@article {pmid40909033,
year = {2025},
author = {Zahed, M and Alesawy, AF and Zahed, ZS and Samir, R and Eleisawy, M},
title = {Exploring the Association Between COVID-19 and Avascular Necrosis: A Systematic Review.},
journal = {Cureus},
volume = {17},
number = {8},
pages = {e89318},
pmid = {40909033},
issn = {2168-8184},
abstract = {Avascular necrosis (AVN) has emerged as an extrapulmonary complication associated with COVID-19 and corticosteroids. This review aims to evaluate the association between COVID-19 infection, corticosteroid use, and the development of AVN. We conducted a systematic review following the PRISMA guidelines, searching five databases until May 30, 2024. We included cohort and case series studies involving COVID-19 patients who developed AVN. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). A total of 13 studies, comprising nine case series and four cohort studies, were included. These studies involved 795 patients with a mean age of 46.1 years and a male predominance (66%). The cumulative dose of corticosteroids varied, with an average of 1,462.9 mg. The duration between COVID-19 infection and initial AVN symptoms ranged from 2 to 62 weeks. The most commonly affected bones were the hip and femoral head. The visual analog scale (VAS) score improved with the treatment, and the cases showed improvements. A significant association was found between COVID-19, corticosteroid use, and AVN development. Clinicians should exercise caution when prescribing corticosteroids and monitor for early signs of AVN. Further research is needed to elucidate the pathophysiological mechanisms and explore alternative treatments to mitigate the risk of AVN.},
}

@article {pmid40908304,
year = {2025},
author = {Ivković, V and Anandh, U and Bell, S and Kronbichler, A and Soler, MJ and Bruchfeld, A},
title = {Long COVID and the kidney.},
journal = {Nature reviews. Nephrology},
volume = {},
number = {},
pages = {},
pmid = {40908304},
issn = {1759-507X},
abstract = {Long coronavirus disease (COVID) - commonly defined as symptoms and/or long-term effects that persist for at least 3 months after acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and cannot be explained by an alternative diagnosis - is a complex, multifaceted and heterogeneous disease that affects many organ systems, including the kidney. COVID-19 can cause acute kidney injury, and several studies have reported an increased risk of chronic kidney disease (CKD) following COVID-19, suggesting that CKD can be a manifestation of long COVID. Furthermore, patients with CKD are at an increased risk of severe COVID-19 and of long COVID. COVID-19 has also been associated with the development of COVID-19-associated nephropathy, which is a collapsing form of focal segmental glomerulosclerosis, and an increased incidence of new-onset vasculitis. Some early reports described associations of COVID-19 and/or SARS-CoV-2 vaccines with relapse or new-onset of other glomerular diseases, but this link was not confirmed in large population-based studies. SARS-CoV-2 vaccination reduces the risk of COVID-19 and long COVID and is particularly important for protecting vulnerable populations such as patients with CKD. Structured long-term follow-up of patients with COVID-19 and post-infectious sequelae is needed to provide further insight into the trajectory of long COVID and enable identification of those at risk of CKD.},
}

@article {pmid40908027,
year = {2025},
author = {Alvis-Zakzuk, NJ and Couto, P and Jara, JH and Descalzo, M and Rondy, M and Tempia, S and Vicari, A},
title = {Economic Burden of Respiratory Viruses in Latin America and the Caribbean (LAC): A Scoping Literature Review.},
journal = {Influenza and other respiratory viruses},
volume = {19},
number = {9},
pages = {e70148},
pmid = {40908027},
issn = {1750-2659},
support = {/WHO_/World Health Organization/International ; },
mesh = {Latin America/epidemiology ; Humans ; Caribbean Region/epidemiology ; *Cost of Illness ; *COVID-19/economics/epidemiology ; *Respiratory Tract Infections/economics/virology/epidemiology ; SARS-CoV-2 ; Influenza, Human/economics/epidemiology ; Respiratory Syncytial Virus Infections/economics/epidemiology ; },
abstract = {OBJECTIVE: The objective of this study is to summarize the state of knowledge on the economic burden and cost of illness due to influenza, SARS-CoV-2, respiratory syncytial virus (RSV), and other respiratory viruses (ORV) in Latin America and the Caribbean (LAC).

METHODS: We performed a scoping review across three databases (PubMed-Medline, Scielo, and Embase) without time restriction, including economic burden and cost-of-illness studies. We extracted and analyzed data on publication year, population, study type, perspective, costing techniques, and settings. We reported absolute and relative frequencies to summarize the results. Economic burden estimates were divided by the gross domestic product (GDP) for each country. Costs were converted into 2022 international dollars (PPP).

RESULTS: Overall, 2638 articles were retrieved; we included 44 full texts from 16 LAC countries. Twenty-four (54.5%) studies focused on influenza, 16 (36.4%) on SARS-CoV-2, 3 (6.8%) on RSV, and 1 on ORV. Twenty two (50.0%) focused on cost-effectiveness (related to vaccination)/cost-benefit analysis, and 17 (38.6%) focused on cost of illness. Most studies (n = 33, 75.0%) were conducted from the third-party perspective. Fifty percent of the studies used a bottom-up costing technique and 29.6% top-down. Influenza direct medical costs ranged from I$6.6-I$300.3 for outpatients and I$62.8-I$222,920 for inpatients; for RSV from I$68.3-I$1292; and for SARS-CoV-2 between I$69.9 and I$38,039. The total annual costs of the influenza economic burden ranged between 0.0003% and 1.33% of the GDP.

CONCLUSION: This study showed variability in costing methods, perspectives, and types of studies among LAC countries. This variability underscores the need for standardized methodologies in future cost studies to ensure comparability and reliability of results.},
}

Latin America/epidemiology
Humans
Caribbean Region/epidemiology
*Cost of Illness
*COVID-19/economics/epidemiology
*Respiratory Tract Infections/economics/virology/epidemiology
SARS-CoV-2
Influenza, Human/economics/epidemiology
Respiratory Syncytial Virus Infections/economics/epidemiology

@article {pmid40907738,
year = {2025},
author = {Simonsen, L and Pedersen, RK and Andreasen, V and Krause, TG and Petersen, E},
title = {A Disease Suppression Strategy in Action: The Impact of Non-Pharmaceutical interventions in the COVID-19 pandemic in Denmark.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {108039},
doi = {10.1016/j.ijid.2025.108039},
pmid = {40907738},
issn = {1878-3511},
abstract = {When a new pandemic virus emerges in a naive population the only control options are Non-Pharmaceutical Interventions, NPI's, until vaccines or effective treatments become available. Here we report on the Danish suppression strategy and use of a combination of NPI's with a notable absence of extremely strict measures (such as stay-at-home orders). Only 7% were infected (serological evidence) in the first year of the pandemic, compared to ∼50% in Lombardy in the first wave alone. This low attack rate was accomplished by initial rapid intervention with a free-of-charge mass testing program beginning in October 2020, a strong digital data infrastructure, timely contact tracing and voluntary home isolation, real time reporting of surveillance data and a high degree of public trust. The individual contribution of each NPI to the pandemic control is difficult to assess; yet evidence points to the mass testing program as being particularly effective in removing infected individuals from the pool. In January 2021 vaccines became available and 96% of Danes over 50 years of age were vaccinated twice with a mRNA vaccine by summer. On February 1, 2022, while facing the Omicron variant and with the elderly newly boosted, Denmark became the first country to drop all NPI's. A few months later, 70% of the population had been infected with Omicron, showing the SARS-CoV-2 transmission potential when unmitigated. Denmark was only close to Intensive Care Unit capacity during the 2[nd] wave in winter 2020-2021 when 5% of the population were infected. In conclusion, the effectiveness of the combined NPI's is evident due to the low (<10%) attack rate in the first two waves before vaccines became available, far from the experience of unmitigated COVID-19 in Lombardy in spring 2020 with ∼50% attack rate with a high morbidity and mortality.},
}

@article {pmid40907700,
year = {2025},
author = {Scherger, SJ and Gomez, CA and Abbas, A and Kalil, AC},
title = {Decoding COVID-19: Phenotypes and the Pursuit of Precision Medicine.},
journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.cmi.2025.08.028},
pmid = {40907700},
issn = {1469-0691},
abstract = {BACKGROUND: The pursuit of personalized medicine has underscored the critical role of phenotypes and sub-phenotypes in biology and medicine. A growing body of literature has identified diverse phenotypic manifestations of SARS-CoV-2 influenced by host and viral factors.

OBJECTIVES: To assess and integrate current knowledge regarding the clinical, immunologic, and molecular phenotypes associated with COVID-19, highlighting their impact on disease management, the personalization of therapeutic strategies, and the advancement of clinical research. We conducted a comprehensive literature search of PubMed, Medline, and Embase databases from 10/1/2024 to 8/5/2025 to identify relevant literature regarding phenotypes observed in SARS-CoV-2 infection.

CONTENT: Clinical phenotypes involve various demographic factors and comorbidities, vital sign trajectories, patterns of acute organ dysfunction, and variations in biomarkers, which may differ among viral variants. Immunologic phenotypes involve dysregulated cytokine responses, altered immune cell functions, disruptions in key signaling pathways, and variations in white blood cell ratios, often reflecting a pattern of immune suppression. Molecular phenotypes reflect variations in host polymorphisms involving IL-18 secretion, inflammasome formation, and HLA-DR expression and alterations in leukocyte function which may persist beyond the acute phase of infection. Viral protein expression influences infectivity and transmissibility as well as disease severity and progression.

IMPLICATIONS: Understanding the phenotypes associated with SARS-CoV-2 infection can assist in clinical management and prognostication, stratification of patient populations for clinical trials, and development of novel therapies targeting various immunologic and molecular factors to improve morbidity and mortality.},
}

@article {pmid40906516,
year = {2025},
author = {Grover, H and Nour, R and Zary, N and Powell, L},
title = {Online Interventions Addressing Health Misinformation: Scoping Review.},
journal = {Journal of medical Internet research},
volume = {27},
number = {},
pages = {e69618},
doi = {10.2196/69618},
pmid = {40906516},
issn = {1438-8871},
mesh = {Humans ; *Communication ; *Social Media ; COVID-19 ; },
abstract = {BACKGROUND: Misinformation in health and health care contexts threatens public health by undermining initiatives, spreading dangerous behaviors, and influencing decision-making. Given its reach on online platforms and social media, there is growing demand for interventions addressing misinformation. Literature highlights the importance of theoretical underpinnings (frameworks and models) to guide the development of educational interventions targeting both the features of misinformation and the human traits that increase susceptibility.

OBJECTIVE: This review examines literature on online interventions targeting health misinformation to mitigate adverse public health impacts. It explores intervention types, population demographics, susceptibility-related human attributes, and misinformation characteristics addressed. It also identifies the theoretical underpinnings used and gaps in the literature.

METHODS: The review followed a methodological framework and adhered to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A search strategy combining Medical Subject Headings (MeSH) and keywords was used to search five databases for studies published between 2018 and 2024. Identified studies underwent deduplication, title and abstract screening using predefined eligibility criteria, full-text screening, and data extraction.

RESULTS: The initial search yielded 513 citations; 30 (5.8%) studies were included after screening. Of these, 19 (63%) focused on COVID-19 misinformation, 11 (37%) on other health contexts, and 1 (3%) addressed misinformation conceptually. Regarding intervention type, 22 (73%) used educational courses, 7 (23%) employed counter speech, and 1 (3%) used inoculation games, with some overlap. Sixteen (53%) interventions targeted characteristics of misinformation, categorized as content and presentation tactics, cognitive and psychological biases, social and cultural influences, and dissemination strategies. Seven (23%) interventions focused on specific demographics, while 14 (47%) addressed human attributes that heighten susceptibility. These attributes were grouped into knowledge and processing, emotional and psychological factors, and trust and social dynamics. Theoretical underpinnings guided intervention development in 23 (77%) studies, often overlapping in categories including inoculation and correction, education and cognition, motivation and emotion, behavior and persuasion, trust and belief, and learning design.

CONCLUSIONS: Online interventions targeting health misinformation often share outcome goals and use overlapping strategies such as educational courses, counter speech, and inoculation games. Many adopt multifaceted approaches to address misinformation's complexity. However, gaps remain in tailoring interventions to misinformation characteristics that could improve specificity and impact. Few studies focus on human attributes contributing to belief in and spread of misinformation, particularly among vulnerable groups. While theoretical models are commonly cited, clearer reporting and stronger connections to intervention design are needed. Collaboration among intervention developers, theorists, and psychologists is recommended to enhance future interventions.

RR2-10.31219/osf.io/mfujb.},
}

Humans
*Communication
*Social Media
COVID-19

@article {pmid40906317,
year = {2025},
author = {Rodríguez-Duarte, MA and Vedel, IM and Cetin-Sahin, D and Bousbiat, I and Godard-Sebillotte, C and Sourial, N and Maclagan, LC and Diong, C and Bronskill, SE and Seitz, D and Morgan, D and Rochette, L and Massamba, V and Quail, J and Arsenault-Lapierre, G and , },
title = {A Meta-Analysis of Sex-Based Differences in Health Service Use for Persons Living With Dementia Between 2018 and 2020 in Four Canadian Provinces.},
journal = {Journal of the American Geriatrics Society},
volume = {},
number = {},
pages = {},
doi = {10.1111/jgs.70066},
pmid = {40906317},
issn = {1532-5415},
support = {//Consortium canadien en neurodégénérescence associée au vieillissement/ ; 02005VR5-448197-CSH-CFAA-19228/CAPMC/CIHR/Canada ; },
abstract = {BACKGROUND: Ensuring equitable healthcare services for persons with dementia is of utmost importance. Recent evidence points to sex-based differences in healthcare use in this population. However, available evidence is based on data from limited geographic regions and predates the COVID-19 pandemic, which is said to have further magnified disparities. This study aims to estimate sex-based differences in ambulatory and acute care service use in persons with dementia in four Canadian provinces between 2018 and 2020.

METHODS: A retrospective multicohort design was conducted using linked health administrative data from Quebec, Ontario, Alberta, and Saskatchewan. Three cohorts (2018, 2019, and 2020) of community-dwelling persons aged 65 and older with dementia were identified. Within each cohort, rates of sex-stratified outcomes were calculated (per 10,000 person-years). The outcomes were visits to family physicians, cognitive specialists, other specialists, all-cause emergency departments, and all-cause hospitalizations. Estimates of the incidence rate difference (IRD) between males and females within each cohort year for each outcome were pooled using random-effect meta-analysis.

RESULTS: The 2018, 2019, and 2020 cohorts included 97,811, 100,316, and 103,638 females, respectively. Similarly, 64,628, 67,013, and 69,839 males were included in the same respective cohorts. We found sex differences in ambulatory and acute care use in all three cohorts. Compared to females, males with dementia had higher rates of other specialists' visits, emergency department visits, and all-cause hospitalizations, with significant IRDs during the three cohort years.

CONCLUSION: Consistent sex differences in healthcare use by persons with dementia were observed before and during the pandemic in four Canadian provinces, especially in acute care. This emphasizes the need to address sex-based differences in dementia care, ultimately working toward ensuring equitable and tailored healthcare services to enhance the quality of care and experiences for all persons with dementia.},
}

@article {pmid40906116,
year = {2025},
author = {Kotsiri, I and Xanthi, M and Domazinaki, CM and Magiorkinis, E},
title = {The Role of Viral Infections in the Immunopathogenesis of Type 1 Diabetes Mellitus: A Narrative Review.},
journal = {Biology},
volume = {14},
number = {8},
pages = {},
pmid = {40906116},
issn = {2079-7737},
abstract = {Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disorder characterized by the destruction of insulin-producing pancreatic beta cells, resulting in lifelong insulin dependence. While genetic susceptibility-particularly human leukocyte antigen (HLA) class II alleles-is a major risk factor, accumulating evidence implicates viral infections as potential environmental triggers in disease onset and progression. This narrative review synthesizes current findings on the role of viral pathogens in T1DM pathogenesis. Enteroviruses, especially Coxsackie B strains, are the most extensively studied and show strong epidemiological and mechanistic associations with beta-cell autoimmunity. Large prospective studies-including Diabetes Virus Detection (DiViD), The environmental determinans of diabetes in the young (TEDDY), Miljøfaktorer i utvikling av type 1 diabetes (MIDIA), and Diabetes Autoimmunity Study in the Young (DAISY)-consistently demonstrate correlations between enteroviral presence and the initiation or acceleration of islet autoimmunity. Other viruses-such as mumps, rubella, rotavirus, influenza A (H1N1), and SARS-CoV-2-have been investigated for their potential involvement through direct cytotoxic effects, immune activation, or molecular mimicry. Interestingly, certain viruses like varicella-zoster virus (VZV) and cytomegalovirus (CMV) may exert modulatory or even protective influences on disease progression. Proposed mechanisms include direct beta-cell infection, molecular mimicry, bystander immune activation, and dysregulation of innate and adaptive immunity. Although definitive causality remains unconfirmed, the complex interplay between genetic predisposition, immune responses, and viral exposure underscores the need for further mechanistic research. Elucidating these pathways may inform future strategies for targeted prevention, early detection, and vaccine or antiviral development in at-risk populations.},
}

@article {pmid40905595,
year = {2025},
author = {Débarre, F and Hensel, Z},
title = {Theories of the origin of SARS-CoV-2 in the light of its continuing evolution.},
journal = {Comptes rendus biologies},
volume = {348},
number = {},
pages = {189-209},
doi = {10.5802/crbiol.183},
pmid = {40905595},
issn = {1768-3238},
mesh = {*SARS-CoV-2/genetics ; Humans ; *COVID-19/virology/epidemiology/transmission ; Animals ; Spike Glycoprotein, Coronavirus/genetics ; Pandemics ; Evolution, Molecular ; China/epidemiology ; Animals, Wild/virology ; Biological Evolution ; },
abstract = {The exact details of the emergence of SARS-CoV-2, the virus causing Covid-19, remain unknown. Scientific publications using data available to date point to a natural origin linked to the wildlife trade at a market in Wuhan, China. Yet, theories postulating a research-related origin of SARS-CoV-2 abound, and currently dominate the public discussion of the origin of the Covid-19 pandemic. Here, we attempt to characterize the diversity of research-related origin scenarios, discuss their characteristics and evidence base, or the lack thereof, and highlight mutual incompatibilities between some scenarios. We then focus on a feature of SARS-CoV-2 that is central in today's leading research-related hypotheses, namely the insertion that led to the introduction of a polybasic cleavage site in the spike glycoprotein. We examine various scenarios put forward to explain this insertion in a research-related context, and we show how SARS-CoV-2's evolution in humans has provided examples demonstrating that such insertions happen naturally.},
}

*SARS-CoV-2/genetics
Humans
*COVID-19/virology/epidemiology/transmission
Animals
Spike Glycoprotein, Coronavirus/genetics
Pandemics
Evolution, Molecular
China/epidemiology
Animals, Wild/virology
Biological Evolution

@article {pmid40905188,
year = {2025},
author = {Bromfield, SG and Periyasamy, R and Babu, VR and Puenpatom, A and Hill, DD},
title = {Effectiveness of molnupiravir for the treatment of COVID-19: a systematic literature review of real-world observational studies.},
journal = {Current medical research and opinion},
volume = {},
number = {},
pages = {1-22},
doi = {10.1080/03007995.2025.2551227},
pmid = {40905188},
issn = {1473-4877},
abstract = {OBJECTIVE: Molnupiravir (MOV), an oral antiviral, is prescribed to treat adult patients with mild-to-moderate COVID-19 at risk of progressing to severe disease. Previous systematic literature reviews (SLRs) have evaluated the effectiveness of MOV in the general population; however, evidence on high-risk population is lacking. This SLR assessed the real-world effectiveness of MOV for reducing the progression to severe COVID-19 outcomes in clinical settings, including high-risk or special populations (such as patients with type 2 diabetes, chronic respiratory diseases, immunocompromised conditions, older adults, and nursing home residents) who have limited alternative COVID-19 treatment options.

METHODS: We searched EMBASE and PubMed databases for studies published between 1 January 2021 and 24 May 2024, using predefined search terms related to MOV. Studies comparing MOV-treated with untreated groups of non-hospitalized adults at risk of progression to severe COVID-19 outcomes (hospitalization, death, and the composite of hospitalization/death) were included. Risk of bias of the included studies was assessed using the ROBINS-I tool.

RESULTS: Twenty-one general and special population studies were included. General population studies (n = 16) showed that MOV reduced the risk of death, hospitalization, and hospitalization/death. Special population studies (n = 10; five additional and five general population articles with subgroups of interest) also showed that MOV reduced the risk of the same outcomes, with a more pronounced effect in older adults (≥60 years). The wide range of risk reduction observed might be attributed to variability in COVID-19 hospitalization guidelines and vaccination status.

CONCLUSIONS: Findings from this SLR suggest that MOV may reduce the risk of hospitalization, death, and hospitalization/death compared with untreated groups, including high-risk adults with underlying comorbidities. Further studies are needed to confirm the effectiveness of MOV in high-risk or special populations.},
}

@article {pmid40904859,
year = {2025},
author = {Klaudel, T and Pelczarski, M and Zaborska, M and Sadowski, J and Ostrowska, SA and Drzymała, A and Bułdak, RJ},
title = {The impact of diabetes and obesity on the severity and mortality of SARS-CoV-2 infection.},
journal = {Journal of diabetes and metabolic disorders},
volume = {24},
number = {2},
pages = {195},
pmid = {40904859},
issn = {2251-6581},
abstract = {PURPOSE OF REVIEW: The purpose of the study was to collect and summarise information available in the scientific literature on the probable reasons that lead to negative outcomes of COVID-19 in patients with pre-existing obesity and /or type 2 diabetes mellitus and influence on their treatment as also mortality.

RECENT FINDINGS: During the COVID-19 pandemic, it was observed that disease severity is often correlated with existing comorbidities, mainly in older obese male patients. SARS-CoV-2-infected patients with chronic diseases required hospitalisation more often and their overall prognosis is worse. The following review describes the impact of obesity and diabetes on the SARS-CoV-2 infection course and mortality risk.

SUMMARY: Diabetes and obesity have a multifactorial impact on the risk of SARS-CoV-2 virus infection, as well as on the nature and dynamics of the development of the infection. In turn, the presence of these diseases significantly increased the risk of requiring intensified treatment, complications and ultimately death. Limited access to medical care systems due to the pandemic and the impact on everyday activities made it even more difficult to control diabetes and obesity, leading to the deterioration of patient's condition and the occurrence of new cases of disease. Therefore, it is necessary not only to appropriately modify treatment of those already infected, but also to use appropriate prevention to reduce the number of potential high-risk patients.},
}

@article {pmid40865289,
year = {2025},
author = {Malli, IA and Alqhtani, SA and Abid, HG and Alqhtani, NA and Alharbi, GE and Aboaljadiel, LH and Alharbi, RK and Aletani, TH and Alamri, TM},
title = {The outcomes of cryptococcal disease in HIV-positive individuals following COVID-19 infection: A systematic review and meta-analysis.},
journal = {Journal of infection and public health},
volume = {18},
number = {10},
pages = {102941},
doi = {10.1016/j.jiph.2025.102941},
pmid = {40865289},
issn = {1876-035X},
mesh = {Humans ; *COVID-19/complications/epidemiology ; *Cryptococcosis/epidemiology/mortality/complications ; *HIV Infections/complications/epidemiology ; Incidence ; *Coinfection/epidemiology ; SARS-CoV-2 ; Prevalence ; Female ; Male ; },
abstract = {BACKGROUND: Cryptococcal disease is considered a major cause of morbidity in individuals with HIV in resource-limited settings. The long-term effects of COVID-19 and cryptococcal coinfection among people living with HIV (PLWHIV) have not been thoroughly investigated. This study examined the incidence of cryptococcosis among HIV-positive individuals following COVID-19.

METHODS: A thorough search was conducted across five databases on November 14, 2023, and updated on May 7, 2024. Observational and case reports on the clinical and pathological outcomes of cryptococcosis in HIV-positive individuals with COVID-19 were eligible. The authors extracted the study characteristics and main outcomes: mortality, prevalence, AIDS-defining diseases, combined cryptococcosis, and COVID-19 impact on hospitalization, in a standard Excel sheet.

RESULTS: Of the 752 identified articles (40 in the initial search and six in the updated search), eight were selected. The minimum follow-up duration varied between the research periods, which was three months. The investigations comprised 5751 PLWHIV: 3830 were COVID-19-positive, 130 developed cryptococcosis, and two case reports revealed individuals with concomitant HIV, COVID-19, and cryptococcal infections. The meta-analysis pooled risk ratio (RR) for incidence was 0.21 (90 % confidence interval [CI]: 0.04-1.31) with high heterogeneity (I[2] = 98 %), while the pooled risk for mortality was 1.49 (95 % confidence interval: 0.60-3.72), with moderate heterogeneity (I[2] = 65 %). The chi-squared test for heterogeneity (X[2] = 125.62, p-value <0.00001) revealed considerable variation.

CONCLUSIONS: Cryptococcosis remains a rare but significant complication for PLWHIV following the COVID-19 infection. The data suggests a decrease in incidence risk while a probable increase in mortality. The observed heterogeneity and variability address the importance of enhanced surveillance and targeted interventions for this vulnerable population. Further research is essential to identify factors contributing to heterogeneity and develop effective strategies for managing cryptococcosis in PLWHIV.},
}

Humans
*COVID-19/complications/epidemiology
*Cryptococcosis/epidemiology/mortality/complications
*HIV Infections/complications/epidemiology
Incidence
*Coinfection/epidemiology
SARS-CoV-2
Prevalence
Female
Male

@article {pmid40614684,
year = {2025},
author = {AlOmeir, O and Alhowail, AH and Rabbani, SI and Asdaq, SMB and Gilkaramenthi, R and Khan, A and Imran, M and Dzinamarira, T},
title = {Safety and efficacy of tocilizumab in COVID-19: A systematic evaluation of adverse effects and therapeutic outcomes.},
journal = {Journal of infection and public health},
volume = {18},
number = {10},
pages = {102873},
doi = {10.1016/j.jiph.2025.102873},
pmid = {40614684},
issn = {1876-035X},
mesh = {Humans ; *Antibodies, Monoclonal, Humanized/adverse effects/therapeutic use ; *COVID-19 Drug Treatment ; Treatment Outcome ; COVID-19 ; Male ; SARS-CoV-2 ; Female ; Receptors, Interleukin-6/antagonists & inhibitors ; Middle Aged ; },
abstract = {BACKGROUND: While COVID-19 has transitioned from a pandemic to an endemic state, the management of its persistent complications continues to present substantial clinical challenges. Tocilizumab, an interleukin-6 receptor antagonist endorsed by the World Health Organization (WHO) for severe COVID-19 management, remains a critical therapeutic intervention. This systematic evaluation provides a comprehensive assessment of tocilizumab's safety and efficacy profile to inform clinical decision-making.

METHODS: The study involved exhaustive search across multiple databases (PubMed, SCOPUS, WoS, BIOSIS) utilizing MeSH terms and Boolean operators to identify relevant studies. Methodological worthiness was rigorously evaluated utilizing the Risk of Bias 2 (RoB 2) tool. The statistical analysis of the findings incorporated one-way ANOVA, Mann-Whitney U tests, and Pearson's correlation coefficient (r) with 95 % confidence intervals to quantify adverse effects and therapeutic outcomes.

RESULTS: The analysis of nine studies encompassing diverse demographic populations (ages ≥2 years, both sexes) established a clear safety profile for tocilizumab. The treatment demonstrated a statistically important association (P < 0.05) with mild adverse effects (nausea, diarrhea, headache, fatigue; r = 0.62, 95 % CI = 0.59-0.71) and moderate adverse effects (tremors, urinary difficulties, mood changes; r = 0.54, 95 % CI = 0.47-0.60). More concerning were the severe adverse effects, including hepatobiliary dysfunction and hypersensitivity reactions (r = 0.36, 95 % CI = 0.32-0.41), with rare but critical instances of acute liver failure (r = 0.18, 95 % CI = 0.15-0.22). Notably, despite this safety profile, tocilizumab exhibited significant therapeutic efficacy (P < 0.01) in ameliorating COVID-19 symptoms, particularly in cases complicated by cytokine storm syndrome.

CONCLUSION: This study confirms tocilizumab's position as a valuable therapeutic agent for COVID-19 complications while highlighting the necessity for judicious patient selection and vigilant monitoring due to its potential for significant adverse effects. The findings underscore the importance of pre-treatment screening, adherence to contraindications, and ongoing pharmacovigilance to optimize risk-benefit ratios.},
}

Humans
*Antibodies, Monoclonal, Humanized/adverse effects/therapeutic use
*COVID-19 Drug Treatment
Treatment Outcome
COVID-19
Male
SARS-CoV-2
Female
Receptors, Interleukin-6/antagonists & inhibitors
Middle Aged

@article {pmid40607689,
year = {2025},
author = {Becker, DJ and Vicente-Santos, A and Reers, AB and Ansil, BR and O'Shea, M and Cummings, CA and Roistacher, AJ and Quintela-Tizon, RM and Pereira, MMT and Rosen, J and Banerjee, A and Frank, HK},
title = {Diverse hosts, diverse immune systems: Evolutionary variation in bat immunology.},
journal = {Annals of the New York Academy of Sciences},
volume = {1550},
number = {1},
pages = {151-172},
pmid = {40607689},
issn = {1749-6632},
support = {NFRFE-2023-00025//Government of Canada/ ; LT0017/2024-L//Human Frontier Science Program/ ; RGP002/2023//Human Frontier Science Program/ ; //Edward Mallinckrodt, Jr. Foundation/ ; 5R21AI169548-02/NH/NIH HHS/United States ; P20GM134973/NH/NIH HHS/United States ; R01AI185127/NH/NIH HHS/United States ; RGPIN-2022-03010//Natural Sciences and Engineering Research Council of Canada/ ; DBI 2515340//National Science Foundation/ ; RAPID 2032157//National Science Foundation/ ; 5R21AI169548-02/NH/NIH HHS/United States ; P20GM134973/NH/NIH HHS/United States ; R01AI185127/NH/NIH HHS/United States ; },
mesh = {*Chiroptera/immunology/virology/classification/genetics ; Animals ; *Biological Evolution ; COVID-19/immunology ; SARS-CoV-2/immunology ; Humans ; *Immune System/immunology ; Phylogeny ; Host-Pathogen Interactions/immunology ; },
abstract = {The ability of multiple bat species to host zoonotic pathogens without often showing disease has fostered a growing interest in bat immunology to discover the ways immune systems may differ between bats and other vertebrates. However, interspecific variation in immunological diversity among bats has only begun to be recognized. The order Chiroptera accounts for over 20% of all mammalian species and shows extreme diversity in a suite of correlated ecological traits, such that bats should not be expected to be immunologically homogenous. We review the ecological and evolutionary diversity of chiropteran hosts and highlight case studies emphasizing the range of immune strategies thus far observed across bat species, including responses to SARS-CoV-2. Next, we synthesize and propose hypotheses to explain this immunological diversity, focusing on pathogen exposure, biogeography, host energetics, and environmental stability. We then analyze immunology-related citations across bat species to motivate discussions of key research priorities. Broad sampling is needed to remedy current biases, as only a fraction of bat species has been immunologically studied. Such work should integrate methodological advancements, in vitro and in vivo studies, and phylogenetic comparative methods to robustly test evolutionary hypotheses and understand the drivers and consequences of immunological diversity among bats.},
}

*Chiroptera/immunology/virology/classification/genetics
Animals
*Biological Evolution
COVID-19/immunology
SARS-CoV-2/immunology
Humans
*Immune System/immunology
Phylogeny
Host-Pathogen Interactions/immunology

@article {pmid39161203,
year = {2025},
author = {Voniati, L and Armostis, S and Georgiou, R and Tafiadis, D},
title = {Using telepractice for language sampling during COVID-19 pandemic: A scoping review.},
journal = {Journal of telemedicine and telecare},
volume = {31},
number = {9},
pages = {1239-1248},
doi = {10.1177/1357633X241273068},
pmid = {39161203},
issn = {1758-1109},
mesh = {Humans ; *COVID-19/epidemiology ; SARS-CoV-2 ; Telemedicine ; *Language Therapy/methods ; Pandemics ; *Speech Therapy/methods ; },
abstract = {IntroductionLanguage sampling is a widely used means of language assessment; it is based on the collection and transcription of a child's language production in various communicative contexts. The need for social distancing due to the COVID-19 pandemic impacted language sampling and speech and language therapy services in general. The in-person assessment became extremely challenging leading to the immediate increased use of telepractice in speech and language therapy. This scoping review aimed to identify the use of telepractice for language sampling in speech and language therapy during the COVID-19 pandemic.MethodsA scoping review of existing literature was performed to collect evidence on using language sample collection via telepractice. A database search was conducted in PubMed, PsycINFO, Cochrane Library, Mendeley, Electronic, and grey bibliography in 2022. Articles were included if they met the inclusion criteria. The quality of each selected study was assessed using the modified critical appraisal skills program (CASP) checklist.ResultsSystematic searches identified 51 studies with six studies in total meeting the inclusion criteria. The results showed that telepractice was a necessary tool during the pandemic of COVID-19 to conduct language sampling in speech and language assessment.ConclusionSpeech and language therapists (SLTs) effectively collected language samples through telepractice during the COVID-19 pandemic. Although, to date, the literature on language sampling via telepractice is limited. The need for SLTs to rely on telepractice for language sampling warrants further investigation.},
}

Humans
*COVID-19/epidemiology
SARS-CoV-2
Telemedicine
*Language Therapy/methods
Pandemics
*Speech Therapy/methods

@article {pmid40904653,
year = {2025},
author = {Rzymski, P and Dobrowolska, K and Brzdęk, M and Zarębska-Michaluk, D and Flisiak, R},
title = {Hepatic involvement in major respiratory viral infections.},
journal = {Clinical and experimental hepatology},
volume = {11},
number = {2},
pages = {121-128},
pmid = {40904653},
issn = {2392-1099},
abstract = {Common respiratory viral pathogens, including SARS-CoV-2, influenza viruses, and respiratory syncytial virus (RSV), can lead to extrapulmonary manifestations, including clinically significant liver involvement. This review synthesizes current evidence on the epidemiology, mechanisms, and prognostic implications of hepatic injury associated with these viruses. We discuss the distinct mechanisms of liver dysfunction, ranging from the possibility of direct viral infection of hepatocytes to indirect effects of systemic inflammatory responses, hypoxic injury, preexisting liver disease, and drug-related hepatotoxicity. Liver involvement in COVID-19 has been explored to a much greater extent than in the case of influenza or RSV infections, highlighting the need for further studies. Clinically, recognizing liver involvement in respiratory viral infections is crucial, particularly in high-risk populations such as patients with chronic liver disease, transplant recipients, and children. We underscore the importance of integrating hepatic evaluation into the clinical approach to severe respiratory viral illnesses to improve patient outcomes.},
}

@article {pmid40904575,
year = {2025},
author = {Shen, S and Zhao, X and Pei, J and Wang, B and Hou, J and Chai, R and Guo, Y and Li, F and Hao, J and Wu, Z},
title = {Exploring the psychological impact of long COVID: symptoms, mechanisms, and treatments.},
journal = {Frontiers in psychiatry},
volume = {16},
number = {},
pages = {1555370},
pmid = {40904575},
issn = {1664-0640},
abstract = {Long COVID (LC) refers to a multisystem condition that persists after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). In addition to physical symptoms, the psychological impact is particularly pronounced. This review summarizes the manifestations, potential mechanisms, epidemiological characteristics, and current interventions related to psychological disorders in LC. Drawing on domestic and international literature, it highlights anxiety, depression, cognitive dysfunction, and post-traumatic stress disorder (PTSD) as the primary psychological symptoms. These symptoms may be associated with neuroinflammation, immune abnormalities, vascular dysfunction, and psychosocial stress. Although research in this area is still developing, psychotherapy, pharmacotherapy, neuromodulation, and lifestyle interventions show promise as treatment approaches. This review aims to provide insights that can inform future research on clinical treatments and psychological care for individuals with LC.},
}

@article {pmid40904531,
year = {2025},
author = {Sentell, T and Berreman, JM and Reichhardt, L and Grace, A and Yamauchi, J and Marshall, J and Withy, K},
title = {Quantifying the Public Health Workforce for Hawai'i: Current Data, Measurement Complexities, and Conceptual Frameworks for Next Steps.},
journal = {Hawai'i journal of health & social welfare},
volume = {84},
number = {7},
pages = {87-95},
pmid = {40904531},
issn = {2641-5224},
mesh = {Hawaii ; Humans ; *Public Health/methods/statistics & numerical data/trends ; *Health Workforce/statistics & numerical data/trends/standards ; COVID-19/epidemiology ; },
abstract = {The public health workforce is critical to community well-being and too often overlooked. The goal of public health is to prevent disease, promote health, and protect the public from current and emerging health threats. This work is vital to the health, safety, security, and prosperity of all communities and requires an adequate workforce. Despite the well-articulated gaps in the clinical health care workforce, Hawai'i's public health workforce needs and capacities are not as well understood. Public health workforce enumeration is complex. The field lacks a consistent definition of its full workforce and agreed-upon mechanisms for measuring it. Resolving these issues is an active area of scholarship and action, particularly given the COVID-19 pandemic-induced workforce capacity strain. This article reviews existing literature on public health workforce enumeration as a step toward filling this knowledge gap for practical use in the state of Hawai'i. Specifically, using a critical literature review method, this article (1) consolidates existing data about Hawai'i's public health workforce, (2) summarizes public health workforce measurement challenges, (3) shares existing frameworks and models for quantifying the public health workforce, and (4) discusses next steps to provide actionable information for ensuring Hawai'i's public health workforce can fulfill its mission. The article confirms that core public health functions as articulated in the (a) updated 10 Essential Public Health Services framework and (b) Foundational Public Health Services framework provide useful guidance for public health workforce enumeration in Hawai'i. The article also concludes that the US Department of Health and Human Services (HHS) definition of public health workers provides comprehensive framing for this enumeration. Based on this literature synthesis, a descriptive figure of the public health workforce in Hawai'i was developed to guide future work and prioritization.},
}

Hawaii
Humans
*Public Health/methods/statistics & numerical data/trends
*Health Workforce/statistics & numerical data/trends/standards
COVID-19/epidemiology

@article {pmid40903638,
year = {2025},
author = {Resende, GG and Sousa, LP and Teixeira, MM},
title = {Bridging worlds: a narrative review of IL-17 at the crossroads of inflammation and thrombosis.},
journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]},
volume = {74},
number = {1},
pages = {118},
pmid = {40903638},
issn = {1420-908X},
mesh = {Humans ; *Interleukin-17/immunology/physiology/antagonists & inhibitors ; *Thrombosis/immunology ; *Inflammation/immunology ; Animals ; COVID-19/immunology/complications ; Extracellular Traps/immunology ; Platelet Activation ; Autoimmune Diseases/immunology ; },
abstract = {Interleukin-17 (IL-17) has emerged as a key cytokine at the intersection of inflammation and thrombosis, potentially playing a pivotal role in thromboinflammation. This review explores the mechanistic contributions of IL-17 to endothelial dysfunction, platelet activation, monocytes activation, and neutrophil extracellular trap (NET) formation, which collectively promotes a pro-thrombotic state. We summarize findings from experimental models and clinical studies linking IL-17 to thrombosis in autoimmune diseases, atherosclerosis, and infectious diseases such sepsis and COVID-19. Additionally, we discuss the therapeutic implications of IL-17 inhibition in mitigating thromboinflammatory complications. Understanding the role of IL-17 in this process may provide new avenues for targeted interventions in thromboinflammatory disorders.},
}

Humans
*Interleukin-17/immunology/physiology/antagonists & inhibitors
*Thrombosis/immunology
*Inflammation/immunology
Animals
COVID-19/immunology/complications
Extracellular Traps/immunology
Platelet Activation
Autoimmune Diseases/immunology

@article {pmid40903166,
year = {2025},
author = {Abdelkader, S and Voladri, DR and Kennedy, JL},
title = {Beyond respiratory syncytial virus and rhinovirus: The other viral respiratory bandits.},
journal = {Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology},
volume = {135},
number = {3},
pages = {249-260},
doi = {10.1016/j.anai.2025.06.012},
pmid = {40903166},
issn = {1534-4436},
mesh = {Humans ; *Asthma/virology/epidemiology/immunology ; COVID-19/epidemiology ; SARS-CoV-2 ; Respiratory Syncytial Virus Infections/epidemiology ; Rhinovirus ; *Respiratory Tract Infections/virology/epidemiology ; Picornaviridae Infections/epidemiology ; Influenza, Human/epidemiology ; Respiratory Sounds ; },
abstract = {Asthma affects approximately 25 million people in the United States, with respiratory viruses playing a significant role in both the onset and exacerbations of the condition. Although rhinovirus and respiratory syncytial virus (RSV) are the most well-known triggers, other iratory viruses playing a significant role in both the on, human parainfluenza virus, human bocavirus, enterovirus D68, influenza, and SARS-CoV-2 are increasingly recognized for their significant impact on asthma. These viruses contribute to both the development of asthma and exacerbations by inducing airway inflammation, disrupting epithelial barriers, and skewing immune responses-particularly toward type 2 inflammation. Human metapneumovirus and human parainfluenza virus, members of the Paramyxoviridae family such as RSV, have been linked to early life wheezing and long-term airway changes. Although often co-detected with other viruses, human bocavirus has been associated with recurrent wheezing and asthma risk. Enterovirus D68, notably during the 2014 outbreak, caused severe exacerbations in children with asthma. Influenza and SARS-CoV-2 can cause significant morbidity in those with asthma, even if they are not the primary drivers of exacerbations or onset. As RSV vaccines become more widespread, shifts in viral ecology may lead to increased prevalence of these lesser known viruses due to viral interference and immunity gaps. Understanding their epidemiology and mechanisms is crucial for addressing the evolving asthma burden. Comprehensive surveillance, improved diagnostics, and mechanistic research are essential for developing effective preventive strategies. Broadening the focus beyond rhinovirus and RSV will be critical to fully understand and mitigate the impact of asthma on childrenng be critical to fth.},
}

Humans
*Asthma/virology/epidemiology/immunology
COVID-19/epidemiology
SARS-CoV-2
Respiratory Syncytial Virus Infections/epidemiology
Rhinovirus
*Respiratory Tract Infections/virology/epidemiology
Picornaviridae Infections/epidemiology
Influenza, Human/epidemiology
Respiratory Sounds

@article {pmid40903129,
year = {2025},
author = {Nascimento, ED and de Almeida, SV and Dos Santos Araújo, S and da Silva, PRL and Santos, VS and Faria, RC},
title = {A review of magnetic particles as separation tools in electrochemical detection of Biomarkers: Insights from COVID-19.},
journal = {Analytica chimica acta},
volume = {1372},
number = {},
pages = {344371},
doi = {10.1016/j.aca.2025.344371},
pmid = {40903129},
issn = {1873-4324},
mesh = {Humans ; *Biomarkers/analysis ; *Electrochemical Techniques/methods ; *COVID-19/diagnosis ; *Biosensing Techniques/methods ; SARS-CoV-2/isolation & purification ; },
abstract = {BACKGROUND: Magnetic particles (MPs) are widely used in bioanalytical systems to quickly separate specific targets from complex samples using a magnetic field. MPs can be easily functionalized with bioreceptors to capture, separate, and concentrate biomarkers like proteins, oligonucleotides, and cells. Combining MPs-separation capabilities with electrochemical sensors can greatly enhance the sensitivity of these devices, helping achieve ultralow limits of detection for biomarkers. Thus, MPs-based electrochemical bioassays have led to the development of highly sensitive and selective detection platforms for biomedical applications, with promising results for early disease diagnosis.

RESULTS: Herein, we present a comprehensive critical review on the use of MPs for biomarker detection in complex samples by combining magnetophoretic force and electrochemical biosensing. MPs-based bioassays have been widely applied for the separation and detection of a broad spectrum of clinically significant biomarkers. We explored different strategies for using MPs for biomarker separation from complex biological samples and their integration with electrochemical platforms to achieve highly sensitive and selective analytical methods for application in clinical diagnosis.

SIGNIFICANCE: This review highlights the recent research on MPs-based electrochemical assays for ultrasensitive biomarker detection in complex samples. These findings suggest that MP-based electrochemical biosensing offers a cost-effective and straightforward option for developing point-of-care devices for the detection of diagnostic biomarkers. The key aspects involving the use of MPs in electrochemical bioassays are broadly discussed, which may benefit researchers interested in this field.},
}

Humans
*Biomarkers/analysis
*Electrochemical Techniques/methods
*COVID-19/diagnosis
*Biosensing Techniques/methods
SARS-CoV-2/isolation & purification

@article {pmid40903042,
year = {2025},
author = {Eisenkraft Klein, D and Schouten, A},
title = {Equity in rhetoric and (in)action: a thematic analysis of Canada's approach to intellectual property rights in pandemics.},
journal = {BMJ global health},
volume = {10},
number = {9},
pages = {},
pmid = {40903042},
issn = {2059-7908},
mesh = {*Intellectual Property ; Humans ; Canada ; *COVID-19/epidemiology ; *Health Equity ; *Pandemics ; SARS-CoV-2 ; Patents as Topic/legislation & jurisprudence ; Health Services Accessibility ; },
abstract = {The Canadian federal government has consistently emphasized its commitment to global health equity. However, during the COVID-19 pandemic and its aftermath, Canada repeatedly resisted measures designed to promote equitable and timely global access to medicines through intellectual property (IP) sharing. This research study employs a qualitative, document-based thematic analysis to examine how Canada's rhetorical commitments to equity intersected with its policy actions across three key cases: Canada's Patent Act flexibilities surrounding the COVID-19 World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Waiver; Bolivia and Biolyse's efforts to navigate Canada's Access to Medicines Regime and the World Health Assembly's intergovernmental negotiating body's efforts to draft a treaty for pandemic prevention, preparedness and response. Across these cases, we find that Canadian representatives strategically advanced a narrow conception of equity centred on inclusion and gender, while sidelining intellectual property reform and the structural conditions of access. We conclude by outlining three policy recommendations for Canada to better align its commitment to equity with action on encouraging access to life-saving medicines.},
}

*Intellectual Property
Humans
Canada
*COVID-19/epidemiology
*Health Equity
*Pandemics
SARS-CoV-2
Patents as Topic/legislation & jurisprudence
Health Services Accessibility

@article {pmid40901914,
year = {2025},
author = {Müller-Polyzou, R and Reuter-Oppermann, M},
title = {Radiotherapy continuity for cancer treatment: Lessons learned from natural disasters.},
journal = {PloS one},
volume = {20},
number = {9},
pages = {e0308056},
doi = {10.1371/journal.pone.0308056},
pmid = {40901914},
issn = {1932-6203},
mesh = {Humans ; *Neoplasms/radiotherapy ; *Natural Disasters ; *Radiotherapy ; COVID-19/epidemiology ; *Continuity of Patient Care ; Disaster Planning ; },
abstract = {BACKGROUND: The contemporary world is challenged by natural disasters accelerated by climate change, affecting a growing world population. Simultaneously, cancer remains a persistent threat as a leading cause of death, killing 10 million people annually. The efficacy of radiotherapy, a cornerstone in cancer treatment worldwide, depends on an uninterrupted course of therapy. However, natural disasters cause significant disruptions to the continuity of radiotherapy services, posing a critical challenge to cancer treatment. This paper explores how natural disasters impact radiotherapy practice, compares them to man-made disasters, and outlines strategies to mitigate adverse effects of natural disasters. Through this analysis, the study seeks to contribute to developing resilient healthcare frameworks capable of sustaining essential cancer treatment amidst the challenges posed by natural disasters.

METHOD: We conducted a Structured Literature Review to investigate this matter comprehensively, gathering and evaluating relevant academic publications. We explored how natural disasters affected radiotherapy practice and examined the experience of radiotherapy centres worldwide in resuming operations after such events. Subsequently, we validated and extended our research findings through a global online survey involving radiotherapy professionals.

RESULTS: The Structured Literature Review identified twelve academic publications describing hurricanes, floods, and earthquakes as the primary disruptors of radiotherapy practice. The analysis confirms and complements risk mitigation themes identified in our previous research, which focused on the continuity of radiotherapy practice during the COVID-19 pandemic. Our work describes nine overarching themes, forming the basis for a taxonomy of 36 distinct groups. The subsequent confirmative online survey supported and solidified our findings and served as a basis for developing a conceptual framework for natural disaster-resilient radiotherapy as well as a checklist for practitioners.

DISCUSSION: The growing threat posed by natural disasters underscores the need to develop business continuity programs and define risk mitigation measures to ensure the uninterrupted provision of radiotherapy services. By drawing lessons from past disasters, we can better prepare for future hazards, supporting disaster management and planning efforts, particularly enhancing the resilience of radiotherapy practice. Additionally, our study can serve as a resource for shaping policy initiatives aimed at mitigating the impact of natural hazards.},
}

Humans
*Neoplasms/radiotherapy
*Natural Disasters
*Radiotherapy
COVID-19/epidemiology
*Continuity of Patient Care
Disaster Planning

@article {pmid40901740,
year = {2025},
author = {Raza, A and Zhang, R and Lu, R and Wen, J and Wu, W},
title = {Emerging lipid nanoparticle systems capable of efficient intramuscular RNA delivery.},
journal = {Nanomedicine (London, England)},
volume = {},
number = {},
pages = {1-25},
doi = {10.1080/17435889.2025.2555507},
pmid = {40901740},
issn = {1748-6963},
abstract = {Lipid nanoparticles (LNPs) enable RNA delivery, primarily via intramuscular (IM) injection, catalyzing breakthroughs like the Pfizer-BioNTech and Moderna COVID-19 vaccines. LNPs encapsulate RNA, using ionizable lipids for endosomal escape and PEG-lipids for stability. IM administration leverages muscle tissue's immune-rich environment, enabling localized antigen production, reduced systemic toxicity, and scalability. Challenges include cold-chain dependence, RNA instability, and immunogenicity from PEG/lipids. Future advancements, driven by AI (e.g. AGILE platform), hybrid lipid-polymer systems, and stimuli-responsive formulations, aim to enhance controlled release and stability. Innovations like thermostable lyophilized LNPs and biodegradable materials promise improved accessibility and safety. Beyond pandemics, LNPs hold potential for accelerating vaccines against HIV and malaria, and advancing personalized medicine through CRISPR therapies and cancer neoantigen vaccines. Interdisciplinary efforts in chemistry, immunology, and AI are poised to expand RNA therapeutics for genetic disorders, infectious diseases, and precision oncology. Evolving from emergency tools to mainstream platforms, LNPs herald a paradigm shift toward equitable access and tailored treatments for unmet clinical needs.},
}

@article {pmid40901683,
year = {2025},
author = {Miteva, DG and Gulinac, M and Peruhova, M and Velikova, T},
title = {Exploring the oncogenic potential of SARS-CoV-2 in the gastrointestinal tract.},
journal = {World journal of gastroenterology},
volume = {31},
number = {31},
pages = {105665},
pmid = {40901683},
issn = {2219-2840},
mesh = {Humans ; *COVID-19/complications/virology ; *SARS-CoV-2/pathogenicity ; *Gastrointestinal Neoplasms/virology/pathology/etiology ; *Gastrointestinal Tract/virology/pathology ; *Carcinogenesis ; },
abstract = {Recent research has increasingly highlighted the potential oncogenic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection within the gastrointestinal tract. Growing evidence suggests that SARS-CoV-2 may contribute to the development of gastrointestinal malignancies through several mechanisms, including sustained chronic inflammation, disruption of normal cellular homeostasis, and potential viral integration into host cells. These pathological processes have the potential to dysregulate critical cellular pathways, thereby promoting cancer development in vulnerable populations. A thorough understanding of how SARS-CoV-2 interacts with the development of gastrointestinal cancer is essential for optimizing patient care and establishing comprehensive, long-term monitoring protocols. This review highlighted the pressing need for ongoing research into the complex relationship between SARS-CoV-2 infection and the risk of gastrointestinal cancer.},
}

Humans
*COVID-19/complications/virology
*SARS-CoV-2/pathogenicity
*Gastrointestinal Neoplasms/virology/pathology/etiology
*Gastrointestinal Tract/virology/pathology
*Carcinogenesis

@article {pmid40901375,
year = {2025},
author = {Baker, C and Chalmers, JD},
title = {Viruses in bronchiectasis.},
journal = {ERJ open research},
volume = {11},
number = {5},
pages = {},
pmid = {40901375},
issn = {2312-0541},
abstract = {Bronchiectasis is a chronic respiratory condition characterised by irreversible dilation of the bronchi, leading to recurrent respiratory infections and chronic inflammation. Bacterial infections have been well-recognised as contributors to disease progression as well as potent inducers of exacerbations for decades. However, recent studies have indicated that viruses are present in up to 50% of exacerbations, raising questions over the role viruses may play in bronchiectasis. Despite the evidence of their presence, the role of viral infections in bronchiectasis remains largely underexplored. Understanding how viruses impact bronchiectasis is crucial in providing patients with better care and treatment strategies. Given the persistent threat of viral infections, as highlighted by the coronavirus disease 2019 (COVID-19) pandemic, this review aims to provide an overview of the current knowledge surrounding viruses in bronchiectasis, how they may trigger exacerbations and insights from other chronic respiratory conditions where the role of viruses is better understood.},
}

@article {pmid40901358,
year = {2025},
author = {Teymourzadeh, A and Abramov, D and Norouzi, S and Grewal, D and Heidari-Bateni, G},
title = {Infection to hypertension: a review of post-COVID-19 new-onset hypertension prevalence and potential underlying mechanisms.},
journal = {Frontiers in cardiovascular medicine},
volume = {12},
number = {},
pages = {1609768},
pmid = {40901358},
issn = {2297-055X},
abstract = {Post-COVID new-onset hypertension (PCNH) is an increasingly reported complication among COVID-19 survivors. PCNH can emerge up to 12 months postinfection, with elevated risks observed among older patients, particularly those who experienced severe COVID-19, and among females, implicating the possibility of age and hormonal influence. Leading theories converge on enduring dysregulation of the angiotensin pathway and endothelial dysfunction. In addition to renin-angiotensin alterations, sustained inflammation, lung vascular damage, deconditioning, and mental health decline may also impact the likelihood of PCNH. Conventional renin-angiotensin system (RAS) antagonists may help improve pathway distortions, while novel anti-inflammatory agents and recombinant ACE2 biologics can help mitigate endothelial injury to alleviate cardiovascular burden. This review highlights the multifaceted mechanisms driving PCNH and the need to elucidate timing, predictors, pathophysiology, and tailored interventions to address this parallel pandemic among COVID-19 survivors.},
}

@article {pmid40901148,
year = {2025},
author = {Abdul-Rahman, T and Faith, OE and Ajetunmobi, OA and Thaalibi, HI and Ikele, CG and Gautam, G and Omotayo, FO and Roy, P and Adebayo, AA and Mojeed, MA and Kareem, TT and Ali, HI and Atieno, RG and Ademeta, EO and Garg, N and Ashinze, P and Scott, GY},
title = {Potential of MRNA vaccines for mpox prevention: current evidence and future directions.},
journal = {Annals of medicine and surgery (2012)},
volume = {87},
number = {9},
pages = {5650-5660},
pmid = {40901148},
issn = {2049-0801},
abstract = {In 2022, the presumption of monkeypox (mpox) to be of limited epidemiology shifted when a global outbreak was announced. Being a member of the Orthopoxvirus genus in the Poxviridae family, it'd been reported in over 82 countries with over 17 000 confirmed cases by July 2022, thus showing its capability for spreading rapidly. As the smallpox vaccine offers 85% cross-immunity against mpox, the outbreak highlighted the attenuation of global immunity against orthopoxviruses after the cessation of vaccination campaigns against smallpox. The mortality of this virus is higher in vulnerable populations such as children, pregnant women, the elderly, and immunosuppressed individuals. With treatment methods being limited to off-label use of antivirals, the need for urgent and efficient preventative measures is emphasized. At present, JYNNEOS (Modified Vaccinia Ankara-Bavarian Nordic), showing favorable safety, and ACAM2000, a live attenuated virus with a high risk of side effects, are two vaccines that are indicated for mpox immunization. However, neither of them has proven full safety, efficacy, and widespread accessibility against mpox. Hence, the use of mRNA vaccines has emerged as a better alternative to traditional vaccinations, as they leverage synthetic messenger RNA to instruct host cells to produce antigens, eliciting both humoral and cellular immune responses. Though they provided rapid scalability, adaptability to emerging viral variants, and an established safety profile after the COVID-19 pandemic, their usage in preventing mpox remains an area of research. This paper elucidates the potential of mRNA technology to address the unmet needs in mpox prevention. It also highlights the need for genomic surveillance, immunological insights, and innovative delivery systems.},
}

@article {pmid40842393,
year = {2025},
author = {Christie, CDC},
title = {Resurgence of pertussis: whopping the '100-day cough'.},
journal = {Current opinion in pediatrics},
volume = {37},
number = {5},
pages = {508-516},
doi = {10.1097/MOP.0000000000001486},
pmid = {40842393},
issn = {1531-698X},
mesh = {Humans ; *Whooping Cough/epidemiology/prevention & control ; *COVID-19/epidemiology/prevention & control ; Bordetella pertussis ; Infant ; Child ; Anti-Bacterial Agents/therapeutic use ; Pertussis Vaccine ; Global Health ; Infant, Newborn ; SARS-CoV-2 ; Vaccination Coverage/statistics & numerical data ; },
abstract = {PURPOSE OF REVIEW: Against the WHO's report of 84% diphtheria-pertussis-tetanus (DPT) primary vaccination coverage globally, the resurgence of pertussis (whooping cough), contributing factors and measures to control it are described.

RECENT FINDINGS: USA and China, with 94-97% primary DPT immunization uptake, reported a 6-fold and 65-fold increase in pertussis between two time periods in 2023 and 2024. The global post-COVID-19 pertussis epidemic is trending towards a shift from infants towards older persons. Macrolide resistance is prevalent in 98% of Bordetella pertussis strains in China and is now reported from other countries. Pertactin-deficient mutant acellular pertussis vaccine-evasive strains are now transmitted in older children and adults. Pertactin-producing B. pertussis is causing fulminant pertussis in newborns whose mothers were not immunized in pregnancy and in under-immunized infants. Circulating epidemic strains of B. pertussis were discordant to those contained in whole-cell (Bp137) pertussis vaccine. The pertussis resurgence maybe explained by increased case ascertainment and reporting, mutant B. pertussis strains with immune escape from acellular and whole cell vaccines, and/or macrolides, waning natural, or vaccine-induced immunity and COVID-19 pandemic factors.

SUMMARY: Pertussis maybe curtailed with public education, active clinical and microbiological surveillance, appropriate antimicrobial treatment and prophylaxis, public health reporting, infection control and optimized immunizations to reduce attributable morbidity and mortality.},
}

Humans
*Whooping Cough/epidemiology/prevention & control
*COVID-19/epidemiology/prevention & control
Bordetella pertussis
Infant
Child
Anti-Bacterial Agents/therapeutic use
Pertussis Vaccine
Global Health
Infant, Newborn
SARS-CoV-2
Vaccination Coverage/statistics & numerical data

@article {pmid40679355,
year = {2025},
author = {Watermeyer, J and Coutts, K and Nattrass, R},
title = {Simulated Learning Experiences in Global Speech-Language Pathology Programs: A Scoping Review.},
journal = {American journal of speech-language pathology},
volume = {34},
number = {5},
pages = {2942-2971},
doi = {10.1044/2025_AJSLP-24-00393},
pmid = {40679355},
issn = {1558-9110},
mesh = {*Speech-Language Pathology/education ; Humans ; *COVID-19/epidemiology ; *Simulation Training/methods ; Curriculum ; Clinical Competence ; SARS-CoV-2 ; },
abstract = {PURPOSE: Simulated learning experiences (SLEs) are increasingly utilized in health care education and to train speech-language pathology students. The increasing popularity of simulations, particularly during the COVID-19 pandemic, has generated interest in their potential for achieving teaching and learning outcomes and a need to map the evidence in the field. This review explores the application of SLEs in speech-language pathology training. It examines the types of simulated learning approaches used across clinical contexts in relation to student outcomes and stakeholder perceptions to guide evidence-based curriculum development.

METHOD: We conducted a scoping review to identify published journal articles and gray literature that described how SLEs were used for clinical training in the profession. Following the abstract and full-text screening, 53 articles were reviewed, and a descriptive synthesis of findings was conducted.

RESULTS: A variety of SLEs are used for training in various areas of practice in the profession. Most studies have been conducted in the Global North and especially post-COVID-19. SLEs offer valuable practice opportunities and can enhance clinical education opportunities for improving students' clinical skills, knowledge, and confidence. Using SLEs can also facilitate the transition from theory to practice. Low-fidelity SLEs appear as effective as higher fidelity options. There are relatively few longitudinal studies and studies that explore how skills learned in SLEs translate into clinical settings. Overall, SLEs were viewed positively for enhancing learning and clinical readiness.

CONCLUSIONS: While SLEs have proven useful tools for teaching and learning across various areas of practice in the speech-language pathology field, they require careful planning, scaffolding, and feedback to students. Future research should explore the use of SLEs in the Global South, gather perspectives from clinical educators and standardized patients, and focus on learning processes as well as, where possible, the long-term transfer of skills into real-world practice.},
}

*Speech-Language Pathology/education
Humans
*COVID-19/epidemiology
*Simulation Training/methods
Curriculum
Clinical Competence
SARS-CoV-2

@article {pmid40675862,
year = {2025},
author = {Miao, S and He, X and Jin, X and Zhang, T and Shen, S and Zhao, Y},
title = {Echinococcosis on the Tibetan Plateau, where to go?.},
journal = {Trends in parasitology},
volume = {41},
number = {9},
pages = {716-719},
doi = {10.1016/j.pt.2025.07.001},
pmid = {40675862},
issn = {1471-5007},
mesh = {Tibet/epidemiology ; *Echinococcosis/prevention & control/epidemiology/transmission ; Humans ; *COVID-19/epidemiology ; Animals ; Neglected Diseases/prevention & control/epidemiology ; },
abstract = {The post-COVID-19 era has exacerbated challenges in controlling echinococcosis on the Tibetan Plateau, the epicentre of alveolar and cystic echinococcosis, where reduced funding for neglected tropical diseases (NTDs) coincides with growing tourism and trade. This convergence heightens transmission risk, and we provide a novel synthesis of context-specific, integrated control strategies.},
}

Tibet/epidemiology
*Echinococcosis/prevention & control/epidemiology/transmission
Humans
*COVID-19/epidemiology
Animals
Neglected Diseases/prevention & control/epidemiology

@article {pmid40532972,
year = {2025},
author = {Orsel, LM and Severin, JA and Knoester, M and Lokate, M and Voss, A and Haanappel, CP and van Kampen, JJA and Haagmans, BL and Koopmans, MPG and Veldkamp, KE and van Mansfeld, R and de Jager, HJ and Voor In 't Holt, AF and Bowles, C},
title = {The role of gowns in preventing nosocomial transmission of respiratory viruses: a systematic review.},
journal = {The Journal of hospital infection},
volume = {163},
number = {},
pages = {57-71},
doi = {10.1016/j.jhin.2025.05.023},
pmid = {40532972},
issn = {1532-2939},
mesh = {Humans ; *Cross Infection/prevention & control/transmission/virology ; *COVID-19/prevention & control/transmission ; Health Personnel ; *Protective Clothing/virology ; SARS-CoV-2 ; *Personal Protective Equipment ; *Respiratory Tract Infections/prevention & control/transmission/virology ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; *Virus Diseases/transmission/prevention & control ; },
abstract = {BACKGROUND: During the COVID-19 pandemic, long-sleeved gowns were advocated as personal protective equipment for healthcare workers (HCWs). The purpose of gowns is preventing transmission of infectious agents via the uniform or arms during contact with patients and their surroundings. Gowns, however, entail a substantial burden; in costs, workload for HCWs, and generated waste.

AIM: To evaluate the current knowledge regarding the use of gowns during care of patients with COVID-19 and other respiratory viruses to prevent nosocomial transmission.

METHODS: PRISMA guidelines were used to search five databases (Medline, Embase, Web of Science, Cochrane, Google Scholar) up to April 11[th], 2023.

FINDINGS: The search identified 2667 potentially relevant studies, of which 30 were selected and divided into four categories. In 12 studies, contamination rates of gowns ranged from 0% to 77.5% (median: 1.43%). Three out of seven studies showed that virus remained infectious the longest on Tyvek coveralls and plastic gowns, and the shortest on cotton and polyester. Two out of seven studies found a protective effect between HCW protective clothing and infection of HCWs. Finally, three out of four studies concluded that short sleeves, cotton gowns, or no gowns provided the same level of protection as standard gowns.

CONCLUSION: Viral RNA can be found on clothing, but it is unclear whether viruses are transmitted to HCWs and/or patients. Evidence for the protective effect of long-sleeved gowns over alternatives is still insufficient. Therefore, well-controlled and adequately powered laboratory transmission experiments that simulate real-life conditions are necessary.},
}

Humans
*Cross Infection/prevention & control/transmission/virology
*COVID-19/prevention & control/transmission
Health Personnel
*Protective Clothing/virology
SARS-CoV-2
*Personal Protective Equipment
*Respiratory Tract Infections/prevention & control/transmission/virology
Infectious Disease Transmission, Patient-to-Professional/prevention & control
*Virus Diseases/transmission/prevention & control

@article {pmid40204602,
year = {2025},
author = {Lin, SH and Liu, JW and Yen, YT and Chen, MT and Wang, JT and Tu, YK and Fang, CT and Chang, SC},
title = {Effectiveness of molnupiravir as early treatment for COVID-19 to prevent mortality and hospitalisation in high-risk adults: A systematic review and meta-analysis of randomised trials and real-world studies involving 1,612,082 patients.},
journal = {Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi},
volume = {58},
number = {5},
pages = {545-553},
doi = {10.1016/j.jmii.2025.03.015},
pmid = {40204602},
issn = {1995-9133},
mesh = {Humans ; *Hospitalization/statistics & numerical data ; Randomized Controlled Trials as Topic ; *COVID-19/mortality ; SARS-CoV-2/drug effects ; *Antiviral Agents/therapeutic use ; *Hydroxylamines/therapeutic use ; *COVID-19 Drug Treatment ; *Cytidine/analogs & derivatives/therapeutic use ; Adult ; Middle Aged ; Treatment Outcome ; Aged ; },
abstract = {BACKGROUND: The efficacy of molnupiravir for COVID-19 treatment remains controversial due to substantial heterogeneity in dosage and study settings across randomised controlled trials (RCTs).

METHOD: We systematically searched Medline, PubMed, Embase, and the Cochrane Register of Clinical Trials up to February 3, 2025, for RCTs and real-world studies evaluating molnupiravir 800 mg twice daily as an early treatment for COVID-19 to prevent mortality and hospitalisation in high-risk adult outpatients. The primary outcomes were all-cause mortality and all-cause hospitalisation. Random-effects models were used to estimate pooled effect sizes.

RESULTS: Thirty-four studies were included, comprising 30,345 participants from 11 RCTs and 1,581,737 participants from 23 cohort studies. Molnupiravir reduced mortality risk by 55 %-65 % at 28 days (RCTs: risk ratio [RR] 0.35; 95 % CI 0.12-0.98, I[2] 0 %; cohort studies: RR 0.45; 95 % CI 0.27-0.73, I[2] 91 %). This benefit persisted at 3 months (RR 0.47; 95 % CI 0.23-0.95, I[2] 93 %) and 6 months (RR 0.62; 95 % CI 0.52-0.74, I[2] 0 %). The effectiveness in preventing 28-day hospitalisation varied by participants' mean age in both RCTs (35-45 vs. 45-57 years: RR 0.55; 95 % CI 0.36-0.84 vs. 1.06; 95 % CI 0.81-1.39, subgroup difference P = 0.01) and cohort studies (62-74 vs. 75-85 years: RR 0.88; 95 % CI 0.77-1.01 vs. 0.56; 95 % CI 0.44-0.72, subgroup difference P < 0.01).

CONCLUSIONS: Molnupiravir significantly reduces the risk of mortality. It also lowers the risk of hospitalisation in the oldest group (mean age ≥75 years) but not in younger groups (mean age 45-74 years).},
}

Humans
*Hospitalization/statistics & numerical data
Randomized Controlled Trials as Topic
*COVID-19/mortality
SARS-CoV-2/drug effects
*Antiviral Agents/therapeutic use
*Hydroxylamines/therapeutic use
*COVID-19 Drug Treatment
*Cytidine/analogs & derivatives/therapeutic use
Adult
Middle Aged
Treatment Outcome
Aged

@article {pmid40901141,
year = {2025},
author = {Ogunbola, O and Amodu, L and Miteu, GD and Ajayi, O},
title = {Covid-19 infodemic: media literacy and perception of fake news among residents of Ikeja, Lagos state.},
journal = {Annals of medicine and surgery (2012)},
volume = {87},
number = {9},
pages = {5644-5649},
doi = {10.1097/MS9.0000000000003530},
pmid = {40901141},
issn = {2049-0801},
abstract = {This study investigates media literacy and the perception of fake news among residents of Ikeja, Lagos State, during the COVID-19 pandemic. Using a descriptive survey design, data were collected from 378 respondents selected through a multi-stage sampling approach across two wards. A structured questionnaire assessed participants' exposure to news, awareness of misinformation, and their strategies for verification. Results indicated that social media platforms especially WhatsApp and Facebook were the primary sources of both COVID-19 information and misinformation. Despite this, a majority of respondents demonstrated high media literacy, applying fact-checking strategies such as source verification and cross-referencing. Chi-square analysis found no significant association between the platform used and exposure to fake news (P > 0.05), suggesting that misinformation was pervasive across all platforms. The findings emphasize the importance of digital media literacy in mitigating the impact of infodemics. We recommend targeted public health communication and digital education strategies to combat misinformation and support informed decision-making during health crises.},
}

@article {pmid40901136,
year = {2025},
author = {Tamdin, T and Bhandari, S and Bhandari, S and Barbery, M and Bajwa, R},
title = {Barriers to timely transitions to comfort care in cancer patients: a review.},
journal = {Annals of medicine and surgery (2012)},
volume = {87},
number = {9},
pages = {5770-5774},
doi = {10.1097/MS9.0000000000003618},
pmid = {40901136},
issn = {2049-0801},
abstract = {INTRODUCTION: "Comfort care" is a holistic approach for patients with terminal conditions, such as cancer, who are not expected to recover. It focuses on managing pain, among other end-of-life symptoms, and providing support to both the patient and their family during the dying process, which can last unpredictably from hours to days. End-of-life care concepts are often shaped by personal judgment and culture and thus lack a single consensus. This can lead to ambiguity in the term "comfort care" itself as well as create confusion in medical communication and treatment, making the transition to comfort care more challenging. In this review, we strive to evaluate the barriers preventing the timely conversion of end-stage cancer patients to comfort care. We also discuss the possible measures to limit these sensitive barriers to avoid futility in treatment and to ensure an ambiguity-free transition to ensure the best possible outcome for the patient. In this paper, we aim to systematically identify and categorize the key barriers that delay comfort care transitions in terminal cancer patients and to propose actionable strategies grounded in current evidence to address these challenges.

METHODOLOGY: We conducted a literature search using PubMed and MEDLINE, covering studies published between January 2020 and March 2025. Search terms included a combination of MeSH terms and keywords such as "Palliative Care," "Terminal Care," "Hospice Care," "Communication Barriers," "Cultural Factors," "Cancer," and "Prognostic Uncertainty." Eligible studies were peer-reviewed, published in English, and focused on adult cancer patients receiving palliative or end-of-life care, with a clear emphasis on barriers to timely transitions to comfort care. Studies unrelated to cancer, lacking a focus on barriers, or published in non-English languages were excluded. A total of 156 articles were identified; titles and abstracts were screened for relevance, followed by full-text review based on inclusion criteria. Data from the selected studies were analyzed using a thematic synthesis approach, in which two authors independently categorized findings under three main themes: prognostic uncertainty, communication challenges, and cultural factors. Discrepancies were resolved through discussion.

FINDINGS: Based on our extensive search, we classified the barriers for transition to comfort care into three main headings: Prognostic uncertainty, Challenges to Communication, and cultural factors. High levels of distress were observed in both patients and healthcare providers due to prognostic uncertainty, which complicates the prediction of illness trajectories, negatively affecting quality of life and delaying the transition to comfort care. Communication challenges, such as short consultations, language barriers, and difficult conversations about care goals, were also prevalent. The COVID-19 pandemic exacerbated these issues; there was lingering apprehension surrounding end-of-life discussions. Additionally, cultural factors play a significant role in shaping patients' perceptions of cancer, pain, treatment, and death. Family involvement in decision-making varies across cultures, and systemic inequalities in access to palliative care disproportionately affect racialized groups.

CONCLUSION: To overcome these barriers, the study emphasizes the need for effective policy-making to improve the quality of life for cancer patients during their care transition. It also becomes crucial to implement measures to improve communication protocols, validate culturally sensitive interventions, and routinely integrate palliative care in oncological practice early. We also need to work towards culturally appropriate interventions and strive to incorporate appropriate communication techniques to eliminate disparity for access to equitable palliative care.},
}

@article {pmid40901024,
year = {2025},
author = {Chen, N and Li, L and Han, Y and Chen, Z},
title = {The Role of Gut Microbiota in the Modulation of Pulmonary Immune Response to Viral Infection Through the Gut-Lung Axis.},
journal = {Journal of inflammation research},
volume = {18},
number = {},
pages = {11755-11781},
doi = {10.2147/JIR.S525880},
pmid = {40901024},
issn = {1178-7031},
abstract = {Viral respiratory infections, including influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, remain major global health challenges due to their high morbidity and mortality. Emerging evidence highlights the pivotal role of the gut-lung axis in regulating pulmonary immunity. The gut microbiota communicates with the lungs via endocrine, immune, and neuroimmune pathways-particularly through metabolites such as short-chain fatty acids (SCFAs) and vagus nerve-mediated signaling-which modulate immune cells including alveolar macrophages and dendritic cells. Disruption of gut microbial balance has been linked to impaired pulmonary immune responses and increased susceptibility to infection. This review synthesizes findings from animal models and clinical studies, demonstrating that interventions such as probiotics (eg, Lactobacillus gasseri), prebiotics (eg, galacto-oligosaccharides), fecal microbiota transplantation (FMT), and Traditional Chinese Medicine (eg, Astragalus, curcumin) can enhance antiviral cytokine production, restore gut-lung homeostasis, and reduce lung inflammation. For example, FMT from H7N9-survivor mice improved influenza resistance in recipients, and oral probiotics reduced respiratory failure risk in COVID-19 patients. These findings suggest that gut-lung axis modulation is a promising adjunctive approach for treating viral respiratory infections. Future research should prioritize personalized microbiome-based therapies and large-scale clinical trials to validate efficacy and safety.},
}

@article {pmid40900166,
year = {2025},
author = {Torlot, L and Fischer, MR and Zwißler, B and Schroeder, I},
title = {[Hospital surge capacity volunteers in an emergency: a scoping review].},
journal = {Die Anaesthesiologie},
volume = {},
number = {},
pages = {},
pmid = {40900166},
issn = {2731-6866},
abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic was marked by increased patient surge in hospitals around the world as well as significant staff shortages due to illness and isolation. Hospital preparedness plans in Germany should plan for staff surge capacity in the event of a future pandemic or disaster.

OBJECTIVE: We assessed whether non-medical helpers could be incorporated as surge capacity workforce in German hospitals.

METHODS: For this scoping review we performed an initial pilot search using GoogleScholar, followed by a systematic query of the Embase and Medline databases. The identified literature and the results of the pilot search were summarized in a narrative-descriptive way.

RESULTS: We identified 64 relevant articles for the scoping review (4 reports, 5 reviews, 1 book section, 13 interventional and 4 observational studies, 8 cross-sectional surveys, 12 expert articles, 13 case reports, 4 training materials). Previous preparedness plans have included volunteers from nongovernmental-organizations, students from medical and public health faculties and spontaneous volunteers. Training this surge capacity workforce is usually a requirement and can take place pre-emptively or at short notice (just in time).

CONCLUSION: An increasing body of evidence describes including volunteers in preparedness plans within the clinical setting. Especially medical students seem to be a well-established surge capacity workforce that could be systematically planned into preparedness plans in the event of another pandemic or significant disaster in Germany.},
}

@article {pmid40899610,
year = {2025},
author = {Liu, X and Chen, L and Niu, H and Chen, Y and Chen, P and Liu, L and Wu, R},
title = {The bittersweet link between glucose metabolism, cellular microenvironment and viral infection.},
journal = {Virulence},
volume = {16},
number = {1},
pages = {2554302},
doi = {10.1080/21505594.2025.2554302},
pmid = {40899610},
issn = {2150-5608},
mesh = {Humans ; *Glucose/metabolism ; *Cellular Microenvironment ; *Virus Diseases/metabolism/virology/immunology ; SARS-CoV-2 ; *Host-Pathogen Interactions ; Signal Transduction ; Animals ; Glycolysis ; COVID-19/metabolism/virology ; },
abstract = {Viral particles and proteins released during infection profoundly reshape the cellular microenvironment by disrupting host signaling, triggering inflammation, and modulating immune responses. Glucose metabolism, a critical hub for energy production and biosynthesis, is highly susceptible to viral reprogramming. This review summarizes recent findings showing that diverse viruses, including influenza virus, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and enteroviruses, manipulate glucose metabolic pathways to promote replication and evade immune surveillance. Specifically, viruses modulate glycolytic flux, alter the activity of key metabolic enzymes such as hexokinase (HK) and pyruvate kinase, and interfere with signaling networks like PI3K/Akt/mTOR and AMPK. These metabolic alterations further impact the immune landscape by regulating cytokine production, immune cell activation, and antiviral responses. Our analysis highlights a bidirectional interaction: while viruses hijack host glucose metabolism to favor their survival, metabolic changes also generate host-derived antiviral responses. This review highlights the bidirectional crosstalk between metabolic remodeling and microenvironmental changes during viral infection, underscoring the potential of metabolism-based antiviral strategies. A deeper understanding of these mechanisms may inform the development of more effective and targeted interventions against viral diseases.},
}

Humans
*Glucose/metabolism
*Cellular Microenvironment
*Virus Diseases/metabolism/virology/immunology
SARS-CoV-2
*Host-Pathogen Interactions
Signal Transduction
Animals
Glycolysis
COVID-19/metabolism/virology

@article {pmid40899003,
year = {2025},
author = {Li, Q and Li, S and Fu, D and Liao, G and Zhou, X and Gong, T and Zheng, X},
title = {The Role of Emerging Digital Technologies in Revolutionizing Dental Education: A Bibliometric Analysis.},
journal = {Journal of dental education},
volume = {},
number = {},
pages = {},
doi = {10.1002/jdd.70033},
pmid = {40899003},
issn = {1930-7837},
abstract = {BACKGROUND: The integration of artificial intelligence (AI), virtual reality (VR), augmented reality (AR), and other digital technologies in dental education has gained significant attention, revolutionizing teaching methodologies, clinical training, and student assessment. However, despite the growing body of literature, there is no comprehensive bibliometric analysis mapping influential studies, research trends, and emerging topics in this field. This study aims to analyze the structure, hotspots, and evolution of digital technology research in dental education through bibliometric methods.

METHODS: The bibliometric analysis was conducted using data from the Web of Science Core Collection database. Relevant publications were retrieved using predefined keywords related to AI, VR, AR, simulation, and digital learning in dental education. Annual publication, collaboration networks, highly-cited articles, citation analysis, and keyword citation bursts were examined. The study identified research clusters, high-impact articles, and evolving trends over time.

RESULTS: The analysis revealed a steady increase in publications. Collaboration networks highlighted key research hubs in North America and Europe. The most prominent keywords include "dental education," "virtual reality," "e-learning," "augmented reality," "artificial intelligence," and "COVID-19." Strong citation bursts were observed for keywords such as educational technology, online learning, and learning environments, indicating a shift towards technology-driven teaching methods. However, gaps in faculty training, accessibility, and AI validation remain challenges in fully integrating these technologies into curricula.

CONCLUSION: Despite challenges, digital technologies continue to reshape dental education, with VR, AR, AI, and online learning playing increasingly important roles. Future research should focus on standardized implementation guidelines and technology refinement to maximize their effectiveness in dental training.},
}

@article {pmid40898404,
year = {2025},
author = {Raiisi, F and Ahmadi, K},
title = {COVID-19 Anxiety and Psychological Interventions in Iran: A Systematic Review and Meta-Analysis.},
journal = {Disaster medicine and public health preparedness},
volume = {19},
number = {},
pages = {e254},
doi = {10.1017/dmp.2025.10170},
pmid = {40898404},
issn = {1938-744X},
mesh = {Humans ; Iran/epidemiology ; *COVID-19/psychology/complications ; *Anxiety/therapy/psychology/etiology ; *Psychosocial Intervention/methods/standards/statistics & numerical data ; },
abstract = {OBJECTIVES: The symptoms of anxiety in the outbreak of COVID-19 were so severe that they entered the research literature as the term COVID-19 anxiety. This systematic review and meta-analysis study aimed to identify the variables related to COVID-19 anxiety and the effectiveness of psychological interventions on it.

METHODS: In the present systematic review and meta-analysis, the literature was systematically searched in PubMed, Scopus, Web of Science, Science Direct, ISI, and Persian databases such as Noormags and SID on COVID-19 anxiety from January 2020 to April 2022. In the initial search, 105 articles were found. In the data correlation section, 13 studies for the fixed effects model were meta-analyzed. In the interventional section, 14 articles were selected. The systematic review data were extracted, and all statistical data were analyzed by CMA-2.

RESULTS: The results of the meta-analyses for psychopathological correlations with COVID-19 anxiety in 13 articles indicated the correlation between COVID-19 anxiety and other mental states and disorders (P = .0001/I[2] = 97.27%). Other findings demonstrated the effect of psychological interventions on COVID-19 anxiety in 14 articles with high effectiveness of these treatments (P = .00/I[2] = 85.67%).

CONCLUSIONS: It seems COVID-19 anxiety is affected by psychological variables. Hence, psychological interventions represent effective treatments for anxiety due to COVID-19.},
}

Humans
Iran/epidemiology
*COVID-19/psychology/complications
*Anxiety/therapy/psychology/etiology
*Psychosocial Intervention/methods/standards/statistics & numerical data

@article {pmid40898215,
year = {2025},
author = {Jalili, R and Gilani, N and Najafi, B and Gordeev, VS and Doshmangir, L},
title = {Health financial resilience in individuals and households: a scoping review of components, strategies and outcomes.},
journal = {BMC public health},
volume = {25},
number = {1},
pages = {3021},
pmid = {40898215},
issn = {1471-2458},
support = {72657//Tabriz University of Medical Sciences/ ; 72657//Tabriz University of Medical Sciences/ ; 72657//Tabriz University of Medical Sciences/ ; 72657//Tabriz University of Medical Sciences/ ; 72657//Tabriz University of Medical Sciences/ ; },
mesh = {Humans ; *COVID-19/economics ; Family Characteristics ; Social Capital ; *Resilience, Psychological ; Pandemics/economics ; },
abstract = {BACKGROUND: Financial resilience, the ability to withstand and recover from financial shocks, has become increasingly critical amid economic volatility, rising healthcare costs, and global crises such as the COVID-19 pandemic. While prior research has explored broad determinants of financial resilience.

METHODS: Following the Arksey and O'Malley framework, this review systematically mapped literature from multiple databases (PubMed, Scopus, Web of Science, EconLit) and Google Scholar search engine from 1990 to 2024. Inclusion criteria focused on studies discussing financial, resilience components, strategies and outcomes in individuals or households. Data were extracted and analyzed thematically.

RESULTS: A comprehensive search strategy was developed to identify relevant studies across multiple databases, including PubMed, Scopus, Web of Science, EconLit.The review included 30 studies from 15 countries, highlighting four key components of financial resilience: economic resources, financial knowledge and behavior, social capital, and access to financial services. Common strategies to enhance resilience included income diversification, savings, borrowing, reducing expenditures, and leveraging social networks. Outcomes of financial resilience included reduced financial fragility, improved life satisfaction, and enhanced financial stability. High-income countries emphasized financial literacy and planning, while low- and middle-income countries relied more on informal coping mechanisms like borrowing and asset sales. Some coping strategies have been used in times of illness.

CONCLUSION: Financial resilience is a multidimensional construct influenced by economic resources, financial knowledge, social capital, and access to financial services. Policymakers should prioritize financial literacy, expand access to financial services, and strengthen social safety nets to promote financial resilience, particularly among vulnerable populations, such as low-income individuals and the sick. Future research should explore the intersectionality of financial resilience and the role of digital financial services in enhancing resilience. Policymakers and financial institutions should focus on promoting financial literacy, expanding access to financial services, and strengthening social safety nets to support individuals and households in building financial resilience.},
}

Humans
*COVID-19/economics
Family Characteristics
Social Capital
*Resilience, Psychological
Pandemics/economics

@article {pmid40897503,
year = {2025},
author = {Chen, HB and Chen, H and Xu, JY and Yu, RX and Shi, N and Chi, Y and Ge, YY and Cui, LB and Zhang, S and Xie, J and Qiu, H},
title = {Antithrombotic strategies in adult COVID-19 patients: a systematic review and Bayesian network meta-analysis.},
journal = {BMJ open},
volume = {15},
number = {9},
pages = {e088917},
pmid = {40897503},
issn = {2044-6055},
mesh = {Humans ; Bayes Theorem ; *COVID-19/mortality/complications ; *Fibrinolytic Agents/therapeutic use/adverse effects ; Network Meta-Analysis as Topic ; *Anticoagulants/therapeutic use ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Platelet Aggregation Inhibitors/therapeutic use ; *Thrombosis/prevention & control ; Adult ; Hemorrhage/chemically induced ; Randomized Controlled Trials as Topic ; },
abstract = {OBJECTIVES: To systematically compare the effects of various antithrombotic strategies on prespecified outcomes including 28-day all-cause mortality (primary outcome), major thrombotic events and major bleeding events (secondary outcomes) in adult COVID-19 patients.

DESIGN: Systematic review and Bayesian network meta-analysis (NMA).

DATA SOURCES: PubMed, Web of Science, Embase, Cochrane Library and ClinicalTrials.gov up to February 2024.

ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs; published in English) comparing different antithrombotic strategies (eg, anticoagulants, antiplatelet (AP) agents, fibrinolytics or combinations) in adults (aged≥18 years) with laboratory-confirmed SARS-CoV-2 infection. Eligible trials had at least one active antithrombotic arm versus another strategy or standard care.

DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data using a standardised form; disagreements were resolved by consensus or third-party adjudication. Bayesian NMA was performed using Markov chain Monte Carlo methods with random/fixed effects models selected by the deviance information criterion. The risk of bias (RoB) was assessed using the Cochrane Collaboration's tool. The confidence in NMA framework was used to assess the quality of evidence.

RESULTS: 35 RCTs that randomly assigned 39 949 participants were included in the main analysis.

PRIMARY OUTCOME: evidence of low to moderate certainty suggested that, compared with standard of care (SoC), both prophylactic-dose anticoagulation (PA) (risk ratio (RR) 0.71, 95% credible interval (CrI) 0.44 to 0.99) and therapeutic-dose anticoagulation (TA; RR 0.65, 95% CrI 0.38 to 0.94) reduced the 28-day all-cause mortality.

SECONDARY OUTCOMES: TA (RR 0.19, 95% CrI 0.09 to 0.31), TA+AP (RR 0.27, 95% CrI 0.05 to 0.95), PA (RR 0.33, 95% CrI 0.18 to 0.53) and AP+PA (RR 0.52, 95% CrI 0.25 to 0.94) were effective in reducing major thrombotic events. AP was associated with an increased risk of major bleeding events (RR 2.27, 95% CrI 1.01 to 5.07). Subgroup analyses by hospitalisation status showed that PA significantly reduced 28-day mortality versus SoC (RR 0.52, 95% CrI 0.26 to 0.90) for non-hospitalised patients, whereas no strategies showed significant benefit in hospitalised patients. Subgroup analysis based on severity of hospitalised patients indicated that TA was more favourable than PA in decreasing the 28-day mortality in non-critically ill patients (fixed-effect model: RR 0.75, 95% CI 0.61 to 0.91; random-effect model: RR 0.71, 95% CI 0.48 to 1.05), but for critically ill patients, all antithrombotic strategies showed no significant difference.

CONCLUSIONS: Our NMA indicates that both PA and TA reduced the 28-day all-cause mortality of adult COVID-19 patients. However, subgroup analyses revealed substantial heterogeneity, and the benefit may differ across hospitalisation status and disease severity.

PROSPERO REGISTRATION NUMBER: CRD42022355213.},
}

Humans
Bayes Theorem
*COVID-19/mortality/complications
*Fibrinolytic Agents/therapeutic use/adverse effects
Network Meta-Analysis as Topic
*Anticoagulants/therapeutic use
SARS-CoV-2
*COVID-19 Drug Treatment
Platelet Aggregation Inhibitors/therapeutic use
*Thrombosis/prevention & control
Adult
Hemorrhage/chemically induced
Randomized Controlled Trials as Topic

@article {pmid40897326,
year = {2025},
author = {You, Y and Huang, J and Zhu, X and Sheng, H and Liu, Y},
title = {Cytochrome P450 (CYP) 1 enzymes in acute lung injury: from molecular insights to therapeutic implications.},
journal = {Redox report : communications in free radical research},
volume = {30},
number = {1},
pages = {2550807},
pmid = {40897326},
issn = {1743-2928},
mesh = {Humans ; *Acute Lung Injury/enzymology/metabolism ; *Cytochrome P-450 CYP1B1/metabolism/genetics ; COVID-19/enzymology ; Oxidative Stress ; Animals ; *Cytochrome P-450 CYP1A1/metabolism/genetics ; Receptors, Aryl Hydrocarbon/metabolism ; SARS-CoV-2 ; Sepsis ; },
abstract = {OBJECTIVE: This review aims to explore the roles and mechanisms of cytochrome P450 subfamily 1 (CYP1) enzymes in acute lung injury (ALI), and to discuss their potential as therapeutic targets.

METHODS: A comprehensive literature search was conducted using PubMed and Web of Science to identify relevant studies on the involvement of CYP1 enzymes-specifically CYP1A and CYP1B1-in various forms of ALI, including hyperoxic lung injury, sepsis-associated ALI, and COVID-19 pneumonia.

RESULTS: CYP1 enzymes, induced by the aromatic hydrocarbon receptor (AhR), contribute differentially to ALI. CYP1A enzymes exhibit protective effects, whereas CYP1B1 promotes lung injury, potentially through oxidative stress-related pathways such as Nrf2, NF-κB, and MAPK signaling.

CONCLUSION: The distinct functions of CYP1 isoforms in ALI suggest their clinical relevance, highlighting the potential for isoform-specific targeting in the treatment of acute respiratory conditions.},
}

Humans
*Acute Lung Injury/enzymology/metabolism
*Cytochrome P-450 CYP1B1/metabolism/genetics
COVID-19/enzymology
Oxidative Stress
Animals
*Cytochrome P-450 CYP1A1/metabolism/genetics
Receptors, Aryl Hydrocarbon/metabolism
SARS-CoV-2
Sepsis

@article {pmid40895839,
year = {2025},
author = {Nigatu, BZ and Dessie, NT},
title = {Prevalence of comorbidities and their association with disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.},
journal = {Journal of multimorbidity and comorbidity},
volume = {15},
number = {},
pages = {26335565251371256},
pmid = {40895839},
issn = {2633-5565},
abstract = {BACKGROUND: Comorbidity among coronavirus disease-19 (COVID-19) patients contributes to increasing their susceptibility to severe illness. The objectives of this systematic review and meta-analysis were to assess the prevalence of comorbidities and their association in increased severity of disease and mortality in COVID-19 patients.

METHODS: A thorough search of the literature was conducted using PubMed, Google Scholar, and other sources to include pertinent studies. Two independent authors extracted pertinent data using Microsoft Excel and exported it to Stata version 17 for meta-analysis. This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Heterogeneity was assessed through I[2] statistics, subgroup analysis for categorical variables, and meta-regression for continuous variables. Publication bias was assessed through funnel plot and Egger statistics. Furthermore, a meta-analysis was performed using a random-effects model to estimate the pooled odds ratio (OR) with 95% CI, which was used to assess the association between comorbidity and severity and/or mortality of COVID-19.

RESULTS: A total of 62 studies with 611,646 patients were included. The pooled prevalence of comorbidity among COVID-19 was 53.9% (95% CI: 48.4-59.3). Comorbidity was significantly associated with severity of COVID-19. Specifically, hypertension (OR: 1.09; 95% CI: 1.03-2.51), diabetes mellitus (OR: 1.29; 95% CI: 1.07-1.56), and obesity (OR: 1.61; 95% CI: 1.46-1.76) significantly increased the odds of severe COVID-19. Furthermore, hypertension (OR: 1.14; 95% CI: 1.02-1.57), diabetes mellitus (OR: 1.39; 95% CI: 1.17-1.65), obesity (OR: 1.24; 95% CI: 1.15-1.32), chronic kidney diseases (OR: 1.62; 95% CI: 1.25-2.09), and chronic obstructive pulmonary diseases (COPD) (OR: 1.23; 95% CI: 1.15-1.32) were significantly associated with mortality of COVID-19 patients.

CONCLUSION: The pooled prevalence of comorbidity among COVID-19 was found slightly higher than that reported in previous systematic reviews, which ranged from 40.0% to 41.1%. Comorbidity increased the odds of severe COVID-19. Participants with hypertension, obesity, or diabetes mellitus had significantly increased odds of severe COVID-19. There is a need to have close follow-up of COVID-19 patients who have comorbidity.

PROTOCOL REGISTRATION: This systematic review and meta-analysis study was registered under the registration number CRD42023493170.},
}

@article {pmid40895553,
year = {2025},
author = {Xu, J and Chen, X and Guan, X and Zhang, H and Liu, Y and Zhang, M},
title = {Therapeutic frontiers in viral myocarditis: targeting inflammation, viruses, oxidative stress, and myocardial repair.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1643502},
pmid = {40895553},
issn = {1664-3224},
mesh = {Humans ; *Myocarditis/virology/therapy/drug therapy ; Oxidative Stress/drug effects ; Antiviral Agents/therapeutic use ; COVID-19/complications ; SARS-CoV-2 ; Inflammation ; Animals ; Myocardium/pathology ; *Virus Diseases/therapy ; Parvovirus B19, Human ; },
abstract = {Viral myocarditis (VMC) is a life-threatening inflammatory cardiomyopathy with a global incidence rate of 10-22 per 100,000 people. It is the most common clinical manifestation of myocardial inflammation. Myocardial cell injury and fibrosis are the pathological characteristics of VMC. Coxsackievirus B3 (CVB3), parvovirus B19 (PVB19), Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), and adenovirus (AdV) are the main causes that induce viral myocarditis. Among them, CVB3 has become the main pathogen, accounting for more than 50% of the confirmed cases of VMC. The clinical manifestations of this disease are extensive, ranging from asymptomatic carriers to sudden cardiac death caused by acute decompensated heart failure and arrhythmia. Current therapeutic strategies for VMC focus on four key approaches: (1) Anti-inflammatory interventions targeting inflammatory cells and mediators; (2) Antiviral therapies employing gene editing, viral protease inhibitors, and RNA polymerase inhibitors; (3) Myocardial protection through tissue repair promotion and nutritional support; (4) Oxidative stress mitigation using antioxidants. This article will systematically summarize the progress of VMC management in recent years and provide personal insights for VMC management.},
}

Humans
*Myocarditis/virology/therapy/drug therapy
Oxidative Stress/drug effects
Antiviral Agents/therapeutic use
COVID-19/complications
SARS-CoV-2
Inflammation
Animals
Myocardium/pathology
*Virus Diseases/therapy
Parvovirus B19, Human

@article {pmid40895341,
year = {2025},
author = {Sun, J and Dong, S and Gong, J and Xie, J and Yan, H},
title = {Human papillomavirus vaccination willingness and influencing factors among women in China: A systematic review and meta-analysis.},
journal = {Preventive medicine reports},
volume = {58},
number = {},
pages = {103215},
pmid = {40895341},
issn = {2211-3355},
abstract = {OBJECTIVE: This study aims to comprehensively review the human papillomavirus (HPV) vaccination willingness among Chinese women and explore the factors influencing their vaccination intentions.

METHODS: A comprehensive systematic search was conducted across nine electronic databases-China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Journal Integration Service Platform, SinoMed, PubMed, Embase, Scopus, Cochrane Library, and Web of Science-from database inception to February six, 2025, to identify studies examining HPV vaccine acceptance among Chinese women.

RESULTS: The pooled willingness to receive the HPV vaccine among Chinese women was estimated at 65.7 % (95 % CI: 55.2 %-76.2 %). Subgroup analyses indicated higher intent among women with a college education or above (71.1 % versus 60.1 %), urban residents (68.3 % versus 56.0 % in rural areas), southern China residents (69.0 % versus 59.7 % in northern regions), individuals with medical-related backgrounds (84.2 % versus 35.7 %), and those with prior HPV or vaccine knowledge (66.1 %/76.4 % versus 50.2 %/57.8 %), Willingness was also higher among women with a family cancer history (74.5 % versus 55.3 %), and those impacted by COVID-19 (67.5 % versus 57.5 %). Anonymous questionnaires yielded higher willingness (71.8 % versus. 58.8 %). Other influencing factors included age, attitudes toward premarital sex, and awareness of HPV risks and vaccine benefits.

CONCLUSIONS: Chinese women's overall willingness to receive the HPV vaccine remains below the World Health Organization (WHO)'s 90 % target, with significant disparities across subpopulations. Targeted public health efforts are urgently needed to enhance vaccine awareness and acceptance, especially among women in rural or underdeveloped areas, with lower education, non-medical backgrounds, or no family history of cancer.},
}

@article {pmid40895261,
year = {2025},
author = {Samadani, AA and Vahidi, S and Babaei, K and Norollahi, SE and Delpasand, K and Gharakhyli, EA},
title = {Comprehensive and translational pathobiology of COVID-19 based on cellular and molecular techniques.},
journal = {Practical laboratory medicine},
volume = {46},
number = {},
pages = {e00497},
pmid = {40895261},
issn = {2352-5517},
abstract = {The biggest health issue in the world right now is the COVID-19 pandemic. This outbreak has caused a lot more people to be hospitalized for pneumonia and serious health problems, leading to many deaths. This report talks about many studies that showed the causes and how common COVID-19 is, as well as how to diagnose it in clinics and labs, and how to prevent and control it. These studies are very important and directly related to COVID-19 to help manage the current public emergency. Many parts of this dangerous disease, like how it spreads, how to diagnose it, how it infects people, and how to treat it, are still not well understood. It's important that to prevent, diagnose, and treat COVID-19 well, we need research at the molecular and clinical levels, along with public health measures and medical treatments. Clearly, new treatments like mesenchymal stem cell therapy have shown great promise in this area. Here, we will talk about and show the advanced lab methods used to understand how COVID-19 spreads, how it is diagnosed, and how it can be treated.},
}

@article {pmid40894189,
year = {2025},
author = {Ajibade, AA and Sethi, R and Lee, CJ and Post, ER and Meeks, SO and Alligood, T and Rainwater-Lovett, K and Kimball, MM and Leone, R and Zanker, M and Freeman, JD and Kirsch, TD},
title = {The Need to Incorporate Post-Acute Care Entities Into the National Disaster Medical System.},
journal = {Journal of the American College of Emergency Physicians open},
volume = {6},
number = {5},
pages = {100237},
pmid = {40894189},
issn = {2688-1152},
abstract = {The National Disaster Medical System (NDMS) is critical to healthcare preparedness and response in the United States but currently has limited capacity for handling large-scale mass-casualty surge events. Crises, such as the COVID-19 pandemic, have shown how quickly the US healthcare system can become overwhelmed, necessitating novel solutions for handling a large-scale influx of patients. This paper proposes the inclusion of post-acute care (PAC) entities, which provide long-term care rehabilitation and short-stay subacute rehabilitation support rather than acute or critical care, into the NDMS as one solution to increase its capacity during mass-casualty surges. By reviewing the unique capabilities and functions of PAC entities and considering evidence of their role in national emergencies, this paper demonstrates that PAC entities are well positioned to support the wider healthcare system in managing a mass influx of patients. We base this assertion on 4 points: (1) the support role PAC entities traditionally play for over-capacity hospitals by providing extra space for stabilized patients, (2) PAC entities' capacity to adapt their functions beyond PAC to support overall community response, (3) recent federal emergency preparedness requirement changes that increase PAC entities' disaster response capabilities, and (4) interim outcomes of NDMS efforts toward NDMS inclusion of PAC entities. We conclude by outlining challenges to integrate PAC entities into the NDMS and highlighting ongoing work by the congressionally directed NDMS Pilot Program, which is designed to increase capacity across the system. However, challenges such as limited staffed bed capacity at PAC entities, reduced availability of emergency medical service ambulances, and ongoing staffing shortages will need to be addressed.},
}

@article {pmid40893900,
year = {2025},
author = {Fama, F and Fattore, R and Raimondo, P and Brivio, F and Holmes, D and Muheberimana, T and Nayfeh, T and Bandera, A and Gori, A and Passerini, M and Colaneri, M},
title = {The impact of SARS-CoV-2 VOCs on clinical outcomes: an overview of reviews.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1624459},
pmid = {40893900},
issn = {2296-858X},
abstract = {BACKGROUND: Synthesizing data from existing literature is crucial for validating the robustness of associations, assessing data quality, and forming recommendations, especially given the vast amount of information available on SARS-CoV-2. This study aims to conduct an overview of reviews to evaluate the strength and validity of associations between VOCs and specific clinical outcomes in COVID-19 patients.

METHODS: An overview of reviews according to the principles of PRIOR protocol was performed searching multiple databases in January 2024 and an updated search was conducted in MEDLINE database in June 2025. Peer reviewed systematic reviews considering two or more VOCs and reporting on clinical outcomes such as mortality, hospitalization, severe disease, admission to ICU, and mechanical ventilation were included. Data on study population and measures of association between clinical outcome and VOCs were considered. The quality of the studies was assessed through the AMSTAR-2 tool. Effect sizes and confidence intervals for each association between VOCs and clinical outcomes were reported. Subgroup analyses were performed where feasible. A citation matrix was used to assess the overlap between the included systematic reviews.

RESULTS: Twelve studies were included in the review, with a total of 24 comparisons, primarily between Omicron and Delta variants (19/24). Omicron was consistently associated with better clinical outcomes compared to Delta. The confidence in the results of 10/12 studies was rated critically low. The overlap between the included reviews was minimal, with 10% having significant overlap (>15%).

CONCLUSION: Our overview of reviews shows the lower hazard on human health of the Omicron compared to Delta variant. However, the quality of the reviews included was generally low, prompting the need for more rigorous systematic reviews.

This overview of reviews was registered in PROSPERO, CRD42024500841; https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42024500841.},
}

@article {pmid40893194,
year = {2025},
author = {Wister, A and Kim, B and Levasseur, M and Poulin, V and Qiu, S and Yuwono, E and Meynet, S and Beadle, J and Kadowaki, L and Klasa, K and Linkov, I},
title = {Resilience applications to social isolation and loneliness in older adults: a scoping review to develop a model and research agenda.},
journal = {Frontiers in public health},
volume = {13},
number = {},
pages = {1589781},
pmid = {40893194},
issn = {2296-2565},
mesh = {Humans ; *Loneliness/psychology ; *Social Isolation/psychology ; *Resilience, Psychological ; *COVID-19/psychology/epidemiology ; Aged ; Social Support ; Adaptation, Psychological ; SARS-CoV-2 ; },
abstract = {BACKGROUND: The development of a theoretical model applied to social isolation and loneliness (SI/L) among older adults has not kept pace with the exponential growth in empirical research, especially since the COVID-19 pandemic. One promising but under-investigated area is the contribution of resilience models to this field. This paper provides a scoping review of the application of resilience theoretical models to social isolation and loneliness and suggests directions for the development of an integrated new model.

METHOD: Using the Arksey and O'Malley scoping review method, searches of four databases with 13 keywords were conducted April 9, 2024, with 17 articles meeting the inclusion criteria of the 1,671 extracted articles.

RESULTS: Findings were summarized using thematic analysis separated into four major themes: (1) coping self-efficacy to reduce SI/L; (2) moderating expectations to foster resilience to SI/L; (3) the effects of social support, the environment and resilience on COVID-19 stressors, and; (4) resilience as a mediator between SI/L and mental health. We integrate these findings into a new model entitled the Resilience and Social Isolation Model of Aging (RSIMA).

CONCLUSION: RSIMA highlights SI/L as a dynamic process on a continuum, as well as elucidating what broader factors can lead to improved social connection, contributing to both individual-level and community resilience. To address the looming public health crisis of social isolation and loneliness among older people, future research studies must consider a systems-level perspective to SI/L and resilience.},
}

Humans
*Loneliness/psychology
*Social Isolation/psychology
*Resilience, Psychological
*COVID-19/psychology/epidemiology
Aged
Social Support
Adaptation, Psychological
SARS-CoV-2

@article {pmid40891644,
year = {2025},
author = {Jalan, M and Singh, S and Desai, M and Sharma, A and Malik, S and Singh, A and Kukreti, R and Kukreti, S and Grewal, GK},
title = {Targeting Oxidative Stress With Combination Treatment of Alpha-Lipoic Acid and Antiseizure Drugs in Rodent Model: A Systematic Review.},
journal = {Journal of biochemical and molecular toxicology},
volume = {39},
number = {9},
pages = {e70488},
doi = {10.1002/jbt.70488},
pmid = {40891644},
issn = {1099-0461},
support = {//Dr Gurpreet Kaur Grewal received funding from Anusandhan National Research Foundation, Science and Engineering Research Board, India (DST-SERB) under TARE scheme (TAR/2022/000636) from Govt. of India under mentorship of Prof. (Dr) Shrikant Kukreti, Nucleic Acids Research Lab, Department of Chemistry, University of Delhi (North Campus), Delhi 110007, India./ ; },
mesh = {*Thioctic Acid/pharmacology/therapeutic use ; Animals ; *Oxidative Stress/drug effects ; *Anticonvulsants/pharmacology/therapeutic use ; Disease Models, Animal ; Rats ; *Antioxidants/pharmacology/therapeutic use ; *Epilepsy/drug therapy/metabolism ; Drug Therapy, Combination ; },
abstract = {Epilepsy is a chronic neurological disease marked by repeated seizures due to excessive neuronal activity, frequently linked to oxidative stress. Treatment in epilepsy involves chronic use of antiseizure drugs (ASDs) which further exacerbates oxidative stress. Given its role in epilepsy, oxidative stress has been a target for therapeutic intervention, with antioxidants being explored as potential agents to mitigate oxidative damage. This systematic review investigates studies which have used alpha lipoic acid (ALA) in conjunction with ASDs in rodents, and focuses on its antioxidant properties on oxidative stress, biochemical activity, molecular activity and behavioral outcomes. Following PRISMA guidelines, a comprehensive literature search across Google Scholar, ScienceDirect, Springer Link, and PubMed databases from 2020 to 2025 yielded 4622 studies, of which seven met the inclusion criteria. The results reveal that ALA, either alone or in combination with ASD, significantly mitigates oxidative stress by reducing malondialdehyde levels and enhancing the role of key antioxidants such as catalase, glutathione, superoxide-dismutase, etc. Additionally, ALA alleviates behavioral deficits and exhibits neuroprotective, hepato-protective, and anti-inflammatory effects. Furthermore, ALA modulates molecular markers by upregulating Nrf-2 and SIRT1 pathways while downregulating TNF-α and caspase 3, thereby reducing apoptosis and inflammation. Although promising, the findings are constrained by limited sample sizes, brief study periods, and a lack of comprehensive investigations on dose-response relationships and systemic effects. Most of the studies focus on limited biochemical and molecular markers, overlooking comprehensive evaluations of systemic and behavioral outcomes. This review highlights the potential of ALA as an adjunct therapy for epilepsy and emphasizes the need for more robust preclinical studies to confirm its efficacy and to fill the lacunas for advancing the therapeutic potential of ALA in epilepsy management.},
}

*Thioctic Acid/pharmacology/therapeutic use
Animals
*Oxidative Stress/drug effects
*Anticonvulsants/pharmacology/therapeutic use
Disease Models, Animal
Rats
*Antioxidants/pharmacology/therapeutic use
*Epilepsy/drug therapy/metabolism
Drug Therapy, Combination

@article {pmid40802287,
year = {2025},
author = {Coughtrey, A and Pereira, SMP and Ladhani, S and Shafran, R and Stephenson, T},
title = {Long COVID in children and young people: then and now.},
journal = {Current opinion in infectious diseases},
volume = {38},
number = {5},
pages = {487-492},
pmid = {40802287},
issn = {1473-6527},
mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology ; Child ; Adolescent ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Fatigue ; Young Adult ; },
abstract = {PURPOSE OF REVIEW: On 11 March 2020, the WHO characterized COVID-19 as a pandemic. A clinical case definition for post-COVID-19 condition in children and adolescents by expert consensus was agreed by the WHO in 2023. It is now 5 years since the WHO declared a pandemic, and this review aims to summarize key advances in our understanding of long COVID over those 5 years.

RECENT FINDINGS: That symptoms could persist in adults and CYP for months after initial infection was first reported in Autumn 2020. Long COVID in adults is frequently characterized by symptoms of fatigue and breathlessness but brain-fog, joint and muscle pain have been reported much more commonly in adult follow-up than CYP. The most common persisting symptoms experienced by CYP after COVID-19 infection in initial studies, often with less than a year of follow-up, were fatigue, headache, shortness of breath and persisting loss of smell and taste. With longer follow-up, up to 2 years, the commonest symptoms still include not only fatigue, headache and shortness of breath but also sleep difficulties, whereas loss of smell and taste persisted only in a minority. However, many symptoms were almost as common in test-negative controls, raising questions about the causal role of SARS-CoV-2 virus. Predictors of long COVID, as defined, were female sex, history of asthma, allergy problems, learning difficulties at school and family history of ongoing COVID-19 problems.

SUMMARY: The implications of the findings for clinical practice and research are that long COVID is not the same in CYP as adults; both their physical and mental health should be studied; and intervention trials are needed.},
}

Humans
*COVID-19/complications/epidemiology/physiopathology
Child
Adolescent
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Fatigue
Young Adult

@article {pmid40802252,
year = {2025},
author = {Alraddadi, A and Kumar, D},
title = {Management of diarrhea in solid organ transplantation.},
journal = {Current opinion in infectious diseases},
volume = {38},
number = {5},
pages = {403-410},
pmid = {40802252},
issn = {1473-6527},
mesh = {Humans ; *Diarrhea/etiology/diagnosis/drug therapy/therapy/microbiology ; *Organ Transplantation/adverse effects ; COVID-19/complications ; SARS-CoV-2 ; Transplant Recipients ; },
abstract = {PURPOSE OF REVIEW: Diarrhea is a common complaint in solid organ transplant recipients. We review both infectious and noninfectious causes of diarrhea and their management.

RECENT FINDINGS: Diagnostics for diarrhea have now commonly incorporated multiplex gastrointestinal panels that provide rapid testing and identification of pathogens. The rate of Clostridium difficile in the transplant population has increased and fidaxomicin is now recommended as the therapy of choice for first episode and recurrences where available. Oral vancomycin remains an alternative. Norovirus is important to rule out in cases of chronic diarrhea. Nitazoxanide has shown mixed results when used as norovirus therapy. SARS-CoV-2, despite being a respiratory virus, can infect gut epithelium and present with diarrhea. Noninfectious causes especially mycophenolate-related as well as inflammatory bowel disease should be in the differential especially when no infectious cause has been identified.

SUMMARY: A detailed history, diagnostics including molecular testing and endoscopy, and targeted therapies for infectious causes are the mainstay for management of diarrhea in the transplant recipient.},
}

Humans
*Diarrhea/etiology/diagnosis/drug therapy/therapy/microbiology
*Organ Transplantation/adverse effects
COVID-19/complications
SARS-CoV-2
Transplant Recipients

@article {pmid40767380,
year = {2025},
author = {de Groot, RCA and Streng, BMM and Bont, LJ and Meyer Sauteur, PM and van Rossum, AMC},
title = {Resurgence of Mycoplasma pneumoniae infections in children: emerging challenges and opportunities.},
journal = {Current opinion in infectious diseases},
volume = {38},
number = {5},
pages = {468-476},
pmid = {40767380},
issn = {1473-6527},
mesh = {Humans ; *Pneumonia, Mycoplasma/epidemiology/diagnosis/drug therapy ; Child ; *Mycoplasma pneumoniae ; *COVID-19/epidemiology ; Anti-Bacterial Agents/therapeutic use ; SARS-CoV-2 ; },
abstract = {PURPOSE OF REVIEW: To summarize recent advances in Mycoplasma pneumoniae epidemiology, pathophysiology, diagnostics, and treatment, since the 2023-2024 global resurgence of M. pneumoniae following the COVID-19 pandemic has provided new insights.

RECENT FINDINGS: The remarkably prolonged reduction of M. pneumoniae infections during COVID-19-related nonpharmaceutical interventions has shed new light on M. pneumoniae transmission, both on an individual and a global level. M. pneumoniae epidemiology showed striking differences in comparison with other respiratory pathogens, including RSV and pneumococcus. We discuss the possible mechanisms behind the delayed resurgence, including waning immunity and the persistence of M. pneumoniae reservoirs. There have been contrasting reports on disease severity with notable differences in severity between children and adults, with young adults showing marked vulnerability. The inability of M. pneumoniae diagnostic tests to differentiate between infection and carriage poses a continuing challenge: in daily clinical practice as well as in the interpretation of study results. Furthermore, several studies report safety and utility for tetracyclines and fluoroquinolones as treatment alternatives to macrolide antibiotics.

SUMMARY: The global resurgence of M. pneumoniae following COVID-19 pandemic restrictions has provided a unique opportunity to study its epidemiology and pathophysiology, which has advanced our understanding of M. pneumoniae infections in children.},
}

Humans
*Pneumonia, Mycoplasma/epidemiology/diagnosis/drug therapy
Child
*Mycoplasma pneumoniae
*COVID-19/epidemiology
Anti-Bacterial Agents/therapeutic use
SARS-CoV-2

@article {pmid40748012,
year = {2025},
author = {Waxse, BJ and Rao, S},
title = {Data science for pediatric infectious disease: utilizing COVID-19 as a model.},
journal = {Current opinion in infectious diseases},
volume = {38},
number = {5},
pages = {493-498},
doi = {10.1097/QCO.0000000000001139},
pmid = {40748012},
issn = {1473-6527},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; Child ; *Data Science/methods ; SARS-CoV-2 ; Pediatrics ; Pandemics ; Public Health ; },
abstract = {PURPOSE OF REVIEW: During the COVID-19 pandemic, governments and public health agencies used data science tools and data sources in real time to evaluate pathogen transmissibility, disease burden, healthcare capacity, and evaluate treatment and preventive measures. The purpose of the review is to highlight the application of these data sources and methods during the COVID-19 response.

RECENT FINDINGS: Advances in the development of common data models enabled multisite data networks to overcome healthcare data fragmentation, enabling national surveillance platforms, and offering unprecedented statistical power to conduct national surveillance and detect emerging clinical entities like MIS-C and long COVID in diverse pediatric populations. These integrated networks were also used in evaluating the effectiveness of vaccines and therapies. New surveillance approaches combining traditional clinical data with novel data sources including wastewater detection, web-based search engines, and mobility patterns yielded comprehensive ensemble approaches that informed public health policy.

SUMMARY: The COVID-19 pandemic highlighted the importance of timely evidence for decision-making during outbreak responses and the benefits of using data science tools to help provide real time, actionable insights, which can help guide our public health response to infectious diseases threats in the future.},
}

Humans
*COVID-19/epidemiology/prevention & control
Child
*Data Science/methods
SARS-CoV-2
Pediatrics
Pandemics
Public Health

@article {pmid40536011,
year = {2025},
author = {Moen, JK and Baker, CA and Iwasaki, A},
title = {Neuroimmune pathophysiology of long COVID.},
journal = {Psychiatry and clinical neurosciences},
volume = {79},
number = {9},
pages = {514-530},
pmid = {40536011},
issn = {1440-1819},
support = {/HHMI/Howard Hughes Medical Institute/United States ; R01 AI157488/AI/NIAID NIH HHS/United States ; R01AI157488//National Institute of Allergy and Infectious Diseases/ ; N/A/HHMI/Howard Hughes Medical Institute/United States ; },
mesh = {Humans ; *COVID-19/immunology/complications/physiopathology ; Post-Acute COVID-19 Syndrome ; *Neuroimmunomodulation/physiology ; *Nervous System Diseases/immunology/physiopathology/etiology ; SARS-CoV-2 ; Animals ; *Peripheral Nervous System Diseases/immunology/physiopathology/etiology ; Fatigue/physiopathology/immunology ; },
abstract = {Although COVID-19 was originally considered a respiratory illness, it is now well established that SARS-CoV-2 infection can have far-reaching impacts on the nervous system. Neurological symptoms such as chemosensory dysfunction are frequently observed during acute infection and approximately 10% of COVID-19 cases will go on to develop new or persistent long-term symptoms, a condition known in the literature as post-acute symptoms of COVID-19 (PASC) or by the patient-coined term Long COVID. Common neurological symptoms in Long COVID include new onset cognitive difficulties, dysautonomia, fatigue, and peripheral neuropathy. The emergence of Long COVID has prompted renewed interest in the study of post-acute infection syndromes (PAIS), particularly in the area of neuroimmune interactions. In this review we provide a comprehensive overview of the current body of literature on neurological manifestations of SARS-CoV-2 infection and Long COVID, with an emphasis on neuroimmune mechanisms drawn largely from autopsy studies and animal models. A more complete understanding of neuroimmune crosstalk in Long COVID will not only guide the development of therapies for this highly disabling condition but will also contribute to our general understanding of neuroimmune interactions in health and disease.},
}

Humans
*COVID-19/immunology/complications/physiopathology
Post-Acute COVID-19 Syndrome
*Neuroimmunomodulation/physiology
*Nervous System Diseases/immunology/physiopathology/etiology
SARS-CoV-2
Animals
*Peripheral Nervous System Diseases/immunology/physiopathology/etiology
Fatigue/physiopathology/immunology

@article {pmid40392198,
year = {2025},
author = {Hojeij, B and Koc, GH and Luime, JJ and Vis, M and Coates, LC and Kok, MR and Tchetverikov, I},
title = {Psoriatic arthritis flare incidence, definition and risk factors: a systematic review.},
journal = {Rheumatology (Oxford, England)},
volume = {64},
number = {9},
pages = {4886-4901},
doi = {10.1093/rheumatology/keaf247},
pmid = {40392198},
issn = {1462-0332},
support = {//Department of Rheumatology of the Erasmus MC/ ; },
mesh = {Humans ; Risk Factors ; Incidence ; *Arthritis, Psoriatic/epidemiology/diagnosis ; *Symptom Flare Up ; },
abstract = {OBJECTIVES: We systematically reviewed the literature to identify the incidence of PsA flare, criteria used to define it and associated risk factors.

METHODS: Databases of Embase, Medline ALL, Web of Science Core Collection and Cochrane Central Register of Controlled Trials were searched until September 2023, for original articles studying PsA flare. The Newcastle-Ottawa scale was used to assess the quality of included studies.

RESULTS: Fifty-four studies of cohort, cross-sectional and clinical trial designs were included. Twelve studies assessed PsA flare rates, 28 assessed risk factors and 44 defined flare. The prevalence of current flare ranged between 7% and 50% (n = 8), while the incidence ranged between 10% and 27% over 6 months (n = 3), and 22% and 23% over 12 months (n = 2). Based on high-quality scoring, the current patient-reported flare was 10% (n = 1), while current physician-reported flare was 7% with 22-23% incidence rate over 12 months (n = 2). Criteria used in flare definition could be grouped into seven categories, with disease activity scores (36%), patient-reported (39%) and physician-reported (30%) flare and change in therapy (25%) being frequently used. Risk factors could be grouped into four categories: arthritis therapies, SARS-CoV, PsA features and other. The factors showed limited or unclear evidence.

CONCLUSION: The current prevalence of flare ranged between 7% and 10%, and the annual incidence was 22-23%, based on high-quality scoring. Forty-four studies defined flare, revealing no consensus on a single flare definition, and highlighting the need for a standardized definition. No conclusions could be drawn on risk factors, highlighting the need for further research.

PROSPERO REGISTRATION: CRD42024482657.},
}

Humans
Risk Factors
Incidence
*Arthritis, Psoriatic/epidemiology/diagnosis
*Symptom Flare Up

@article {pmid40891005,
year = {2025},
author = {Allan, HT and O'Driscoll, M},
title = {Using Recontextualisation Theory to Understand Learning Across Multiple Sites in Simulation-Based Nurse Education.},
journal = {Journal of advanced nursing},
volume = {},
number = {},
pages = {},
doi = {10.1111/jan.70163},
pmid = {40891005},
issn = {1365-2648},
abstract = {AIM: The aim of this discussion paper is to explore whether recontextualisation theory deepens our understanding of learning across multiple sites when introducing simulation-based education (SBE) into nurse education.

BACKGROUND: The requirement for students to learn in clinical placements remains an aspiration as well as a regulatory requirement internationally. Yet, the increasing complexity of healthcare and the numbers of vacancies in the healthcare workforce globally have led to poor learning environments. In the context of faster internet speeds, rapid development in virtual technologies, affordability of hardware, and the move to online educational provision after the COVID-19 pandemic, SBE has emerged as a key teaching method in health professional preparation programmes globally.

DESIGN: Critical discussion paper.

METHODS: This discussion paper is based on current literature on SBE and recontextualisation theory.

FINDINGS: Evaluations of SBE often show positive outcomes for learning in nurse education. Weaknesses and gaps in the evidence on SBE, such as the scarcity of control groups or longitudinal studies, have been identified. Using recontextualization theory, we argue that SBE may also increase the theory-practice split for students across multiple sites of learning.

CONCLUSIONS: The introduction of SBE offers supplementary positive learning opportunities to those in clinical practice while at the same time creating multiple sites of learning which are not always aligned. More needs to be done to teach from a curriculum which relies on students being motivated and able to learn across multiple sites of learning.

To support student nurses in UG professional preparation programmes which rely on SBE as well as clinical practice and universities, shared values between nurse educators and clinical nurses need to be enacted collaboratively. This could be achieved by reframing how students and nurses learn and rework knowledge across sites of learning.},
}

@article {pmid40890766,
year = {2025},
author = {Herdiana, H and Prameswari, HD and Puspadewi, RT and Fajariyani, SB and Diptyanusa, A and Theodora, M and Supriyanto, D and Hawley, WA},
title = {Shrinking the malaria map in Indonesia: progress of subnational control, elimination, and future strategies.},
journal = {BMC medicine},
volume = {23},
number = {1},
pages = {512},
pmid = {40890766},
issn = {1741-7015},
mesh = {Indonesia/epidemiology ; Humans ; *Malaria/epidemiology/prevention & control/transmission ; *Disease Eradication/methods ; COVID-19/epidemiology ; },
abstract = {BACKGROUND: Indonesia has a complex pattern of malaria transmission alongside a highly decentralized system of governance. Indonesia applies a subnational elimination strategy to achieve nationwide malaria elimination by 2030. This review describes Indonesia's subnational verification process, assesses progress towards subnational elimination over the past several decades, and explores strategies to accelerate achievement of elimination, including the challenges of high transmission in lowland Papua region and zoonotic malaria in Sumatra and Kalimantan islands.

METHODS: Published and unpublished data, reports, and grey literature in Indonesian and English from 1950 to 2023 were collected and analyzed. These reports document strategies, geographic coverage, and malaria metrics. Most of the unpublished data and reports are from the Ministry of Health of Indonesia, including the guidelines describing processes for certification of district-level malaria elimination.

RESULTS: While the number of malaria cases has fluctuated over the years, cases decreased significantly by 2015 but increased during the Coronavirus disease-19 (COVID-19) pandemic. Nonetheless, as of 2023, 389 of 514 districts and five of 38 provinces had been verified as having no local transmission of malaria, with the most rapid progress observed in western Indonesia. We describe the malaria elimination verification process in detail, including the criteria used and challenges encountered. Malaria cases are now localized in the Papua region, which reports more than 90% of cases in the country. The lowland Papua region experiences high transmission with malaria incidence of over 400 cases per 1000 person-years due to its efficient vectors and high year-round rainfall. Expansion of malaria transmission to highland Papua due to climate change is likely happening. In the west, pockets of transmission persist in remote areas and among mobile and migrant populations. Further, frequent outbreaks occur in malaria-free districts, with two districts now experiencing re-established transmission. In addition, reports of zoonotic Plasmodium knowlesi infections in humans are increasing.

CONCLUSIONS: Existing interventions will need to be well-managed, and new combinations of interventions implemented if Indonesia is to achieve its goal of malaria elimination by 2030, particularly in high-endemic Papua, which will remain a source of importation of malaria to other regions of Indonesia if malaria there is not eliminated.},
}

Indonesia/epidemiology
Humans
*Malaria/epidemiology/prevention & control/transmission
*Disease Eradication/methods
COVID-19/epidemiology

@article {pmid40889099,
year = {2025},
author = {Pfefferbaum, B},
title = {Mass Trauma in Children: Expanding the Concept of Exposure in the Context of the COVID-19 Pandemic.},
journal = {Current psychiatry reports},
volume = {},
number = {},
pages = {},
pmid = {40889099},
issn = {1535-1645},
abstract = {PURPOSE OF REVIEW: This review examined the concept of exposure in children in the context of the COVID-19 pandemic. Recognizing the varied effects of the pandemic on children across a range of experiences, the review departed from the frequently-used analytic framework based on the stressor criterion for a diagnosis of posttraumatic stress disorder (PTSD).

RECENT FINDINGS: In addition to the more traditional types of exposure such as personal infection, illness or death of loved ones, and the experiences of children whose parents were essential workers, the review identified experiences among children in the general population as they adjusted to public health mandates, consumed pandemic media coverage, and dealt with the many changes in their daily lives.

CONCLUSIONS: While many COVID-19 experiences would not qualify as exposure for a diagnosis of PTSD, the research recognizes the importance of these experiences and their influence on various outcomes in children.},
}

@article {pmid40889005,
year = {2025},
author = {Kumari, N and Raja, K},
title = {Potential Application of Carbon Dots for Sustainable Agriculture: Current Challenges and Future Prospects.},
journal = {Journal of fluorescence},
volume = {},
number = {},
pages = {},
pmid = {40889005},
issn = {1573-4994},
abstract = {The depletion of arable land, water scarcity, frequent climate fluctuations, the onset of the COVID-19 pandemic, inefficiencies in pesticide usage, and the Ukraine-Russia conflict, which disrupted global supplies of fertilisers, have collectively heightened crop strain and reduced agricultural productivity. In this regard, to overcome these agriculture problems, adopting a sustainable approach for agricultural production plays a significant role in ensuring global food security. Carbon dots, a novel member of the carbon-based nanomaterial's family with extraordinary properties such as chemical stability, water solubility, low cytotoxicity, small size, biocompatibility, and photoluminescence, have recently attracted attention in agriculture sectors. The abundant hydrophilic functional groups on the surface of carbon dots, together with their small size and structural features, provide several advantages, such as increased crop growth, improved photosynthesis, stress tolerance, and accelerated seed germination. Carbon dots have also shown impressive advantages in nutrient uptake, and acting as sensors for pesticides, herbicides, and nutrients. Furthermore, carbon dots facilitate precise gene delivery into plant cells creating opportunities for genetic improvement and also enhance post-harvest preservation. This review highlights the potential of carbon dots in the field of agriculture, covering their classification, source of synthesis, and their diverse applications in the field of agriculture. While their potential is vast, further research is essential to address toxicological concerns and environmental impacts to ensure their safe and effective integration into agricultural system. Lastly, the limitations and future perspectives are outlined, which need to be focused on promoting the potential application of carbon dots in the agricultural sector.},
}

@article {pmid40887716,
year = {2025},
author = {Miyashita, N},
title = {Contemporary Concise Review 2024: Respiratory Infections.},
journal = {Respirology (Carlton, Vic.)},
volume = {},
number = {},
pages = {},
doi = {10.1111/resp.70113},
pmid = {40887716},
issn = {1440-1843},
abstract = {Since public health measures against COVID-19 were relaxed, widespread outbreaks of respiratory infections such as influenza and respiratory syncytial virus (RSV), as well as infectious diseases transmitted by droplets and droplet nuclei, have been reported around the world. While there is evidence of antiviral drug efficacy against non-severe influenza, the emergence of two genetic mutations (I223V or S247N) that reduce susceptibility to neuraminidase inhibitors has been confirmed. Influenza vaccines are less effective in older people than in younger people; so high-dose influenza vaccines are recommended. RSV infection has a high disease burden among elderly people; however, vaccination is expected to limit or prevent severe disease. Macrolide-resistant strains of Mycoplasma species and Bordetella pertussis are common in East Asia, but an increase in resistant strains has also been observed in other Asian regions. Pneumonia in elderly people often leads to a decline in physical function. In a super-aging society, aspiration pneumonia occurs frequently. Hence, there is increasing awareness of the need for advance care planning discussions for pneumonia as well as malignant diseases. The use of inhaled steroids in bronchiectasis is not recommended because of the increased risk of infection; but in clinical practice, inhaled steroids are frequently used and are effective in some patients with bronchiectasis.},
}

@article {pmid40886810,
year = {2025},
author = {Bahrami, Y and Bolideei, M and Mohammadzadeh, S and Gahrouei, RB and Mohebbi, E and Haider, KH and Barzigar, R and Mehran, MJ},
title = {Applications of artificial intelligence and nanotechnology in vaccine development.},
journal = {International journal of pharmaceutics},
volume = {},
number = {},
pages = {126096},
doi = {10.1016/j.ijpharm.2025.126096},
pmid = {40886810},
issn = {1873-3476},
abstract = {Vaccines have long been crucial in safeguarding public health by preventing and controlling infectious diseases. However, traditional vaccine development methods face challenges in efficiency, cost, and response time to emerging pathogens. Recent progress in art AI and nanotechnology is revolutionizing this landscape, offering innovative solutions for vaccine design, delivery, and optimization. This manuscript examines the transformative impact of AI and nanotechnology on advancing vaccine development, highlighting their synergistic effect in overcoming traditional limitations. AI, particularly machine learning (ML) and deep learning (DL) algorithms, facilitates rapid identification of immunogenic antigens and epitopes by analyzing vast genomic, proteomic, and immunological datasets. These computational tools optimize vaccine design by predicting antigen stability, immunogenicity, and efficacy, as exemplified by the expedited development of COVID-19 vaccines. Nanotechnology complements these advancements by providing engineered nanoparticles (NPs), including liposomes, polymeric NPs, and biomimetic systems, that enhance antigen delivery, stability, and immune activation. Innovations such as virus-like particles (VLPs) and immune-stimulating complexes (ISCOMs) further enhance vaccine safety and efficacy by mimicking natural infection processes to trigger robust, targeted immune responses. Integrating AI and nanotechnology presents remarkable opportunities for developing personalized immunization strategies. AI algorithms can assess individual immune profiles to design customized vaccines, while nanotechnology enables precise delivery and controlled release of antigens. This interdisciplinary approach accelerates vaccine development, ensuring both safety and efficacy, and lays the foundation for universal vaccines and cancer vaccines that target complex pathogens and non-infectious diseases. Together, AI and nanotechnology herald a new era in vaccinology, enabling the development of vaccines that are faster, more precise, and highly adaptable to emerging and complex health challenges.},
}

@article {pmid40886308,
year = {2025},
author = {Farkas, FB and Karászi, É and Kulcsár, A and Onozó, B and Pék, T and Tróbert-Sipos, D and Mészner, Z and Lakatos, B and Kassa, C and Bereczki, C and Decsi, T and Szabó, T and Szabó, JA},
title = {[RSV infections: characteristics and prevention strategies].},
journal = {Orvosi hetilap},
volume = {166},
number = {35},
pages = {1362-1373},
doi = {10.1556/650.2025.33364},
pmid = {40886308},
issn = {1788-6120},
mesh = {Humans ; *Respiratory Syncytial Virus Infections/prevention & control/epidemiology ; *Respiratory Syncytial Virus Vaccines/administration & dosage ; COVID-19 ; Vaccination ; Respiratory Syncytial Virus, Human/immunology ; },
}

Humans
*Respiratory Syncytial Virus Infections/prevention & control/epidemiology
*Respiratory Syncytial Virus Vaccines/administration & dosage
COVID-19
Vaccination
Respiratory Syncytial Virus, Human/immunology

@article {pmid40885198,
year = {2025},
author = {von Lilienfeld-Toal, M and Khawaja, F and Compagno, F and Robin, C and Piñana, JL and Cesaro, S and Einsele, H and Ljungman, P and Navarro, D and Boeckh, M and Chemaly, RF and Hirsch, HH},
title = {Community-acquired respiratory virus infections in patients with haematological malignancies or undergoing haematopoietic cell transplantation: updated recommendations from the 10th European Conference on Infections in Leukaemia.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(25)00365-2},
pmid = {40885198},
issn = {1474-4457},
abstract = {To update recommendations of the 4th European Conference on Infections in Leukaemia (ECIL-4) on community-acquired respiratory virus (CARV) infections published in 2013, we reviewed publications from between Jan 1, 2014, and June 30, 2024 on adenovirus, bocavirus, coronavirus, influenzavirus, metapneumovirus, parainfluenzavirus, respiratory syncytial virus (RSV), and rhinovirus in patients with haematological malignancies or undergoing haematopoietic cell transplantation (HCT), or both. In the current ECIL recommendations (ECIL-10), we outline a common approach to infection control, laboratory testing, and diagnosis for all CARVs (including SARS-CoV-2) and specific management and deferral strategies for CARVs other than SARS-CoV-2. For influenzavirus, seasonal inactivated-vaccines and early antivirals are recommended, whereas routine antiviral prophylaxis is discouraged for immunocompromised patients. For RSV, licensed vaccines can be considered according to local approval, despite scarce evidence for patients with haematological malignancies and those undergoing HCT. Passive immunisation with palivizumab or nirsevimab is recommended for children younger than 2 years, but data are insufficient for pre-exposure or post-exposure prophylaxis, or treatment of older children and adults. Oral ribavirin or intravenous immunoglobulins, or a combination of the two, are recommended for patients undergoing HCT with severe immunodeficiency scores. For other CARVs, recommendations include only supportive care, improving immune functions, correcting hypogammaglobulinaemia, and judicious lowering of corticosteroids. We highlight unmet needs in immunisation and antivirals for reducing CARV-associated morbidity and mortality in patients with haematological malignancies and those undergoing HCT.},
}

@article {pmid40884531,
year = {2025},
author = {Apoorva, and Singh, SK},
title = {Pathogenic breaches: how viruses compromise blood-tissue barriers.},
journal = {Tissue barriers},
volume = {},
number = {},
pages = {2549020},
doi = {10.1080/21688370.2025.2549020},
pmid = {40884531},
issn = {2168-8370},
abstract = {Blood-tissue barriers (BTBs) are highly specialized, selectively permeable surfaces that separate the circulatory system from delicate tissues and organs. Critical examples include the blood-brain barrier (BBB), blood-retinal barrier (BRB), blood-testis barrier (BTB), and other organ-specific barriers, including the alveolar-capillary interface in the lungs and the glomerular filtration barrier in the kidneys. These barriers regulate the bidirectional transport of nutrients, gases, and waste while restricting pathogens, toxins, and immune cells to maintain physiological balance. Nevertheless, viruses have evolved multiple strategies to circumvent or compromise these barriers, facilitating viral entry, evading immune surveillance, and establishing infection within protected compartments. Neurotropic viruses, including the West Nile virus and Japanese encephalitis virus, impair the blood-brain barrier by disrupting tight junction proteins and cytokine storms. In contrast, respiratory viruses such as influenza and SARS-CoV-2 affect the lung barrier, resulting in alveolar injury and systemic inflammation. Other viruses, such as the Zika virus, affect the BTB and placental barriers, presenting significant risks to fetal development and reproductive health. Such breaches facilitate viral spread, exacerbate tissue damage, and complicate therapeutic interventions. This review provides a comprehensive overview of blood-tissue barrier architecture, function, and mechanisms of viral disruption, highlighting their dual role in protection and susceptibility during viral infections. By elucidating interactions between viruses and blood-tissue barriers, this work highlights emerging research directions to mitigate viral pathogenesis and enhance treatment efficacy for barrier-associated diseases.},
}

@article {pmid40884514,
year = {2025},
author = {Decker, V and Qureshi, K and Roberts, L and Powell, N and Marchesi, JR and Mullish, BH and Alexander, JL},
title = {The emerging role of the gut microbiota in vaccination responses.},
journal = {Gut microbes},
volume = {17},
number = {1},
pages = {2549585},
doi = {10.1080/19490976.2025.2549585},
pmid = {40884514},
issn = {1949-0984},
mesh = {*Gastrointestinal Microbiome/immunology ; Humans ; Animals ; Vaccination ; COVID-19 Vaccines/immunology ; Probiotics/administration & dosage ; Influenza Vaccines/immunology ; SARS-CoV-2/immunology ; Hepatitis B Vaccines/immunology ; COVID-19/prevention & control/immunology ; },
abstract = {The gut microbiota has emerged as a key modulator of host immune responses, and growing evidence suggests it plays a role in shaping vaccine-induced immunity. While immunization remains vital for preventing infectious diseases, inter-individual variability in vaccine responses poses a persistent challenge. Traditional factors such as age, sex, genetics, and immune status do not fully account for this variability. Recent studies highlight the gut microbiome as a potential contributor. This review examines current evidence linking the gut microbiota to vaccine responses, with a focus on vaccines against SARS-CoV-2, hepatitis B virus, and influenza. Human studies show associations between microbial composition, particularly taxa like Bifidobacterium adolescentis, and immunogenicity. Microbial metabolites, such as short-chain fatty acids and bile acids, influence T-cell differentiation, antibody production, and cytokine responses. Factors that alter microbiota composition, including antibiotics, diet, and prebiotic or probiotic supplementation, can impact vaccine responses, highlighting a dynamic gut-immune relationship. Experimental models further support these observations, showing diminished responses in germ-free or antibiotic-treated animals and enhanced responses following microbial-based interventions. These findings also suggest the gut microbiota may be harnessed to improve vaccine efficacy. Future research should explore the potential for microbiota-targeted strategies to optimize vaccine efficacy, particularly in immunocompromised populations.},
}

*Gastrointestinal Microbiome/immunology
Humans
Animals
Vaccination
COVID-19 Vaccines/immunology
Probiotics/administration & dosage
Influenza Vaccines/immunology
SARS-CoV-2/immunology
Hepatitis B Vaccines/immunology
COVID-19/prevention & control/immunology

@article {pmid40883647,
year = {2025},
author = {Fayyad-Kazan, M},
title = {MicroRNAs in SARS-CoV-2 infection: emerging modulators of inflammation, pathogenesis, and therapeutic potential.},
journal = {Inflammopharmacology},
volume = {},
number = {},
pages = {},
pmid = {40883647},
issn = {1568-5608},
abstract = {Since the onset of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), elucidating the molecular regulators of viral pathogenesis and host response has been a critical international research objective. Among these, microRNAs (miRNAs), small non-coding RNAs, that modulate gene expression post-transcriptionally-have emerged as central orchestrators of host-virus interactions. This review exhaustively examines the roles of host-derived miRNAs in SARS-CoV-2 infection, including their roles in viral entry, replication, immune evasion, inflammation, and tissue injury. Dysregulation of certain miRNAs, such as miR-155, miR-146a, and miR-21, has been implicated in disease severity, comorbidities (such as diabetes, obesity), neurological complications, and pregnancy complications. In long COVID (PASC), chronic miRNA changes are linked to persistent inflammation, fibrosis, and cardiometabolic impairment. We emphasize current breakthroughs in miRNA research, including machine learning algorithms for miRNA-based disease stratification, CRISPR-engineered miRNA modulation, exosomal miRNA delivery platforms, and miRNA-adjuvanted vaccines. These advances highlight the potential of miRNAs as diagnostic biomarkers and therapeutic targets. Nevertheless, shortcomings persist in clinical validation, delivery optimization, and tissue-specific miRNA function elucidation. These gaps must be addressed to involve miRNAs in controlling current and future viral infections. This review consolidated differentially expressed miRNAs across disease stages, comorbidities, and clinical settings, providing a valuable resource for translational research and therapeutic innovation.},
}

@article {pmid40276849,
year = {2025},
author = {Kim, DH and Wang, M and Kim, S and Jang, DW and Ko, T and Goldstein, BJ},
title = {Strategies to Develop Regenerative Medicine Approaches for Olfactory Disorders.},
journal = {Clinical and experimental otorhinolaryngology},
volume = {18},
number = {3},
pages = {204-209},
doi = {10.21053/ceo.2025-00065},
pmid = {40276849},
issn = {1976-8710},
support = {//Duke University School of Medicine/ ; //Seoul St. Mary's Hospital, The Catholic University of Korea/ ; RS-2023-00209494//National Research Foundation of Korea/ ; //Ministry of Science and ICT/ ; 23C0121L1//Korean Fund for Regenerative Medicine/ ; },
abstract = {Olfactory loss affects more than 12% of the population, with prevalence increasing in aging individuals. Multiple conditions can lead to a loss of smell (hyposmia or anosmia), including post-viral damage from coronavirus disease 2019 (COVID-19) or influenza, head injuries, sinusitis, or neurodegenerative conditions such as Alzheimer or Parkinson disease. Although treatments like surgery, anti-inflammatory medications, or olfactory training can be beneficial in certain cases, there remains an unmet need for effective therapies addressing many common causes of olfactory dysfunction. This is particularly true for cases attributed to damage of olfactory neurons that fail to spontaneously recover. Regenerative medicine approaches, aimed at either stimulating the regrowth of sensory neural structures or replacing them through cell-based therapies, have attracted considerable interest for treating various neurological disorders, including olfactory loss. Here, we summarize the intrinsic regenerative capabilities of the peripheral olfactory system, focusing on current research strategies and the existing barriers that must be overcome for successful translational applications. A major unmet need in this field involves the establishment of reliable and widely accepted culture models for expanding and differentiating olfactory stem or progenitor cells from rodents and humans, both for use in vitro assays and as potential material for cell-based therapies.},
}

@article {pmid39171491,
year = {2025},
author = {Lenhard, NK and An, C and Jasthi, D and Laurel-Vargas, V and Weinstein, I and Lam, SK},
title = {Virtual global health education partnerships for health professional students: a scoping review.},
journal = {Global health promotion},
volume = {32},
number = {2},
pages = {14-22},
doi = {10.1177/17579759241248401},
pmid = {39171491},
issn = {1757-9767},
mesh = {Humans ; *Global Health/education ; *Education, Distance/methods/organization & administration ; COVID-19/epidemiology ; SARS-CoV-2 ; *Health Personnel/education ; },
abstract = {INTRODUCTION: Although there is rising interest in virtual global health (GH) education in light of the COVID-19 pandemic, there has been no report on the body of literature describing virtual education partnerships for health professional students. This scoping review examines virtual GH partnerships involving health professional students, including any barriers identified or best practices and ways to address them.

METHODS: We searched PubMed for studies describing virtual GH education partnerships using keywords related to GH, virtual learning, and partnerships. Inclusion criteria were that the activity was virtual, involved health professional students in two or more countries, and was reported in English or Spanish. In-person clinical electives and interventions that had not yet occurred were excluded. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI).

RESULTS: The search algorithm yielded 308 articles. Seventeen studies met full inclusion criteria. Four studies described asynchronous formats, whereas 13 were synchronous. Common challenges included scheduling challenges, language barriers, and technological limitations. Suggested improvements included having increased faculty support and expanding partnerships to multiple languages. The median MERSQI score was 8.25 out of 18 possible points.

CONCLUSION: There are limited studies investigating the effectiveness of virtual GH education partnerships, and more robust evaluation is needed to further understand the optimal role of virtual education in teaching GH skills. Despite logistical challenges, virtual partnerships can provide innovative GH education through bidirectional educational exchanges that students find valuable.},
}

Humans
*Global Health/education
*Education, Distance/methods/organization & administration
COVID-19/epidemiology
SARS-CoV-2
*Health Personnel/education

@article {pmid38836418,
year = {2025},
author = {Kunjavara, J and Ali Alomari, AM and Mannethodi, K and Hassan, N and Singh, K and Joy, GV and Al Lenjawi, B},
title = {Middle East Nurses Turnover Intention and its Correlates Amid the COVID-19 Pandemic: A Systematic Review.},
journal = {Hospital topics},
volume = {103},
number = {3},
pages = {173-181},
doi = {10.1080/00185868.2024.2359551},
pmid = {38836418},
issn = {1939-9278},
mesh = {Humans ; *COVID-19/epidemiology/nursing/psychology ; *Personnel Turnover/statistics & numerical data ; Middle East/epidemiology ; Pandemics ; *Nurses/psychology ; *Intention ; *Nursing Staff, Hospital/psychology ; },
abstract = {Global nursing scarcity was more evident during COVID-19. This study investigated the rates and contributing factors of turnover intention in the middle east through meta-analysis. Medline EMCARE, Cochrane, CINAHL, EMBASE, Ovid, Psych Info, PubMed, Science Direct, Scopus, and Web of Science databases searched, Protocol PROSPERO Registration Number was CRD42022337686. The turnover intention rate was 42.3% [CI: 40%, 44.6%]. Working environment, stress, deployment to COVID, fear of infection, long working hours, shift duties, and lack of social support were the major contributing factors.},
}

Humans
*COVID-19/epidemiology/nursing/psychology
*Personnel Turnover/statistics & numerical data
Middle East/epidemiology
Pandemics
*Nurses/psychology
*Intention
*Nursing Staff, Hospital/psychology

@article {pmid40883045,
year = {2025},
author = {Kyriopoulos, I and Athanasakis, K and Tsoli, S and Mossialos, E and Papanicolas, I},
title = {Addressing public health and health system challenges in Greece: reform priorities in a changing landscape.},
journal = {The Lancet. Public health},
volume = {10},
number = {9},
pages = {e794-e803},
doi = {10.1016/S2468-2667(25)00188-4},
pmid = {40883045},
issn = {2468-2667},
mesh = {Greece/epidemiology ; Humans ; *Public Health ; *Health Care Reform/organization & administration ; *Delivery of Health Care/organization & administration ; COVID-19/epidemiology ; Health Policy ; *Health Priorities ; },
abstract = {Health systems are under growing pressure from ageing populations, chronic diseases, and financial constraints, compounded by challenges, such as COVID-19 and climate change. In Greece, these pressures have converged in the past 15 years, exposing structural weaknesses and testing the health system's resilience. Despite successive reforms targeting funding, care delivery, and public health, persistent structural weaknesses, poor planning, and limited monitoring have undermined progress. Most policy responses have remained fragmented and are unable to fulfil their potential to address current public health challenges or prepare for future crises. Building health system sustainability and resilience requires more than enacting reforms. The reform process demands evidence-informed policy making, sustained political commitment, strong institutional capacity, and effective multisectoral coordination. Greece offers valuable lessons for countries facing similar pressures: resilience depends not only on policy adoption, but also on the institutions, resources, and accountability mechanisms that support implementation and translate policies into sustained action.},
}

Greece/epidemiology
Humans
*Public Health
*Health Care Reform/organization & administration
*Delivery of Health Care/organization & administration
COVID-19/epidemiology
Health Policy
*Health Priorities

@article {pmid40881732,
year = {2025},
author = {Yu, J and Cheong, IH and Kozlakidis, Z and Wang, H},
title = {Advancements and challenges of artificial intelligence in dermatology: a review of applications and perspectives in China.},
journal = {Frontiers in digital health},
volume = {7},
number = {},
pages = {1544520},
pmid = {40881732},
issn = {2673-253X},
abstract = {The diagnosis of skin diseases can be challenging due to their diverse manifestations, while early detection of malignant skin cancers greatly improves the prognosis, highlighting the pressing need for efficient screening methods. In recent years, advancements in AI have paved the way for AI-aided diagnosis of skin lesions. Furthermore, the COVID-19 pandemic has spurred the demand of telemedicine, accelerating the integration of AI into medical domains, particularly in China. This article aims to provide an overview of the progress of AI-aided diagnosis in Chinese dermatology. Given the widespread use of public datasets in the reviewed studies, we compared the performance of AI models in segmentation and classification on public datasets. Despite the promising results of AI in experimental settings, we recognize the limitations of these public datasets in representing clinical scenarios in China. To address this gap, we reviewed the studies that used clinical datasets and conducted comparative analyses between AI and dermatologists. Although AI demonstrated comparable results to human experts, AI still cannot replace dermatologists due to limitations in generalizability and interpretability. We attempt to provide insights into improving the performance of AI through advancements in dataset quality, image pre-processing techniques, and integration of medical data. Finally, the role that AI will play in the medical practice and the relationship between AI and dermatologists are discussed. This systematic review addresses the gap in evaluating AI applications in Chinese dermatology, with a focus on dermatological datasets and real-world application.},
}

@article {pmid40881746,
year = {2025},
author = {Bozkurt, HB and Özdemir, Ö},
title = {Changes regarding solid organ transplantation during the COVID-19 pandemic.},
journal = {World journal of transplantation},
volume = {15},
number = {3},
pages = {100591},
pmid = {40881746},
issn = {2220-3230},
abstract = {Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 and emerged in Wuhan, China. It affects millions of people all over the world and has caused the deaths of thousands of people. Mortality rates were higher in transplant recipients and patients awaiting transplantation due to social and psychological issues. It also affected candidates who would be transplant providers and caused the transplant chain to be broken worldwide. The coronavirus disease 2019 pandemic has significantly affected solid organ transplantation procedures and led to various changes in protocols and practices to ensure patient safety and increase transplant success. These include challenges in screening protocols, prioritization of cases, telemedicine and virtual consultations, modified surgical procedures, immunosuppression management, updated research and guidelines, post-transplantation process and difficulties to control side effects, difficulties in organ procurement, and patient education/support. It requires a multidisciplinary approach, close collaboration between transplant teams, and adherence to strict infection control measures to ensure the safety of both transplant recipients and healthcare providers. In this article, we compiled the most important points in an overview of this process.},
}

@article {pmid40743702,
year = {2025},
author = {Roitenberg, N},
title = {Integrating knowledge on diversity in nursing education: A bibliometric review of thematic trends and trajectories.},
journal = {Nurse education in practice},
volume = {87},
number = {},
pages = {104490},
doi = {10.1016/j.nepr.2025.104490},
pmid = {40743702},
issn = {1873-5223},
mesh = {*Bibliometrics ; Humans ; *Cultural Diversity ; *Education, Nursing/trends ; COVID-19 ; },
abstract = {AIM: This study aims to analyze the thematic advances and trajectory of diversity in nursing education through bibliometric analysis.

BACKGROUND: The growing emphasis on diversity in nursing education underscores its increasing importance and impact on nursing practice and healthcare outcomes. However, a key gap remains, as diversity in nursing education has largely been studied in a manner that lacks integration of the various topics composing the scholarly knowledge and lacks cohesive thematic development or exploration of this knowledge base. Consequently, a comprehensive bibliometric review that provides an integrated overview of this critical area, highlighting its thematic evolution and historical development, is still needed.

DESIGN: Bibliometric analytic methods.

METHODS: The data were analyzed, and the graphic representation was made using the Bibliometrix Package of R software. A search of the Web of Science Core Collection was conducted on April 29, 2025. Descriptive analysis, citation analysis, co-word analysis, cooperation analysis and theme map analysis were among the techniques employed.

RESULTS: From 658 articles, 1521 author keywords were identified. Publications have increased over three decades at an annual rate of 10.64 %. Core themes forming the foundation of the field include nursing education and nursing education diversity. Key research drivers are represented by themes such as COVID-19, nursing diversity, cultural safety and health workforce.

CONCLUSIONS: This bibliometric study highlights the growing recognition of diversity's importance in nursing education. Findings show a global rise in research, reflecting increased commitment to addressing diversity-related challenges.},
}

*Bibliometrics
Humans
*Cultural Diversity
*Education, Nursing/trends
COVID-19

@article {pmid40881694,
year = {2025},
author = {Chen, K and Hu, J and Li, J and Wu, G and Tie, X and Wu, H and Li, H and Li, J and Zhang, Y},
title = {Harnessing cellular immunity for next-generation vaccines against respiratory viruses: mechanisms, platforms, and optimization strategies.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1618406},
doi = {10.3389/fimmu.2025.1618406},
pmid = {40881694},
issn = {1664-3224},
mesh = {Humans ; *Immunity, Cellular ; *COVID-19/immunology/prevention & control ; *SARS-CoV-2/immunology ; *Respiratory Syncytial Virus Infections/immunology/prevention & control ; Animals ; *COVID-19 Vaccines/immunology ; *Respiratory Tract Infections/immunology/prevention & control/virology ; *Influenza, Human/immunology/prevention & control ; *Viral Vaccines/immunology ; T-Lymphocytes/immunology ; Respiratory Syncytial Virus Vaccines/immunology ; },
abstract = {Respiratory tract infections, such as influenza, respiratory syncytial virus (RSV) infection, and COVID-19, remain a persistent threat to global public health due to their high transmissibility and disease burden. Vaccination, as a key preventive strategy, not only reduces the risk of infection but also blocks transmission by activating adaptive immunity. While traditional vaccine evaluations have primarily focused on humoral immunity, growing evidence highlights the critical role of T lymphocyte-mediated cellular immunity in clearing virus-infected cells, establishing long-term immune memory, and responding to viral mutations. This review systematically summarizes the cellular immune responses induced by vaccines against respiratory tract infections and their correlation with protective efficacy. It also outlines evaluation methodologies such as flow cytometry, providing a theoretical foundation for optimizing vaccine design and assessment, and advancing the development of effective, broad-spectrum vaccines.},
}

Humans
*Immunity, Cellular
*COVID-19/immunology/prevention & control
*SARS-CoV-2/immunology
*Respiratory Syncytial Virus Infections/immunology/prevention & control
Animals
*COVID-19 Vaccines/immunology
*Respiratory Tract Infections/immunology/prevention & control/virology
*Influenza, Human/immunology/prevention & control
*Viral Vaccines/immunology
T-Lymphocytes/immunology
Respiratory Syncytial Virus Vaccines/immunology

@article {pmid40881003,
year = {2025},
author = {Kelleni, MT},
title = {Kelleni's protocol incorporating non-steroidal anti-inflammatory drugs and nitazoxanide to early manage dengue virus disease: An antiviral silver bullet.},
journal = {World journal of clinical cases},
volume = {13},
number = {28},
pages = {108181},
doi = {10.12998/wjcc.v13.i28.108181},
pmid = {40881003},
issn = {2307-8960},
abstract = {The current recommendation to avoid non-steroidal anti-inflammatory drugs (NSAIDs) in the management of dengue virus disease (DVD) is scientifically considered of very low to low certainty, despite being widely adopted worldwide. The same recommendation, initially made during the coronavirus disease 2019 (COVID-19) pandemic, was subsequently proven incorrect. In this clinical report, we present evidence, for the first time globally, from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19. Moreover, we propose that the personalized immune-modulatory Kelleni's protocol, which includes nitazoxanide as a key component, can be safely and effectively used to manage various separate or concomitant viral infections and co-infections, including DVD. Importantly, this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses. However, it's crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.},
}

@article {pmid40880775,
year = {2025},
author = {Zhou, Y and Qiu, X and Yuan, T and Wang, Q and Du, L and Wang, L and Ding, Z},
title = {Research hotspots and frontiers of application of mass spectrometry breath test in respiratory diseases.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1618588},
doi = {10.3389/fmed.2025.1618588},
pmid = {40880775},
issn = {2296-858X},
abstract = {Mass spectrometry (MS)-based breath analysis has emerged as a promising non-invasive approach for diagnosing and monitoring respiratory diseases through the identification of volatile organic compounds (VOCs). This study conducted a comprehensive bibliometric analysis of 467 publications (2003-2024) to map global research trends, influential contributors, and thematic hotspots in this field. Results showed a sustained annual growth rate of 11.03%, with the United States, the United Kingdom, the Netherlands, and China leading in publication output and institutional collaborations. Key research areas included VOC profiling for COPD, asthma, lung cancer, and COVID-19, as well as advances in real-time MS techniques and machine learning-based data interpretation. Co-citation analysis revealed a shift toward precision medicine and multi-omics integration, underscoring the field's transition from discovery to clinical translation. Despite challenges in standardization and reproducibility, MS-based breathomics holds transformative potential for respiratory diagnostics. This study provides a roadmap for future research priorities, emphasizing the need for interdisciplinary collaboration, composite biomarker validation, and artificial intelligence integration.},
}

@article {pmid40728675,
year = {2025},
author = {Kow, CS and Ramachandram, DS and Hasan, SS and Thiruchelvam, K},
title = {Effect of N-Acetylcysteine on mortality in COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.},
journal = {Inflammopharmacology},
volume = {33},
number = {8},
pages = {4871-4877},
pmid = {40728675},
issn = {1568-5608},
mesh = {Humans ; *Acetylcysteine/therapeutic use/administration & dosage ; Randomized Controlled Trials as Topic/methods ; *COVID-19 Drug Treatment ; *COVID-19/mortality ; },
abstract = {INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has prompted global interest in potential adjunctive therapies. N-acetylcysteine (NAC), a mucolytic agent that enhances intracellular glutathione synthesis, has antioxidant properties and may indirectly modulate inflammation through redox regulation. While preclinical and observational data suggest potential mortality benefits, findings from randomized controlled trials (RCTs) have been inconsistent.

OBJECTIVE: To systematically review and synthesize the evidence from RCTs evaluating the effect of NAC on mortality in patients with COVID-19.

METHODS: This systematic review and meta-analysis was conducted according to PRISMA guidelines. Six databases were searched from inception to March 21, 2025. Eligible studies were RCTs comparing NAC to placebo or standard care in adult COVID-19 patients, with mortality as a reported outcome. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. Statistical analyses were performed with a random-effects model to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: Ten RCTs comprising 1,424 patients were included. NAC regimens varied by dose and route. The pooled OR for mortality was 0.49 (95% CI: 0.25-0.94; I[2] = 67%), indicating a 51% reduction in the odds of death among patients receiving NAC. Seven studies had low risk of bias; three had some concerns, primarily due to open-label designs.

CONCLUSION: NAC may reduce mortality in COVID-19 patients, particularly when administered at higher doses or via non-oral routes. Further large-scale RCTs are needed to confirm these findings and establish optimal dosing and administration strategies.},
}

Humans
*Acetylcysteine/therapeutic use/administration & dosage
Randomized Controlled Trials as Topic/methods
*COVID-19 Drug Treatment
*COVID-19/mortality

@article {pmid40304889,
year = {2025},
author = {Rijcken, CJF},
title = {The translational journey of cancer nanomedicines: biological and entrepreneurial lessons learned.},
journal = {Drug delivery and translational research},
volume = {15},
number = {10},
pages = {3351-3362},
pmid = {40304889},
issn = {2190-3948},
mesh = {Humans ; *Nanomedicine/methods ; *Neoplasms/drug therapy ; *Antineoplastic Agents/administration & dosage/therapeutic use ; *Translational Research, Biomedical ; *Docetaxel/administration & dosage/therapeutic use ; Drug Development ; Micelles ; Drug Liberation ; },
abstract = {Despite exhaustive investments, the breakthrough potential of nanomedicines (NM) is not yet realized. Whilst Doxil and covid-19 vaccines demonstrated certain benefits, many NM failed in clinical development. Lies the true reason for this limited success in inappropriate assumptions, incorrect approaches, or other omissions? This note describes the translational journey of CPC634 (docetaxel entrapping core-crosslinked polymeric micelles) and illustrates lessons learned in drug product development. Scientific elements are to understand the pathophysiology of the diseased tissue, the journey of NM upon administration and resulting drug release and the induced pharmacodynamic effects over time, particularly in actual patients. Industrial elements comprise market-product fit, target product profile, competitive benchmarking, while development efficiency focuses to generate a positive business case. A goal-oriented product design which is validated by external experts increases chances of development success and assures investor-readiness. NM development will progress by aligning fundamental biological insights with industrial product requirements, driving therapeutic breakthroughs.},
}

Humans
*Nanomedicine/methods
*Neoplasms/drug therapy
*Antineoplastic Agents/administration & dosage/therapeutic use
*Translational Research, Biomedical
*Docetaxel/administration & dosage/therapeutic use
Drug Development
Micelles
Drug Liberation

@article {pmid39575994,
year = {2025},
author = {Somerton, A and Jeffrey, H},
title = {'It's that camaraderie': Experiences of a Long-COVID peer support group for staff working in health, social care and emergency services.},
journal = {Journal of health psychology},
volume = {30},
number = {10},
pages = {2460-2474},
doi = {10.1177/13591053241296184},
pmid = {39575994},
issn = {1461-7277},
mesh = {Humans ; *COVID-19/psychology ; *Peer Group ; Male ; United Kingdom ; *Health Personnel/psychology ; Female ; Adult ; *Self-Help Groups ; SARS-CoV-2 ; Middle Aged ; Qualitative Research ; Emergency Medical Services ; },
abstract = {Health, social care and emergency services staff, continue to feel the impact of Long-COVID. Using quantitative and qualitative methods, this study aims to evaluate the experience of UK health and social care staff who participated in a virtual Long-COVID peer support group between May 2021 and May 2023. The outcome measures (SWEMWBS and PHQ9) show an improvement in post-group scores, suggesting participation in the peer support group is linked to improved wellbeing. Thematic analysis identified five key themes: finding connectedness, reciprocity, effective facilitation, filling the gaps and virtual format. This evaluation shows how peer support groups provided space for reciprocity and the positive outcomes associated with this. This evaluation highlights the importance of co-produced, needs-based services providing Long-COVID peer support.},
}

Humans
*COVID-19/psychology
*Peer Group
Male
United Kingdom
*Health Personnel/psychology
Female
Adult
*Self-Help Groups
SARS-CoV-2
Middle Aged
Qualitative Research
Emergency Medical Services

@article {pmid40880768,
year = {2025},
author = {Kudlay, D and Kozlov, V and Savchenko, AA and Simbirtsev, A and Anisimova, E and Kudryavtsev, I and Kulpina, A and Rubinstein, A and Ryabkova, VA and Churilov, LP and Sirotkina, O and Vavilova, T and Starshinova, AA and Borisov, A},
title = {Immunopathological syndromes: state of the art.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1633624},
doi = {10.3389/fmed.2025.1633624},
pmid = {40880768},
issn = {2296-858X},
abstract = {The review of the current state of knowledge on local and systemic immunopathological reactions of cellular and humoral origin, as well as the ways of their interaction, is considered in this article. This study aimed to organize, standardize, and conceptualize existing knowledge about immunopathological syndromes associated with innate immunity. It highlights syndromes linked to type I, II, and III hypersensitivity reactions, while also separately examining manifestations related to immunosuppression disorders. The review outlines how to differentiate humoral immunity syndromes based on the classes of immunoglobulins A, M, E, and the four subclasses of immunoglobulin G. Additionally, it provides a detailed analysis of complement system disorders and the mechanisms of systemic inflammatory response syndrome, as well as their role in various pathological processes. The authors advocate for a unified set of definitions for immunopathological syndromes related to adaptive immunity, aiming to develop a new concept of their pathogenesis. Currently, many definitions of these syndromes lack consensus, stemming from varying interpretations of their manifestations. The authors also propose standardized tools for assessing immunopathological syndromes, along with guidelines for staging and treatment optimization.},
}

@article {pmid40880575,
year = {2025},
author = {Chervenkov, L and Miteva, DG and Velikova, T},
title = {Utilizing artificial intelligence as an arbitrary tool in managing difficult COVID-19 cases in critical care medicine.},
journal = {World journal of critical care medicine},
volume = {14},
number = {3},
pages = {102808},
doi = {10.5492/wjccm.v14.i3.102808},
pmid = {40880575},
issn = {2220-3141},
abstract = {This opinion review paper explores the application of artificial intelligence (AI) as a decisive tool in managing complex coronavirus disease 2019 (COVID-19) cases within critical care medicine. Available data have shown that very severe cases required intensive care, most of which required endotracheal intubation and mechanical ventilation to avoid a lethal outcome if possible. The unprecedented challenges posed by the COVID-19 pandemic necessitate innovative approaches to patient care. AI offers significant potential in enhancing diagnostic accuracy, predicting patient outcomes, and optimizing treatment strategies. By analyzing vast amounts of clinical data, AI can support healthcare professionals in making informed decisions, thus improving patient outcomes. We also focus on current technologies, their implementation in critical care settings, and their impact on patient management during the COVID-19 crisis. Future directions for AI integration in critical care are also discussed.},
}

@article {pmid40880567,
year = {2025},
author = {Savvidis, C and Ragia, D and Kallistrou, E and Kouroglou, E and Tsiama, V and Proikaki, S and Belis, K and Ilias, I},
title = {Critical illness-implications of non-thyroidal illness syndrome and thyroxine therapy.},
journal = {World journal of critical care medicine},
volume = {14},
number = {3},
pages = {102577},
doi = {10.5492/wjccm.v14.i3.102577},
pmid = {40880567},
issn = {2220-3141},
abstract = {Nonthyroidal illness syndrome (NTIS) is a common finding in critically ill patients, characterized by disruptions in the hypothalamus-pituitary-thyroid axis, resulting in altered levels of thyroxine (T4), triiodothyronine (T3), and reverse T3. This condition, often considered to be an adaptive response aimed at conserving energy, can become maladaptive in prolonged critical illness, contributing to poor outcomes in intensive care unit patients. The pathophysiology of NTIS involves cytokine-driven alterations in thyroid hormone (TH) metabolism, impaired hormone transport, and reduced receptor sensitivity, which-collectively-suppress thyroid function. Despite these insights, the therapeutic role of TH replacement in patients with NTIS remains uncertain. Low doses of levothyroxine and T3 have been trialed, particularly in patients with cardiovascular comorbidities, but clinical studies report conflicting results regarding their impact on mortality and overall patient outcomes. While some evidence suggests potential benefits of T3 administration in specific subgroups, such as patients with septic shock or severe coronavirus disease 2019, robust clinical trials have yet to conclusively demonstrate improved survival or recovery. The heterogeneity in NTIS presentation and treatment protocols, as well as the complex nature of TH regulation in critically ill patients, complicates efforts to establish clear guidelines for hormone therapy. Future research should prioritize individualized approaches, optimizing hormone dosing and timing, while aiming to elucidate the long-term effects of such interventions on critically ill patients to improve morbidity and mortality outcomes.},
}

@article {pmid40879755,
year = {2025},
author = {Wang, L and He, D and Satoh-Takayama, N and Zheng, C and Xing, J},
title = {Regulation of antiviral and antimicrobial innate immunity and immune evasion.},
journal = {Cellular and molecular life sciences : CMLS},
volume = {82},
number = {1},
pages = {326},
pmid = {40879755},
issn = {1420-9071},
mesh = {*Immunity, Innate ; Humans ; *Immune Evasion ; Animals ; SARS-CoV-2/immunology ; Host-Pathogen Interactions/immunology ; Inflammasomes/immunology ; Signal Transduction ; Receptors, Pattern Recognition/immunology ; Autophagy ; *Virus Diseases/immunology ; COVID-19/immunology ; },
abstract = {The interplay between host innate immunity and pathogen evasion is a dynamic battle shaping infection outcomes. The Topical Collection "Regulation of Antiviral and Antimicrobial Innate Immunity and Immune Evasion" synthesizes findings from thirteen recent studies to elucidate the molecular mechanisms of innate immune signaling and pathogen countermeasures. Host pattern-recognition receptors (PRRs), including Toll-like receptors (TLRs), RIG-I-like receptors (RLRs), and DNA sensor cyclic GMP-AMP synthase (cGAS), drive type I interferon (IFN-I) and interferon-stimulated genes (ISGs) responses, alongside processes like autophagy and inflammasome activation, to combat viral and bacterial infections. Pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cytomegalovirus, and porcine reproductive and respiratory syndrome virus, deploy sophisticated strategies to target immune sensors and adaptors, enabling replication and persistence. Novel insights, including the roles of ISG15, autophagy protein ATG7, and host factors such as THAP11 and PSMB4, highlight complex interactions influencing viral replication and host defense. These studies propose targeted therapeutic strategies, such as inflammasome modulation for human immunodeficiency viruses (HIV), and prostaglandin E2 regulation for foot-and-mouth disease virus vaccine production, offering promising avenues to enhance host immunity and counter pathogen evasion.},
}

*Immunity, Innate
Humans
*Immune Evasion
Animals
SARS-CoV-2/immunology
Host-Pathogen Interactions/immunology
Inflammasomes/immunology
Signal Transduction
Receptors, Pattern Recognition/immunology
Autophagy
*Virus Diseases/immunology
COVID-19/immunology

@article {pmid40879599,
year = {2025},
author = {Muttamba, W and O'Hare, B and Ramsay, A and Saxena, V and Kirenga, B and Sabiiti, W},
title = {A laboratory-focussed desk review of health systems in Uganda, Kenya, and the UK to respond to current and future pandemics.},
journal = {Journal of global health},
volume = {15},
number = {},
pages = {04194},
pmid = {40879599},
issn = {2047-2986},
mesh = {Humans ; Kenya/epidemiology ; Uganda/epidemiology ; *COVID-19/epidemiology/diagnosis ; United Kingdom/epidemiology ; *Delivery of Health Care/organization & administration ; *Pandemics ; *Laboratories/organization & administration ; SARS-CoV-2 ; World Health Organization ; },
abstract = {BACKGROUND: Laboratory systems play a crucial role in managing diseases effectively, and the COVID-19 pandemic serves as a prime example. The pandemic underscored the need to make laboratory health systems more resilient and robust to respond to future pandemics.

METHODS: We conducted a desk review guided by the six World Health Organization health system building blocks (health service delivery, health financing, medical products, vaccines, and technologies, human resources for health, governance, and health information systems).

RESULTS: The three countries' strengths include health information systems, well-established reference laboratories, mobile and community-level testing, a vibrant private laboratory sector in Uganda and Kenya, and a growing private sector in the UK. In Uganda and Kenya, there are laboratory connectivity solutions for molecular diagnostics, multi-disease testing platforms and specimen referral systems, while in the UK, there are hub-and-spoke networks. Weaknesses in Uganda and Kenya include vertical laboratory systems strengthening, ill-equipped laboratories, constrained and inequitable distribution of laboratory human resources, and limited data use. In the UK, there is chronic underfunding and undervaluing of disciplines supporting infection testing, microbiology and virology.

CONCLUSIONS: The growing contribution of the private sector in the three countries and the deployment of multi-disease testing platforms should be supported, given the advantage of shared financial costs in the face of chronic underfunding for laboratory systems.},
}

Humans
Kenya/epidemiology
Uganda/epidemiology
*COVID-19/epidemiology/diagnosis
United Kingdom/epidemiology
*Delivery of Health Care/organization & administration
*Pandemics
*Laboratories/organization & administration
SARS-CoV-2
World Health Organization

@article {pmid40879383,
year = {2025},
author = {Wang, Y and Peng, D and Li, M and Yao, M and Li, T and Li, S and Qiu, H-J and Li, L-F},
title = {Organoids: physiologically relevant ex vivo models for viral disease research.},
journal = {Journal of virology},
volume = {},
number = {},
pages = {e0113225},
doi = {10.1128/jvi.01132-25},
pmid = {40879383},
issn = {1098-5514},
abstract = {Viral diseases pose serious threats to human health, resulting in substantial economic losses. However, traditional disease models often fail to capture the full complexity of viral pathogenesis. Pluripotent and tissue stem cell-derived organoids help bridge this gap by closely mimicking the structure and function of native organs, thereby enabling new breakthroughs in studying viral pathogenesis. This review discusses the diverse applications of organoid models in virology, including infection modeling, host-virus interaction studies, CRISPR/Cas9-based gene editing, antiviral drug screening, and vaccine development. Here, we focus on human organoid models used to investigate viral infections, covering systemic viral infections (exemplified by viruses such as SARS-CoV-2, Zika virus, influenza virus, and monkeypox virus) as well as localized viral infections (exemplified by viruses including respiratory syncytial virus, herpes simplex virus 1, rotavirus, norovirus, hepatobiliary viruses, and cytomegalovirus). By advancing mechanistic insights and accelerating therapeutic discovery, organoid technology shows significant potential as a complementary tool for combating viral diseases.},
}

@article {pmid40877925,
year = {2025},
author = {Fekih-Romdhane, F and Harb, F and Al Banna, S and Obeid, S and Hallit, S},
title = {Prevalence and risk factors of burnout symptoms among nurses during the COVID-19 pandemic: an updated systematic review and meta-analysis.},
journal = {Human resources for health},
volume = {23},
number = {1},
pages = {48},
pmid = {40877925},
issn = {1478-4491},
mesh = {Humans ; *COVID-19/epidemiology ; *Burnout, Professional/epidemiology ; Prevalence ; Risk Factors ; *Nurses/psychology ; SARS-CoV-2 ; Adult ; Pandemics ; },
abstract = {BACKGROUND: COVID-19 has been a substantial challenge for nurses globally, as they have gone through prolonged crisis times where they were continually under immense psychological pressure. Working in these conditions for months and years has resulted in an increase in the prevalence of job burnout among nurses. This systematic review was conducted to provide solid evidence on the prevalence of burnout and its related factors among nursing staff in different parts of the world after the occurrence of the COVID-19 pandemic.

METHODS: Several electronic databases were searched, between January 2020 and September 15, 2024, for relevant studies, namely MEDLINE, Web of Science, Embase, Scopus, ScienceDirect, ProQuest, APA PsycINFO, Google Scholar, and EBSCOhost Research Platform. Multiple search keywords were defined for the search process. The Newcastle-Ottawa Scale was used to evaluate the quality of each study included. Our main outcome was the prevalence of burnout in nurses during COVID-19. We subsequently analyzed our data by age (< 30 vs. ≥ 30 years), country income levels (defined based on the World Bank Classification for the 2023 fiscal year), and culture (Western vs. Non-Western). We used RevMan software, developed by Cochrane, to perform the statistical analysis. The outcomes were assessed using odds ratios (OR) with corresponding 95% confidence intervals (CI) to ensure accurate and reliable estimates.

RESULTS: Data from the 19 studies and 11 countries indicated an overall burnout prevalence rate of 59.5% in the nurse population during COVID-19. In addition, analyses of 37 studies and 15,015 nurses revealed a pooled prevalence rate for emotional exhaustion of 36.1%. Analyses of 36 studies involving 14,864 nurses showed a pooled prevalence rate for depersonalization of 32.4%. Finally, data from 36 studies and 14,864 participants found a pooled prevalence rate for reduced personal accomplishment of 33.3%. Regarding subgroup analysis of total burnout by nurses' characteristics, our results demonstrated that nurses working in higher income countries reported significantly higher prevalence rates of burnout relative to those working in low- and lower-to-middle-income countries. Those working in a Western context exhibited significantly higher risk for overall burnout compared to those working in a non-Western context. Finally, comparisons across age groups noted significantly higher levels of burnout among nurses aged 30 years and above compared to those aged < 30 years.

CONCLUSION: This review urges nursing leaders' intervention, hospital administrators, and policymakers to minimize and prevent burnout among nurses, especially during crises times such as the COVID-19 pandemic. This review also encourages further research into efficient evidence-based interventions to support nurses and combat burnout in the nursing profession.},
}

Humans
*COVID-19/epidemiology
*Burnout, Professional/epidemiology
Prevalence
Risk Factors
*Nurses/psychology
SARS-CoV-2
Adult
Pandemics

@article {pmid40875678,
year = {2025},
author = {Schapowal, A},
title = {[Long COVID, Post-COVID-Syndrom: Langzeitfolgen von SARS-CoV-2-Infektionen und Nutzen von Ginkgo biloba].},
journal = {Complementary medicine research},
volume = {},
number = {},
pages = {1-8},
doi = {10.1159/000548075},
pmid = {40875678},
issn = {2504-2106},
abstract = {Background Long COVID and Post-COVID Syndrome are long-term consequences of SARS-CoV-2 infections, causing a range of physical, cognitive, and psychological symptoms such as fatigue, shortness of breath, memory impairment, and sleep disturbances. The exact pathophysiology remains unclear but is thought to involve persistent viral particles, microvascular dysfunction, autoimmune reactions, and autonomic nervous system dysregulation. Summary Diagnosing Long COVID is challenging due to the lack of standardized tests. A multimodal treatment approach is recommended, incorporating symptomatic medication, physiotherapy, psychotherapy, as well as nutritional and exercise therapy. One promising complementary therapeutic option is the use of standardized Ginkgo biloba extracts. Their antioxidant, anti-inflammatory, and neuroprotective properties may help alleviate cognitive impairments, fatigue, and cardiovascular symptoms. Initial studies and case reports suggest positive effects, but further clinical trials are necessary to confirm efficacy. Key Messages Long COVID and Post-COVID Syndrome affect multiple organ systems and significantly reduce quality of life. Diagnosis remains difficult due to the absence of specific tests. A multimodal therapy approach is currently the most promising strategy. Standardized Ginkgo biloba extracts show potential benefits for neurocognitive and cardiovascular symptoms in early studies.},
}

@article {pmid40875162,
year = {2025},
author = {Sedky, D and Ghazy, AA and Abou-Zeina, HAA},
title = {Advances in diagnosis of diseases causing diarrhea in newborn calves.},
journal = {Veterinary research communications},
volume = {49},
number = {5},
pages = {293},
pmid = {40875162},
issn = {1573-7446},
mesh = {Animals ; Cattle ; *Cattle Diseases/diagnosis/parasitology/microbiology ; *Diarrhea/veterinary/diagnosis/microbiology ; Animals, Newborn ; },
abstract = {Diarrhea in newborn calves is a serious global health problem. It poses challenges for animal industry, veterinarians and researchers due to the rapid onset of dehydration. Mixed infections make treatment complicated, and many young calves suffer high rates of illness and death from this condition. Numerous enteropathogens are associated with diarrhea in newborn calves, encompassing viruses, bacteria, parasites, and protozoa. Their occurrence differs by region, yet the most prevalent infections include E. coli, Salmonella species, Clostridium perfringens, Clostridium difficile, Rotavirus, Coronavirus, Cryptosporidium, Toxocara, Giardia and Eimeria. This review outlines the diagnostic techniques for diseases that lead to diarrhea in newborn calves. Diagnosis is based on clinical manifestations; however, the laboratory identification of etiological items is the only valid way for detecting the illness's aetiology and initiating treatment protocols. Classic methods such as bacterial culturing, fecal flotation, direct microscopy, and virus isolation help us understand pathogens better. Immunological assays like ELISA and immunochromatography are fast, accurate, affordable, and useful for on-farm detection. They help identify specific antigens or antibodies efficiently. Molecular methods including PCR (standard, multiplex, real time and digital), LAMP assays, DNA microarrays and whole-genome sequencing allow highly accurate and sensitive detection. They can identify pathogens effectively, even at very low levels. Nanotechnology-based assays introduce a novel level of sensitivity and specificity, often yielding quick results with minimal sample volumes. In conclusion, accurate and rapid diagnosis using advanced techniques is critical for managing and preventing diseases that lead to diarrhea in newborn calves.},
}

Animals
Cattle
*Cattle Diseases/diagnosis/parasitology/microbiology
*Diarrhea/veterinary/diagnosis/microbiology
Animals, Newborn

@article {pmid40874746,
year = {2025},
author = {Olarte-Castillo, XA and Frazier, LE and Gomes Noll, JC and Choi, A and Whittaker, GR},
title = {Rethinking the drivers of coronavirus virulence and pathogenesis; toward an understanding of the dynamic world of mutations, indels, and recombination within the alphacoronaviruses.},
journal = {mBio},
volume = {},
number = {},
pages = {e0192125},
doi = {10.1128/mbio.01921-25},
pmid = {40874746},
issn = {2150-7511},
abstract = {Alphacoronaviruses are widespread but understudied in comparison to betacoronaviruses. Within the alphacoronaviruses is the species Alphacoronavirus-1, which comprises distinct viruses of cats, dogs, and pigs, along with a separate species that infects mustelids-as well as other related viruses of pigs and circulating human viruses. High-pathogenicity feline coronavirus (FCoV) is infamous as the cause of feline infectious peritonitis (FIP), existing as two distinct genotypes (types 1 and 2) and transmitted as a low-pathogenicity virus. The high-pathogenicity variants arise in cats infected with FCoV, and while the mutations responsible remain enigmatic, the main determinant is the spike glycoprotein. FCoV-1 disease outcome is driven by a combination of both within- and between-host evolution. Virulence can be largely explained by the "internal mutation hypothesis," which argues that high-pathogenicity-but poorly transmissible-variants are selected in individual cats. Canine coronaviruses are generally considered low pathogenicity but can cause severe enteritis and can be systemic. Notably, the canine coronavirus spike gene periodically recombines with FCoV-1 to generate FCoV-2, exemplified by FCoV-23, which has caused a widespread outbreak of FIP in Cyprus and has a notably truncated spike N-terminal domain (NTD). In pigs, coronaviruses often cause severe gastrointestinal disease but can become respiratory and have low pathogenicity based on what can also be considered an "internal deletion" of the spike NTD. These viruses may exist as a dynamic "metavirome" (the sum of all viral genomes present in a sample) that is in a constant state of flux, presenting notable challenges for disease surveillance and management.},
}

@article {pmid40873776,
year = {2025},
author = {Busis, NA and Alexander, CM and Castner, J and Singer, S and Smith, CD and Bernstein, CA and Hoyt, DB and Tran, TA and Cipriano, P},
title = {A Path to Improved Health Care Worker Well-being: Lessons from the COVID-19 Pandemic.},
journal = {NAM perspectives},
volume = {2025},
number = {},
pages = {},
pmid = {40873776},
issn = {2578-6865},
}

@article {pmid40873637,
year = {2025},
author = {Wang, L and Wang, L and Dong, C and Liu, J and Cui, G and Gao, S and Liu, Z},
title = {Exploring the Potential and Advancements of Circular RNA Therapeutics.},
journal = {Exploration (Beijing, China)},
volume = {5},
number = {4},
pages = {e20240044},
pmid = {40873637},
issn = {2766-2098},
abstract = {Messenger RNA (mRNA) technology is revolutionizing the pharmaceutical industry owing to its superior safety profile, manufacturing capabilities, and potential applications in previously undruggable therapeutic targets. In addition to linear mRNA, such as conventional mRNA, self-amplifying mRNA, and trans-amplifying mRNA, circular mRNA has emerged as a promising candidate. Circular RNA (circRNA) is a class of single-stranded RNA with a covalently closed loop structure that offers enhanced stability compared to linear RNA by resisting degradation from RNases. Recent studies have revolutionized our understanding of their biological functions, surpassing the notion that they are merely byproducts of aberrant splicing events. Given the remarkable success achieved in cancer and SARS-CoV-2/monkeypox virus (MPXV) vaccines, circRNA is being intensively investigated for gene and cell therapies. In this review, we provide an overview of circRNA biogenesis mechanisms in vivo, along with synthesis strategies in vitro, while discussing translation regulation mechanisms and quality control processes involved in circRNA production. Furthermore, we explore the potential application scenarios for circRNAs.},
}

@article {pmid40873308,
year = {2025},
author = {He, L and Liu, Z and Yang, H and Li, Y and Zhang, H},
title = {[Research progress in application of field effect transistor biosensors in virus detection].},
journal = {Sheng wu gong cheng xue bao = Chinese journal of biotechnology},
volume = {41},
number = {8},
pages = {3021-3035},
doi = {10.13345/j.cjb.240882},
pmid = {40873308},
issn = {1872-2075},
mesh = {*Biosensing Techniques/methods/instrumentation ; *Transistors, Electronic ; Humans ; SARS-CoV-2/isolation & purification ; *Viruses/isolation & purification ; Orthomyxoviridae/isolation & purification ; Hepatitis Viruses/isolation & purification ; *Virus Diseases/diagnosis/virology ; HIV/isolation & purification ; COVID-19/diagnosis ; },
abstract = {Viral infections are one of the main causes of deaths and economic losses around the globe, and effective virus detection methods are essential for epidemic prevention and control. Most existing detection methods have problems such as high false negative/positive rates, slow responses, high costs, and dependence on professional equipment and personnel, which are not conducive to the rapid and accurate detection of viruses. Field effect transistor (FET) biosensors have attracted widespread attention due to their advantages of label-free detection, high sensitivity, fast responses, real-time measurement, low power consumption, and small sizes for portability. This article first briefly describes the basic situation of viruses and the structure and detection principle of FET biosensors. Subsequently, it delves into the research achievements in the application of FET biosensors in the detection of influenza viruses, hepatitis viruses, human immunodeficiency virus, and severe acute respiratory syndrome coronavirus 2. Finally, we make a comprehensive summary and reasonable outlook on the role played by FET biosensors in biomedicine.},
}

*Biosensing Techniques/methods/instrumentation
*Transistors, Electronic
Humans
SARS-CoV-2/isolation & purification
*Viruses/isolation & purification
Orthomyxoviridae/isolation & purification
Hepatitis Viruses/isolation & purification
*Virus Diseases/diagnosis/virology
HIV/isolation & purification
COVID-19/diagnosis

@article {pmid40836510,
year = {2025},
author = {Avila-Aguero, ML and Betancourt-Cravioto, M and Trejo Varon, R and Torres, JP and Lucas, AG and Becerra-Posada, F and Espinal, C},
title = {Impact of acellular immunization against pertussis; comparative experience of four countries in North, Central and South America.},
journal = {Expert review of vaccines},
volume = {24},
number = {1},
pages = {834-839},
doi = {10.1080/14760584.2025.2550973},
pmid = {40836510},
issn = {1744-8395},
mesh = {Humans ; *Whooping Cough/prevention & control/epidemiology/immunology ; *Pertussis Vaccine/administration & dosage/immunology ; COVID-19/epidemiology/prevention & control ; Vaccines, Acellular/administration & dosage/immunology ; South America/epidemiology ; Female ; Central America/epidemiology ; Vaccination Coverage/statistics & numerical data ; Immunization, Secondary ; Vaccination ; Chile/epidemiology ; Immunization Programs ; Adolescent ; },
abstract = {INTRODUCTION: Pertussis remains a public health concern despite widespread vaccination, due to waning immunity and asymptomatic transmission. The shift to acellular pertussis (aP) vaccines, aimed at reducing side effects, has changed disease dynamics, requiring ongoing evaluation.

AREAS COVERED: We examined immunization strategies and epidemiological trends in Chile, Costa Rica, Mexico, and Panama following aP vaccine introduction. Compared vaccine coverage (VC), maternal immunization (MI), and booster strategies (BS), and explored their role in disease control, including post-COVID-19 resurgence.

EXPERT OPINION: High aP VC and MI programs have reduced pertussis in Latin America (LATAM). However, waning immunity, uneven coverage, and disrupted surveillance pose challenges. Strengthening adolescent BS, expanding MI, and improving data systems are vital for sustained control.},
}

Humans
*Whooping Cough/prevention & control/epidemiology/immunology
*Pertussis Vaccine/administration & dosage/immunology
COVID-19/epidemiology/prevention & control
Vaccines, Acellular/administration & dosage/immunology
South America/epidemiology
Female
Central America/epidemiology
Vaccination Coverage/statistics & numerical data
Immunization, Secondary
Vaccination
Chile/epidemiology
Immunization Programs
Adolescent

@article {pmid40803754,
year = {2025},
author = {Tian, L and Wang, Y and Qi, W and Wang, B and Zhang, X and Gong, M and Zhang, X and Wang, T},
title = {Pathophysiological Insights and Clinical Management Strategies for Interstitial Lung Diseases.},
journal = {Biomolecules & therapeutics},
volume = {33},
number = {5},
pages = {785-803},
doi = {10.4062/biomolther.2025.004},
pmid = {40803754},
issn = {1976-9148},
abstract = {Interstitial lung disease (ILD) represents a heterogeneous group of diseases in which inflammation and/or fibrosis in the pulmonary interstitium results in an impaired gas exchange, difficulties in breathing, and reduced quality of daily life, and contributes to elevated global morbidity and mortality rates. ILD is an umbrella term, with idiopathic pulmonary fibrosis (IPF) being a prime focus because of its progressive and severe form. Out of 300 underlying etiologies, ILD is one of the major reasons for global morbidity and mortality. This review offers a comprehensive overview of six main categories of ILD covering autoimmune, idiopathic interstitial pneumonia, hypersensitivity pneumonitis, drug-induced, infection-related, and unclassified ILD that underscore the complexity of diagnosis and treatment challenges. This review also provides an evidence-based overview of recent advancements in the diagnosis and management of ILD, with precision pharmacotherapy, multidisciplinary care, and emerging therapeutic strategies. From clinical trial data, it also recommends the disease-specific use of pharmacological agents-such as pirfenidone and nintedanib for IPF, and mycophenolate mofetil for connective tissue disease-associated ILD. The manuscript also emphasizes the evolving role of non-pharmacological interventions, including the 6-minute walk test and pulmonary rehabilitation, in enhancing functional capacity and quality of life. To address the current global health concerns, topics of post-COVID-19 ILD and immune checkpoint inhibitor-associated lung disease are integrated. Additionally, future directions are explored, including the role of lung transplantation and novel antifibrotic therapies like anti-Transforming Growth Factor (TGF)-β antibody cocktails. Together, these insights aim to refine diagnostic precision, personalize treatment, and improve clinical outcomes across the heterogeneous ILD spectrum.},
}

@article {pmid40580944,
year = {2025},
author = {Asasah, SI and Imade, EE and Enagbonma, BJ},
title = {Lessons from COVID-19 vaccine hesitancy among healthcare workers in West Africa and strategies for future pandemic preparedness: a structured literature review.},
journal = {Journal of public health (Oxford, England)},
volume = {47},
number = {3},
pages = {487-498},
doi = {10.1093/pubmed/fdaf071},
pmid = {40580944},
issn = {1741-3850},
mesh = {Humans ; *Health Personnel/psychology/statistics & numerical data ; *Vaccination Hesitancy/statistics & numerical data/psychology ; *COVID-19 Vaccines/administration & dosage ; Africa, Western/epidemiology ; *COVID-19/prevention & control/epidemiology ; Cross-Sectional Studies ; SARS-CoV-2 ; Pandemics/prevention & control ; Pandemic Preparedness ; },
abstract = {BACKGROUND: Healthcare workers (HCWs) are at high risk of acquiring and transmitting infections, including COVID-19. Vaccination is a crucial method for preventing the spread of infectious diseases; however, vaccine non-acceptance can hinder optimal vaccine coverage. This research aims to evaluate the level of COVID-19 vaccine acceptance and the associated factors among HCWs in West Africa.

METHODS: A structured literature review of quantitative cross-sectional studies was conducted, searching databases including Medical Literature Analysis and Retrieval System Online (MEDLINE), African Journals Online, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Google Scholar. The review focused on studies from April 2021 to February 2023 that examined factors influencing COVID-19 vaccine acceptance among HCWs in West Africa. Data extraction and quality assessment of the included studies were conducted using Joanna Briggs Institute tools.

RESULTS: Five articles met the inclusion criteria, and they reported that the acceptance level of the COVID-19 vaccine ranged from 38.3% to 73.6%. Barriers to acceptance included concerns about vaccine safety and effectiveness, side effects, short duration of clinical trials, limited and false information, and lack of social trust.

CONCLUSIONS: COVID-19 vaccine acceptance among West African HCWs is influenced by sociodemographic factors, vaccine concerns, and accurate information, necessitating health promotion strategies and multisectoral collaboration for improved acceptance.},
}

Humans
*Health Personnel/psychology/statistics & numerical data
*Vaccination Hesitancy/statistics & numerical data/psychology
*COVID-19 Vaccines/administration & dosage
Africa, Western/epidemiology
*COVID-19/prevention & control/epidemiology
Cross-Sectional Studies
SARS-CoV-2
Pandemics/prevention & control
Pandemic Preparedness

@article {pmid39471824,
year = {2025},
author = {Beaineh, P and El-Bsat, A and Hafez, B and Bizri, AR and Kibbi, AG and Merashli, M and Haddad, F},
title = {COVID-19 and COVID-19 Vaccine-Related Skin Ulcerations in the Lower Extremities: A Case Report and Literature Review.},
journal = {The international journal of lower extremity wounds},
volume = {24},
number = {3},
pages = {723-727},
doi = {10.1177/15347346241275785},
pmid = {39471824},
issn = {1552-6941},
mesh = {Humans ; Male ; Middle Aged ; *COVID-19/prevention & control ; *COVID-19 Vaccines/adverse effects ; *BNT162 Vaccine/adverse effects ; *Vasculitis, Leukocytoclastic, Cutaneous/etiology/diagnosis/therapy ; Debridement/methods ; Lower Extremity ; SARS-CoV-2 ; *Skin Ulcer/etiology/therapy ; },
abstract = {Several associations have been made between COVID-19 and vasculitis. Recent data also shows the prevalence and association of de novo vasculitis with either COVID-19 infection or COVID-19 post vaccination. In this article, we present the case of new-onset leukocytoclastic vasculitis, secondary to COVID-19 vaccination, that was complicated by severe infected and nonhealing ulcers in the lower extremities.CaseA 53-year-old male patient presented to the dermatology clinics with a three-week history of painful necrotic patches coalescent of the lateral malleolus of the right and left ankles. History goes back to when the patient reported developing pruritic papules two weeks after receiving his second shot of the Pfizer BioNTech COVID-19 vaccine (BNT162b2). Punch biopsy was consistent with leukocytoclastic vasculitis. He was prescribed a four-week course of systemic corticosteroids and antibiotics as per cultures. Vascular assessment confirmed normal peripheral arterial and venous system. Two months later, the patient re-presented with fever and worsening of his lower extremity ulcers. He underwent debridement of his wounds. Intra-operative cultures revealed multidrug resistant bacteria. He required an additional debridement session a few days later and a 14-day course of Piperacillin-Tazobactam. The patient was subsequently discharged on corticosteroids and Azathioprine and followed up in the vascular surgery and rheumatology clinics. At four months follow-up, the patient's wounds were almost completely healed.ConclusionThis article highlights a case of severe new-onset COVID-19 vaccine-associated leukocytoclastic vasculitis complicated with infected ulcers that required debridement twice in addition to a prolonged course of antibiotics and immunosuppression therapy. To our knowledge, none of the cases reported in the literature were this severe in nature. In this post-pandemic era, it must remain high on the differential list, and healthcare specialists should maintain a high index of suspicion when evaluating sudden new-onset skin lesions that do not have an immediately apparent etiology.},
}

Humans
Male
Middle Aged
*COVID-19/prevention & control
*COVID-19 Vaccines/adverse effects
*BNT162 Vaccine/adverse effects
*Vasculitis, Leukocytoclastic, Cutaneous/etiology/diagnosis/therapy
Debridement/methods
Lower Extremity
SARS-CoV-2
*Skin Ulcer/etiology/therapy

@article {pmid40872946,
year = {2025},
author = {Smith, B and Farakh, F and Hanif, A and Tunio, JH and Tunio, SNJ},
title = {Rural-Urban Disparities in COVID-19 Vaccine Uptake and Associated Mortality and Cardiovascular Disease Outcomes in the United States.},
journal = {Vaccines},
volume = {13},
number = {8},
pages = {},
doi = {10.3390/vaccines13080861},
pmid = {40872946},
issn = {2076-393X},
abstract = {Background: The COVID-19 pandemic magnified long-standing health disparities in the United States, particularly among rural, disadvantaged populations. These communities experience greater barriers to healthcare access, a higher prevalence of chronic illness, and increased vaccine hesitancy factors that collectively contribute to poorer health outcomes. Methods: This narrative review examines rural-urban disparities in COVID-19 vaccine uptake and their impact on mortality, with a focus on cardiovascular disease (CVD) outcomes. We synthesized the peer-reviewed literature, CDC data, and U.S. Census reports to assess factors contributing to vaccine hesitancy, vaccination coverage, COVID-19-related mortality, and CVD mortality trends. Results: Rural residents were less likely to initiate COVID-19 vaccination, showed greater vaccine hesitancy, and experienced higher rates of both COVID-19 and CVD mortality. These disparities were further driven by safety concerns surrounding mRNA technology, misinformation, infrastructural barriers, and sociodemographic factors including political affiliation, education, poverty, and religion. Notably, pre-existing CVD increased vulnerability to severe COVID-19 outcomes in rural communities. Conclusions: Expanding vaccination efforts and improving healthcare infrastructure are essential for addressing these widening health inequities. Future public health strategies should prioritize culturally tailored interventions and rural-specific outreach to reduce vaccine hesitancy and improve mortality outcomes in underserved populations.},
}

@article {pmid40872945,
year = {2025},
author = {Bishop, C and Parashar, D and Kizza, D and Abeshu, M and Kaddar, M and Bchir, A and El Maghraby, A and Schirrmacher, H and Wang, Z and Griffiths, U and Malm, S and Kadandale, S and Farrukh, S},
title = {New Vaccine Introduction in Middle-Income Countries Across the Middle East and North Africa-Progress and Challenges.},
journal = {Vaccines},
volume = {13},
number = {8},
pages = {},
doi = {10.3390/vaccines13080860},
pmid = {40872945},
issn = {2076-393X},
support = {SC220896//Gavi/ ; },
abstract = {Background/Objectives: The middle-income countries (MICs) in the Middle East and North Africa (MENA) region face multifaceted challenges-including fiscal constraints, conflict, and vaccine hesitancy-that impede the timely introduction of critical vaccines. This study examines the status, barriers, and facilitators to introducing three critical vaccines-human papillomavirus vaccine (HPV), pneumococcal conjugate vaccine (PCV), and rotavirus vaccine (RV)-across seven MENA MICs, to identify actionable solutions to enhance vaccine uptake and immunisation coverage. Methods: Using the READ methodology (ready materials, extract, analyse, and distil data), this review systematically analysed policy documents, reports, and the literature on the introduction of HPV, PCV, and RV vaccines in seven MENA MICs. A data extraction framework was designed to capture the status of vaccine introduction and barriers and facilitators to introduction. Findings and data gaps were validated with stakeholder consultations. Results: Of the seven study countries, progress in introducing PCV and RV has been uneven across the region (five countries have introduced PCV, four have introduced RV, and only a single country has introduced HPV at time of writing), hindered by vaccine hesitancy, fiscal challenges, and insufficient epidemiological data. Morocco is the only country to introduce all three vaccines, while Egypt has yet to introduce any. Other common barriers include the impact of conflict and displacement on healthcare infrastructure, delayed introduction due to the 2020 COVID-19 pandemic, and limited local production facilities and regional cooperation. In addition, not all countries eligible for Gavi MICs support have applied. These findings provide a roadmap for policymakers to accelerate equitable vaccine introduction in the MENA region. Conclusions: Targeted efforts, such as addressing fiscal constraints, improving local manufacturing, tackling gender barriers, and fostering public trust, paired with regional collaboration, can help bridge gaps and ensure no community is left behind in preventing vaccine-preventable diseases.},
}