pneumococcal vaccine (V114 / PCV15, Merck / Vaxneuvance)

Comparative Sequence Analysis of the Envelope Gene of Kyasanur Forest Disease Virus Vaccine Strain With Currently Circulating Field Strains.

Kaje Keerthi K, Marinaik Chandranaik B CB, Gomes Amitha Reena AR, Rizwan Apsana A et al.

The present study was undertaken with the objective of performing comparative sequence analysis of the envelope (E) gene of Kyasanur forest disease virus (KFDV) vaccine strain P9605 with the circulating field strains. The study was taken up as the currently used KFDV vaccine strain, KFDV P9605, was isolated in the 1960s. For this study, we designed two sets of primers targeting the complete amplification of the E gene of KFDV. The sequencing was performed by the Sanger method, and the deduced sequence of the vaccine virus was deposited in GenBank with accession number PX067005. This sequence obtained for the vaccine virus was aligned and compared with sequences of GenBank-deposited circulating field strains. We also performed comparative sequence analysis of the Kyasanur forest disease (KFD) vaccine seed virus having passaged twice in mouse brain with the vaccine seed virus passaged six times in mouse brain to investigate whether multiple passages in mouse brain will lead to genetic mutation in the immunologically important E gene. The phylogenetic analysis revealed seven amino acid mutations in the field strains at positions A123T, S158N, D178E, D239N, A313S, M429I, and G479A when compared with the vaccine strain. We did not find any mutations at the critical fusogenic segment (residues 98-113) in the E gene of currently circulating field strains compared to the vaccine seed virus. The study found no genetic variations in the E gene of the KFD virus passed two times and passed six times in mouse brain. We performed SWISS-MODEL homology modeling, AlphaFold protein analysis, and Ramachandran plot analysis to study the E protein structures and stability. The observations made in this study suggest slow evolutionary drift and conserved structural stability of the envelope gene of KFDV ever since its emergence 7 decades ago; however, the functional implications of these amino acid substitutions need further studies on their roles in viral infectivity, transmission, and impact on immunity.

Who Is Reporting Recovery? Concerns About Guardian-Completed QoR-15 in a Pediatric Anaesthesia Trial [Letter].

Zhu Tianjie T

Earthquake preparedness and earthquake-related anxiety among emergency department patients: a cross-sectional study.

Demirci Burak B, Akın Burak B, Ferhatlar Enes E, Gündoğan Selman S et al.

To describe earthquake-preparedness behaviors and earthquake-related anxiety responses in emergency department patients and examine associated factors and the relationship between the two composites. This cross-sectional study included 3,964 adults presenting to an emergency department in an earthquake-prone region between July and December 2025. A structured questionnaire assessed sociodemographic and housing characteristics, 15 binary preparedness behaviors, and five earthquake-related anxiety items. Preparedness was summarized as a behavioral composite (0-15) and anxiety as an exploratory composite (5-25). Nonparametric tests, effect sizes, false discovery rate adjustment, exploratory internal-structure analyses, and multivariable regression were used. Median preparedness was 9 (IQR, 7-12) and median anxiety was 13 (IQR, 7-18). Knowledge-based behaviors were common, whereas practical measures were less frequent. Most group differences had small effect sizes. Preparedness showed a multidimensional structure, whereas anxiety showed a single-dimension exploratory structure. The inverse correlation was very weak (Spearman's ρ=-0.107; 95 % CI, -0.140 to -0.070). After adjustment, higher anxiety was associated with lower preparedness (B=-0.074; 95 % CI, -0.090 to -0.059), and higher preparedness with lower anxiety (B=-0.241; 95 % CI, -0.289 to -0.193). Practical preparedness remained incomplete. Preparedness and anxiety were weakly associated; findings are exploratory and should not be interpreted causally or diagnostically.

The Association Between Depression and Survival in Asthma: The Mediating Role of Income.

Wang Zhiyi Z, Teng Xiaojing X

Depression is common among individuals with asthma and is linked to increased mortality. However, whether socioeconomic factors contribute to this association remains unclear. We explored whether income may partially account for the association between depressive symptoms and reduced survival in adults with asthma. A total of 4945 asthma patients were included using baseline data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 linked to the National Death Index (NDI) mortality follow-up through December 31, 2019. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), and mortality was identified through linkage to the NDI. Cox proportional hazards models were used to evaluate the association between depression symptoms and all-cause mortality, and restricted mean survival time (RMST) analysis quantified survival differences over 15 years. Exploratory mediation analysis with quasi-Bayesian simulation was conducted to evaluate whether the poverty-income ratio (PIR) may partially account for the observed association, adjusting for demographic, behavioral, and clinical covariates. Depression was associated with all-cause mortality in asthma patients, and the strength of this association decreased after adjustment for demographic, behavioral, and clinical factors. Over a 15-year period, patients with depression symptoms (PHQ-9 ≥ 10) had markedly shorter survival, losing 9.89 months in RMST (155.2 vs. 165.1 months; p < 0.001). In exploratory mediation analysis, PIR accounted for 23.8% of the observed association between depressive symptoms and reduced survival, suggesting a potential socioeconomic contribution to the survival gap. Depressive symptoms were associated with reduced survival among adults with asthma, and income may partially account for this observed relationship. These findings should be interpreted cautiously because depressive symptoms and income were measured at baseline, limiting causal interpretation of the mediation analysis. Further longitudinal studies are needed to confirm these findings and clarify temporal relationships.