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Background At the end of 2021, the European Medicines Agency (EMA) expanded its approval for the recombinant human interleukin-1 (IL-1) receptor antagonist Anakinra for the treatment of COVID-19 patients with elevated soluble urokinase plasminogen activator receptor (suPAR). However, the role of Anakinra in COVID-19 remains unanswered, especially in patients receiving different forms of respiratory support. Therefore, the objective of this systematic review is to assess the safety and effects of Anakinra compared to placebo or standard care alone on clinical outcomes in adult hospitalized patients with SARS-CoV-2 infection. Methods We searched the Cochrane COVID-19 Study Register (comprising MEDLINE, Embase, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, medRxiv, and the Cochrane Central Register of Controlled Trials (CCSR)) and the WHO COVID-19 Global literature on coronavirus disease database to identify completed and ongoing studies from inception of each database to December 13, 2021. Since then, we monitored new published studies weekly up to June 30, 2022 using the CCSR. We included RCTs comparing treatment with Anakinra to placebo or standard care alone in adult hospitalized patients with SARS-CoV-2 infection. Results We included five RCTs with 1,627 patients ( n Anakinra  = 888, n control  = 739, mean age 59.63 years, 64% male). Random-effects meta-analysis was used to pool data. We found that Anakinra makes little or no difference to all-cause mortality at up to day 28 compared to placebo or standard care alone (RR 0.96 , 95% CI 0.64–1.45; RD 9 fewer per 1000, 95% CI 84 fewer to 104 more; 4 studies, 1593 participants; I 2  = 49%; low certainty of evidence). Conclusions Anakinra has no effect on adult hospitalized patients with SARS-CoV-2 infection regarding mortality, clinical improvement and worsening as well as on safety outcomes compared to placebo or standard care alone. Trial Registration : PROSPERO Registration Number: CRD42021257552.

Background Right from the beginning of the SARS-CoV-2 pandemic the general public faced the challenge to find reliable and understandable information in the overwhelming flood of information. To enhance informed decision-making, evidence-based information should be provided. Aim was to explore the general public’s information needs and preferences on COVID-19 as well as the barriers to accessing evidence-based information. Methods We performed a cross-sectional study. Nine hundred twenty-seven panel members were invited to an online survey (12/2020-02/2021). The HeReCa-online-panel is installed at the Martin Luther University Halle-Wittenberg to assess regularly the general public’s view on health issues in five regions in Germany. The survey was set up in LimeSurvey, with nine items, multiple-choice and open-ended questions that allowed to gather qualitative data. Quantitative data were analysed descriptively and a content analysis was carried out to categorise the qualitative data. Results Six hundred thirty-six panel members provided data; mean age 52 years, 56.2% female, and 64.9% with higher education qualifications. Asked about relevant topics related to COVID-19, most participants selected vaccination (63.8%), infection control (52%), and long-term effects (47.8%). The following 11 categories were derived from the qualitative analysis representing the topics of interest: vaccination, infection control, long-term effects, therapies, test methods, mental health, symptoms, structures for pandemic control, infrastructure in health care, research. Participants preferred traditional media (TV 70.6%; radio 58.5%; newspaper 32.7%) to social media, but also used the internet as sources of information, becoming aware of new information on websites (28.5%) or via email/newsletter (20.1%). The knowledge question (Which European country is most affected by the SARS-CoV-2 pandemic?) was correctly answered by 7.5% of participants. The Robert Koch Institute (93.7%) and the World Health Organization (78%) were well known, while other organisations providing health information were rarely known (< 10%). Barriers to accessing trustworthy information were lack of time (30.7%), little experience (23.1%), uncertainty about how to get access (22.2%), complexity and difficulties in understanding (23.9%), and a lack of target group orientation (15,3%). Conclusions There are extensive information needs regarding various aspects on COVID-19 among the general population. In addition, target-specific dissemination strategies are still needed to reach different groups.

Given the growing challenges of healthcare, including an aging population and increasing shortages of specialized intensive care staff, this systematic review investigates the efficacy of telemedicine in intensive care compared to standard of care (SoC) or any other type or mode of telemedicine on patient-relevant outcomes for adult intensive care unit (ICU) patients. This systematic review follows Cochrane's methodological standards. Comprehensive searches for any controlled clinical studies were conducted in MEDLINE, Scopus, CINAHL, and CENTRAL (up to 18 April 2024, and an updated search for randomized controlled trials (RCTs) up to 29 September 2025). Twenty-six studies comparing telemedicine in intensive care to SoC with approximately 2,164,508 analysed patients were identified, including data from one cluster RCT (cRCT), two stepped-wedge cluster RCTs (sw-cRCTs), and 23 non-randomized studies of interventions (NRSIs). No other comparisons were identified. Due to high clinical and methodological heterogeneity among studies, no meta-analysis was conducted. For ICU mortality, one cRCT (15,230 patients) and two sw-cRCTs (5,915 patients) showed heterogeneous results: two found no evidence for a difference, while one favoured SoC (very low-certainty). One sw-cRCT (1,462 patients) reporting overall mortality at 180 days suggested no evidence for a difference between groups (very low-certainty). Data from one cRCT (15,230 patients) and one sw-cRCT (1,462 patients) on ICU length of stay (LOS) showed no evidence for a difference between groups (moderate- and very low-certainty). Quality of life from one sw-cRCT (786 patients) indicated no evidence for a difference (very low-certainty). Six NRSIs reported adjusted data on ICU mortality, two on overall mortality, and three on ICU LOS, with heterogeneous results. High risk of bias and substantial heterogeneity limited the certainty, emphasizing the need for robust, patient-centered research in clinical studies to define telemedicine's role in intensive care and optimize its implementation. Future studies should particularly ensure transparent and comprehensive reporting.

Plants recognize surrounding microbes by sensing microbe-associated molecular patterns (MAMPs) to activate pattern-triggered immunity (PTI). Despite their significance for microbial control, the evolution of PTI responses remains largely uncharacterized. Employing comparative transcriptomics of six Arabidopsis thaliana accessions and three additional Brassicaceae species for PTI responses to the MAMP flg22, we identified a set of genes with expression changes under purifying selection in the Brassicaceae species and genes exhibiting species-specific expression signatures. Variation in flg22-triggered transcriptome and metabolome responses across Brassicaceae species was incongruent with their phylogeny while expression changes were strongly conserved within A. thaliana, suggesting directional selection for some species-specific gene expression. We found the enrichment of WRKY transcription factor binding sites in 5'-regulatory regions in conserved and species-specific responsive genes, linking the emergence of WRKY-binding sites with the evolution of gene responses in PTI. Our findings advance our understanding of transcriptome evolution during biotic stress.