Category: 8. Health

Children with multiple long-term health issues undergo severe emotional stress at the same time as they are trying to cope with the physical challenges of their condition, a study has found.

Research led by the University of Plymouth used AI language models to analyze sentiments and emotions expressed by almost 400 pediatric patients and their caregivers on social media. In particular, they wanted to assess young people’s opinions regarding their care and experiences during the COVID-19 pandemic, and the impact that had on their emotional and psychological wellbeing.

Using anonymous data sourced from the Care Opinion platform they found that of the narratives analysed, almost 94% of the comments posted were classed as negative and less than 6% were positive. More than six out of ten negative comments were classed as being associated with sadness, with feelings of fear (at almost one in every six comments) also being prevalent.

Children with conditions such as cancer, asthma, chronic pain and mental health conditions showed particularly high emotional distress, highlighting the emotional burden of managing multiple long-term health issues.

The COVID-19 pandemic was also shown to exacerbate the negative sentiments, particularly sadness and disgust, with patients expressing frustration with the healthcare system while isolation and disrupted care routines triggered intense emotional responses.

And while just 6% of the comments were classed as positive, the study found that most of them related to effective communication, compassionate care, and successful treatment outcomes.

The researchers say the study highlights the importance of supporting vulnerable young patients managing complex medical conditions, and the need for integrated care approaches to both physical and emotional well-being.

This research was conceived and led by Professor of e-Health Shang-Ming Zhou, and its data analysis was implemented by MSc Data Science and Business Analytics student Temidayo (Israel) Oluwalade with support from Dr. Hossein Ahmadi in Plymouth’s Centre for Health Technology, Dr. Richard Sharpe with Cornwall Council, and Professor Lin Huo with Guangxi University. 

Professor Zhou, a recognized expert in the use of AI to analyze health data, said: “To our knowledge, this is the first study of its kind to analyze the sentiments and emotions of pediatric patients using social media data. Our findings bring to light the deeply emotional journey patients with multiple long-term health issues go through, fills a critical gap in knowledge for healthcare professionals and agencies. It also highlights the disproportionate emotional burden faced by paediatric patients with multiple health issues and their caregivers during the COVID pandemic, showing the need for targeted interventions to address emotional responses during public health emergencies.“

Israel Oluwalade, who graduated with a Distinction in 2024, added: “As I worked through the dataset, I was particularly struck by how clearly children’s emotional responses aligned with specific comorbidity patterns – for example, fear and sadness were especially dominant among those discussing multiple hospital visits or long-term medication. What also surprised me most was the unexpectedly high frequency of ‘satisfaction’ and ‘amazement’ in posts referencing kind staff or successful treatment episodes. It reminded me how digital expressions can reflect not only distress but also resilience and hope, even among young patients with complex conditions.”

This new article publication from Acta Pharmaceutica Sinica B, discusses how an anti-complement homogeneous polysaccharide from Houttuynia cordata ameliorates acute pneumonia with H1N1 and MRSA coinfection through rectifying Treg/Th17 imbalance in the gut–lung axis and NLRP3 inflammasome activation.

The coinfection of respiratory viruses and bacteria is a major cause of morbidity and mortality worldwide, despite the development of vaccines and powerful antibiotics. As a macromolecule that is difficult to absorb in the gastrointestinal tract, a homogeneous polysaccharide from Houttuynia cordata (HCPM) has been reported to exhibit anti-complement properties and alleviate influenza A virus (H1N1)-induced lung injury; however, the effects of HCPM without in vitro antiviral and antibacterial activities on more complicated pulmonary diseases resulting from viral-bacterial coinfection remains unclear.

This study established a representative coinfection murine pneumonia model infected with H1N1 (0.2 LD₅₀) and methicillin-resistant Staphylococcus aureus (MRSA, 10⁷ CFU). HCPM significantly improved survival rate and weight loss, and ameliorated gut–lung damage and inflammatory cytokine production. Interestingly, the therapeutic effect of HCPM on intestinal damage preceded that in the lungs. Mechanistically, HCPM inhibited the overactivation of the intestinal complement (C3a and C5a) and suppressed the activation of the NLR family pyrin domain-containing 3 (NLRP3) pathway, which contributes to the regulation of the Treg/Th17 cell balance in the gut–lung axis.

The results indicate the beneficial effects of an anti-complement polysaccharide against viral–bacterial coinfection pneumonia by modulating crosstalk between multiple immune regulatory networks.

This new article publication from Acta Pharmaceutica Sinica B, discusses how ALKBH3-regulated m¹A of ALDOA potentiates glycolysis and doxorubicin resistance of triple negative breast cancer cells.

Chemotherapy is currently the mainstay of systemic management for triple-negative breast cancer (TNBC), but chemoresistance significantly impacts patient outcomes.

This research indicates that Doxorubicin (Dox)-resistant TNBC cells exhibit increased glycolysis and ATP generation compared to their parental cells, with this metabolic shift contributing to chemoresistance. It was discovered that ALKBH3, an m¹A demethylase enzyme, is crucial in regulating the enhanced glycolysis in Dox-resistant TNBC cells.

Knocking down ALKBH3 reduced ATP generation, glucose consumption, and lactate production, implicating its involvement in mediating glycolysis. Further investigation revealed that aldolase A (ALDOA), a key enzyme in glycolysis, is a downstream target of ALKBH3. ALKBH3 regulates ALDOA mRNA stability through m¹A demethylation at the 3′-untranslated region (3′UTR). This methylation negatively affects ALDOA mRNA stability by recruiting the YTHDF2/PAN2–PAN3 complex, leading to mRNA degradation. The ALKBH3/ALDOA axis promotes Dox resistance both in vitro and in vivo.

Clinical analysis demonstrated that ALKBH3 and ALDOA are upregulated in breast cancer tissues, and higher expression of these proteins is associated with reduced overall survival in TNBC patients. This study highlights the role of the ALKBH3/ALDOA axis in contributing to Dox resistance in TNBC cells through regulation of ALDOA mRNA stability and glycolysis. 

A recently published cohort study using data from an Italian multiple sclerosis (MS) register revealed a downward trend in the number of patients converting from onset to secondary progression (SP), partially explained by improvements in therapeutic coverage. Investigators concluded that these findings could inform clinical algorithms and health policy development, underscoring the imperative for continued therapeutic innovation in MS management.¹

The study, which aimed to characterize the MS disease course from onset to SP, included 9958 patients from 1993 to 2018, 1364 (13.7%) of which converted to SP. Five eras were established, each lasting 5 years, except for the second era, which was extended to 6 years to ensure a more homogenous distribution following the approval of highly effective disease-modifying therapies (DMTs).

Led by Emanuele D’Amico, MD, PhD, a medical doctor at the University of Catania, SPMS conversion was defined as a 3-strata progression magnitude with a minimum Expanded Disability Scale Score (EDSS) of 4.0 and a minimal pyramidal FS score of 2.0 at the time of conversion to SPMS confirmed at 3 months and at the end of follow-up (last EDSS score ≥4.0; last FS pyramidal score ≥2). In order to reduce the impact of transient EDSS modification due to relapses, all the EDSS scores collected during a relapse (+30 days) were excluded.

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The overall SP incidence rate was 1.26 (95% CI, 1.19-1.32), with rates showing a downward trend as each era passes (1^st era: 1.98 [95% CI, 1.73-2.27]; 5^th era: 1.15 [95% CI, 0.97-1.35]). Using multivariable Cox models, investigators found that the risk of SP conversion was lower in era 2 (HR, 0.78, 95% CI 0.66-0.93), in era 3 (HR, 0.63, 95% CI 0.52-0.76), in era 4 (HR, 0.57, 95% CI 0.46-0.70) and in era V (HR, 0.65, 95% CI 0.50-0.83) relative to the first era. When the multivariable model included the treatment coverage, a 10% increase was associated to a 19% lower risk of converting to SP.

Conversion to an SP form occurred after a mean time of 8.5 years (SD, 5.5), with converted patients showing an older mean age at onset (36.6 [SD, 10.3] vs 32.7 [SD, 9.5]) and higher baseline EDSS (2.0 vs 1.5) than non-converting patients. Furthermore, Patients who converted to SP had a higher rate of no prior DMT exposure (9.9% vs 5.2%) and lower overall treatment coverage (58.4 ± 31.5 vs 73.6 ± 27.6) compared to non-converting patients. Additionally, time to first treatment was longer in patients converting to SP (1.9 [SD, 2.3]) than non-converting ones (1.6 [SD, 2.4]).

In the 5^th disease onset era, investigators observed a significant improvement of 10-year longitudinal trajectories of EDSS in the non-converting patients (P for interaction = 0.0117). Conversely, in converting to SP patients, there was no difference in 10 year longitudinal trajectories between disease onset era (P for interaction = 0.4723). In non-converting patients, 10-year MSSS trajectories declined more in recent onset eras (P = 0.0035), whereas in SP-converting patients, MSSS increased over time without significant variation across onset eras (P = 0.7096).

D’Amico et al concluded that, “This 30-year analysis suggests that SPMS conversion rates have decreased over time, partially explained by improvements in therapeutic coverage and earlier treatment initiation. However, our findings suggest that DMT utilization alone cannot fully account for these changes. Additional factors likely contribute to this evolution, including shifts in diagnostic criteria, more stringent definitions of disease progression, changes in patient selection and evolving clinical practices.”

REFERENCE
1. Zanghi A, Copetti M, Avolio C, et al. Multiple sclerosis from onset to secondary progression: a 30-year Italian register study. Neurol, Neurosurg, & Psych. Published June 15, 2025. doi:10.1136/jnnp-2025-335958

This study provides a significant contribution to understanding the factors associated with severe malaria hospitalizations in a non-endemic region, expanding the knowledge of the disease’s dynamics in areas with epidemiological patterns distinct from those observed in the Amazon Region. By addressing sociodemographic vulnerabilities, such as ethnicity, education level, and the origin of cases, the study identified critical gaps in the malaria surveillance and response system in the extra-Amazon Region. These findings hold practical and policy implications not only for Brazil but also for other countries facing similar challenges. On a global scale, the results offer an applicable model for malaria-free countries vulnerable to imported cases, supporting the development of adaptable strategies for surveillance, risk mitigation, and rapid outbreak response, ultimately contributing to the reduction of severe cases.

Approximately half of the malaria cases reported in Piauí from 2002 to 2013 were autochthonous. While imported cases occur are registered at the end of the rainy season, particularly in municipalities bordering Maranhão [23]. This trend was observed in hospitalizations originating from municipalities near the Maranhão border and from Maranhão itself. Regarding the high number of hospitalizations in Wenceslau Guimarães, Bahia, it was the result of an outbreak in 2018, which led to 50 confirmed cases, mainly within a settlement area [24].

It is important to understand that hospitalization is determined by medical criteria, not solely by clinical condition. Patients who are difficult to treat and more likely to relapse are hospitalized more frequently, as are children. In some cases, such as outbreaks like the one in Piauí, to prevent relapses and severe malaria cases, most patients are hospitalized until treatment is completed. Thus, not only the severity but also medical caution may be factors that lead to hospitalization in the extra-Amazon Region.

The profiles of hospitalizations in the extra-Amazon Region predominantly affected men, Black or mixed-race individuals, and those aged 20 to 39 years. In a study of Brazil’s Extra-Amazon Region, Garcia et al. [5] identified a similar profile. According to the authors, this profile is closely linked to socioeconomic factors, such as education, economic activity, and income, which are inherently related to social inequalities. The analyses indicated that patients with lower educational attainment (elementary or high school) were more likely to be hospitalized than those with higher education. A similar profile was found by Forero-Peña et al. [25] in Venezuela, which was closely related to economic activities.

There was also an association between hospitalization risk and Black or mixed-race ethnicity. According to Silva et al. [26], most of the Black population holds less-skilled positions with lower pay, lives in areas with limited infrastructure services, and faces greater restrictions in accessing healthcare. When this population does access healthcare, the quality and effectiveness tend to be lower, contributing to an increased risk of severe malaria cases.

According to Degarege et al. [27] in a meta-analysis conducted, low education levels are usually associated with low income and low-standard housing, which are linked to a higher risk of malaria, heavily influenced by the limited access to diagnosis, treatment, and prevention measures, often due to difficulty in accessing these services because of a lack of economic resources. Education is connected to occupational opportunities and improved life status, further increasing knowledge and access to information that promotes health and health services, leading to better acceptance of prevention practices carried out by the individual as well as those promoted by local health services. At the same time, it promotes higher income and better housing [27]. Moreover, the difficulty in accessing services, whether due to distance and transportation costs or low quality of the services, contributes to delays in treatment.

Proper and timely treatment of malaria significantly reduces hospitalization risk. The low incidence of malaria in the extra-Amazon Region makes its diagnosis challenging for local physicians, as it is not part of their routine practice [28]. For example, in Rio de Janeiro, a healthcare professional in an emergency department is 466 times less likely to identify a malaria case than a dengue case. Moreover, 55% of malaria cases treated at the Evandro Chagas National Institute of Infectious Diseases (a reference centre in Rio de Janeiro) were initially misdiagnosed as dengue during the first consultation [28]. The adjusted regression model showed that patients treated more than 48 h after symptom onset were more likely to be hospitalized, with increasing likelihood for delays of 3–7 days or 8 days or more. Nearly all severe malaria cases are caused by P. falciparum, while P. vivax and P. malariae rarely cause severe complications [29].

Active detection was protective against hospitalization compared to passive detection. This is closely linked to surveillance activities during outbreaks and patient follow-ups during treatment. The notification of autochthonous cases, which represent a risk of reintroduction and a sharp increase in cases in a short time, is an alert for healthcare services. This alert prompts temporary sensitization of local surveillance systems, increasing the detection of undiagnosed patients and follow-up of those identified through an index case. These actions improve timely diagnosis and, consequently, reduce hospitalization risk [5, 20]. The severity of the disease is intrinsically related to the level of parasitaemia, especially when it comes to malaria caused by P. falciparum, which is capable of infecting red blood cells of all ages, while P. vivax prefers young red blood cells [30]. Similarly, the level of parasitaemia results in symptoms arising from haematological changes and the immune response, which is usually higher in children without immunity to the disease [31]. Thus, case detection through active case finding is also a protective factor, as it can identify asymptomatic cases or those with few symptoms before they reach high parasitaemia that results in more severe clinical symptoms.

The Brazilian experience mirrors what occurs in other countries. For instance, in Australia, traveller movements occur constantly, with approximately 324 cases reported annually between 2012 and 2022, exhibiting a demographic profile similar to that observed in Brazil’s extra-Amazon Region, primarily men aged 20 to 39 years [32]. The main difference lies in the origin of imported cases, which reflect global trends. A high prevalence of P. falciparum cases is reported from African countries, whereas Australia has received the highest number of P. vivax cases, accounting for up to one-third of imported cases [32]. Nevertheless, imported malaria represents an ongoing threat to malaria-free countries due to the potential for reintroduction of transmission and the occurrence of severe cases requiring intensive care unit hospitalization. This risk is often exacerbated by diagnostic delays caused by a lack of clinical suspicion, which is influenced by determinants similar to those identified in Brazil’s extra-Amazon Region [32].

In the extra-Amazon Region, only 19% of malaria cases are treated within 48 h of symptom onset, compared to 60% in the Amazon Region, where malaria is more quickly suspected. Delays in diagnosis and treatment contribute to the higher proportion of severe malaria cases in non-endemic areas. Also, malaria fatality rates in the extra-Amazon Region can be up to 123 times higher than in the Amazon Region [8, 33].

In the context of global changes, climate change can directly or indirectly impact human health and malaria transmission. Long-term predictive models suggest that climate change will significantly affect efforts to eradicate malaria if environmental interventions do not continue, further increasing the population at risk for the disease [24, 34]. Furthermore, climate change may impact the achievement of the goals proposed by Brazil’s National Malaria Elimination Plan, which aims to eliminate autochthonous disease transmission by 2035 [35], potentially causing disease outbreaks in both the Extra-Amazon and Amazon Regions, as well as deaths resulting from severe cases.

What if you are told that being healthy does not mean you have to compromise on taste? That you can boost your metabolism, fight inflammation, protect your skin barrier, and even support weight loss — all with a warm, sweet-spicy drink you’ll look forward to? Enter honey and cinnamon water. A combination that is as delicious as it is healthy. Rooted in Ayurvedic and folk medicine, this simple mix offers a surprising list of benefits for your heart, skin, digestion, and more. But before we understand what its benefits are, let us understand what the two ingredients contain: