning about the reliance on a single drug for schistosomiasis control and highlight the need for comprehensive surveillance to monitor the potential emergence of drug resistance.”

Schistosomiasis affects more than 250 million people worldwide, with 90% of infections occurring in sub‑Saharan Africa. With elimination targets set for 2030, the emergence of resistance could jeopardize decades of progress.

The authors argue that genomic surveillance should become a routine part of schistosomiasis control. Their dataset, the largest genomic analysis of S. mansoni from human infections to date, provides a baseline for tracking resistance‑linked variants as MDA programs continue.

The post Early Genomic Indicators of Praziquantel Resistance in <i>Schistosoma mansoni</i> appeared first on GEN – Genetic Engineering and Biotechnology News.

Flu Virus Interaction with Host Cell Machinery Mapped Inside Infected Cells

Researchers at EMBL Hamburg and collaborators at the Leibniz Research Institute for Molecular Pharmacology (FMP) have mapped in unprecedented detail how the influenza A virus (AIV) rewires infected human cells. The researchers developed a customized experimental workflow that used in-cell cross-linking mass spectrometry (XL-MS), combined with AlphaFold-based structural modeling and functional assays, to directly map protein-protein interactions (PPIs) in IAV-infected human cells.

They claim that the study marks the first time that scientists have mapped direct virus-host protein contacts at scale inside intact influenza-infected cells, with enough structural detail to model how the proteins fit together. “Our work provides a new way to study flu-host interactions in their native context and with structural insight,” said Jan Kosinski, PhD, group leader at EMBL Hamburg and the Centre for Structural Systems Biology (CSSB). “The current results are a snapshot of a moment during infection, and it opens the door to studying flu-host interactions across the entire infection cycle.”

Kosinski is co-senior and co-corresponding author of the team’s published paper in Nature Microbiology, titled “Mapping in-cell protein contact sites reveals hijacking of paraspeckles during influenza A virus infection,” stating that their findings “… uncover mechanisms by which IAV exploits and remodels host compartments during infection.”

Every year, seasonal influenza kills up to 650,000 people globally and causes serious illness for 3–5 million individuals. When IAV infects cells, it releases RNA that contains the blueprints for a handful of proteins that spread throughout the host cell and repurpose its molecular machinery to make more viruses. “Its replication relies on protein–protein interactions (PPIs) between up to 14 viral proteins and host factors, often confined to cellular compartments and organelles,” the team stated.

Scientists want to understand this process in detail, as it would help in designing better drug therapies and vaccines against the flu virus. “Understanding these host–IAV PPIs in context is essential for elucidating viral strategies and therapeutic targets,” they added.

Studying protein-protein interactions in action during infection is challenging. Most previous studies relied on biochemical methods that required the cell to be broken open before the interactions could be measured. Once the cell’s compartments were gone, proteins that were never in contact inside the cell could meet in the test tube, and fragile or location-specific contacts could be lost. It was then hard to know which interactions actually happened inside an infected cell.

“This is when we learned that our collaborators—Boris Bogdanow and Fan Liu—at FMP Berlin had developed a specialized version of cross-linking mass spectrometry (XL-MS), a long-established technique for mapping protein contacts, tailored specifically to virus-infected cells,” said Kosinski. This was the critical breakthrough. It allowed researchers to do what previous methods couldn’t, including capturing short-lived and location-specific interactions.

“XL-MS allows us to capture protein-protein interactions directly in infected intact cells, while also providing structural information about how these interactions are happening,” explained Bogdanow, who is now a junior research group leader at the Institute of Virology, Charité—Universitätsmedizin Berlin. “This gives us insight into the interface between the virus and the human cell and may, through structural modelling, help identify actionable targets for future pharmaceutical interventions.”

By combining the results obtained through XL-MS with computational structural modeling, the researchers could identify which viral and human proteins interact and also predict how they physically fit together. For this, they used a modified version of the protein structure prediction algorithm AlphaFold.

“The key advantage of the modified AlphaFold approach is that it allowed us to feed our experimental cross-linking data directly into the structural modeling,” explained Kosinski. “This tells the model which parts of the viral and host proteins are close to each other inside infected cells. This was especially useful for virus-host complexes, which are often difficult to predict reliably.”

The study findings revealed two important ways in which the virus hijacks the cell. One involves hemagglutinin, a protein on the virus’s surface that it uses to bind and enter host cells. Tracing how hemagglutinin moves through the cell’s internal transport and processing system revealed how host proteins, some with previously unknown functions, helped the virus correctly fold and modify hemagglutinin during infection.

The other involves paraspeckles, small droplet-like compartments in the nucleus. The researchers found that infection by the influenza A virus causes these organelles to dissolve, releasing the RNA-binding proteins bound within them, which the virus can then use to replicate. “We identified host factors linked to the maturation of distinct glycoforms of the viral surface glycoprotein haemagglutinin through the membrane-bound endoplasmic reticulum–Golgi system,” the scientists wrote in summary. “In the nucleus, we observed the progressive disassembly of paraspeckles (phase-separated membraneless compartments) across multiple cell lines.”

First author Iuliia Kotova, PhD, former predoctoral fellow at the Kosinski group at EMBL Hamburg, and currently at ETH, said, “What surprised us most was the paraspeckles. Watching these tiny organelles in the nucleus dissolve, consistently across every cell line and every flu strain we tested, told us this isn’t a side effect of infection—it might be a strategy.”

Kosinski added, “There may also be a second benefit for the virus: some evidence suggests paraspeckles contribute to cellular stress responses and antiviral gene regulation, so disrupting them could also weaken parts of the cell’s defense response.”

The researchers believe that their “mapping in context” approach can be used to understand the mechanism of action of other viruses that act similarly. “While the exact host factors and mechanisms often differ from virus to virus, we think our overall approach—combining in-cell cross-linking, structural modeling, and targeted cell-biology follow-up to map native virus-host interactions at specific stages of infection—remains broadly applicable,” Kosinski said.

Bogdanow further commented, “Although this study has focused on a lab-adapted strain, this study lays the groundwork to apply the methodology to viruses of potential pandemic relevance, such as H5N1, and for uncovering the interaction networks that support their multiplication in human cells.”

The post Flu Virus Interaction with Host Cell Machinery Mapped Inside Infected Cells appeared first on GEN – Genetic Engineering and Biotechnology News.

A 3-Tier AI Model for COVID-19 Triage Using Pharyngeal Images: Algorithm Development and Validation

Background: SARS-CoV-2 remains a common cause of acute respiratory illness; however, symptom-based triage poorly discriminates it from other febrile conditions. A recently developed artificial intelligence (AI)–powered pharyngeal camera acquires pharyngeal images and clinical data to assist in influenza diagnosis; leveraging this workflow, we evaluated an adjunct AI algorithm (COVID-19-AI) that reports high, medium, or low suspicion to guide whether SARS-CoV-2 testing should subsequently be performed. Objective: This study aimed to report diagnostic accuracy outcomes and clinical utility of the COVID-19-AI as a triage support tool. Methods: We conducted a performance evaluation using a prospectively collected multicenter dataset from 26 Japanese institutions between December 2023 and March 2024. Patients with suspected influenza or COVID-19 were eligible. The COVID-19-AI algorithm, a stacked ensemble of a Swin Transformer and boosting models, was developed using pharyngeal images combined with routine clinical variables from 2133 patients, and it produced a 3-tier output. Classification thresholds were predefined to optimize clinical rule-out and rule-in utilities. Diagnostic performance was assessed in 696 independent patients against centralized reverse transcription polymerase chain reaction–confirmed SARS-CoV-2 infection under 2 prespecified operating criteria: inclusive (high or medium=positive and low=negative) and strict (high=positive and medium or low=negative). A subanalysis stratified accuracy by time from symptom onset (12-hour bins to 72 hours). Results: Among 696 analyzed participants (all Asian), 247 (35.5%) had reverse transcription polymerase chain reaction–confirmed SARS-CoV-2 infection. The COVID-19-AI categorized 12.4% (n=86), 72.8% (n=507), and 14.8% (n=103) patients as high, medium, and low suspicion, respectively. Under the inclusive criteria, sensitivity of COVID-19-AI was 93.9% (95% CI 90.4%‐96.4%), specificity was 19.6% (95% CI 16.1%‐23.5%), and negative predictive value was 85.4% (95% CI 77.6%‐91.3%). Under the strict criteria, sensitivity was 24.7% (95% CI 19.6%‐30.4%), specificity was 94.4% (95% CI 92.0%‐96.3%), and positive predictive value was 70.9% (95% CI 60.7%‐79.8%). Across 12-hour onset strata, sensitivity under the inclusive criteria remained ≥92.0% and specificity under the strict criteria remained ≥83.3%; no pronounced temporal trend was observed. Additionally, an integrated model using both pharyngeal images and clinical variables (area under the receiver operating characteristic curve [AUROC] 0.78) outperformed models using only clinical variables (AUROC 0.75) or images alone (AUROC 0.71); feature importance analysis further confirmed that pharyngeal image information was the most influential individual predictor, providing greater predictive value than any single clinical variable. Conclusions: Embedded within AI-powered pharyngeal camera workflows, a 3-tier AI suspicion output enables complementary operating behaviors—high sensitivity to rule out COVID-19 (inclusive criteria) and high specificity to support immediate infection control measures (strict criteria), although these criteria involve inherent trade-offs with low specificity and low sensitivity, respectively. Performance stability across onset times suggests robustness to symptom chronology, offering a standardized tool for clinical triage. Trial Registration: UMIN Clinical Trials Registry UMIN000052896; https://tinyurl.com/3b7et428
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High-Risk Multiple Myeloma Redefined in Era of Modern Quadruplet Therapy

Advances in frontline treatment for multiple myeloma may prompt clinicians to rethink how they identify patients with the poorest prognosis, according to a study published in Cancer. Researchers report that patients whose disease progresses within 36 months—not the longstanding 18-month benchmark—should now be considered to have functional high-risk (FHR) multiple myeloma.

Functional high-risk disease has traditionally been defined as myeloma that progresses within 18 months of starting therapy, a group historically associated with survival of less than two years after relapse. However, widespread adoption of quadruplet therapy—combining an anti-CD38 antibody, a proteasome inhibitor, an immunomodulatory agent, and dexamethasone—followed by autologous stem cell transplantation (ASCT) has substantially prolonged remission for many patients.

To determine whether the historical definition remains appropriate, investigators from the University of Alabama at Birmingham and the CoMMiT consortium analyzed outcomes in 310 patients with newly diagnosed multiple myeloma treated with quadruplet therapy plus ASCT. Patients were followed for a median of 41.8 months (3.5 years), during which 66 experienced disease progression.

The researchers evaluated several definitions of FHR disease based on progression occurring within 12, 18, 24, or 36 months after treatment initiation. Their analysis found that progression within 36 months most accurately identified patients whose survival after relapse remained approximately two years or less despite current frontline therapy.

“The current analysis provides validation of FHR36 as the optimal classification for FHR multiple myeloma in the era of QUAD + ASCT, providing a benchmark for future therapies to be explored in this setting,” the authors conclude.

Using the new definition, 16.4% of patients were classified as having FHR36 disease. Many would not have been identified as high risk using conventional staging systems: more than one-third had lower-stage disease according to the second revised International Staging System, and more than half met standard-risk criteria under current International Myeloma Society guidelines.

The study also suggests that T-cell redirecting therapies (TCRTs), including CAR T-cell therapies and bispecific antibodies, may improve outcomes in this population. Although only 11 patients received TCRTs as second-line treatment, outcomes were markedly better than with conventional therapies.

The 12-month second progression-free survival rate was 80% for patients treated with TCRTs, compared with 23% for those receiving other therapies. Overall response rates were 91% versus 47%, respectively. Multivariable analysis showed that TCRT remained associated with improved progression-free survival after adjustment for FHR status.

The authors caution that these findings require confirmation because relatively few patients received TCRTs. Still, they argue that patients meeting the FHR36 definition should be prioritized for early T-cell redirecting therapy and enrollment in clinical trials evaluating novel agents.

“We believe FHR36 should be a standard definition for FHR going forward and that the safety and efficacy of experimental agents should be reported in this important subset of patients or dedicated trials should be designed and conducted for this special population,” the authors write.

 

The post High-Risk Multiple Myeloma Redefined in Era of Modern Quadruplet Therapy appeared first on Inside Precision Medicine.

FDA still focused on lettuce supplier as source of parasite, despite faulty test result

WASHINGTON — Federal health officials said Monday they remain focused on lettuce from Taylor Farms as the source of a multistate outbreak of a diarrhea-causing parasite, despite inaccurate test results that the government briefly publicized over the weekend.

Food and Drug Administration officials on Monday said a laboratory test incorrectly identified a positive result for cyclospora on a sample of lettuce from Taylor Farms. The FDA posted the finding to its website on Saturday but then said Sunday that the result had been a false positive.

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Defining and Assessing Empathic Communication in Patient Portal Secure Messages: Adapted Coding Framework Development Study

Background: Empathic communication in the clinical setting has been associated with improved clinical outcomes, decreased anxiety, and increased patient satisfaction, treatment adherence, and trust. Despite the recent growth in patient portal use, the expression of empathic communication through patient portal secure messages is not well understood. Objective: This study aimed to construct a coding schema to define and assess empathic opportunities initiated by patients and primary care clinicians’ responses to these opportunities within a patient portal messaging environment. Methods: Data for this study included adult patient secure messages and responding messages from clinicians working in family practice clinics within a regional health care system serving central and northeast Pennsylvania between January 2018 and December 2023. We conducted a manual review of messages using the Empathic Communication Coding System as a guiding framework, which defines empathic opportunities created by patients and corresponding empathic responses by clinicians. We double-coded 500 patient messages for 3 empathic opportunity types: statements of emotion, progress, and challenge. Coding definitions were iteratively updated to describe specific textual cues unique to the patient portal context. This procedure was repeated to code for empathy in clinician responses to empathic opportunities. An additional 100 patient messages were double-coded for interrater reliability testing, and 500 patient messages were single-coded using the finalized coding schema. Results: Among 1100 patient messages coded, 576 (52.4%) included an empathic opportunity. Of these messages, 100 (17.3%) included a statement of emotion, 85 (14.7%) included a statement of progress, and 539 (93.6%) included a statement of challenge. Statements of challenge were primarily characterized by patients explicitly describing physical or mental health issues, a barrier in care, or difficulties in their personal lives. Among the 576 patient messages with empathic opportunities, 446 (77.4%) received at least 1 response from a clinician. Clinicians sent 483 response messages, of which 64 (13.2%) expressed empathy. Conclusions: While patients created empathic opportunities in over half of patient portal secure messages, primary care clinicians infrequently responded with empathy. The findings of this study provide initial evidence of gaps in empathic communication within patient portal secure messages and lay the groundwork for using artificial intelligence models to systematically measure and improve this communication across the patient portal messaging system.
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